Literature Review

Hospice created Christmas for patient in NovemberBBC News; by Harry Whitehead; 12/24/25 Guernsey's hospice recreated Christmas for a patient in November so she could enjoy a festive experience with her family before she died. Carrie Watson's mother Tracey De La Mare passed away just days after nurses at Les Bourgs Hospice made her wish of a final Christmas come true. Mrs. Watson said her family were "blown away" by the effort put in by hospice staff. 

A woman in hospice granted a wish of one last swim WEAU-13 News, Bloomer, WI; by Danile Gomez; 7/16/25 Often times the small things are taken for granted. Like a dip in the pool. For Barbara Melby, it was on the final list of things to do as she lives out her time in hospice care. “Barbara has been doing pretty well. She has had some fatigue and some tiredness,” said Leah Grace, the registered nurse with St. Croix Hospice assigned to Melby’s case. ... Grace worked hard to make sure Melby’s last dip in the pool would come to fruition. She cleared it with Melby, her family and the managers at the hospice center. The aquatic center helped in granting the wish too. ... “The way the chair put me in down the water was very nice,” said Melby. Of those in Melby’s family that jumped in the pool with her included Stoll and her kids Colby, Sydney and Brody. “I grew up swimming in my grandmother’s pool. ...” said Stoll. She is happy to be there for her grandmother’s last swim. “Just a pretty special memory we will all hold on to for a pretty long time.” Melby was a swim instructor, ... It was something she always loved and it made her happy to have had her wish granted.

Palliative care staff attitudes toward music therapy for hospitalized adult patients American Journal of Hospice and Palliative Medicine (AJHPM); by Katherine A. Carney, APRN, CNP, MS, Rachel M. Wiste, APRN, CNP, MSN, Susanne M. Cutshall, APRN, CNS, DNP, MS, Christina Wood, MA, MT-BC, Rachel C. Gentes, APRN, CNP, MSN, Brianna E. Larsen, MA, MT-BC, Nana A. Tiwaa, MAS, Amelia E. Tetlie, APRN, CNP, DNP, and Regina M. Mackey, MD; 12/18/25 ... Top reasons for music therapy (MT) referral were psychosocial support, pain and symptom management, and coping. The most common symptom-focused indications were anxiety, mood, and existential distress. A variety of factors influenced decisions to refer for MT. Most felt that at least half of their patients could benefit from MT, and nearly all rated MT as “extremely” or “very” effective for improving patients’ quality of life.Editor's Note: Visit stories about music therapy the American Music Therapy Association. For extensive uses of music therapy in hospice and bereavement care, I invite you to explore my book, Music of the Soul - Composing Life Out of Loss, published in Routledge's Series in Death, Dying and Bereavement, 2006. 

End-of-life care needs cultural humility and social justice BMJ; by Jamilla Akhter Hussain, Rekha Vijayshankar, and Mary Hodgson; 12/18/25 Death, dying, and grief are not medical events—they are profoundly social, relational, and shaped by the histories people carry into their final days. ... [A] key question is: how can end-of-life care services become more trustworthy? Too often, institutions respond with so-called cultural competency initiatives. ... What is needed is cultural humility and social justice. Cultural humility involves ongoing self-reflection and acknowledgement of bias at individual, organisational, and system levels. Palliative care must prioritise cultural humility and social justice: trust grows not through outreach alone but through shared creation of knowledge, meaning, and care—and at the end of life ...

The results are in: Palliative care professionals share how they’re doing in 2025Center to Advance Palliative Care - CAPC; by Rachael Heitner, MPH; 12/16/25 CAPC’s second annual Palliative Pulse survey offers insight on how palliative care professionals across the country are feeling this year and what they’re focused on—see how they responded. ... In this blog, we share four key findings from participants’ self-reports and take a closer look at the data behind each one. ...

Is moral adequacy possible in the face of structural disadvantage? The experiences of health and social care staff in supporting homeless people using substances at the end of life Palliative Care and Social Practice; by Gary Witham https, Gemma Anne Yarwood, Sarah Galvani, Lucy Webb, and Sam Wright; 11/26/25 Background: Homeless people using substances at the end-of-life face many challenges in accessing and receiving good care. These can relate to poor interdisciplinary working by health and social care practitioners, stigma and structural disadvantage. Results: The data analysis resulted in three key discourse positions relating to how practitioners position themselves in relation to the practice challenges of supporting homeless people using AODs and approaching end of life. These were as follows: (i) what constitutes a good death and where, (ii) the limitations of professional boundaries and (iii) maintaining moral adequacy in the face of traumatic death.

Small but mighty: 5 lessons from smaller teams delivering high-quality palliative care CAPC; by Megan Hesketh; 12/16/25 ... High-quality palliative care isn’t defined by program size or budget—it’s defined by consistency, collaboration, and a shared commitment to patients and families. Across the country, smaller palliative care programs are demonstrating what’s possible when teams focus on training, teamwork, and outcomes that matter. In summer 2025, CAPC spoke with twenty smaller organizations—community hospitals, critical access hospitals, independent hospices, and small practice groups serving fewer than 150 beds—to understand how they sustain their commitment to high-quality palliative care. Their experiences highlight what makes these programs effective: clear structures, intentional learning, and a deep sense of accountability to their communities.

