Literature Review

All posts tagged with “Clinical News | Advance Directives.”



Niagara Hospice to offer free community presentation for National Healthcare Decisions Day

04/02/25 at 03:00 AM

Niagara Hospice to offer free community presentation for National Healthcare Decisions Day Niagara Frontier Publications; Press Release; 3/28/25 April 16 is National Healthcare Decisions Day, which is a day set aside to educate and empower individuals to discuss and document their end-of-life health care wishes. Niagara Hospice invites the community to attend the free presentation, “Advance Care Planning: Advance Directives for Health Care,” ... Advance care planning includes advance directives like health care proxies, do not resuscitate (DNR) orders, and living wills. Advance directives help to ensure end-of-life care wishes are followed if one is unable to make necessary decisions for themselves. [Continue reading ...]Editor's note: For more information about National Healthcare Decisions Day (NHDD), explor The Conversation Project, at the Institute for Healthcare Improvement. 

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Hospice of the Chesapeake leader aims to think outside the box on hospice, palliative care

04/02/25 at 03:00 AM

Hospice of the Chesapeake leader aims to think outside the box on hospice, palliative care McKnights Home Care; podcast by Liza Berger with Rachel Jordan; 3/27/25 As the director of legislative affairs and advocacy at Hospice of the Chesapeake, the largest independent not-for-profit hospice provider in the state of Maryland, Rachel Jordan strives to treat the patient and not the disease. This helps explain why she worries less about the line between “curative” and “noncurative” care and more about whether a particular treatment helps to make a patient feel more comfortable. Jordan spoke to McKnight’s Home Care about her views of hospice and palliative care for a Newsmakers podcast. [Continue to the podcast ...]

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Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patients

03/29/25 at 03:30 AM

Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patientsCancer Medicine; Nithya Krishnamurthy, Melanie Besculides, Ksenia Gorbenko, Melissa Mazor, Marsha Augustin, Jose Morillo, Marcos Vargas, Cardinale B. Smith; 3/25There are significant disparities in outcomes at the end-of-life (EOL) for minoritized patients with advanced cancer, with most dying without a documented serious illness conversation (SIC). This study aims to assess clinician perceptions of the utility and challenges of implementing a machine learning [ML] model (ALERT) to predict 6-month mortality among patients with advanced solid cancers to prompt timely SIC. Our study found that clinicians expressed widespread acceptability of ALERT and identified clear benefits, particularly in triggering earlier SIC and standardizing prognosis discussions across care teams. [Additionally,] a recent study found that ML prognostic models decreased use of aggressive chemotherapy at EOL and increased SIC frequency fourfold.

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Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support

03/29/25 at 03:25 AM

Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support Cureus; by Taposh P. Dutta Roy; 3/12/25 Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support. 

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‘Show up and share’: How one UCLA ICU helps patients and staff live with dying

03/27/25 at 03:00 AM

‘Show up and share’: How one UCLA ICU helps patients and staff live with dying Los Angeles Times; by Corinne Purtill; 3/20/25 

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Hidden battles: Keeping cancer secret

03/27/25 at 03:00 AM

Hidden battles: Keeping cancer secret Harvard Health Publishing - Harvard Medical School; by Maureen Salamon; post is dated 4/1/25, retrieved from the internet 3/25/25 Some people choose to conceal their diagnosis and treatment. Here's why — and reasons that approach can sometimes backfire. ... [In addition to privacy motives, Cristina Pozo-Kaderman, a senior psychologist at Harvard-affiliated Dana-Farber Cancer Institute] says cancer patients may also wish to:

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Bringing palliative care to every patient with cancer: A conversation with Janet L. Abrahm, MD, FACP, FAAHPM, FASCO

03/25/25 at 03:00 AM

Bringing palliative care to every patient with cancer: A conversation with Janet L. Abrahm, MD, FACP, FAAHPM, FASCO The ASCO Post, in partnership with the American Society of Clinical Oncology; by Jo Cavallo; 3/25/25 Janet L. Abrahm, MD, FACP, FAAHPM, FASCO, ... has become a widely recognized leader in the field of supportive care and palliative medicine, serving for nearly a decade on the leadership team of the American Academy of Hospice and Palliative Medicine and helping to craft the first Hospice and Palliative Medicine certifying examination offered by the American Board of Internal Medicine. ... In a wide-ranging interview with The ASCO Post, Dr. Abrahm discussed the importance of providing every patient with cancer access to palliative medicine throughout survivorship, how oncologists can become more effective communicators, and strategies to alleviate patients’ suffering at the end of life.

