Literature Review

[Ireland] Palliative care nurse specialists’ perspectives on spiritual care at end of life—A scoping reviewJournal of Hospice & Pallaitive Nursing; Dunning, Bronagh MSc, PGCert, BSc, RGN, RNT, FHEA; Connolly, Michael PhD, MSc, BA, RGN, RNT; Timmins, Fiona PhD, FAAN, MSc, BA (Open), BSc (Open), BNS, FFNRSCI, RNT, RGN; June 2025The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist’s perspectives of spiritual care at end of life. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses’ own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.

Dr. Anne Merriman obituary: doctor known as ‘mother of palliative care in Africa’ The Times, London, England; 6/18/25 Dr. Anne Merriman revolutionised palliative and end-of-life care in Africa after developing a cheap form of oral morphine with a Singapore hospital pharmacist. ... Universally known as “Dr. Anne”, she said: “It’s easier than baking a cake.” She developed the pain-controlling recipe after seeing terminally ill patients discharged from hospital because “nothing more could be done for them”. Many died at home in severe and prolonged pain. “A wild, undisciplined schoolgirl” who became a nun and a doctor, Merriman founded the pioneering Hospice Africa Uganda (HAU) in 1993 at the age of 57. Palliative care was largely unknown in Africa when she started her work in Uganda. HAU has treated more than 35,000 patients and trained more than 10,000 healthcare professionals from 37 African countries in the so-called Merriman model. ... Anne Merriman, doctor, was born on May 13, 1935. She died from respiratory failure on May 18, 2025, aged 90.

Recommendations for palliative care program standards Center to Advance Palliative Care (CAPC); last updated 5/29/25CAPC has synthesized the NCP Guidelines into an operational summary for payers and policymakers to use in credentialing palliative care providers or informing minimum program requirements. These recommendations call for: an interdisciplinary team with 3 or more essential clinical disciplines: physician, advance practice provider, nurse, social worker, spiritual care professional and a child life specialist for programs serving children. One or more prescribers must have specialty certification in palliative care with others documenting some specialty training. PC services must include Comprehensive patient assessments, Pain and symptom management, Documented conversations about condition, treatment options, and goals of care, Psychological, social and spiritual support, Patient and family/caregiver education, and Coordination with behavior health and community health resources, and Development of a crisis intervention plan. The recommendations also specify 24/7 access to a prescribing clinician, clear discharge criteria, and routine evaluations of program quality.Guest Editor's Note, Ira Byock: These new recommendations from CAPC are timely and important. Building from the NCP Guidelines, CAPC is providing a framework for developing formal standards. That task is urgent given the pressures programs are under to reduce staffing, limit hours of service, and scope of services. I appreciate inclusion of crisis intervention planning, which should be a critical part of every palliative plan of care. The recommendations are strong, yet the statement’s wording is hesitant in tone. CAPC has the organizational stature to issue explicit minimum specifications for programs that purport to deliver palliative care. Health plans, payers, referring providers, and patients deserve assurance that such minimums are met or exceeded. CAPC has taken a significant step in the right direction.  

Alliance official: Medicare Advantage growth, PDGM cuts create converging crises for at-home care Home Health Care News; by Morgan Gonzales; 6/13/25 At-home care is reaching a crisis point, according to Scott Levy, chief government affairs officer  at the National Alliance for Care at Home (the Alliance). The pressure on providers is not only unsustainable – it threatens access to cost-saving in-home care. Already, over one-third of patients referred to home health fail to receive those services. Home health is facing a triple threat, with deepening patient-driven groupings model (PDGM) payment cuts, Medicare rate updates that fail to keep up with real inflation and increased Medicare Advantage (MA) penetration. Meanwhile, home- and community-based services are in the crosshairs of the budget reconciliation bill passed by Congress and now in the Senate’s hands. Access to care is sure to be impacted, Levy said, but questions remain as to what extent. ...

Nursing home is pressuring my mother-in-law to enter hospiceAging Care - Caregiver Forum - End of Life - Questions; question posed by "concerned8"; 6/12/25 I am her Health Care Surrogate but as they won't declare her incompetent it has not come into effect. I believe the home's intent is to prevent me from making the decision regarding hospice and instead to pressure her to enter it in various ways. ... I am not anti-hospice and expect her to enter it in the near future, but want that to be my decision, not the home's (even if it's portrayed as hers).  ... [An answer from another reader" Our family has only had bad experiences with three different hospice companies. Contrary to what most people believe, many patients are placed on hospice for free equipment and free services. I was told this by more than one hospice worker.Editor's Note: This post raises numerous troubling perceptions, with descriptions of poor hospice experiences. 

