Literature Review

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.

Grateful patient finds strength and support through UConn Health’s ALS Program UConn Today; by Jennifer Walker; 11/17/25 ... ALS, also known as Lou Gehrig’s disease, is a progressive neurodegenerative disorder that affects the nerve cells in the brain and spinal cord responsible for muscle movement. ... Originally conceptualized by Dr. Amanda Hernandez, division chief of Neuromuscular Medicine, the UConn Health ALS and MD Program provides a “one-stop shop” for patients with progressive neuromuscular diseases that often require coordination across multiple specialties. ... “Our social worker meets every patient,” said Viguera Altolaguirre. “We address caregiver stress, financial barriers, and emotional coping. Palliative care helps patients navigate difficult decisions about feeding tubes, ventilation, and future planning—always at their own pace and comfort level.” 

Navigating choice: Eating, drinking and decision-making at end of life for individuals with cognitive impairmentJournal of Clinical Practice in Speech-Language Pathology; by Laura Chahdaa, Druvni Pererab, Darcy Longc, Laura Knauerb, Sanora Yonand; 10/25Current clinical guidelines offer limited direction for speech-language pathologists (SLPs) supporting eating and drinking decisions in palliative care (PC), particularly for individuals with dysphagia and co-occurring cognitive impairment. This population presents unique clinical, ethical and interpersonal challenges that often fall outside existing frameworks such as ‘Eating and Drinking with Acknowledged Risk’. This scoping review explores the key considerations for SLPs involved in end-of-life decisionmaking in these complex cases. A qualitative scoping review was conducted and analysed thematically [and] ... six overarching themes were identified: person-centred care; emotional and relational dynamics; ethical decision-making complexity; medical risk; barriers to effective clinical practice; and legal considerations. Findings reveal inconsistencies in practice and limited guidance for SLPs navigating care for individuals with cognitive impairment at the end of life.

Reducing moral distress through interdisciplinary collaboration: the impact of a weekly palliative care and neonatology conference BMC Palliative Care; by Kirthi Devireddy, Riddhi Shukla, Rachel Boren, James E Slaven, Rebecca A Baker, Jayme D Allen, Karen M Moody; 11/11/25 Conclusion: A neonatal intensive care unit (NICU) and palliative care-weekly-collaborative conference resulted in significantly decreased moral distress among NICU staff. Qualitative data revealed that both prolonging life with life-sustaining medical therapies (LSMTs) and ending it by withdrawing LSMTs in the context of prognostic uncertainty and institutional constraints creates significant moral distress among staff. Palliative care and NICU programs should consider implementing regular interdisciplinary collaborative conferences to address this distress.

The human cost of health care automation MedPageToday's KevinMD.com; by Christie Mulholland; 11/8/25 AI is rolling out in medicine faster than most of us can process. Ambient scribes documenting visits. Clinical decision support algorithms. Automated prior authorizations. The promises are compelling: reduced clerical burden, more face-time with patients, less burnout. I wanted this. As a palliative care doctor and director of physician well-being at my institution, ... [when] AI tools promised relief, I advocated for them. ... 

Living with dementia report emphasizes that even those with advanced disease have stories to share JAMA Medical News; by Rita Rubin, MA; 10/31/25 As the average age of the US population has risen, so has the number of people living with Alzheimer disease and related dementias. And yet, dementia is still a highly stigmatized condition, a new collection of essays published by the Hastings Center for Bioethics points out. Clinicians, caregivers, and loved ones could improve the lives of the more than 7 million people in the US who are living with dementia if they only recognized that such individuals still have their own stories to tell, even when they can’t express themselves the same way they did before their symptoms appeared. 

Four nurses in two weeks assaulted at Essentia Hospitals: Nurses say violence is a consequence of unsafe staffing and inaction Minnesota Nurses Association, Brainer, MN; Press Release; 10/28/25Nurses with the Minnesota Nurses Association (MNA) are once again outraged and deeply concerned after two more violent assaults on nurses at Essentia Health. A nurse at Essentia Health St. Joseph’s Medical Center in Brainerd was attacked by a patient last Thursday, followed by another assault at the same facility over the weekend. The latest incidents come less than two weeks after two nurses were injured at Essentia Health St. Mary’s Medical Center in Duluth. Four nurses assaulted in under two weeks reflects a dangerous pattern in Essentia facilities—one that nurses have been warning about for years.Editor's Note: Continue reading for preventable actions and red flags, "True safety comes from care-based prevention." These were hospital settings; the home care settings your staff and volunteers enter provide much higher risks with less control. Ask your direct care staff for examples of professional situations that were unsafe. Office-based leaders, you might be surprised. Examine your workplace violence policies, procedures, trainings, incident reporting, and follow-up.

When words matter: NFDA releases groundbreaking communication guide for funeral professionals National Funeral Directors Association (NFDA), Brookfield, WI; Press Release; 10/27/25 The National Funeral Directors Association (NFDA) has released “When Words Matter: A Funeral Director’s Guide to Clear and Compassionate Communication,” a groundbreaking, research-driven resource designed to bridge the growing language gap between funeral professionals and the families they serve. ... Available now as a free download at NFDA.org/Research, this new guide is grounded in original NFDA research conducted earlier this year with more than 1,100 U.S. consumers across four generations. ... While funeral professionals have long used terms like “funeral,” “memorial service” and “celebration of life,” the new study revealed that families often define – or misunderstand – these terms in radically different ways. Editor's Note: Basic decisions about burial versus cremation usually need to be made before the death. Your interdisciplinary team members need to be up-to-date with this NFDA communication guide, for consistent family information and planning.

Hospice chaplains play key role in addressing emotional pain, VITAS spiritual lead explains McKnights Home Care; by Foster Stubbs; 10/26/25 In hospice care, maintaining the comfort and dignity of the patient are top priorities for clinicians. But there are some aspects of the end-of-life experience that they are not equipped to handle. That’s where hospice chaplains like Jason Cooper, national spiritual lead at VITAS Healthcare, come in.  ... In hospice care, maintaining the comfort and dignity of the patient are top priorities for clinicians. But there are some aspects of the end-of-life experience that they are not equipped to handle. That’s where hospice chaplains like Jason Cooper, national spiritual lead at VITAS Healthcare, come in. In his role, Cooper supports over 300 chaplains and spiritual caregivers and up to 23,000 patients with terminal diagnoses nationwide. 

How to manage financial caregiving for an aging parent AOL.com; by Kerry Hannon; 10/25/25Steering end-of-life financial decisions for an aging parent is not a job many of us would choose. But we do — and feel our way through the messy emotions as best we can. ...[From an interview:] "[Your mom] was rejected for hospice care, which is covered by Medicare. Can you elaborate on that?""That was just such a slap in the face because it's a hard decision to go to hospice. ... My mom made that decision for herself, but my brother, the doctors, and me had to be on board with it in order for her to do it. The only reason they rejected her is because they thought she would be too costly. They do a cost-benefit analysis of how long that person is going to last— how much [in] resources is she going to consume? They decided that her diagnosis was too murky to justify putting her on hospice at that point. I finally found another hospice company to accept her. And she died in two weeks."