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Utah funeral home is first in state to offer "human composting" as a green alternative to traditional burials

03/24/25 at 03:00 AM

Utah funeral home is first in state to offer "human composting" as a green alternative to traditional burials Salt Lake City Weekly, Salt Lake City, UT; by Aimee L. Cook; 3/19/25 ... Jason and Shayneh Starks, who opened [Starks Funeral Parlor in Millcreek] in 2005, offer their clients an innovative and environmentally conscious option—natural organic reduction (NOR), often called human composting. This process transforms the deceased into nutrient-rich soil over a period of 8 to 12 weeks. While the concept may sound unconventional to some, it's gaining traction with families in Utah and beyond, ... "We're seeing a lot of interest from environmentally conscious individuals who want a natural, meaningful way to return to the earth," observed Shayneh Starks, who has worked in funeral services since 1995. Natural organic reduction has already been legalized in states like Washington, Oregon and California, but Utah has yet to officially approve this process.  Currently, Starks Funeral Parlor assists families who wish to choose this option by transferring remains out of state to Seattle, ensuring that those who value NOR have access to it.

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Medical interpreters’ experiences with patients who are near end-of-life and their family members

03/22/25 at 03:15 AM

Medical interpreters’ experiences with patients who are near end-of-life and their family membersJournal of Pain and Symptom Management; Joycelyn Howard DNP, RN, AGCNS, ACHPN ; Alexia M. Torke MD, MS; Susan E. Hickman PhD; Greg Sachs MD; Sylk Sotto-Santiago EdD, MBA, MPS; James E. Slaven MS, MA; Denise Robinson PhD, RN, FNP; 3/25In 2019 the United States Census Bureau reported 8% of the United States Population “speak English less than very well”. Ensuring individuals with a non-English language preference (NELP), previously referred to as limited English proficiency, have equitable access to healthcare includes providing high quality interpreter services. Although self-efficacy for interpreting EOL [end of life]conversations is generally high, interpreters desire education about EOL care. Interventions are also needed to address the high emotional toll of interpreting EOL conversations. Education and training about EOL care may help them to not only convey information accurately but also cope with emotional nuances characteristic of these significant conversations, ultimately elevating the quality of care for patients and family members in vulnerable and important moments.

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Nursing home residents, family members, and staff members views about a good death and preferred place of death for a nursing home resident

03/22/25 at 03:15 AM

Nursing home residents, family members, and staff members views about a good death and preferred place of death for a nursing home residentOmega-Journal of Death and Dying; Janet Sopcheck, Ruth M. Tappen; 2/25Our study ... revealed that residents, like family members and staff members, had mixed opinions of the place of death for the NH resident, highlighting the importance of having advance care planning sessions with residents and their families to gain an understanding regarding their choices. Our study found the predominant and common qualities across the three participant groups of a good death include painless or pain-free, without suffering, peaceful, quiet, and dying in my sleep. Interestingly, almost one-fifth of the participants disagreed with the term good death, offering that death is not good as the person is no longer alive. Based on this study’s finding, using the term a good death in research and in advance care planning sessions may not be relevant or appropriate and instead focus on what care is necessary to promote a natural death, as mentioned by a few participants.

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Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe

03/21/25 at 03:00 AM

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

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[Australia] Advance care planning has brought 'comfort and peace' to Annaliese Holland

03/21/25 at 03:00 AM

[Australia] Advance care planning has brought 'comfort and peace' to Annaliese Holland ABC News; by Eva Blandis and Daniel Keane; 3/19/25Young South Australian woman Annaliese Holland, who is preparing for major high-risk surgery, has spoken about the importance of advance care planning. The 25-year-old was diagnosed with a rare autoimmune disease and terminal illness several years ago. Ms. Holland wants young people to have more open conversations about death and end-of-life care. ... "I say my life is like walking on a field of landmines, not knowing when it will go off,"  she said. While it is a harrowing statement, she is harnessing her situation to help others — Ms. Holland is a strong supporter of advance care planning.

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Delaware House passes end-of-life option bill for terminally ill adults

03/21/25 at 03:00 AM

Delaware House passes end-of-life option bill for terminally ill adults ABC Action News 6, Dover, DE; by 6abc Digital Staff; 3/20/25 Currently, medical aid for euthanasia is legal in 10 U.S. states and the District of Columbia. Delaware's House of Representatives has passed a bill giving some terminally ill residents the right to take their life. The bill allows mentally capable adult residents, who have been given a prognosis of six months or less to live, the option to request and obtain life-ending medication. The bill now heads to the Senate. ... Now, for the 10th time, Delaware lawmakers are trying once again to get the bill passed. ... Governor Matt Meyer has signaled his support if the bill passes the Senate,  ...

