Literature Review

Q&A: Addressing palliative care in dialysis settings Physician's Weekly; interview with Jane O. Schell, MD; 5/20/25 Jane O. Schell, MD, discusses factors that impact use of palliative care in dialysis settings for patients in the United States, as well as potential solutions. 

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.

Interim HealthCare expands Alzheimer’s offerings through new partnership Home Health Care News; by Audrie Martin; 4/30/25 Interim HealthCare has expanded its Alzheimer’s care program through a new partnership with the Alzheimer’s Association. The partnership, announced on Wednesday, will enable Interim to bolster its existing Alzheimer’s offerings through additional educational programs and opportunities to participate in Alzheimer’s Association events.

Hospice use by cause of death: A cohort study using Utah population database American Journal of Hospice and Palliative Medicine - Sage Journals; by Rebecca L. Utz, PhD, Michael Hollingshaus, PhD, Attrayee Bandyopadhyay, MS, Kathie Supiano, PhD, Margaret Clayton, PhD, Katherine A. Ornstein, PhD, Djin Tay, PhD, Eli Iacob, Ken Smith, PhD, and Caroline Stephens, PhD; first published online 4/29/25 Illnesses such as cancer often follow a predictable trajectory of decline, while others, such as Alzheimer’s Disease and Related Dementias (ADRD) and Chronic Obstructive Pulmonary Disease (COPD), follow a more dwindling and protracted decline. ... This study assesses whether hospice use differs by the underlying cause of death and whether current hospice eligibility and practices provide optimal EOL to all causes of death. Major Findings: Non-cancer decedents were more likely to have sub-optimal patterns of hospice care, including minimal use, lasting less than a week, and extended use, lasting more than 6 months. Stroke decedents were the most likely to have minimal-use patterns of hospice, whereas dementia and COPD decedents were most likely to have extended use. Conclusion: New models of hospice-like EOL care that can accommodate both short-term and long-term palliative care needs may help meet the diverse needs of patients and families facing different EOL trajectories associated with common causes of death.Editor's note: Compare this data with your own data of disease-related Length of Stay (LOS), live discharges, disease-related accuity needs, and more. How can we improve disease-related patient care, across the different trajectories of palliative/hospice care?

7 signs at home care is needed for someone with dementia VeryWell Health; by Christopher Bergland; 4/25/25 ... At-home dementia care can look different for every family. Some people live alone and may get by with periodic check-ins from professionals in the dementia care community throughout the week. Others might require daily visits from Alzheimer's home care dementia services. Sometimes, a paid caregiver comes to the house daily, or unpaid loved ones provide 24/7 in-home care.

Circadian rhythm in end-of-life delirium: a secondary analysis of two randomized controlled trials Journal of Pain and Symptom Management; Sonal Admane MD, MPH; Sarah Pasyar MS; Roland Bassett Jr. MS; Eduardo Bruera MD; David Hui MD, MSc; 4/25Over 90% of patients with advanced cancer in the last weeks and days of life experience delirium, a neurocognitive syndrome associated with increased restlessness, agitation, hallucinations, and even violent behaviors. Long term psychological morbidity is also seen in caregivers, who may develop prolonged grief, anxiety, and post-traumatic stress disorder. Healthcare professionals caring for patients with delirium also report delirium-related distress, particularly in relation to patients with persistent restlessness and agitation. Delirious patients were more restless between 3 pm and 11 pm. This observation of “sundowning” may help clinicians to better anticipate this symptom, schedule monitoring and treatments, and educate patients and caregivers.

5 risk factors at 50 can steal a decade of life Medscape; by Nadine Eckert; 4/17/25 Five classic risk factors for cardiovascular disease — high blood pressure, high cholesterol, obesity, diabetes, and smoking — at age 50 can reduce life expectancy by more than 10 years. This is the conclusion of an international study led by German researchers and presented at the 2025 American College of Cardiology Scientific Session. These five factors account for approximately 50% of the global burden of cardiovascular diseases. ... The findings, also published in The New England Journal of Medicine, show that lifestyle changes and risk management in middle age can make a significant difference. Lowering blood pressure and quitting smoking had the most significant impacts.

When they don't recognize you anymore The New York Times - The New Old Age; by Paula Span; 4/20/25 People with dementia often forget even close family members as the disease advances. "It can throw people into an existential crisis," one expert said. [Additional access may require subscription.]