Literature Review

Palliative care in liver transplantationCurrent Transplantation Reports; Michelle Ng, Elliot Tapper; 5/25 Palliative care is an underutilized resource due to the misconception that being a liver transplant candidate precludes patients from accessing these services. However, early integration of palliative care has become increasingly important for both pre- and post-liver transplant patients as it not only improves patient outcomes, but also promotes quality of life that extends beyond graft or patient survival. We discuss strategies to manage pain, ascites, hepatic encephalopathy, pruritis, muscle cramps, sexual dysfunction, depression, anxiety, insomnia, and malnutrition. These symptoms are best addressed with a multi-modal approach with non-pharmacologic therapies as an adjunct. 

How long was Adriana Smith on life support? Brain‑dead nurse's baby delivered by C‑section Enstarz; by David Unyime Nkanta; 6/18/25 The 31-year-old nurse was declared brain dead early in her pregnancy—her baby was born via C-section nearly four months later, sparking legal and ethical debate. Adriana Smith, a 31‑year‑old nurse in Atlanta, was declared brain dead in mid‑February after suffering serious blood clots in her brain. Despite devastating diagnosis, she remained on life support for nearly four months—a decision doctors said was legally necessary under Georgia's strict abortion laws. This rare case of maternal somatic support—keeping a brain-dead woman alive to deliver a baby—is highly unusual. On 13 June, doctors at Emory University Hospital performed an emergency c‑section, delivering a boy they named Chance, weighing just 1 lb 13 oz (around 830 g). ... Smith's mother, April Newkirk, described the ordeal as 'torture,' saying: 'I see my daughter breathing, but she's not there.' The family maintain that they were never allowed to make treatment decisions, a situation that has deeply distressed them and prompted calls for change. 

Sky Harbor program teaches TSA to help passengers with dementia. It's the 1st of its kind in U.S. 91.5 KJZZ Phoenix; by Kathy Ritchie; 6/17/25  For the first time anywhere in the U.S., Transportation Security Administration officers at Sky Harbor Airport are learning how to help travelers living with dementia. "So during this simulation, we're going to be wearing sunglasses, headphones, and both pairs of gloves," said Calli Carlson with Hospice of the Valley during a recent training session. "It's going to be about an 8-minute experience.  So those headphones are going to tell you what to do with your blue bag. Do the best that you can." She’s leading the agents in a simulation so they experience what it's like to have dementia. "So this interactive Dementia Moments training is one of the first trainings that has been provided to TSA agents." This simulation uses special glasses that impair vision, headphones to mimic audio distortion and gloves which affect dexterity.Editor's Note: Bravo! Do you provide any similar type of training for your employees and volunteers, designed to simulate contexts and interactions with persons with dementia? Surely, you can! 

Nurse practitioners step in as geriatrician ranks shrink The Washington Post; by Jariel Arvin; 6/15/25 On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient’s home to the next, seeing eight people in all. Pregnant with her second child, she schleps a backpack instead of a traditional black bag to carry a laptop and essential medical supplies ... “Our patient isn’t just the older adult,” Johnson said. “It’s also often the family member or the person helping to manage them.” Johnson isn’t alone. Today, nurse practitioners are increasingly filling a gap that is expected to widen as the senior population explodes and the number of geriatricians declines. The Health Resources and Services Administration projects a 50 percent increas in demand for geriatricians from 2018 to 2030, when the entire baby boom generation will be older than 65. ...

Sex and racial/ethnic differences in end-of-life care preferences in persons with Parkinson's Disease and related disordersMovement Disorders; Whitley W Aamodt, Lynn Eickholt, David G Coughlin, Lisa Solomon, Katharine A Rendle, Carly Marshall, Joaquin A Vizcarra, Nabila Dahodwala; 5/25In persons with Parkinson's disease (PD) and related disorders (PDRD), rates of end-of-life (EoL) hospitalization are greatest, and rates of hospice utilization lowest, among men and persons of color. In adjusted models, women with PDRD were more likely than men to prefer religious/spiritual support at the end of life. Compared with White participants with PDRD, non-White participants were more likely to consider EoL hospitalization, less likely to consider medical aid in dying, and less familiar with palliative care. In four focus groups involving 14 questionnaire respondents, contributors to EoL decision-making included medical knowledge/information, personal experiences, family dynamics, religion/spirituality, and resources/cost. Conclusions: EoL care preferences differ by sex and race/ethnicity in persons with PDRD. These preferences are influenced by multiple factors and may contribute to differential EoL outcomes, emphasizing the need for individualized, culturally competent EoL care. 

Palliative care for patients with end-stage renal disease-An examination of unmet needs and experiencing problemsJournal of Hospice & Palliative Nursing; Darawad, Muhammad W. PhD, RN; Reinke, Lynn F. PhD, ANP-BC, FPCN, FAAN; Khalil, Amani PhD, RN; Melhem, Ghaith Bani PhD, RN; Alnajar, Malek MSN, CNS, RN; June 2025Patients with end-stage renal disease face numerous physical, emotional, and financial burdens, necessitating palliative care (PC) interventions. This cross-sectional study ... revealed that 64.7% of participants experienced significant challenges, primarily financial difficulties (78.5%), autonomy concerns (68.8%), and a need for information (68.0%). More than half (51.9%) reported needing PC [palliative care], particularly for managing fatigue (78.3%), pain (79.8%), and depression (72.9%). Unmet needs were common (47.6%), with the most notable gaps in financial support (52.5%) and information provision (50%). These findings underscored the urgent need for tailored PC interventions for end-stage renal disease patients, particularly in addressing symptom management, psychosocial and spiritual support, financial support, and information deficits, to enhance their quality of life.

