Literature Review

Top ten tips palliative care clinicians should know about intensive care unit consultationJournal of Palliative Medicine; by Ankita Mehta, Karen Bullock, Jillian L. Gustin, Rachel A. Hadler, Judith E. Nelson, William E. Rosa, Jennifer B. Seaman, Shelley E. Varner-Perez, Douglas B. White; 8/25Critical illness and ICU stays can be extremely distressing for patients and their loved ones. Providing palliative care in the ICU, although a standard component of comprehensive care delivery, involves understanding the individual culture of each specific ICU, collaboration with multiple providers, and interfacing with surrogate decision makers while patients may not be able to communicate and are undergoing interventions that are unfamiliar to them and loved ones. These top ten tips aim to support palliative care clinicians providing consultation in ICUs. Specifically, these tips address initial relationship building with ICU clinicians and teams to foster effective collaboration, establishing goals of care by assessing health-related values, explaining treatment options, individualizing prognostic discussions, and managing end-of-life symptoms for patients while in the ICU and throughout ICU discharge transition.

Why palliative care is more than just end-of-life support MedPageToday's KevinMD.com; by Dr. Vishal Parackal; 9/1/25 ... Palliative care as a system requires strong interpersonal and cross-specialty communication for smooth functioning, as patients may require expert opinions from different fields to optimize their treatment plan. Patient education for systemic follow-ups and establishing a baseline of knowledge regarding their diagnosis and potential danger signs helps create a better environment for holistic care. While we focus on the physical aspects of care and diagnosis, we often fail to realize the psychological and mental impact that such conditions can have on the patient and their family. ... The opportunity to make a meaningful difference in patients’ lives by easing their suffering and enhancing their quality of life is profoundly fulfilling. ... Editor's Note: Excellent descriptions of palliative care.

[Global] Palliative care for special populations ehospice; by Howard Kinyua; 9/1/25

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.

Proportional sedation for persistent agitated delirium in palliative care-A randomized clinical trialJAMA Oncology; David Hui, Allison De La Rosa, Jaw-Shiun Tsai, Shao-Yi Cheng, Egidio Del Fabbro, Anita Thankam Thomas Kuzhiyil, Kendra Rowe, Ahsan Azhar, Thuc Nguyen, Michael Tang, Chien-An Yao, Hsien-Liang Huang, Jen-Kuei Peng, Wen-Yu Hu, Sonal Admane, Rony Dev, Minxing Chen, Patricia Bramati, Sanjay Shete, Eduardo Bruera; 7/25Neuroleptic and benzodiazepine medications are often considered for patients with persistent agitated delirium in the last days of life; however, the risk-to-benefit ratio of these medications is ill-defined and benzodiazepine medications have not been compared to placebo. The results of this randomized clinical trial indicate that proactive use of scheduled sedatives, particularly lorazepam-based regimens, may reduce persistent restlessness and/or agitation in patients with advanced cancer and delirium in the palliative care setting. 

35 years of palliative care progress: What lies ahead for society engagement? Journal of Pain & Symptom Management; by Vilma A Tripodoro, Marie-Charlotte Bouësseau, Stephen Connor, Carlos Centeno; 8/14/25This special article presents a narrative synthesis of key policy milestones, conceptual transitions, and global indicators in the development of palliative care. It contrasts two WHO-endorsed public health models: the 2007 "Umbrella" strategy and the 2021 "House" framework, analysing their complementarities and global relevance. ... The future of global palliative care depends on political will, fair allocation of resources, robust monitoring, and meaningful community participation. ...

[Belgium] Christian perspectives on palliative sedation: A literature studyBMC Palliative Care; Jonathan Lambaerts, Bert Broeckaert; 7/25Overall, there is a positive but cautious attitude towards palliative sedation in the four major Christian traditions. All recognise that palliative sedation can help alleviate patient suffering. They remain cautious in their support, however, as they consider the line between palliative sedation and life-ending treatments (e.g. euthanasia) to be too blurred. Moreover, the Christian traditions are aware that lowering the level of consciousness is not without its problems.

Medicaid payments and racial and ethnic disparities in Alzheimer disease special care unitsThe Journal of the American Medical Association - JAMA Network Open; by Huiwen Xu, PhD, Shuang Li, PhD, John R. Bowblis, PhD, Monique R. Pappadis, PhD, Yong-Fang Kuo, PhD; James S. Goodwin, MD; 8/4/25 In this cohort study of 13, 229 nursing homes, those with higher proportions of Black or Hispanic residents were less likely to have Alzheimer disease special care units. The disparities among nursing homes serving high proportions of Black residents, however, narrowed and even disappeared in states with higher Medicaid payment-to-cost ratios. ... This study suggests that more generous Medicaid payments may be associated with improved availability of specialized dementia care in nursing homes that serve primarily marginalized Black residents.

