Literature Review

Hospice chaplain provides comfort in life's final moments Central Florida Public Media, Orlando, FL; by Bryan Gozalez and Claire Macchiarola; 6/4/25 The hum of an oxygen machine fills the room as Mary Durkin is helped from her bed and slowly takes a seat on her couch. As someone under home hospice care, the goal of her caretakers is to ensure the comfort of their patient as she nears the end of her life. And one of those caretakers is Vishisho Awomi, known to her patients as Chaplain Avika. She sits beside her, clasping Durkin’s small hands in her own for their weekly visit. Durkin is one of roughly 150 patients that fall under Avika’s spiritual care. As a hospice chaplain with VITAS Healthcare, it is Avika’s job to comfort, pray, or just be present with all of her patients. “I get to build that personal relationship and build that connection, I get to know that person from beginning to end,” Avika said. ...

10 Signs death is near for dementia patients The Healthy; by Dr. Patricia Varacollo, DO; 6/2/25 For families and caregivers, recognizing the final stages of dementia can be difficult, but understanding the signs can help ensure comfort and dignity in a loved one's last days. Dr. Koncilja highlights these key indicators that may suggest the end of life is near:

The importance of humanity in internal medicine I.M. Matters from the American College of Physicians; President's Message by Jason M. Goldman, MD, MACP; June 2025I recently attended the funeral of one of my long-time patients, who had required hospice care after a long battle with heart disease. Many of us have had the experience of telling a patient and their family that their disease has progressed and we have reached the limits of medical science. In training, we are taught to be compassionate but professional, maintaining a certain level of emotional detachment ... As internal medicine specialists, we have the awesome responsibility and privilege to be the doctor for our patients through decades of their life experiences and to offer them not just medical science, but also humanity and comfort. ... One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated. This patient had been in my practice for almost two decades, and I had the privilege of taking care of both her and her husband.Editor's note: Re-read this powerful statement, "One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated." 

US trends from 1999 to 2020: Mortality and location of deaths in ischemic stroke Neurology Advisor; by Meghna Rao; 6/2/25 Patterns of ischemic stroke mortality have varied over the last 2 decades in the United States, according to study findings published in PLOS One. Stroke is one of the leading causes of mortality in the US. Researchers studied the trends in location of ischemic stroke deaths to improve end-of-life care and address health care inequities.The Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to examine trends in ischemic stroke mortality between 1999 and 2020. 

All You Need is Love The Republic; by Sharon Mangas; 5/28/25The call came in at 4:00 a.m., waking me from a deep sleep. It was the kind of call that puts you on high alert; like when you have a teenage driver at home, or a mother-in-law on hospice care. ... “Hello. Is this Sharon Mangas? I’m calling from the hospice center. I wasn’t able to reach Mike. I’m sorry to share this news…your mother-in-law, Carmen, passed away a few minutes ago.” ... To the best of my knowledge, I was privy to her last spoken words to family. After Mike and I helped Carmen settle in at the Hospice Center near midnight Saturday, May 3—barely 24 hours before she passed—I bent over to tell her we’d see her in the morning. She looked deeply into my eyes and said, “I love you, Sharon.” I took her hand gently and said, “I love you, too.” ... As the first daughter-in-law in Carmen’s orbit, the two of us had occasional dust-ups and misunderstandings that challenged our family bond. But we shared a lot of love, too, and love is healing. 

Lanterns light up the sky in east Wichita to remember lost loved ones on Memorial Day ABC KAKE, Wichita, KS; by Jocelyn Schifferdecker; 5/26/25 About a hundred lanterns lit up the sky Monday night at the Harry Hynes Memorial Hospice memory garden in East Wichita. Each lantern floating on the water told its own special story. [Candace] Dudley says [her husband] Ricky died about a year and a half ago from colon cancer. ... She says she misses him every day and she's thankful for Lanterns of Life because it gave her an opportunity to remember him. "My heart is full tonight. Making his lanyard, I made it very special ... I did all four sides with a lot of thought and put a lot of love into it because he was the love of my life," she said while holding back tears.The event is arranged by Harry Hynes Memorial Hospice. Organizers say they hope lighting a lantern for their lost loved one will bring them peace in some way. ... The event also featured food trucks, music, and more. This was the first year the hospice held it but it says it doesn't plan for it to be the last.

