Literature Review

New voices, shared vision: How emerging research scholars are supporting HPNA's research prioritiesJournal of Hospice & Palliative Nursing; by Jyotsana Parajuli, Kristin Levoy, Avery C Bechthold, Lyndsay Degroot, C Robert Bennett, Shena Gazaway, Heather Coats; 12/25Evidence-based practice is critical to providing high-quality hospice and palliative nursing care. Professional organizations, such as the Hospice and Palliative Nurses Association (HPNA), play a critical role in shaping the future of the hospice and palliative nursing field by identifying gaps in the science and fostering collaborative research efforts to inform evidence-based practices. One such driver is the tri-annual HPNA Research Agenda, which outlines key research priorities in hospice and palliative nursing, ultimately aiming to accelerate translation of research into practice and practice improvements. In this article, 6 emerging research scholars in the field and present and former co-chairs of the HPNA Emerging Research Scholar Special Interest Group reflect on the experiences that led them to pursue research careers in hospice and palliative nursing. Through a process of collective self-assessment, these scholars articulated their shared progress toward addressing the research priorities outlined in the 2023-2026 HPNA Research Agenda as a means of generating insights to direct future research efforts in the field.

Neuropalliative care in movement disordersContinuum: Lifelong Learning in Neurology; by Benzi M Kluger; 12/25Over the past decade, significant progress has been made to advance palliative care approaches for patients with Parkinson disease and other movement disorders. This population has significant palliative care needs that are poorly met under traditional models of care, including nonmotor symptom management, advance care planning, psychosocial support, spiritual and existential support, care partner support, and timely referrals for specialist and end-of-life palliative care (hospice). Clinical trials demonstrate that specialist palliative care can improve many patient and family outcomes. Neurologists can use the five-pillars framework (nonmotor symptoms, advance care planning, psychosocial and spiritual support, care partner support, and timely involvement of specialist palliative care) to systematically address common sources of suffering that are poorly recognized in traditional models of care. This framework can be integrated into previsit screening forms and note templates to improve the detection of palliative issues.

A peer support intervention for Black family caregivers of persons living with dementia: A feasibility studyJournal of the American Geriatrics Society; by Karen O Moss, Alai Tan, Abraham A Brody, Karen Bullock, Kathy D Wright, Kimberly Johnson, Mary Beth Happ; 12/25Black family caregivers of older adults living with dementia are at high risk for physical, spiritual, and psychosocial challenges. Culturally responsive interventions are needed to address disparities in this population. The purpose of this National Institute on Aging Stage Model 1A study was to test the feasibility, acceptability, and fidelity of the Peer Support for Black Family Caregivers of Persons Living with Dementia (Pair 2 Care) intervention. Pair 2 Care is a culturally responsive, non-judgmental, flexible, co-designed virtual peer support intervention in which former caregivers are paired as peer mentors with current caregivers for 6 months.  On average, participants rated their overall Pair 2 Care satisfaction as very high (4.6/5).

Preparedness as a bridge: How religious coping shapes acceptance of death in dementia caregivingClinical Gerontologist; by L. Blake Peeples, Lauren Chrzanowski, Benjamin T. Mast; 12/25This study examined the role of religious coping and preparedness in shaping caregivers’ acceptance of death following the loss of a care recipient with Alzheimer’s disease or related dementias. Bivariate analyses indicated that both positive and negative religious coping were significantly associated with greater preparedness, and preparedness was strongly related to acceptance. Findings suggest that interventions focused on religious coping enhance preparedness which improves caregivers’ acceptance in the bereavement process.

Development of a mortality prediction model for incarcerated adults to identify palliative care needsJournal of General Internal Medicine; by W. James Deardorff, Alexandra K. Lee, Kaiwei Lu, Bocheng Jing, W. John Boscardin, Michele DiTomas, John Dunlap, Brie A. Williams, Sei J. Lee, Alexander K. Smith; 12/25The United States prison population has seen a rapid rise in the number of older adults, with roughly 14% of male prisoners and 9% of female prisoners aged 55 years or older in 2020.  Incarcerated adults experience accelerated aging, leading to reduced life expectancy and higher rates of chronic medical conditions, functional impairments, and mental health conditions compared with non-incarcerated persons. For individuals with advanced age, multimorbidity, and/or serious illness, advance care planning discussions, palliative care, and hospice services are crucial for improving quality of life and ensuring medical care that is consistent with an individual’s values and goals. As the number of incarcerated adults with limited life expectancy increases, there is a clear need for a systematic way to identify individuals who may most benefit from these services. Our 2-year mortality prediction model for adults within the California prison system performed well on measures of discrimination, calibration, and classification. The model can be used to flag individuals at higher risk for mortality for consideration of advance care planning interventions, palliative care and hospice referrals, and compassionate release.

