Literature Review

Honoring a young girl’s love of nature on her final dayMayo Clinic News Network; by Mayo Clinic Staff; 3/27/25 On a Saturday evening in September of 2024, Mae Helgeson arrived at Mayo Clinic in Rochester, her small body reeling from the trauma of a life-threatening accident. Although she was intubated and sedated, it didn't take long for the care team to learn what made this little girl special. ... "I often ask parents to tell me about their child. Is there anything you think is important or that I should know about your family?" says Paige Dighton, one of the Child Life specialists who partnered with Mae's family. "This allows them to share the special things — those unique qualities that make them a family. You learn more than just what's in their chart." ... It was only a couple of days later that Mae's family was faced with the devastating decision they'd hoped to avoid. ... The question shifted from "Can we save her?" to "How do we say goodbye?" Following their lead, the team began focusing on end-of-life care. "Dr. Schiltz gave us the space to think and process our emotions — it didn't feel rushed," says Matt. 

‘Show up and share’: How one UCLA ICU helps patients and staff live with dying Los Angeles Times; by Corinne Purtill; 3/20/25 

The COVID mistake no one talks enough about The Atlantic; by Sunita Puri; 3/25/25 Deaths in isolation have been treated as a painful memory, not as a problem that hospitals need to address. He was one of the few ICU patients whose face I saw in early 2021, when COVID raged through Los Angeles. As a palliative-care physician, my job was to meet, over Zoom, with the families of intubated patients to ensure that they had complete medical updates and to help them make difficult medical decisions on behalf of their loved one, particularly when that person faced death. But in a surreal departure from my usual practice, I’d never once seen these patients myself: At the time, to minimize exposure to COVID, the only people permitted to enter the ICU regularly were members of the ICU team. ... His wife told me that during his many previous illnesses, she had slept every night in his hospital room, making sure he asked for pain medications and watching movies with him to pass the time. “He fought harder to live when I was there,” she told me. [Continue reading ... full access may require a free trial or subscription]

Carolyn Hax: Does sibling love justify traveling to abusive mom’s deathbed?The Washington Post, Washington, DC; 3/24/25 Sister asks the letter writer to join her at their dying mom’s bedside — despite their PTSD-inducing childhoods. [The rest of this article may require a subscription to The Washington Post.]Editor's note: Even if you're not able to access the full article, what does this question stir in you? Be aware that many family caregivers (or simply family members) face complex, conflicted relationships with the persons they are tending--or in this case, even considering visiting or not. Be attuned to these common, everyday occurrences that your direct care interdisciplinary team members regularly navigate. What family systems' education and support do you provide for them?

Improvement plans for hospital car park BBC News; by Ruth Lucas; 3/18/25 ... NHS Frimley has announced plans to make "positive improvements" to the car park at Frimley Park Hospital in Surrey Heath. ... NHS Frimley says this will increase capacity by 10%, while LED lighting and improved parking bay markings will also be installed. ... Free parking is currently available for disabled people, frequent outpatient attenders, parents of sick children staying overnight and visitors with relatives who are gravely sick, terminally ill or under palliative care.Editor's note: For hospital-based hospice/palliative care, do you provide any type of free parking, vouchers, middle-of-the-night security, or some other type of support for families of persons in your hospice/palliative care units? Consider the common experience of the patient dying in the middle of the night, and family leaving the hospital--especially if your parking conditions are unsafe or expensive. 

Lutz Foundation grant funds additional hospital beds at the Wayne T. Patrick Hospice House The News & Reporter; 3/12/25 Hospice & Community Care is honored to announce a generous $24,000 grant from The Herbert and Anna Lutz Foundation to support the ongoing replacement of hospital beds at the Wayne T. Patrick Hospice House. This funding will allow Hospice & Community Care to upgrade five additional high-quality, medical-grade beds, enhancing comfort and care for patients and their families. Last year, thanks to the support of the Lutz Foundation and Chester Healthcare Foundation, 8 beds were replaced. With this latest contribution, a total of 13 beds have now been upgraded, ensuring that more patients receive the highest level of comfort and support during their hospice journey. 

