Literature Review

Advance care planning in an urban hospital: Sustainability and growth in documenting care plans over four-yearsAmerican Journal of Hospice & Palliative Care; by Khadeja Kausar, Edward Coffield, Sampath Gopalan, Regina Tarkovsky, Sarah Egan, Robert A Press, John Marshall; 8/26Many acute care patients are admitted without advance care plans (AC-Plans) which may result in patients receiving care misaligned with their preferences. Accordingly, ACP [advance care planning] is needed within hospitals, however, implementation barriers exist. [In this study] the hospital's ACP program components included: primary palliative care, simulation-based training, and ACP and AC-Plan training and education. The percentage of patients with ACPs at discharge increased from 4.4% to 19.1% from the first to fourth program year. The odds of having an AC-Plan at discharge in years 2, three, and four were 3.44, ... 5.87, ... and 8.97 ... times higher than the odds of having one during the first program year. The growth and sustainability of the hospital's ACP program demonstrates that barriers to ACP within hospitals can be overcome and successful programs implemented.

Digital Deception: Survey Bots and the Ethics of Data IntegrityEthics & Human Research; by W Frank-Ito, LA Eldridge, J Matthews; 9/26The rapid growth of artificial intelligence and automated systems has significantly impacted digital survey-based research, particularly when recruitment is conducted via social media platforms. This case study details the erosion of data integrity in a 2025 follow-up survey, originally designed to replicate a successful 2021 study. Despite implementing increasingly sophisticated antifraud mechanisms such as CAPTCHA, IP geo-restrictions, and behavioral validation, survey bots repeatedly infiltrated the study, rendering the dataset unusable. This highlights a critical tension between broad digital accessibility and the vulnerability of online research to fraud. Moreover, the use of financial incentives to participate in research, while effective in increasing response rates, was found to amplify bot activity and raise ethical dilemmas surrounding compensation and data quality... The authors call for the urgent development of fieldwide standards, institutional support, and robust fraud prevention strategies to preserve the methodological and ethical integrity of digital research.

[UK] A policy scoping review of how ‘Hospitals at Home’ can and could support people with dementia Age & Ageing; by Anthony Zheng Wang, Anita Wong, Nathan Davies, Sevim Hodge, Elizabeth L Sampson, Victoria Vickerstaff, Kate Walters, Catherine J Evans, Mark James Rawle, Jane Ward, Simon Conroy, Bastien Genet, Claudia Cooper; 8/26People with dementia are often hospitalised due to comorbidities and superimposed delirium and have poorer outcomes in hospital compared to people without dementia, especially among under-served groups. Hospital at Home (HaH) schemes could reduce these inequalities by facilitating care in a familiar home environment that offers similar outcomes to acute hospital care with lower risks of harms. We developed three themes: (i) benefits of HaH for people with dementia, including more person-centred care and familiar treatment environments; (ii) how HaH can be inclusively designed for people with dementia, accommodating needs and mitigating concerns over digital exclusion and safety; and (iii) the critical role of family carers in enabling HaH, including potential carer burden. Future policies should drive consistent inclusive eligibility criteria and processes for ensuring continuity with primary care, dementia care as a HaH staff core competency.

Time is of the essence: evaluating short-term prognosis tools in cancer and non-cancer patients Journal of Pain and Symptom Management; by Kayla Sheehan, Navasuja Kumar, Julia Pudar, Susan Duong, Megan Bricely, Mohamman Alhameed, Mohammed Kabeto, Donglin Zeng, Adam Marks; 8/27/26 Accurate end-of-life prognostication supports patient, family, clinician, and health system decision-making. The Palliative Prognostic Index (PPI), Palliative Performance Scale (PPS), and Short-Term Prognosis Signs (SPS) have been used in palliative care populations, particularly advanced cancer (1-3), but their utility for short-term prognostication in non-cancer patients is less established.

Impact of outpatient palliative care consult triggers on end-of-life outcomes in a VA hematology/oncology clinic Medscape; by Morgan Lyttle, MD, Michelle Popadiuk, MBA, LPN, RHIT, ODS-C, Seema Limaye, MD, Alexi Vahlkamp, Shannon Carrigan, MD, and Jean Vendiola, MD; 9/4/26 ... Conclusions: Outpatient palliative care (PC) triggers successfully shifted referral origin from inpatient to outpatient, halved the rate of trigger-eligible patients not receiving PC, and maintained hospice engagement despite loss of the inpatient oncology service. Future directions include expanding triggers to other subspecialty clinics managing oncology patients.

