Literature Review

‘Early discussions on what to expect can lessen the strain’ Nursing Times; by Kylie Chaffin; 3/19/25 The article explains the pros and cons of nutrition and hydration at end of life and the several types of artificial nutrition and hydration that can be used, written in a way patients and families can understand. Resources and educational articles, like this one, can also be a great way to introduce new or even more effective ways nurses and care team members can support patients and families when pursuing a palliative approach to their health and wellbeing. My question for readers is, “Should the conversation of end-of-life, hospice and palliative care, and nutritional changes, be initiated sooner rather than later in patients with a terminal diagnosis?”

Impacting end-of-life care with new healthcare legislation: Patient-Directed Medical Orders (PDMO) in advance care planningAmerican Nurse - State Nurses Associations - Florida News Journal; by Meredith Fischer, BSN, RN, CHPN; 3/19/25 Over the summer, a friend’s elderly father underwent resuscitation and intubation because his nursing facility could not locate his Do Not Resuscitate Order (DNRO) or Advanced Directive (AD). ... New legislation is being filed for a Patient-Directed Medical Order (PDMO) document designed to address the shortcomings of the ADs and DNRO forms—currently the primary tools for addressing end-of-life care preferences in Florida. The PDMO form originates from the POLST paradigm, which has been adopted by most states since its inception in Oregon in the early 1990s (National POLST, 2022). Healthcare professionals recognized that many individuals were not receiving the end-of-life care outlined in their ADs and DNROs due to accessibility, clarity, and practicality (National POLST, 2022).

Improvement plans for hospital car park BBC News; by Ruth Lucas; 3/18/25 ... NHS Frimley has announced plans to make "positive improvements" to the car park at Frimley Park Hospital in Surrey Heath. ... NHS Frimley says this will increase capacity by 10%, while LED lighting and improved parking bay markings will also be installed. ... Free parking is currently available for disabled people, frequent outpatient attenders, parents of sick children staying overnight and visitors with relatives who are gravely sick, terminally ill or under palliative care.Editor's note: For hospital-based hospice/palliative care, do you provide any type of free parking, vouchers, middle-of-the-night security, or some other type of support for families of persons in your hospice/palliative care units? Consider the common experience of the patient dying in the middle of the night, and family leaving the hospital--especially if your parking conditions are unsafe or expensive. 

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

[International] Healthcare on the brink: Palliative Care Unit and Late Shift The 75th Berlin International Film Festival - Part 7, wsws.org; by Martin Nowak and Bernd Reinhardt; 3/16/25 Two films, the drama Late Shift (Heldin) and the documentary Palliative Care Unit (Palliativstation), featured at this year's Berlin International Film Festival, addressed the current situation in German and Swiss hospitals. The sold-out festival screenings reflected the burning public interest in this topic. This is particularly remarkable bearing in mind that Palliative Care Unit has a running time of more than four hours. ... [In the] documentary Palliative Care Unit by Philipp Döring, shot at the Franziskus Hospital in Berlin, ... [the] camera quietly observes the daily routine, staff consultations and the constant empathy of the head of the ward towards employees and seriously ill patients, who usually spend their last weeks here. The very calm, always discreet images emphasise the necessity of sufficient time for care and reflection when making life-critical decisions. ... How can the highest possible quality of life be achieved? The high ethical standard of treating incurable patients as active human beings ... is admirable and makes a lasting impression throughout the film.

Leverage collaboration, detailed notes to improve end-of-life care Home Helath Line; by MaryKent Wolff; 3/13/25 Educate your hospice staff on monitoring symptoms that could indicate a patient is nearing the end of life. Agencies that manage these symptoms early and take the time to prepare and comfort caregivers and families for the transition could see these successes reflected in their CAHPS Hospice survey scores. [Subscription required for more content.]

Questions to ask when choosing a memory care facility The Kansas State Collegian; 3/10/25 ...  Your goal is to find a community where your family member can feel safe, truly cared for, and supported during this next chapter of their life. To help, we’ve put together a list of questions you should ask when touring memory care facilities. These questions will help you cut through the sales pitches and get to the heart of what each community offers. ...

My Stories program preserves cherished memories of patients in hospice The Alpena News, Alpena, MI; by Reagan Voetberg; 3/8/25 The Hospice of Michigan in Alpena preserves the stories of patients, not in a book or photo album, but on a flashdrive. It’s called the My Stories program. Patients in hospice are given the opportunity to video record their stories and memories for their loved ones to hear once they’ve passed. Patients do not have to pay a dime to record their life stories. Alpena’s Hospice of Michigan Volunteer Program Coordinator Kristie Lukes talked about how meaningful the My Stories project is to patients and their families. Lukes coordinates volunteers to help patients with their recordings. Lukes explained further what My Stories is. “It’s a recording of the patient’s life and the stories that they want to share with family and patients,” she said. “So it becomes kind of a legacy project.” 