[United Kingdom] Rethinking palliative care for people affected by homelessness Nursing in Practice; by Karita Razzell; 8/5/25 Well-timed palliative intervention can be a game-changer for people affected by homelessness facing advanced ill health, says Karita Razzell, palliative care manager at the charity St Mungo’s. ... There are various reasons behind the stark health disparities faced by people experiencing homelessness. ... Many individuals are living with serious mental health conditions, substance use issues, undiagnosed neurodiversity, and chronic physical illnesses – all of which can make clinical environments like hospitals particularly challenging for them. ... There are also digital hurdles: appointment systems and prescription services are increasingly online, yet many people without stable housing lack access to mobile phones or the internet. ... As a result, treatable conditions in people affected by homelessness often go undiagnosed until they reach an advanced stage.Editor's Note: People experiencing homelessness in the U.S. face similar challenges. Organizations such as The Hildegard House in Louisville, KY, and others in the national Omega Home Network of “comfort care homes” quietly provide palliative and hospice care for them. Click here to see a national map of these homes.

Monastery dig uncovers details about 8th century end-of-life care Care Home Professional; by Stephen Hall; 8/4/25 Archaeologists have picked up their trowels to learn more about how people lived, died and were cared for at the site of an 8th-9th century monastery in Cookham. The remains of the monastery were first discovered in 2021 in a test excavation by staff from the University of Reading’s Archaeology Department and volunteers from local archaeological societies. ... Thomas Hayes, director of the university’s field school, told the BBC this year they had found evidence of illness and treatment in human remains, including bedsores, suggesting palliative care may have taken place.

The state of pediatric concurrent hospice care in the United States American Academy of Pediatrics; by Meaghann S. Weaver, MD, PhD, MPH, HEC-CCorresponding Author; Steven M. Smith, MD; Christy Torkildson, PhD, RN, PHN; Deborah Fisher, PhD, RN, PPCNP; Betsy Hawley, MA; Alix Ware, JD, MPH; Holly Davis, MS, APRN; Conrad S. P. Williams, MD; Lisa C. Lindley, PhD, RN, FPCN, FAAN; 8/1/25 The Patient Protection and Affordable Care Act (ACA) required all state Medicaid programs to pay for both curative and hospice services for children and adolescents. The purpose of this Special Article report is to quantify and describe the use of concurrent care for children, including a depiction of the barriers and benefits according to community-based hospice organizations in the United States. A total of 295 hospice organizations from 50 states and Washington, DC responded to the National Alliance for Care at Home call for engagement.

End-of-life course and subspecialty palliative care involvement for children on mechanical circulatory support: Five-center retrospective cohort study from the United States, 2015–2020Pediatric Critical Care Medicine ; by Vazquez Colon, Zasha; Robinson, Lorelei; Lopez-Colon, Dalia; Joong, Anna; Waldman, Elisha; Delgado-Corcoran, Claudia; May, Lindsay J.; Cousino, Melissa K.; Peng, David M.; Lukich, Stevan; Blume, Elizabeth D.; Machado, Desiree S.; M. Moynihan, Katie; 7/25Objectives: To characterize end-of-life (EOL) care and subspecialty palliative care (SPC) involvement in children with heart disease supported on mechanical circulatory support (MCS), including ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO). Most pediatric deaths after MCS occur soon after discontinuation of devices while receiving invasive therapies in ICUs. SPC teams were involved in less than half of the cases, with only 21% being consulted early. SPC was associated with more ACP [advance care planning] and less CPR at EOL.

Telehealth use in palliative care has declined since pandemic, study finds McKnights Home Care; by Adam Healy; 8/5/25 Medicare beneficiaries are generally using less telehealth during palliative care than during the COVID-19 pandemic, but some patient cohorts continue to have high rates of virtual care use, according to a new study published in JAMA Network Open. ... “Since the COVID-19 pandemic, telehealth use for palliative care has declined slightly but continued to play a sizable role in outpatient palliative care, accounting for 18.2% of specialist encounters in 2023,” the researchers said. Telehealth may be best suited for patients with certain conditions, they noted. For instance, the study indicated that patients with poor-prognosis cancers — meaning cancers that commonly cause death, rare cancers with high mortality rates or solid tumors with concurrent nonlymphatic metastasis — may benefit the most from telehealth. Virtual care use was also high among psychiatry patients, the study found.