Bride rushes wedding so dying dad can walk her down aisle Doniphan Herald, Doniphan, NE; by TImogen Howse; 3/4/25  A bride planned her wedding in less than 24 hours - so her dying dad could walk her down the aisle. Maurice Haynes, 69, is currently being cared for at St. Giles Hospice in Whittington, Staffs. [UK], ... His daughter Hannah Haynes, 29, was desperate for him to be present at her upcoming wedding - and knew Maurice had always wanted to walk her down the aisle. So she made sure her dad's dream came true. With the help of the hospice staff, Hannah and her partner, Josh, also 29, organized their special day in less than 24 hours. Carers transformed the hospice's chapel into a beautiful venue - complete with bunting and candles - and Hannah managed to secure a wedding dress on the morning of the ceremony. Just hours later, on February 18, Maurice, from Cannock, Staffs. [UK], walked Hannah down the aisle ... Hannah said: "What St Giles have done for my dad is unbelievable.

Baber Hospice Home to close The Messenger, Fort Dodge, IA; by Bill Shea; 2/26/25 The Paula J. Baber Hospice Home will close at the end of next month, but UnityPoint Health — Fort Dodge will continue providing hospice care to patients in their own homes and in long term care facilities. “This is not the end of hospice care,” said Leah Glasgo, the president of UnityPoint Health — Fort Dodge. She said the decision to close the home was driven by the fact that most hospice patients are now cared for in their homes or in long term care facilities. “We are committed to meeting patients where they want to be and they want to be at home,” she said. As the number of hospice patients being served at home or in care facilities grew, the number of those patients in the Baber home dropped.

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

Patients without family or health care proxies face overtreatment or limbo in hospitals WHYY - PBS; by Maiken Scott; 2/24/25 A program matches unrepresented patients with volunteers who can make care decisions for them during health care crises. ... [Intensive care physician David] Oxman says unrepresented patients are a small, but growing group. Some have outlived their family members, or are estranged from them. Maybe they’ve moved a lot, sometimes substance use or homelessness plays a role. The situation is especially complicated with patients who have dementia, or who can’t communicate their wishes for other reasons. ... Most states have provisions where medical guardians and medical decision makers can be appointed by a court, but that takes a long time. In the meantime, a search for relatives begins. David Sontag, director of ethics for Beth Israel Lahey Health in Massachusetts, ... created a matching program where health care professionals volunteer to represent patients, not within their own hospital systems because that could cross ethical boundaries, but at other hospitals. “This is an opportunity for us to help some of the most vulnerable members of our communities, those who have nobody to speak for them when they can no longer speak for themselves. And that allows us to respect their autonomy throughout their lives,” he said.

The green ICU: how to interpret green? A multiple perspective approach Critical Care; by Elisabeth Smale, Heather Baid, Marko Balan, Forbes McGain, Scott McAlistar, Jan J. de Waele, Jan Carel Diehl, Erik van Raaij, Michel van Genderen, Dick Tibboel & Nicole Hunfeld; 2/18/25Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. ... To put this challenge of achieving quality care standards with sustainable use of resources into perspective, the current paper pinpoints a three-step approach towards a green ICU by (I) measuring environmental sustainability, (II) outlining strategies to improve sustainability and (III) elaborating on how to communicate results to create a synergy of sustainability initiatives within ICUs. Editor's note: With its focus on care for critically ill patients, how might this three-step approach be applied to hospice GIP settings?

Death Matters: The gift of presence: Tips for visiting someone who is dying Squim Gazette, Squim, WA; by Jeanette Stehr-Green, Volunteer Hospice of Clallam County; 2/12/25 We sometimes avoid visiting friends or family members who are terminally ill. We make lots of excuses. We don’t know what to say. We don’t know how to act. We don’t want to be a bother. The hard truth is that dying, the final stage of life, can be a lonely experience without the presence of family and friends. A visit during this time can bring comfort to the dying person and their family. It can also provide an opportunity to share feelings, reminisce, and say goodbye. Visiting a dying person seems difficult because most of us lack experience. It only takes a little courage and a few ideas to create a meaningful moment. ... Editor's note: These excellent guidelines empower hospice patients' families and friends--and protect patients' vulnerable energies and emotions--in multiple settings across the trajectory of dying. How might you adapt these for your own patient/caregiver support and community outreach?