When end-of-life becomes the beginning of new life: Application of the Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU to the setting of donation after circulatory deathCritical Care Explorations; by Ian M. Oppenheim, Rita N. Bakhru, Carolina B. Maciel, Katharina M. Busl, on behalf of the Donor Care Unit Network for Optimizing Recovery (DONOR) GroupThe recently published Society of Critical Care Medicine Guidelines on Adult End-of-Life Care in the ICU provide a detailed and well-thought-out approach to a vital component of critical care, although they explicitly refrain from discussing how they may apply to organ donation. As representatives of the Donor Care Unit Network for Optimizing Recovery (DONOR), a group of intensivists experienced in managing donation after circulatory death (DCD), we wish to endorse equal delivery of high-quality end-of-life (EOL) care for organ donors. Although some logistical differences must be addressed, the EOL recommendations outlined in the Guidelines are still applicable to patients being evaluated for or undergoing DCD. Recent accounts of unacceptable patient care in the setting of DCD highlight a critical threat to patient welfare and public trust. Our mandate is clear: implement and audit protocols that guarantee dignity and symptom control while demonstrating that DCD remains wholly consistent with a compassionate, honorable, and fulfilling EOL.

Using case studies to bridge the undergraduate nursing education gap in palliative and hospice careJournal of Hospice & Palliative Nursing; by Katherine Adams, Lisa Cross; 8/26Undergraduate nursing students struggle with understanding pharmacological pain management, especially in palliative care. New nurses indicate needing more experience with pain management and ethical dilemmas surrounding pain management. This project aimed to develop real-life case scenarios aligned with palliative competencies for use in undergraduate courses. Traditionally, palliative and hospice content is delivered with community courses, possibly limiting student competency across settings. These case studies present an opportunity for formative student assessment in pharmacological and other palliative management over 4 settings. Facilitation requires reflective techniques, and nurse faculty may need support in guiding discussions.

[Portugal] International differences in the technical qualities of place of death classifications and data: A survey of researchers' perspectivesPalliative Medicine; by Mayra Delalibera, Sílvia Lopes, Inês Dias da Silva, Barbara Gomes; 9/26Place of death is a key population-level indicator for palliative care and health services planning. However, substantial international variation in how it is recorded limits cross-country comparisons and health system evaluations. This is the first study to assess place of death classifications and data from researchers' perspectives. Findings highlight critical limitations in current classification systems and provide guidance for developing an international classification aligned with UN and WHO recommendations. This will enable more meaningful cross-country comparisons and strengthen evidence to inform palliative care and health services planning worldwide.

Evasiveness in everyday hospital palliative care practice: a focused ethnography Journal of Clinical Nursing; by Carolien van Leussen, Evelien Kuip, Renske Kruizinga, Els van Wijngaarden; 9/2/26 Conclusion: This study shows how evasiveness in hospital-based palliative care is produced and sustained through biomedical routines, organizational pressures and professional and personal orientations. These factors make it difficult to realize the holistic ideals of palliative care in everyday practice. As a result, patients' fears, uncertainties and end-of-life wishes often remain insufficiently explored, whereas organizational routines shape what is considered appropriate and possible in clinical interactions.

Patient and caregiver perspectives on communication quality in tele-palliative care Journal of Palliative Medicine; by Julia I. Bandini, PhD, Elaine Li, BA, Dio Kavalieratos, PhD, FAAHPM, Natalie C. Ernecoff, PhD, Kimberly Curseen, MD, and Jordan Harrison, PhD; 8/27/26 Objective: To qualitatively explore patient and family caregiver experiences with telehealth and in-person visits for outpatient palliative care, including preferences related to mode of care and any perceived differences in communication quality by mode in a post-pandemic context. Results: Three themes emerged: (1) participants weighed convenience, symptom burden, and visit reason in choosing mode of care; (2) opinions differed on the authenticity of communication via telehealth; and (3) comfort and privacy shaped communication quality. Some patients and family caregivers perceived communication via telehealth as comparable to in-person care, while others felt in-person visits allowed for more authentic interactions. Many found that the convenience of telehealth outweighed any perceived differences in communication quality. In addition, some patients noted that without the option for telehealth, the benefits of an in-person palliative care visit may not have outweighed the travel burden.