My patient was gone. I had to help his family see it: The art of medicine means sitting with families’ grief and hope Stat10 - First Opinion; by Raya Elfadel Kheirbek; 12/15/25 Bullets tore through Michael Thompson’s car at a stop sign, ending the life of a 35-year-old father in an instant. Just minutes earlier, he had dropped his 8-year-old daughter, Emma, at dance class, her pink tutu bouncing as she waved goodbye. Now, in the ICU, his young body lay tethered to machines — ... a ventilator’s hiss forcing his chest to rise. ... His family’s grief filled the room, raw and heavy, as I prepared to document our meeting. On the screen, a pop-up appeared: “Patient is deceased; do you want to continue?” Its cold bluntness paled against their pain. Michael looked alive. His chest rose and fell with the ventilator. ... Medicine isn’t just tests or machines. It is presence — sitting with families in their grief, faith, and love. Our tools should support that presence, not interrupt it with cold prompts. ... Most U.S. hospitals lack clear guidelines for these situations, leaving families and clinicians alike in limbo. They also worried about organ donation — a decision fewer than 1% of families consent to after brain death, often because the body still looks alive.Editor's Note: We thank the palliative care physicians, nurses, social workers, and chaplains who provide sensitive presence with families in the unbearable spaces between hope and loss, especially when life support decisions arise. In this season, may we pause to honor those who carry this sacred work—and remember the families who have had to accept harsh truths while machines still “breathe.”

The ethical challenge of negative compassion: How excessive empathy in end-of-life care affects decision-making and patient autonomy Journal of Hospice and Palliative Nursing; by Victoria Pérez-Rugosa, Gina Lladó-Jordan, Pablo de Lorena-Quintal, Esther Domínguez-Valdés, Antonia Rodríguez-Rodríguez, Carmen Sarabia-Cobo; 12/11/25 Online ahead of print ... 3 key themes emerged: decision paralysis and emotional overload, conflicts between personal beliefs and professional responsibilities, and institutional barriers to ethical practice. Findings reveal that excessive emotional involvement can hinder the implementation of patients' documented wishes, potentially compromising patient autonomy and increasing caregiver distress. The study highlights the need for institutional policies that support emotional resilience, structured debriefing, and ethics training. ... These insights are highly relevant for palliative nursing practice, offering guidance for supporting staff and upholding patient-centered care in end-of-life settings.

Ask Sheri: Overcoming fear and expressing thanks Lovin' Life; by Sheri Simpson; 12/7/25Dear Sheri, When my mother’s health began to decline, our family found ourselves standing at the edge of something we couldn’t quite prepare for. ... From the very first visit, the hospice team wrapped my mother — and our entire family — in comfort, dignity and compassion. They didn’t just care for her; they cared about her. They learned her favorite songs, listened to her stories, and treated her as the vibrant, funny, loving woman she’d always been. The nurses would hum along when she sang softly, and one even brought her a small, crocheted blanket because she noticed how much mom loved the color lavender. Hospice is not about giving up, it’s about giving more: more peace, more presence, more love. Azorna Hospice helped us see that. ...

Holidays can be celebrated even during illness SNJ Today, Cumberland County, NJ; 11/30/25 The holidays often bring warmth, tradition, and togetherness, but when a loved one is facing a terminal diagnosis, the season can also bring intense emotion, uncertainty, and sadness. The joyful anticipation of the season may now feel solemn and bittersweet. Yet, according to NJ Health Hospice and Palliative Care, observing the holidays, gently and intentionally, can foster comfort, connection, and cherished memories.

Unique ethical dilemmas occur in long-term care settings: Staff need ethics resources  Medical Ethics Advisor; by Stacey Kusterbeck; online ahead of print 12/1/25 issue ... “The position paper was developed in response to concerns from our members about the ethical challenges of the changing environment in long-term services,” says Jason M. Goldman, MD, MACP, president of the American College of Physicians. ... Discharge disposition, communication issues (either among the clinical team or between clinicians and parents), behavior problems, and goals of care were the top ethical issues reported. Lack of caregiver support was another frequent unique ethical concern. Editor's Note: Your hospice is in a unique role to provide ethics trainings for end-of-life care, and thus building trust, clinical best practices, and referrals. The CMS Hospice Conditions of Participation require: Hospices That Provide Hospice Care to Residents of a SNF/NF or ICF/MR (§ 418.112) (f) Standard: Orientation and training of staff. Finally, this rule requires a hospice to assure the orientation of SNF/NF and ICF/MR staff caring for hospice patients. Staff orientation must address the following topics: hospice philosophy; hospice policies regarding patient comfort methods, pain control, and symptom management; principles about death and dying; individual responses to death; patient rights; appropriate forms; and record keeping requirements.