Serious illness has mental health implications — palliative care can help Becker's Behavioral Health; by Dr. Simeon Kwan and Dr. Rowland Pearsall; 6/12/25 ... As health plans and providers strive to deliver whole-person, value-based care, we must recognize that treating the body is only part of the equation. Mental and emotional well-being are critical dimensions of serious illness, and they demand more focused attention. Fortunately, we have a powerful but often underutilized ally: palliative care. ... According to multiple studies, up to 40% of patients with advanced cancer experience clinical depression. Anxiety and spiritual distress are also common, particularly when facing the unknown or confronting the loss of autonomy. For those managing progressive illnesses over time, mental health concerns can erode treatment adherence, accelerate physical decline, and strain family caregivers.

[Canada] The discourse of medical assistance in dying and its relationship with hospice palliative care in Canada: An integrative literature reviewJournal of Advanced Nursing; Jennifer D Dorman, D Shelley Raffin Bouchal, Eric Wasylenko, Shane Sinclair; 5/25Three themes identified from the data were the relationship between MAiD [medical assistance in dying] and HPC [hospice pallaitive care], suffering in the context of MAiD, and moral distress and moral uncertainty in providing or not providing MAiD. The discourse around the relationship between MAiD and HPC is complex and contextual. Personal and professional understandings of end-of-life care differ and influence perspectives on how and whether MAiD and hospice palliative care can be reconciled. Findings consider how the concepts of end of life, MAiD, HPC, suffering, and moral distress influence and are influenced by the discourse of dying. 

My dad had an Advance Directive. He still had to fight to die Newsweek - My Turn; by Maggie Schneider Huston; 8/26/24, published in our newsletter 8/27/24My mom died peacefully. My dad died 72 days later, angry at the doctors for ignoring his wishes. ... Dad had heart surgery on December 20, 2023. An hour after the surgery ended, his vital systems started shutting down. A cascade of interventions, one after another, kept him alive. Four days later, he said: "Put me on hospice." The doctor dismissed this request, rolling his eyes and saying: "Everyone on a ventilator says that." On Christmas Day, my father asked for hospice again. He was in pain. He knew his recovery would be long and ultimately futile. He would never have an acceptable quality of life again. ... Dad's care team insisted palliative care was the same as hospice care, but he knew the difference. He wanted hospice care. Finally, they reluctantly agreed and called for a social worker to make arrangements. It wasn't necessary. Once they removed his treatment and relieved his pain, he died five hours later. ... Editor's Note: This article is not about Medical Aid in Dying (MAiD). It is about honoring Advance Directives, person-centered care with communications and actions related to "palliative" vs. "hospice" care. Pair this with other posts in our newsletter today, namely "Improving post-hospital care of older cancer patients."

Understanding hospice care: Eligibility, cost and purpose Emmanuel Hospice; 6/5/25 How do you want to live? It may be surprising to learn that’s the first question Emmanuel Hospice asks every new patient. Isn’t hospice about dying? While hospice is often associated with death, Melissa Wedberg will tell you it’s more about living, especially at Emmanuel Hospice, where she serves as vice president of community relations. With more than a decade in the hospice industry, Wedberg has spent years dispelling this and many other myths. Despite having roots in the U.S. dating back to the 70s, there remains a lot of mystery about hospice. Common questions Wedberg hears include: What is hospice and who’s eligible? How does hospice work? How is hospice paid for? Editor's note: This simple question jumps to the core of person-centered care, "How do you want to live?"

Summerlin Hospice and Palliative Care transforms hospice care in Las Vegas with comprehensive in-home services East Coastsentinel; Press Release; 6/8/25 The healthcare industry is experiencing significant advancements as Summerlin Hospice and Palliative Care announces the expansion of comprehensive services that redefine compassionate end-of-life care throughout Nevada. ... The in-home care model provides comprehensive medical oversight, including pain management, regular health assessments, and specialized medical testing, all administered by trained healthcare professionals. This approach to hospice allows families to remain together while receiving the highest quality medical attention and emotional support throughout the care process.

Implementing palliative care in nursing homes: A podcast with Connie Cole, Kathleen Unroe, and Cari Levy GeriPal; podcast by Connie Cole, Kathleen Unroe and Cari Levy; 6/5/25 Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dementia. Many also suffer from distressing symptoms like pain. In addition, about 25% of all deaths in the United States occur within these facilities. Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve palliative care for individuals in nursing homes? [This] podcast explores this crucial question with three leading experts: Connie Cole, Kathleen Unroe, and Cari Levy. 

Nurse Elaine Gillard and her lifelong calling for caring New York Amsterdam News; by Leyrian Colón Santiago; 6/5/25 Treating patients with dignity and with an awareness of the disparities that Black people face in accessing health care were the two main reasons Elaine Gillard decided to become a nurse 14 years ago. ... According to a 2024 analysis, Black-American New Yorkers experienced the lowest health system performance in the state compared to white individuals. For Gillard, a 41-year-old native of Staten Island and a nurse at VNS Health Care, the disparities affecting the Black-American population were what inspired her to focus her nursing career on hospice care. ... Gillard believes that being a Black nurse and caring for patients from Black-American communities helps foster greater trust in the health care system.