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‘Early discussions on what to expect can lessen the strain’

03/21/25 at 03:00 AM

‘Early discussions on what to expect can lessen the strain’ Nursing Times; by Kylie Chaffin; 3/19/25 The article explains the pros and cons of nutrition and hydration at end of life and the several types of artificial nutrition and hydration that can be used, written in a way patients and families can understand. Resources and educational articles, like this one, can also be a great way to introduce new or even more effective ways nurses and care team members can support patients and families when pursuing a palliative approach to their health and wellbeing. My question for readers is, “Should the conversation of end-of-life, hospice and palliative care, and nutritional changes, be initiated sooner rather than later in patients with a terminal diagnosis?”

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The Stanford Letter Project helps you discuss your end-of-life wishes

03/20/25 at 03:00 AM

The Stanford Letter Project helps you discuss your end-of-life wishesKALW 91.7 FM - Your Call, Bay Area, CA; by Rose Aguilar and Nina Kissinger; 3/18/25 On this edition of Your Call, we discuss the importance of conversations, letters, and advance directives in communicating your end-of-life care wishes to loved ones and doctors. Although 92 percent of US adults say it's important to discuss their end-of-life care wishes, only 32 percent have had this conversation, and less than one-third have advanced-care directives in place. ... The Stanford Letter Project was designed to give you the tools you need to start the process. Dr. VJ Periyakoil, the founder and director of the project, shares her insights into making end-of-life care plans and resources to help guide you through the process. ... Resources [with links to the content]:

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Impacting end-of-life care with new healthcare legislation: Patient-Directed Medical Orders (PDMO) in advance care planning

03/20/25 at 03:00 AM

Impacting end-of-life care with new healthcare legislation: Patient-Directed Medical Orders (PDMO) in advance care planningAmerican Nurse - State Nurses Associations - Florida News Journal; by Meredith Fischer, BSN, RN, CHPN; 3/19/25 Over the summer, a friend’s elderly father underwent resuscitation and intubation because his nursing facility could not locate his Do Not Resuscitate Order (DNRO) or Advanced Directive (AD). ... New legislation is being filed for a Patient-Directed Medical Order (PDMO) document designed to address the shortcomings of the ADs and DNRO forms—currently the primary tools for addressing end-of-life care preferences in Florida. The PDMO form originates from the POLST paradigm, which has been adopted by most states since its inception in Oregon in the early 1990s (National POLST, 2022). Healthcare professionals recognized that many individuals were not receiving the end-of-life care outlined in their ADs and DNROs due to accessibility, clarity, and practicality (National POLST, 2022).

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Why aging parents make DNR choices before crisis strikes

03/19/25 at 03:00 AM

Why aging parents make DNR choices before crisis strikes Rolling Out 25; by Khalil Best; 3/17/25The conversation typically begins quietly. ... An aging parent mentions their desire for a Do Not Resuscitate order—commonly known as a DNR—and the atmosphere in the room shifts. For many adult children, this moment arrives unexpectedly, triggering complex emotions ranging from denial to grief. Yet these discussions, uncomfortable as they may be, represent one of the most meaningful exchanges families can share. Understanding why many elderly parents choose to sign DNR orders in advance illuminates not just practical healthcare concerns, but deeper values about dignity, autonomy, and what constitutes a meaningful life.

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[International] Healthcare on the brink: Palliative Care Unit and Late Shift

03/18/25 at 03:00 AM

[International] Healthcare on the brink: Palliative Care Unit and Late Shift The 75th Berlin International Film Festival - Part 7, wsws.org; by Martin Nowak and Bernd Reinhardt; 3/16/25 Two films, the drama Late Shift (Heldin) and the documentary Palliative Care Unit (Palliativstation), featured at this year's Berlin International Film Festival, addressed the current situation in German and Swiss hospitals. The sold-out festival screenings reflected the burning public interest in this topic. This is particularly remarkable bearing in mind that Palliative Care Unit has a running time of more than four hours. ... [In the] documentary Palliative Care Unit by Philipp Döring, shot at the Franziskus Hospital in Berlin, ... [the] camera quietly observes the daily routine, staff consultations and the constant empathy of the head of the ward towards employees and seriously ill patients, who usually spend their last weeks here. The very calm, always discreet images emphasise the necessity of sufficient time for care and reflection when making life-critical decisions. ... How can the highest possible quality of life be achieved? The high ethical standard of treating incurable patients as active human beings ... is admirable and makes a lasting impression throughout the film.