No time like the present: End-of-life simulation in the first semester of a 12-month accelerated baccalaureate nursing programJournal of Hospice & Palliative Nursing; by Alexander T Wolf, Karen L Hunt, Maura D Penfield; 12/25Accelerated nursing programs face unique challenges in incorporating palliative care. This report describes a high-fidelity home hospice simulation developed for first-semester students in a 12-month accelerated baccalaureate nursing program in the northeastern United States. The simulation integrated foundational nursing skills with palliative care competencies. Thematic analysis of student reflections revealed 5 emerging themes: pain management, empathy, family involvement, communication, and knowledge and preparation. Despite challenges in creating a realistic home environment, the simulation provided valuable hands-on experience in palliative care, demonstrating the potential for early curricular integration of these crucial skills.

Association between patient-reported engagement and medical record of advance care planning among older adults in the ED: A cross sectional studyAmerican Journal of Hospice and Palliative Medicine; by Nanako Shirai, Tadayuki Hashimoto, Sho Fukui, Upeka Samarakoon, Gabriel Paasche-Orlow, Seth N. Randa, Yuchiao Chang, Charlotta Lindvall, Katren R. Tyler, Hacho B. Bohossian, Kate R. Sciacca, Karina Klein, Allyson C. Sage, Donovan Nielsen, Eric Hanson, Milton Joel, Timothy F. Platts-Mills, Angelo Volandes, Kei Ouchi; 12/25Most older adults in the U.S. visit the emergency department (ED) in their final 6 months of life, providing an opportunity to engage patients in advance care planning (ACP) conversations ... While many report ACP engagement, the link between self-reported engagement and pre-existing ACP documentation in the ED, where ACP documentation is especially critical, remains unclear. ACP engagement was measured using the validated ACP Engagement Survey. On ED presentation, patient-reported ACP engagement correlated with the presence of pre-existing ACP documentation in the EHR. Conclusion: The ACP Engagement Survey may help identify older adults less likely to have documented ACP,  guiding targeted interventions in the ED.

Palliative care integration in oncology: A review and updateJournal of Hospice & Palliative Care; by Claire Wang, Thomas W LeBlanc; 12/25Palliative care (PC) is increasingly recognized as an essential component of high-quality cancer care, with evidence from randomized trials and meta-analyses demonstrating that it improves quality of life, mood, and goal-concordant end-of-life care. Despite these benefits, PC integration has been inconsistent, with many patients still receiving PC later in their disease course. Current models of integration include outpatient co-located PC clinics, inpatient consultation services, community- and home-based programs, and more recent innovations, such as telehealth and stepped approaches. Symptom control, coping support, longitudinal communication, and existential or spiritual interventions are among the active ingredients that are most consistently associated with improvements in patient outcomes. Implementation of precision PC requires embedding validated patient-reported outcomes and structured referral algorithms into oncology workflows, enabling real-time triage of targeted interventions.

[Taiwan] Effects of administering essential oil blends on depressive mood and sleep quality in elderly residents with dementia in long-term care facilitiesChinese Journal of Nursing; by An-En Lin, Wan-Ching Shen, Yueh-Yuan Chang, Mei-Hsiu Shen, Jing-Jy Wang; 12/25Depression and poor sleep quality are common symptoms among people with dementia. Inhalation-based aromatherapy, a non-pharmacological intervention known to help alleviate these symptoms, may be used therapeutically in long-term care facilities, especially those facing staff shortages. After pre-test data collection, the participants received a twice-daily aromatherapy intervention five days per week for two weeks. Improvements in overall depression, behavioral disturbances, physical symptoms, and emotion-related symptoms were found between pre- and post-test measurements. Also, positive effects on overall sleep quality, sleep disturbances, and daytime dysfunction were recorded.

[UK] "The system doesn't really cater for the trauma that Black people have experienced" - Experiences of grief and bereavement in Black British and Black Caribbean heritage communities in England: A qualitative studyDeath Studies; by Lucy E Selman, Oliver Clabburn, Yansie Rolston, Karl Murray, Tracey Stone, Lesel Dawson, Michelle Farr, Sabi Redwood, Debi Lewinson-Roberts; 12/25People from Black and other minoritized ethnic communities are known to experience health and social care inequities, including barriers to accessing bereavement support. This qualitative, co-produced study aimed to explore experiences of grief and bereavement among people of Black British and Black Caribbean heritage in England. Through community conversations and interviews with 35 participants, the study illuminates how structural inequities, cultural norms, and systemic racism intersect to shape grief experiences. Participants highlighted the importance of extended family and community in grief, which often clashed with the individualistic norms of white British society. Cultural customs that discouraged emotional expression made grieving harder, while rituals like Nine-Night and storytelling provided crucial communal support.