Literature Review

Advance care planning in the inpatient setting: The role of the hospitalistAmerican Journal of Hospice and Palliative Medicine; Nikhil Sood, MD; Rohini Garg, MBBS; Anthony D. Slonim, MD, DrPH, FCCM; 3/25Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation.

Patient-centered communication drives supportive care needs in incurable cancer Oncology Nursing News; by Kristie L. Kahl; 4/16/25 The Primary Palliative Care Communication Intervention (PRECURSOR) may improve the psychosocial experiences of patients with incurable gynecologic cancer and their caregivers in the outpatient setting, according to results of a pilot study presented at the 50th Annual ONS Congress. ... Currently, most of the conversation around supportive care is provider-driven, and clinical tendency is to insert palliative care in the terminal setting. However, the study investigators aimed to integrate supportive care across the cancer continuum.

For AYAs with advanced cancer, study finds serious communication gaps about their care National Cancer Institute; by Daryl McGrath; 4/15/25 Many adolescents and young adults (AYAs) with advanced cancer don’t have discussions with their clinicians about how they want to approach palliative care until the final weeks of life, a study of medical records of nearly 2,000 young patients showed. ... Talking about care and treatment near the end of life is one of the most challenging aspects of caring for AYAs with advanced cancer, said Ashley Wilder Smith, Ph.D., M.P.H., of NCI’s Healthcare Delivery Research Program and co-leader of NCI’s Adolescent and Young Adult Oncology Working Group. ... “When a young person is faced with a disease that may lead to an early death, it’s vitally important to give them the opportunity to think about what’s most important to them and what happens to them in terms of care in the time they have left,” she said.

Ahead of National Healthcare Decisions Day, aging and hospice expert urges Americans to commit to vital advance care and end-of-life conversationsNational Partnership for Healthcare and Hospice Innovation (NPHI) press release; by Tom Koutsoumpas; 4/10/25With National Healthcare Decisions Day next Wednesday, April 16, 2025, the National Partnership for Healthcare and Hospice Innovation (NPHI) is marking the occasion by encouraging Americans to use the day as an opportunity to have conversations with family or loved ones about steps they have—or have not—taken regarding their advance care and end-of-life plans. To help with conversations and prepare individuals to have the most effective discussion with their loved ones about these difficult topics, NPHI is also releasing its Five Point Guide below to show everyday Americans on how to have advance care planning conversations. [Points include:]

Family Hospice partners with Alzheimer’s Association to expand educational outreach EIN Presswire.com, Atlanta, GA; by Brittany Brown; 4/8/25 Family Hospice announces an official partnership with the Alzheimer’s Association, Georgia Chapter, to enhance educational outreach and raise awareness of available resources for individuals facing Alzheimer’s or other dementia.This collaboration will provide families, caregivers, and healthcare professionals with critical information on hospice and Alzheimer’s and dementia-related support. As part of this effort, Family Hospice and the Alzheimer's Association are planning an upcoming statewide initiative in Georgia aimed at expanding awareness and support. Both organizations will share educational materials at community events and through social media to ensure families and caregivers have access to the guidance they need. [Continue reading ...]

Terri Schiavo's death 20 years ago sparked lingering debate about death and politics USA Today; by Marc Ramirez; 3/31/25 Monday [March 31st marked] 20 years since the death of Terri Schiavo, whose landmark case became the symbol of the "right to die" movement, generated political controversy and sparked public outcry as her husband and family members took their fight over her fate to the courts. Schiavo died on March 31, 2005, after a dragged-out legal and political battle ... The case thrust discussions about end-of-life care into the public consciousness, a topic that continues to provoke heightened emotions among Americans. “It became the most reviewed, debated end-of-life case in history,” said Arthur Caplan, who heads the division of medical ethics at New York University’s Grossman School of Medicine. [Continue reading ...]

Interprofessional advance care planning to enhance end-of-life care: A community assessmentCreighton Journal of Collaborative Practice and Education; Meghan Potthoff, Amanda Kirkpatrick, Jenny Jessen, Cathy Fox, Victoria Haneman, Megan Piotrowski, Beatriz Rodriguez, Sydney Langlois; 3/25Lawyers and financial planners are more often sought for estate directives than primary care providers for end-of life planning. Lack of role clarity and divergent views about advance care planning (ACP) responsibility among healthcare providers lead to further delay of these important discussions. A qualitative, exploratory design was employed to investigate ACP understanding, barriers, and needs among aging Nebraskans and Omaha-metro community agencies that serve these consumers. Conclusions: Improved ACP discussions are needed for supporting value-aligned end-of-life care by educating aging adults about, and documenting their wishes for, life-sustaining treatments and other decisions surrounding death. Enhanced role clarity, increased competence, and a collaborative approach are needed among interprofessional team members involved to improve these end-of-life discussions. 

[Germany] Do we have a knowledge gap with our patients?-On the problems of knowledge transfer and the implications at the end of lifeInternational Journal of Environmental Research and Public Health; Nils Heuser, Hendrik Heers, Martin Gschnell, Fabian Urhahn, Severin Schrade, Christian Volberg; 2/25Cancer patients are often unaware of their exact diagnosis, stage of disease, and prognosis. In the patients observed, it was found that many of them were unaware of their stage of disease, which can have a huge impact on their end-of-life decisions, such as the type of treatment they want. Many patients were also unaware of their own treatment. There is a risk that false hopes of cure may be attached to therapies and that, as a result, patients may be less likely to opt for palliative care with a focus on maintaining quality of life.

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 ...]

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.

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:

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.