Literature Review

When lung cancer spreads to the liver: what to expect Everyday Health; by Ashley Welch, medically reviewed by Tingting Tan, MD, PhD; 9/8/26 Liver metastasis from lung cancer occurs when cancer cells from the tumor in the lung travel to the liver. Also known as stage 4, it’s the most advanced stage of lung cancer. ...

Central Illinois nursing home fined $25K by state after resident's death Pekin Daily Times, Perioa, IL; by Zach Roth; 9/6/26 A Canton nursing home was fined $25,000 after a resident died last year after being taken off medication that was prescribed to prevent blood clots. ... On March 31, 2025, a verbal order was given to stop providing Xarelto because the woman began hospice care one month prior. ... The care plan noted that she had a history of strokes and that medication needed to be provided as ordered by her doctor. ... The hospice's owner said that the power of attorney had contacted them after the woman had died asking about the medication situation, noting that they hadn't seen anything to show that her Xarelto had been discontinued. The hospice owner also said that they hadn't received an order from a hospice physician or nurse to discontinue it. Editor's Note: Details are more complex than space allows in the short summary above. A verbal order to stop a medication, without a documented physician directive or clear communications with the family, is a quiet risk hiding in plain sight at hospice transitions — one that can hasten death rather than ease it. Deprescribing has its place in end-of-life care, but only through structured, physician-ordered, shared decision-making. Does your hospice's process protect against this, or could it happen to one of your patients tomorrow? 

Nearly half of veterans with stage IV cancer die without hospice: a national VHA analysis of 45,397 decedents Medscape; by Sasmith Menakuru, MD; Alexander Quattlebaum, MD; Chance Bloomer, MD; Lara Khoury, MD; Abdulsabur Sanni, MD; Michael Goodman, MD; 9/3/26  Results: Of 45,937 veterans, 20,338 ... had no hospice admission or consultation.  ... Conclusions: Hospice access for veterans with Stage IV cancer deteriorated during COVID-19 and shows no meaningful recovery; ... These findings identify Stage IV hospice access as an underrecognized national VHA quality priority warranting Stage IV—triggered automated palliative care consultation, embedded outpatient palliative care in oncology clinics, standardized referral protocols at documented progression, and veteran/family-facing hospice education. This analysis establishes a statistically rigorous national baseline for benchmarking interventions–and a call to action for the VHA oncology community to restore hospice as a core element of veteran-centered end-of-life care.

Priorities for advancing palliative care for Amyotrophic Lateral Sclerosis: a consensus report from a palliative care for ALS working group in the United States Muscle & Nerve; by Kara E. Bischoff, Yaowaree L. Leavell, Jessica M. Besbris, Christi Lero, Kelsey Noble, Astrid Grouls, Jerome Kurent, Benzi M. Kluger, Steven Z. Pantilat, Ambereen K. Mehta, on behalf of the International Neuropalliative Care Society's Palliative Care for ALS Working Group; 8/31/2026 The Palliative Care for ALS Working Group was formed within the International Neuropalliative Care Society, consisting of interprofessional ALS and palliative care clinicians, researchers, advocates, and patients and care partner representatives who are committed to improving palliative care for people living with ALS. The group engaged in a strategic planning process to determine what is needed to advance palliative care for people with ALS over the next 3–5 years. This report outlines the core recommendations from that strategic planning process. Recommendations are divided into five sections: (1) clinician education, (2) clinical service expansion, (3) research, (4) public awareness, and (5) policy change. Editor's Note: ALS is an especially devastating, demanding disease for patients, caregivers and families, for your clinical staff and volunteers. What disease-specific education and resources do you provide? How many ALS patients have your organization served in "x" years? Do you partner in any way with your regional ALS association? For non-clinical leaders, an important, easy distinction for you to remember the clinical, deeply personal differences between ALS versus ALZ: 

Pittsburgh Caregivers get federal lifeline as dementia cases swell across Allegheny County hoodline; by Ryan Miller; 8/21/26 Caregivers looking after loved ones with dementia in Pittsburgh now have a new federal tool to lean on, and it is already showing up at a day center in Squirrel Hill. The Anathan Club, run by the Jewish Association on Aging, has begun connecting families to the Guiding an Improved Dementia Experience Model, a Medicare program that can cover up to $2,500 a year in respite care for qualifying beneficiaries. The Guiding an Improved Dementia Experience Model, known as GUIDE, was developed by the Centers for Medicare and Medicaid Services and launched nationwide on July 1, 2024, as an eight-year voluntary pilot running through June 30, 2032, according to CMS. Nearly 390 provider organizations across the country are participating. 

