Literature Review

Tele-palliative care offers access to needed support Rand; by Shira H. Fischer, Jordan M. Harrison, Julia Bandini; 7/18/25 On first consideration, the idea of providing palliative care via video chat seems counterintuitive or even insensitive. Palliative care focuses on improving quality of life for individuals with serious illnesses. At such a delicate time, would a computer screen between patients and their doctors really suffice? Yet tele-palliative care—palliative care via telehealth— is emerging as a promising option. It offers access to care for those who might otherwise go without and has surprising advantages over traditional, in-person care.

Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trialCritical Care Medicine; Marie A. Bakitas, DNSc, RN; Shena Gazaway, PhD, RN; Felicia Underwood, MSW, MPS, LICSW-S; Christiana Ekelem, BS; Vantrice T. Heard, PhD; Richard Kennedy, MD, PhD; Andres Azuero, PhD; Rodney Tucker, MD, MMM; Susan McCammon, MD, PhD; Joshua M. Hauser, MD; Lucas McElwain, MD; Ronit Elk, PhD; 7/25The triple threat of rural geography, racial inequities, and older age has hindered access to high-quality palliative care for many people in the US. Only 70% of the deep South vs 85% to 94% of the rest of the US has palliative care despite the deep South having the greatest needs due to suboptimal health care access and elevated morbidity and mortality. In this RCT [randomized clinical trial] among Black or African American and White chronically ill hospitalized adults, culturally based specialist palliative care video consultation was not associated with statistically significant reduced symptom distress compared with usual care, but there was a clinically meaningful difference ... between groups. Contrary to our hypotheses, intervention participants’ QOL [quality of life] and resource use (secondary outcomes) also were not improved. Assistant Editor's note: This study reminds us that palliative care delivered virtually, as opposed to in-person, may not be of benefit to some individuals. It also reminds us that palliative care, at its best, is delivered on an ongoing basis by a known, trusted professional, as opposed to a one-time session with a consultant. 

[Norway] iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countriesPalliative Medicine; Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw; 5/25Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders. 20 Volunteers and 20 healthcare professionals were recruited. Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs. These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs.

Opinion: My health and my politics walk into a doctor’s office … The Washington Post; by Kim Fellner; 7/16/25 [Note: Access is behind a paid firewall, with an option to set up a temporary free account]... My palliative care doctor and I have almost nothing in common. We’re still learning from each other. ... It began simply enough. By October, my sarcoma had moved from possibly curable to definitively terminal, and, since metastasis to the bones can be painful, my anchor oncologist offered to connect me with a palliative care doctor to help with the physical and conceptual aches and pains of dying. Which seemed like a good thing to do. ... I did not anticipate, however, that the personal and the political would collide in my doctor’s office. ... [Descriptions unfold of significant, conflicted dialogue between (1) this Jewish daughter of holocaust survivors whose life-long vocation was social justice and (2) this Christian palliative care physician who asked about mental health and then dismissed this person's primary concerns that were affecting her dying.] ... Clearly, my doctor and I shared some beliefs about the importance of the palliative approach. ... But as the doctor noted, the best palliative care goes beyond the purely physical to address the more cosmic questions of life and death, and I was uncertain we were well matched as partners for this intimate process. ... I had no idea how to proceed. ... [More descriptions.] ... And that’s where the magic happened. Within a few days, my palliative care doctor sent me back a transparent, thoughtful and moving response. ... Her courage and openness, her willingness to risk a forthright response, have precipitated a remarkable dialogue about what each of us brings into the room, and how we can honor the space and each other once we get there. ... Editor's Note: Whatever one's political or religious stance, this article is sure to spark fireworks—of conflict, dissonance, and, hopefully, powerful insight. I encourage readers to engage with it attentively, attuned to three things:

Leveraging speedy admissions to support hospice growth Hospice News; by Jim Parker; 7/16/25 Seamless and fast admissions processes are crucial to hospice growth. Speedy hospice patient admissions can lead to improved referral numbers, profitability and length of stay. Yet, hospices need to carefully navigate their patient admission processes to maximize both quality and their revenue. The hospices that do this effectively have a core set of key performance indicators that they look at consistently, according to Tony Kudner, chief strategy officer of the consulting firm Transcend Strategy Group. “The ones that look at data and are constantly asking themselves, ‘How can we paint the fullest picture of eligibility and get to that patient as quickly as possible?’ are the ones that we would say are the ones that are successful,” Kudner told Hospice News. “The people who have that information at their fingertips and use it to drive decision making are usually the ones who are sustaining their organizations and growing.”

Palliative care education in pediatric cardiology fellowships: A survey of program directorsPediatric Cardiology; Lesje DeRose, Sarah Godfrey, Shabnam Peyvandi, Nicole M. Cresalia, Jill M. Steiner, Emily Morell; 6/25 Our survey demonstrated a wide range of PC [palliative care] educational practices among categorical pediatric cardiology fellowship programs. While most programs provided some form of PC education to their fellows, the amount and modality varied widely between programs, from very minimal PC exposure to required core PC rotations. Almost half of the participating PDs [program directors] reported dissatisfaction with the current amount of PC education in their fellowship programs. Programs such as VitalTalk (www.vitaltalk.org) and other (both in-person or virtual) modules have been utilized in other training environments with improvement in trainee comfort in PC topics, including CardioTalk for adult cardiology trainees. Didactic-based curricula in PC topics, such as mental health and ethics, have also been shown to help providers gain confidence in PC domains.