Gaps in the coordination of care for older adults with or at risk for cardiovascular disease The American Journal of Managed Care; by Lisa M. Kern, MD, MPH,Joselyne E. Aucapina,Samprit Banerjee, PhD, Joanna B. Ringel, MPH, Jonathan N. Tobin, PhD, Semhar Fisseha, MPH, Helena Meiri, MA, RN, Madeline R. Sterling, MD, MPH, Kurt C. Stange, MD, PhD, Monika M. Safford, MD, Paul N. Casale, MD, MPH; 6/3/25 ... To determine whether older adults with cardiovascular disease (CVD) or CVD risk factors perceive gaps in communication among their providers and whether they consider those gaps to be consequential, we conducted a cross-sectional survey of Medicare beneficiaries 65 years and older with CVD or CVD risk factors and highly fragmented ambulatory care (reversed Bice-Boxerman Index score ≥ 0.85).

US trends from 1999 to 2020: Mortality and location of deaths in ischemic stroke Neurology Advisor; by Meghna Rao; 6/2/25 Patterns of ischemic stroke mortality have varied over the last 2 decades in the United States, according to study findings published in PLOS One. Stroke is one of the leading causes of mortality in the US. Researchers studied the trends in location of ischemic stroke deaths to improve end-of-life care and address health care inequities.The Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to examine trends in ischemic stroke mortality between 1999 and 2020. 

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancerOncology Practice; Jeremiah Bonnet, BA; Colin Cernik, MS; Hajime Uno, PhD; Lanfang Xu, MS; Cecile A. Laurent, MS; Lauren Fisher, MS; Nancy Cannizzaro, BA; Julie Munneke, BA; Robert M. Cooper, MD; Joshua R. Lakin, MD; Corey M. Schwartz, MD; Mallory Casperson, BA; Andrea Altschuler, PhD; Lawrence H. Kushi, ScD; Chun R. Chao, PhD; Lori Wiener, PhD; Jennifer W. Mack, MD, MPH; 5/25Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ... 

A ‘cloak of comfort’: an integrated approach to palliative care for cancer patients Sinai Health; 5/26/25 At Mount Sinai Hospital, palliative care is fully integrated into cancer care, providing comprehensive, person-centered support for those with advanced illness. Palliative care, derived from the Latin pallium meaning “cloak,” offers comfort and support to individuals with serious illnesses. Often misunderstood as solely end-of-life care, it actually provides relief at any stage of a life-threatening illness and can be provided in tandem with cancer treatment. This holistic approach addresses physical, emotional, and spiritual needs, aiming to improve quality of life for both patients and their families. In fact, early integration of palliative care can enhance symptom management, extend life and offer greater support to caregivers. Patients can receive care at Mount Sinai Hospital’s Cancer Care Clinic, at home through the Temmy Latner Centre’s home palliative care program, and in the palliative care unit at Hennick Bridgepoint Hospital.  

ALS and mental health: The importance of caring for the whole person ALS Association; by Amber Johnstone, MSW, LISW-S; retrieved from the internet 5/27/25 ... May is ALS Awareness Month and also Mental Health Awareness month. ALS and Mental Health go hand in hand. One of the first things I tell newly diagnosed individuals that I work with is that ALS affects the whole family. And to be truthful, it affects many more than just that nuclear family unit. A person living with ALS is like a pebble thrown into a pond. That first splash is the biggest, but then the water ripples all the way out to the edges of the pond. Those ripples are all the people with which the person with ALS shares their journey. ... The ALS Association understands how important mental health can be.  ... The ALS Association is proud to offer ALS Academy to community healthcare professionals and caregivers.  ALS Academy is free, online, self-paced, catalog of ALS education videos.  

Hospice volunteer donates 10,000 gift cards to cancer patients AZ Family - CBS-5, Phoenix, AZ; by Tianna Morimoto; 5/20/25 One Valley man has made a difference in times of need for those who may be losing hope by donating thousands of gift cards, and that’s Something Good. Jeff Lewis volunteers with Hospice of the Valley and was recently recognized for donating 10,000 grocery gift cards to help cancer patients in need. Jeff is a cancer survivor and has made it his mission to help those going through treatments with no family or support. He created a nonprofit called the Froth and Bubble Foundation. Every month, the foundation provides gift cards to more than 100 people in the Valley who are struggling financially. Often, these patients have to decide between paying for food, medicine or doctor bills, and these gift cards can help them with their bills or other necessities to survive. ... “These gift cards help families bridge the gap when they need food and are juggling bills and feeling stressed,” said Hospice of the Valley Executive Director Debbie Shumway. “He is a servant leader who quietly gives back and makes a huge difference, one person at a time.” Thank you, Jeff, for all you do to help others!

What caregivers should know about end-of-life rallies  AARP; by Jamie Ducharme; 5/19/25People with advanced illnesses sometimes experience unpredictable bursts of energy or clarity. Here’s how caregivers should handle these episodes. Roughly a decade after her mother was diagnosed with Alzheimer’s disease, Liz Donnarumma got her back — but only for an instant. It happened one evening in 2021, more than a year after Donnarumma first realized her mother, Theresa, didn’t recognize her. Theresa took Donnarumma’s face in her hands, called her by her nickname and thanked her. “When she put her hands on my face and I looked into her eyes, she was totally there. It was my mother,” Donnarumma says. “It was like a second, just one second, and it was gone.” Donnarumma’s mother had an episode of “paradoxical lucidity” — that is, an unexpected burst of mental clarity, despite her advanced condition. While these moments are as unexplained as they are unexpected, experts say they are more common than many people realize. ...