Literature Review

[Portugal] Ketamine for cancer-related pain in palliative care: A systematic review of clinical use and safetyJournal of Pain & Palliative Care Pharmacotherapy; by Catarina Vitorino-Afonso, Paulo Reis-Pina; 7/26Ketamine has emerged as an adjuvant for opioid-refractory cancer-related pain in palliative care, but evidence remains limited. [This study found that] ketamine was used mainly as an adjuvant. Many reports described reduced pain and/or lower opioid use, although certainty was very low and attribution was limited by polypharmacy and regimen changes. Intravenous infusions were most common, but subcutaneous, oral, and intranasal routes were also used. Intranasal ketamine showed pragmatic utility for breakthrough pain, while oral ketamine was described in ambulatory palliative care settings.

Palliative care with guided open communication improves patients’ well-being Oncology Nurse Advisor; by Jessica Nye, PhD; 8/13/26 Guided open communication in the palliative care setting had beneficial effects on patients with advanced lung cancer, according to findings published in Frontiers in Public Health. ... A total of 276 patients were evaluated for outcomes using a battery of validated instruments. ... The study investigators concluded, “[I]ntegrating guided honesty intervention and palliative care into a comprehensive nursing model can significantly alleviate negative emotions such as depression, anxiety, and stress in patients with advanced lung cancer, effectively reduce cancer pain and cancer-related fatigue, and significantly improve nursing satisfaction while enhancing patients’ quality of life in multiple dimensions.”

Palliative care consults for the oldest-old: A retrospective study of referral patterns, patient characteristics, and clinical outcomes Geriatric Nursing; by John Cameron, Kalli Stilos, Anita Chakraborty; 8/11/26Objective: This study describes the characteristics and outcomes of patients aged 90 and older (the oldest-old) receiving inpatient palliative care consultation at a tertiary care hospital, to identify gaps and opportunities to improve care. ... Conclusion: Referrals for specialist palliative care in the oldest-old occur late in hospitalization, predominantly among those with non-cancer illnesses and poor functional status. Systemic changes, including the use of prognostication tools and enhanced collaboration between geriatric and palliative care services, are needed. Nurses are pivotal in advocating for earlier advance care planning (ACP) and identifying patients who would benefit from timely palliative integration to ensure goal-concordant care.

52 hospitals closing departments or ending servicesBecker's Hospital Review; by Andrew Cass; 8/7/26A number of healthcare organizations have recently closed medical departments or ended services at facilities to shore up finances, focus on more in-demand services or address staffing shortages. Here are 52 department closures or services that are ending or have been announced, advanced or finalized that Becker’s reported since Jan. 1: ... [#40 names, "Minot, N.D.-based Trinity Health is suspending home health and outpatient hospice services. ...] 

Hospice leaders: palliative care through home health a limited prospect Hospice News; by Jim Parker; 8/6/26 Structuring palliative care payment through the home health benefit is the wrong approach, according to some hospice leaders. The U.S Centers for Medicare & Medicaid Services (CMS) in its proposed 2027 home health rule included language specifying that Medicare would cover community-based palliative care through the Medicare home health benefit. ... CMS indicated in a statement, “Therefore, in this proposed rule, CMS states that skilled palliative care services can be furnished and billed under existing Medicare home health benefits for eligible patients with serious illnesses.” ... But the home health chassis is not built to support the full range of interdisciplinary palliative care, some hospice leaders contend. The benefit also imposes certain limitations. For example, patients would need to be homebound. ...

Mandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomesJournal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.

Safeguarding palliative and serious illness care in America The Lancet Regional Health - Americas; by William E. Rosa, Gina Piscitello, Diane E. Meier, Arif H. Kamal, Jean S. Kutner, Abby R. Rosenberg, Allison Silvers, Stacie Sinclair, Robert M. Arnold; August 2026If a society's greatness is measured by how it treats its most vulnerable, we live in discouraging times for the more than 13 million adults and 700,000 children with serious illnesses in the United States of America (U.S.). ... In this personal view, we describe three threats to specialty palliative care in the U.S., namely healthcare financing changes, increased privatization of services, and low prioritization of palliative care research in myriad contexts, including pharmaceutical and clinical trial research and development. We subsequently provide guidance for multi-sector actors to address these threats and mitigate harms while optimizing palliative care for U.S. populations.

Hospice's bad reputation amid fraud crisis will hurt patients, industry experts warn U.S. News & World Report; by Laurie Udesky and KFF Health News; 7/30/26... “The fraud situation has done a lot of damage to the reputation of hospices overall and undone a lot of the progress that had been made in destigmatizing hospice,” said Lauren Hunt, an associate professor at the University of California-San Francisco’s Philip R. Lee Institute for Health Policy Studies who focuses on hospice care. “Policymakers should pursue targeted strategies that root out fraud and abuse without overburdening the many providers who are doing the right thing.” ... Hunt said she’s heard from California healthcare providers who are reluctant to refer patients to hospice because they’re unsure the patients will receive high-quality care and from patients who don’t know which hospice providers they can trust. 

Quality domains in home-based pediatric hospice and palliative care: Adolescent and young adult perspectivesBMC Palliative Care; by Daniel H Grossoehme, Claire A Crawford, Jhansi Chandra Ellakula, Toluwalase Ajayi, Justin N Baker, Sarah Friebert, Lisa Humphrey, JillAnn Jarrell, Rachel Thienprayoon, Pamela S Hinds; 7/26Previous research with pediatric providers and caregivers concluded that pediatric hospice and palliative care have unique attributes. Not known is how adolescent hospice and palliative care patients understand quality palliative care. Methods: Semi-structured interviews with 10-26 year-olds who received home-based hospice and/or palliative care visits in the prior three years at six diverse sites in the United States. The results address an important gap by including adolescent/young adult patients' voices regarding delivery of home-based hospice and palliative care. Clinical implications include prioritizing and making time to build trusting relationships directly with the AYA, empowering them to participate in their care to the extent appropriate and prepare for transition to adult care when needed, providing support for family members, and training for all providers in generalist spiritual care.

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.

Poverty level affects end-of-life care in adolescent and young adult cancer patients  Cancer Therapy Advisor; by Liam Andrew DAvenport, MA; 7/24/26 Adolescent and young adult (AYA) cancer patients from high-poverty neighborhoods face disparities in end-of-life (EoL) care, according to research published in the Journal of the National Comprehensive Cancer Network. AYA patients from high-poverty neighborhoods have more emergency department visits and hospitalizations, and less hospice use, than their low-poverty counterparts, study researchers reported. ... Eligible patients had been diagnosed with cancer and died between 12 and 39 years of age, and were enrolled in one of the participant health systems for more than 90 days prior to their death.