Trends in Pediatric Palliative Care Research (TPPCR) 2025; Issue #2 Siden Research Team; Commentary by Kim Mooney-Doyle, MD; 3/6/25Kim Mooney-Doyle – University of Maryland School of Nursing, MD, USA: I am a nurse scientist dedicated to advancing family health in serious pediatric illness. I have studied parent-sibling relationships and the social ecological factors that impact it for the past decade. ... Siblings are special and, too often, invisible in the care of seriously ill children, adolescents, and young adults. Two articles in this month’s collection bring the needs and experiences of siblings into focus using a family lens. A key take-away from this important work is that while siblings want to communicate with their parents about their brother’s or sister’s illness, it can be hard to initiate such conversations. As clinicians and researchers, we can work with families to devise strategies that foster these conversations, such as providing prompts or a scripted conversation guide to help a parent engage the sibling.  

At the end of life, doctors’ actions and patients’ wishes may be misaligned, according to a Rutgers Health study Rutgers; by Greg Bruno; 2/28/25 For terminally ill cancer patients, the final days of life are immensely personal, having the choice to continue cancer treatments, or to stop treatments and prioritize a more comfortable passing. What a patient wants, however, isn’t always what they receive, according to a Rutgers Health study published in the journal Cancer. “A patient's end of life is often not a reflection of what they want, but rather, who their oncologist happens to be,” said Login S. George, a health services researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research, and lead author of the national study. “The data doesn’t indicate patient-centered treatment decisions, but rather, more habitual or default ways of treating patients,” says George, who is also a member of the Cancer Prevention and Control Program at Rutgers Cancer Institute, the state’s only National Cancer Institute-designated Comprehensive Cancer Center. ... [Click on the title's link for more statistics, insights, and recommendations.]

A walk in the Bywater was just the medicine I needed NOLA.com, New Orleans, LA; by Danny Heitman; 3/2/25 Last fall, I asked Pico Iyer, a travel writer and spiritual thinker I’ve followed for years, how he keeps a sense of hope in a troubled world. Iyer touched on several points, but his parting comment is the one I remember most vividly. “During the worst days of the pandemic,” Iyer recalled, “I was asked to give a talk to a local hospice organization. At the end, the moderator asked me to offer some advice. I’m sure he was expecting something wise or sonorous or lofty. All I could say was, ‘Take a walk. If the world doesn’t look better after you do, you will almost certainly feel better.'” A few days later, Iyer’s words came back to me as my wife and I took a weekend walk in the Bywater neighborhood of New Orleans. ... Editor's note: Just in time for Mardi Gras, enjoy this inspirational story. Whether at work or at home, find time to use this advice, "Take a walk."

Central Coast VNA & Hospice expands registered nursing services in Monterey Buzz; 3/5/25 Central Coast VNA & Hospice is significantly expanding its registered nursing care services in Monterey, providing residents with increased access to high-quality, personalized healthcare delivered directly in their homes. … Key expanded services include advanced care planning, which helps patients and families make informed medical decisions, and a palliative care program focused on relieving symptoms and reducing stress for patients with serious illnesses. The organization also offers specialty programs targeting specific health conditions such as cardiac care, diabetic care, and orthopedic support. 

My mother and brother have terminal cancer. I'm worried I won't feel anything when they die. Business Insider; essay by Kimanzi Constable; 3/1/25 ... My brother was diagnosed with Cutaneous T-cell lymphoma (CTCL) three years ago, and my mother found out she had stage four lung cancer a year ago. I got a call earlier this year that the cancer was spreading, and I flew to spend time with them. I knew it would be hard seeing them battling late-stage cancer, but what I walked into was my brother in the Advanced Cancer Care Center, unable to move, and my mother wanting to hold an "end of life" planning meeting. It was worse than I anticipated. It was hard to see him not moving and the nurses having to help him do everything. My mother looked like she weighed 50 pounds ... I'm worried I won't feel anything when they pass away. ... I think it might be just another day when they pass away. I've been thinking — what does that say about me? Am I a bad person for not falling on the ground and losing it for over half of my family dying? Or is this nothingness an OK feeling due to the complicated relationship we've had most of my life? ... Editor's note: Leaders, welcome to the daily world of your clinicians, especially your social workers, chaplains, and grief counselors. Read this with openness to the normalcy of this author's conflicted relationships, emotions, thoughts, and empowered actions toward "not wanting to regret how I handled this opportunity to say goodbye more healthily."