Literature Review

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. ...

Yes, you can die from a broken heartMedscape; by F. Perry Wilson, MD, MSCE; 5/14/25 A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: [graphic]. As a doctor, if you see this, you’re calling the cardiac cath lab. This is an ST-elevation myocardial infarction — the big one — indicative of a blood clot blocking blood flow to a large section of the heart. The sooner you get that blood clot out, the better chance the patient has to survive. So the patient is rushed to the cath lab, and they find… nothing. Clear coronaries. No blood clot. Further questioning reveals that the patient, an older woman, lost her husband recently. This is stress-induced cardiomyopathy, medically known as Takotsubo cardiomyopathy (TC). It’s the pathophysiologic manifestation of a broken heart. First described in 1991, Takotsubo syndrome occurs in the setting of deep psychological, emotional, or physical stress.

Palliative and end-of-life care during critical cardiovascular illness: A scientific statement from the American Heart Association American Heart Association; by Erin A. Bohula, MD, DPhil, Michael J. Landzberg, MD, Venu Menon, MD, FAHA, Carlos L. Alviar, MD, Gregory W. Barsness, MD, FAHA, Daniela R. Crousillat, MD, Nelia Jain, MD, MA, Robert Page II, PharmD, MSPH, FAHA, Rachel Wells, PhD, MSN, and Abdulla A. Damluji, MD, PhD, MBA, FAHA on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing; 5/15/25 Abstract: Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

AI tool uses face photos to estimate biological age and predict cancer outcomes Mass General Brigham - Technology & Innovation - Research; by Hugo Alerts, Ray Mak, Dennis Bontempi, Osbert Zalay, Danielle S. Bitterman, Fridolin Haugg, Jack M. Qian, Hannah Roberts, Subha Perni, Vasco Prudente, Suraj Pai, Christian Guthier, Tracy Balboni, Laura Warren, Monica Krishan, and Benjamin H. Kann; 5/8/25 Mass General Brigham findings suggest FaceAge tool could provide objective data to help inform treatment decisions in cancer care and other chronic diseases. Eyes may be the window to the soul, but a person’s biological age could be reflected in their facial characteristics. Investigators from Mass General Brigham developed a deep learning algorithm called FaceAge that uses a photo of a person’s face to predict biological age and survival outcomes for patients with cancer. They found that patients with cancer, on average, had a higher FaceAge than those without and appeared about five years older than their chronological age. Older FaceAge predictions were associated with worse overall survival outcomes across multiple cancer types. They also found that FaceAge outperformed clinicians in predicting short-term life expectancies of patients receiving palliative radiotherapy. Their results are published in The Lancet Digital Health.Editor's note: This summary article is published by the main source, Mass General Brigham. Various articles are being written about this new use of AI.

When they don’t recognize you anymore: Dementia study looks at loved ones’ responses Penn Live - Nation & World News; by Paula Span, KFF Health News; 5/4/25 It happened more than a decade ago, but the moment remains with her. Sara Stewart was talking at the dining room table with her mother, Barbara Cole, 86 at the time, in Bar Harbor, Maine. Stewart, then 59, a lawyer, was making one of her extended visits from out of state. ... “She said to me: ‘Now, where is it we know each other from? Was it from school?’” her daughter and firstborn recalled. “I felt like I’d been kicked.” Stewart remembers thinking, “In the natural course of things, you were supposed to die before me. But you were never supposed to forget who I am.” Later, alone, she wept.

Preferences for communication about prognosis among children with cancer, parents, and oncologistsJAMA Network Open; Caroline Christianson, MD; Calliope Reeves; Harmony Farner, MA; Shoshana Mehler, BA; Tara M. Brinkman, PhD; Justin N. Baker, MD; Pamela Hinds, PhD, RN; Jennifer W. Mack, MD, MPH; Erica C. Kaye, MD, MPH; 4/25Should oncologists elicit communication preferences from patients with pediatric cancer and their parents before disclosing prognosis? In this study, patients, parents, and oncologists recommended preemptive elicitation of communication preferences with the goal of improving alignment of prognostic disclosure with patient and caregiver communication needs, thereby enhancing quality of care. These findings demonstrate that patients and caregivers are open to discussing prognostic communication preferences, and that oncologists also recognize the potential value in this communication approach, even as they rarely engage in it. 

Identifying palliative care needs in heart failure patients with nurse-led screening Journal of Hospice & Palliative Nursing; by Cantey, Christina DNP, FNP-C, AACC, CCK; Douglas-Mattis, Yhaneek DNP, AGACNP-BC; Lisiakowski, Jillian DNP, FNP-C; Fowler, Caley MSN, RN; Ejem, Deborah PhD, MA; 4/18/25 ... This quality improvement project aimed to improve the identification of unmet palliative care needs in patients with heart failure admitted to a progressive care unit by implementing a standardized nurse-administered palliative care screening tool. ... Implementing a nurse-administered screening tool effectively identified unmet palliative care needs among patients with heart failure with reduced ejection fraction and NYHA III. Despite low rates of palliative consults, standardization using IPOS could increase screening, contribute to institutional triggering palliative consultations, and improve awareness of unmet needs.