Literature Review

[Japan] Half of hospice and palliative care unit inpatients' family members are surprised by death Journal of Palliative Medicine; by Satoko Ito, Tatsuya Morita, Masanori Mori, Isseki Maeda, Yutaka Hatano, Takashi Yamaguchi, Hiroyuki Otani, Tetsuya Yamagiwa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita; 3/10/26 Background: Sudden unexpected death can occur even among patients with advanced cancer receiving hospice and palliative care. How bereaved families perceive this remains unclear. ... Design/setting/subjects: We analyzed longitudinally linked data from a prospective cohort of advanced cancer patients in 23 palliative care units in Japan and a nationwide survey of bereaved families. Conclusions: Compared with physicians' perspectives, bereaved family members perceive death to be sudden or unexpected more frequently and differently, and their perceptions are associated with postbereavement mental health.

Delivering palliative care in mental health nursing settings: A systematic review Journal of Psychiatric and Mental Health Nursing; by Oladapo Akinlotan, Allen O'Connor, Ruben Seetharamdoo, Mo Ghoorun; 3/6/26 Palliative care can provide comfort, alleviate suffering, and improve quality of life; however, access to palliative care for people with mental illnesses at the end of their lives is extremely poor. As the need for palliative care is expected to rise significantly in the future, palliative care must be considered a global health priority. ...  Recommendations: Although care for people with complex mental illness is complex while dying, conversations around palliative care need to be as part of a therapeutic relationship and engagement. Also, palliative care staff have an important role in communicating end-of-life planning to patients' families and carers.

Oncologist perspectives on timely hospice referral: A qualitative study American Journal of Hospice and Palliative Care; by Andrew Lynch, Andrea Altschuler, Joseph P Cosgrove, Hannah Whitehead, Corey Schwartz, Raymond Liu, Mina Chang; 3/7/26 Background: Late hospice referral rates are on the rise and are associated with negative outcomes at the end of life (EoL). Rates of late hospice referral vary drastically from oncologist to oncologist, and behavioral and psychological factors among individual oncologists have been identified as potential contributors to this variability. ...  Conclusions: Numerous factors independent of hospice eligibility were reported to influence hospice referral practices among oncologists. While some factors represent challenging cultural and social barriers to timely hospice referral, other system- and patient-specific barriers offer opportunities for potential interventions. 

Executive Summary: Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICUCritical Care Medicine; by Mary Faith Marshall, F Daniel Davis, Patricia A Fogelman, Simon Oczkowski, Julie C Reid, Daniel Arellano, Rebecca A Aslakson, Joshua Campbell, Katherine Courtright, Katarine Egressy, Elizabeth Epstein, Ebonye Green, May Hua, Preeti R John, Erin K Kross, Niels D Martin, Bethany A Melo, Susanne Muehlschlegel, Silvia Perez-Protto, Ben Roberts, Daniel Shalev, Jennifer Wescoe Singley, Shawna L Strickland, Karen A Korzick; 12/25[Recommendations include:]

Use of nebulized tranexamic acid (TA) in combination with nebulized recombinant coagulation factor VIIa to treat hemoptysis in pediatric patients with cancer at end-of-life (EOL)Journal of Pain and Symptom Management; by Santosh Yatam Ganesh, Nelda Itzep, Eduardo Bruera; 2/26Hemoptysis is a distressing symptom for both patients and families at end of life (EOL). In the acute care setting, this can be managed surgically or medically. However, research regarding interventions, such as nebulized tranexamic acid (TA) and nebulized factor VIIa, for palliative management of hemoptysis at EOL is limited. In our case series, we found that combination of nebulized recombinant factor VIIa and nebulized TA relieved hemoptysis in both pediatric cancer patients at the end of life. This case series highlights the potential use of this combination to reduce suffering and distress secondary to hemoptysis in the palliative setting.