[India] Enhancing palliative care through university-community partnerships: A systematic review of models, impacts, and challengesBMC Palliative Care; Alaka Chandak, Priyadarshini Bhalchandra Kulkarni; 6/25This systematic review highlights the deep potential of university–community partnerships (UCPs) to act as agents of change in palliative care education and service provision. Such collaborations complementarily improve the quality of life of the elderly while availing healthcare students with essential experiential learning opportunities. Exceptional models, such as the CARE program, illustrate the double benefit of improved community welfare and the creation of effective empathetic professionals with the capability to cater to the complex demands of caring.

New Winship web tool helps Georgians find palliative care services Emory University Winship Cancer Institute; Press Release; 7/7/25 Patients, families and referring physicians now have a new online source for locating palliative care services in Georgia. Developed by Winship Cancer Institute of Emory University, More Access to Palliative Care Georgia (MAPGA) is a searchable database of vetted inpatient and outpatient palliative care agencies and hospital-based programs across the state. ... Users who visit MAPGA can view a list and interactive map of nearby palliative care services, including hospital-based outpatient clinics and home-based care. For more customized results, they can enter their zip code or filter by location (clinic, in-home or hospital-based/inpatient) and type (adult or pediatric). MAPGA also features a “heat map” that highlights gaps in access to care. 

Pallitus Health Partners receives CHAP Accreditation for Adult Palliative Care and Pediatric Care Certification for Kourageous Kids Pallitus Health Partners, Louisville, KY; Press Release; 7/8/25 Community Health Accreditation Partner, Inc. (CHAP) has awarded Care Guide Partners, Inc. (dba Pallitus Health Partners) CHAP Accreditation under the CHAP Palliative Care Standards of Excellence. The nonprofit also received certification for its Kourageous Kids (KKids) palliative care program. CHAP Accreditation demonstrates that Pallitus Health Partners meets the industry’s highest nationally recognized standards. The rigorous evaluation by CHAP focuses on structure and function, quality of services and products, human and financial resources, and long-term viability. Simply stated, adherence to CHAP’s standards leads to better quality care. ... Pallitus Health Partners, an affiliate of Hosparus Health, offers comprehensive palliative care for serious illnesses in Kentucky and Indiana. Editor's Note: Congratulations to Pallitus Health Partners and Hosparus Health! This accreditation marks yet another milestone of excellence this organization—originally founded as Hospice of Louisville—which pioneered one of the nation’s first pediatric hospice teams in 1980. I had the privilege of serving on the Pediatric Team of Hospice & Palliative Care of Louisville from 1997 to 2001. Profound experiences with these children, their parents, siblings, grandparents, our dedicated team members, and community partners are forever embedded in me. They continue to shape my perspective and purpose in my role as editor in chief of this newsletter.

When less is more: Addressing polypharmacy in high-risk populations Pharmacy Times; by Andrew E. Esch, MD, MBA and Alain Hipensteele; 7/7/25 As digital health tools and artificial intelligence (AI)–powered clinical decision support systems become increasingly embedded in pharmacy workflows, pharmacists are gaining new opportunities to identify and address the risks of polypharmacy—particularly in high-risk populations such as older adults and those receiving palliative care. At the same time, evolving deprescribing guidelines and ongoing drug shortages have underscored the need for coordinated, patient-centered medication management strategies. In this interview with Pharmacy Times®, Andrew E. Esch, MD, MBA, director of the Palliative Care Program Development at the Center to Advance Palliative Care, discusses how pharmacists are using emerging technologies to streamline medication reviews, reduce therapeutic duplication, and engage caregivers in deprescribing conversations. 

Clinicians’ perceptions about institutional factors in moral distress related to potentially nonbeneficial treatmentsJAMA Network Open; Teva D. Brender, MD; Julia K. Axelrod, BA; Sofia Weiss Goitiandia, MA, MSc; Jason N. Batten, MD, MA; Elizabeth W. Dzeng, MD, PhD, MPH; 6/25In this qualitative study, we described institutional factors that may exacerbate, prevent, or mitigate the influence of societal factors contributing to moral distress related to potentially nonbeneficial LST [life-sustaining treatments]. Health systems should consider how health care consumerism influences patients’, families’, and clinicians’ expectations regarding potentially nonbeneficial LST, particularly at hospitals with advanced technological interventions (eg, organ transplantation, extracorporeal membrane oxygenation, salvage chemotherapies). Future studies should explore the societal and institutional factors contributing to moral distress for clinicians at lower-resourced hospitals, such as inaccessible advanced treatments and barriers to transferring patients for higher levels of care. While some institutions lacked sufficient structures to support clinicians’ efforts to de-escalate potentially nonbeneficial treatments, policies empowering clinicians across the medical hierarchy, as well as conflict resolution and emotional support resources (eg, palliative care) might prevent or mitigate moral distress.

Fireproofing the soul: Navigating fear of the afterlife among palliative care patientsJournal of Palliative Medicine; Ptr Shannon Blower, Jonathan Walker, Lucius Walker, Steven Radwany; 6/25Among palliative care patients, spiritual uncertainty about what may await them after death is a fairly common but often overlooked source of anxiety. Specifically, patients (especially those from orthodox Christian backgrounds that propound the concept of hell as a literal place) may harbor unexpressed fears about being consigned to hell due to the perceived sins they have committed in life. Such fears can be genuinely debilitating and may result in non-responsiveness to traditional palliative therapy. Here, we discuss our experiences with this phenomenon and propose some possible solutions. We offer readers suggestions for how to best identify potential sufferers, broach the subject with such patients, and reassure them.