When patients die: A myeloma specialist grieves Medscape; by Manni Mohyuddin, MD; 5/28/25 ... We form such beautiful bonds with patients as we guide them through the highs and lows of treatment. And that is why I struggled so profoundly with the abrupt separation created by a transition of a patient to hospice. How can it be okay for me to be seeing a patient weekly (and sometimes more often) for such a long time and then suddenly never see them again after they transition to hospice? How can we just disappear from their lives at such a critical juncture? I understand that I may not have more chemotherapy to offer, but I at least can offer emotional support, validation, and my friendship. ...Editor's note: Continue reading this powerful commentary. Taking this further, do you have HIPAA compliant systems in place to notify the patient's oncologist or pre-hospice primary physician of the death? 

Mom takes first picture with new baby, not knowing in weeks he'll be gone Newsweek; by Daniella  Gray; 5/24/25 A grieving mom has shared the first picture of herself with her newborn baby, not knowing she'd lose him just weeks later. Wunmi Babalola from the West Midlands in the UK, shared photos on TikTok looking at her baby in his hospital crib. In the same carousel on TikTok, Babalola also included the last photo the two of them would have together, just six and a half weeks later. ...  

Mount Sinai establishes Steven S. Elbaum Family Center for Caregiving Mount Sinai, New York, NY; Press Release; 5/20/25 Mount Sinai announced that it will establish the Steven S. Elbaum Family Center for Caregiving, a groundbreaking initiative designed to improve how America's health care system recognizes and supports caregivers. Allison J. Applebaum, PhD, an expert in the psychological needs of caregivers and a Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, will lead the new Center. Dr. Applebaum joined Mount Sinai in early September from Memorial Sloan Kettering Cancer Center, where she was the founding director of the Caregivers Clinic, an innovative program providing targeted psychosocial care to family caregivers of patients with cancer, from diagnosis through bereavement.  

New law will fast-track completion of hospice death certificatesFlorida Politics; by Drew Wilson; 5/21/25 Grieving families will spend less time waiting on paperwork come July 1.Gov. Ron DeSantis has signed legislation that would take some stress off palliative care physicians who guide patients through their final hours, as well as the grieving families they leave behind. Sponsored by Republican Rep. Dana Trabulsy, HB 647 would allow Advanced Practice Registered Nurses (APRNs) to complete and file death certificates for hospice care patients. Valid death certificates must record both time of death and cause of death before the deceased’s remains can be turned over to a funeral director. Under current law, a doctor must determine the cause of death and sign the certificate. That will remain the case after Trabulsy’s bill goes into effect July 1 for non-hospice deaths.

First FDA-cleared Alzheimer's blood test could make diagnoses faster, more accurate NPR; by Jon Hamilton; 5/21/25 A new blood test that detects a hallmark of Alzheimer's is poised to change the way doctors diagnose and treat the disease. The test, the first of its kind to be cleared by the Food and Drug Administration, is for people 55 and older who already have memory problems or other signs and symptoms of Alzheimer's. The results show whether the brain of a person with cognitive symptoms also has amyloid plaques, clumps of toxic proteins that build up in the spaces between brain cells. The presence of plaques in a person with cognitive symptoms usually confirms an Alzheimer's diagnosis.Editor's note: Game-changer!

What caregivers should know about end-of-life rallies  AARP; by Jamie Ducharme; 5/19/25People with advanced illnesses sometimes experience unpredictable bursts of energy or clarity. Here’s how caregivers should handle these episodes. Roughly a decade after her mother was diagnosed with Alzheimer’s disease, Liz Donnarumma got her back — but only for an instant. It happened one evening in 2021, more than a year after Donnarumma first realized her mother, Theresa, didn’t recognize her. Theresa took Donnarumma’s face in her hands, called her by her nickname and thanked her. “When she put her hands on my face and I looked into her eyes, she was totally there. It was my mother,” Donnarumma says. “It was like a second, just one second, and it was gone.” Donnarumma’s mother had an episode of “paradoxical lucidity” — that is, an unexpected burst of mental clarity, despite her advanced condition. While these moments are as unexplained as they are unexpected, experts say they are more common than many people realize. ...

Sixteen years with leukemia taught me to savor life Cure; by Michelle Lawrence; 5/21/25 I’ve lived with large granular lymphocytic leukemia for 16 years and have learned to spend my energy wisely, embrace palliative care and choose joy over anger. ... It has been an exhausting journey, but I am blessed to have survived 16 years. ... In the beginning, I didn't care; I told everyone because I was treatment-focused, but now I am focused on quality of life. Cancer has robbed me repeatedly. Peers and family members are married and have careers and families. They plan birthday parties and playdates and worry about their kids’ homework. I celebrate the fact that I could take a shower and get dressed by myself. I grieve for those missed opportunities. ... I have recently, in the past couple of years, transitioned into palliative care, a choice I never dreamed of ever making. ... I am a survivor — I am more than my diagnosis. I am not Michelle, the cancer patient; I am Michelle who has cancer. ...