Values considerations in telemedicine: Pause before shiftingJournal of Pain and Symptom Management; by Meaghann S. Weaver, Kenneth A. Berkowitz; 12/25As a contingency standard of care, telemedicine use surged during the COVID-19 pandemic. The Medicare telehealth flexibilities introduced during the COVID-19 pandemic expired in September 2025. Any ongoing sustained pivot to telemedicine warrants purposeful attentiveness to ethical considerations and not just technology use as an end unto itself. Telemedicine has the potential to complement face-to-face care practices and enhance clinical interactions when its use is based on shared values. Values such as access, equity, justice, compassion, autonomy, and dignity warrant thoughtful use of telemedicine. Patients and families need to be able to trust that clinicians and health systems will place patient welfare and shared values above technical convenience. As demonstrated in this case description, upholding values fundamental to the practice of medicine in telemedicine can enhance patient connection and foster trustworthy postpandemic practices.

Dementia, taboo, and the need for a cultural reckoningJournal of Aging Studies; Kelly Marnfeldt; 3/26Dementia is one of the most feared and misunderstood conditions of our time. Even as public awareness has increased, people living with dementia continue to face exclusion, moral disregard, and systemic neglect. Decades of advocacy, education, and contact-based interventions have sought to reduce stigma. [This study] proposes that dementia becomes stigmatized not only because it is misunderstood, but because it violates cultural expectations of personhood, consistency, and intelligibility. The paper concludes by proposing culturally grounded provocations that imagine what it might look like to reframe how dementia is seen, told, and recognized, both socially and culturally.

[Canada] What about the family? A content analysis of international legislative frameworks and guidelines on assisted dyingPolicy, Politics & Nursing Practice; by Charlotte Boven, Gilla K Shapiro, Liesbeth Van Humbeeck, Let Dillen, Nele Van Den Noortgate, Gary Rodin; 2/26When a person chooses assisted dying, the impact on their family can be profound. Legislation and professional guidelines not only regulate and standardize practice, but also support the delivery of high-quality care. Within this framework, bereavement care plays a vital role by helping families prepare for the death and potentially reducing the risk of prolonged grief. To improve quality care, there is a clear need to better integrate family support into assisted dying guidelines by establishing best practices for bereavement care. Future research should focus on family members' perspectives and needs.

Clinicians outline strategies to improve cancer care in U.S. prisons Oncology Times; by Kumar Das, Dibash PhD; March 2026 Cancer is now the leading cause of death in U.S. prisons, and outcomes for incarcerated patients are markedly worse than for those in the general population. A 2022 study of Connecticut's prison system found that people diagnosed with cancer while incarcerated had 92% higher mortality compared with 16% higher mortality observed in England and Wales. The difference, researchers said, underscores the role of healthcare access and correctional policy in shaping cancer survival.

Q&A: Why are more Americans under 50 years of age dying of colorectal cancer? Medscape; by Keith Mulvihill; 2/10/26 First, the good news: Fewer Americans younger than 50 years are dying from cancer vs just a decade ago — reflecting progress in prevention, early detection, and treatment. There is, however, one big exception. Colorectal cancer mortality has been steadily inching up, and the disease now stands as the leading cause of cancer death in this age group, up from the fifth-leading in the early 1990s. ... The outlier is colorectal cancer, where mortality has been rising by about 1% per year since 2005. And it’s a pattern seen in both men and women. ... [The researchers are asked,] "Can you offer some possible reasons for the declining mortality in most of the cancers you studied?" 

"The best, most difficult thing I've ever done": The complex experiences of palliative and hospice familial caregiversAmerican Journal of Hospice & Palliative Care; by Hannah Rachiele, Kathryn Levy, Gina Schuster, Sheila Conboy, Pei C Grant, Christopher W Kerr; 2/26Caring for chronically or terminally ill individuals comes with unique challenges and circumstances that are specific to each situation and individual involved. The purpose of the current study was to better elucidate the scope of challenges and benefits attributed to caring for a loved one with a serious, life-limiting illness. Four main themes emerged: (1) Burdens on the Caregiver, (2) Navigating Caregiving, (3) The Positives, and (4) Evolution of Relationships. Findings suggest that family caregivers of individuals with terminal or life-limiting illness experience complex, and often contradictory feelings, which may differ from perceptions by those not providing similar care to a loved one. The data suggest that clinicians working with the caregiving population should explore the duality of caregiving beyond just the anticipated negative impacts.