Advance care planning in sickle cell disease: A scoping reviewJournal of Palliative Medicine; by Megan R Marshall, Miranda Ravicz Adelmann, Miriam A Osei, Sharl S Azar, Stephanie Kiser, Richard Newcomb; 7/26Sickle cell disease (SCD) is an inherited hemoglobinopathy characterized by abnormal red blood cell sickling, leading to pain, organ dysfunction, and early mortality. Its severe, unpredictable course and the emergence of complex decisions surrounding transformative therapies have prompted recommendations to integrate palliative care (PC) to support patients and families. The limited available evidence suggests that patients are open to ACP discussions with trusted clinicians, but few patients had participated in formal or informal ACP. Personal and environmental factors may influence ACP engagement, including patient-clinician trust, patient and clinician understanding of ACP in SCD, timing of ACP conversations, and previous experiences with critical illness or end-of-life care. Proposed steps for advancing ACP in SCD include education, early PC integration, and strengthened patient-clinician communication and relationships.

Goal-concordant care for older adults with advanced heart failure: A retrospective cohort studyPalliative Medicine; by Sarah Godfrey, Maryjane Farr; 7/26Older adults with advanced heart failure experience significant morbidity and mortality and face higher complication rates from advanced therapies. Of 212 patients, 91 (42.9%) underwent evaluation for advanced therapies, though few received a heart transplant (16, 7.5%) or left ventricular assist device (32, 15.1%). Most (148, 69.8%) had only one palliative physician visit. One hundred thirty-nine (65.6%) died, often in the hospital (55, 40%) and with life-sustaining therapy in the last 24 h (73, 52.5%). Most (167, 78.8%) received goal-concordant care, with the main reasons for discordance being the desire for advanced therapy (33, 15.6%) and complications post-implantation affecting quality of life (9, 4.2%). Conclusions: Few older adults received advanced therapies, and palliative care was underutilized, with many patients seeing palliative care only once. Most received goal-concordant care, but decisions were often made late, highlighting the need for earlier, longitudinal palliative care for these vulnerable patients.

Dementia coach Jeannine Forrest of Through the Forrest recently featured on Close Up Radio EIN Presswire, Chicago, IL; by Close Up Television & Radio; 8/17/26 Jeannine Forrest still remembers the moment her mother looked at her in her own home and said, “I’m living in a house of strangers.” At that moment, as a registered nurse, she realized she was not prepared to understand what her mother was truly experiencing. That realization became her life’s work. More than 30 years later, Forrest is a dementia coach and founder of Through the Forrest, where she works directly with family caregivers. ... Forrest explains that dementia shows up differently in every person, and is much more than memory loss alone. Her approach rests on one idea: When families understand what is happening, have a plan, and feel supported, life can become less frightening and more meaningful for both the person living with dementia and the caregiver.

[Portugal] Ketamine for cancer-related pain in palliative care: A systematic review of clinical use and safetyJournal of Pain & Palliative Care Pharmacotherapy; by Catarina Vitorino-Afonso, Paulo Reis-Pina; 7/26Ketamine has emerged as an adjuvant for opioid-refractory cancer-related pain in palliative care, but evidence remains limited. [This study found that] ketamine was used mainly as an adjuvant. Many reports described reduced pain and/or lower opioid use, although certainty was very low and attribution was limited by polypharmacy and regimen changes. Intravenous infusions were most common, but subcutaneous, oral, and intranasal routes were also used. Intranasal ketamine showed pragmatic utility for breakthrough pain, while oral ketamine was described in ambulatory palliative care settings.