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[UK] RCGP shifts to position of neither supporting nor opposing assisted dying

03/17/25 at 03:00 AM

[UK] RCGP shifts to position of neither supporting nor opposing assisted dying RCGP - Royal College of General Pracitioners, London, UK; Press Release; 3/14/25 The Royal College of General Practitioners' Council has voted to move to a position of neither supporting nor opposing assisted dying being legal. The RCGP UK governing Council - elected representatives of the wider College membership – today voted to determine what the College’s stance should be on whether or not assisted dying should be legal:

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The preference for acute rehospitalization scale: Evaluating preference for acute rehospitalization in pediatric hospice patients

03/15/25 at 03:10 AM

The preference for acute rehospitalization scale: Evaluating preference for acute rehospitalization in pediatric hospice patientsJournal of Palliative Medicine; Kelley Newcomer, Katherine Maddox; 3/25Since the passage of the Affordable Care Act, children are able to access pediatric hospice while still pursuing life-prolonging care. This can create confusion between hospice and palliative care staff and families about current goals of care (GOC), which evolve over time. Hospice and palliative care teams created, implemented, and evaluated a five-point scale to summarize the Preference for Acute Rehospitalization (PAR) Scale for children on concurrent care hospice. Most users reported they agreed or strongly agreed the PAR Scale helped them to understand families' GOC and feel more confident giving advice with urgent questions.

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How Houston Methodist’s ACO reduced its end-of-life spending by nearly 20%

03/13/25 at 03:00 AM

How Houston Methodist’s ACO reduced its end-of-life spending by nearly 20% MedCity News - Hospitals; by Katie Adams; March 10, 2025 Houston Methodist Coordinate Care is reducing costs through a partnership with Koda Health, a digital platform that guides patients through their end-of-life choices. Preliminary findings show the technology resulted in a 19% reduction in the total cost of care for patients at the end of their life, which equals nearly $9,000 in savings per patient. ... The ACO has been working with Koda Health for more than three years — and it is saving money by getting patients more involved in their end-of-life care plan.

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How to start the hospice conversation: Judy Bartel

03/11/25 at 03:00 AM

How to start the hospice conversation: Judy Bartel Cleveland.com, Cleveland, OH; by Guest columnist Judy Bartel, chief clinical officer for Hospice of the Western Reserve; 3/9/25 Discussing hospice care with a loved one is one of life’s most delicate and emotional conversations. For many, the word “hospice” evokes fear -- fear of finality, of giving up, of losing hope. But the truth is, hospice isn’t about giving up; it’s about focusing on what matters most -- comfort, dignity and quality of life. ...

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At the end of life, doctors’ actions and patients’ wishes may be misaligned, according to a Rutgers Health study

03/10/25 at 03:00 AM

At the end of life, doctors’ actions and patients’ wishes may be misaligned, according to a Rutgers Health study Rutgers; by Greg Bruno; 2/28/25 For terminally ill cancer patients, the final days of life are immensely personal, having the choice to continue cancer treatments, or to stop treatments and prioritize a more comfortable passing. What a patient wants, however, isn’t always what they receive, according to a Rutgers Health study published in the journal Cancer. “A patient's end of life is often not a reflection of what they want, but rather, who their oncologist happens to be,” said Login S. George, a health services researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research, and lead author of the national study. “The data doesn’t indicate patient-centered treatment decisions, but rather, more habitual or default ways of treating patients,” says George, who is also a member of the Cancer Prevention and Control Program at Rutgers Cancer Institute, the state’s only National Cancer Institute-designated Comprehensive Cancer Center. ... [Click on the title's link for more statistics, insights, and recommendations.]

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Report finds those with Parkinson’s have unmet hospice needs

03/10/25 at 02:10 AM

Report finds those with Parkinson’s have unmet hospice needsMcKnights Long-Term Care News; by Kristen Fischer; 3/6/25 Hospice use varies depending on whether a person has Parkinson’s disease, Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds. Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their study, which was published Tuesday in JAMA Network Open. ... Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)

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[UK] Coming to terms with dying: Advance care planning as a conduit between clinicians, patients, and conversations about death and dying - A qualitative interview study

03/08/25 at 03:55 AM

[UK] Coming to terms with dying: Advance care planning as a conduit between clinicians, patients, and conversations about death and dying - A qualitative interview studyPalliative Medicine; Rowena Jane Eason, Lisa Jane Brighton, Jonathan Koffman, Katherine Bristowe; 2/25Advance care planning elicits multiple complex thoughts, emotions, and behaviours, with responses ranging from the procedural to the profound. Discussions empowered and instilled confidence, promoted openness with relatives, encouraged people to make the most of their time remaining, and sometimes contributed to coming to terms with their mortality. Factors influencing experiences of discussions reflected the complexity and diversity in participants' lives, personalities, and life experiences, with discussions exposing the realities of living with terminal illness. 

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