Literature Review

Cardiologists treating increasingly complex patients as America ages Medscape; by Sarah Amandolare; 7/14/26 ... Heart failure (HF) affects 15%-20% of adults over 80, according to the American Heart Association/American College of Cardiology/Heart Failure Society of America Guideline for the Management of Heart Failure. HF with preserved ejection fraction (HFpEF), which becomes more likely after age 80, is related to other common conditions of aging, including hypertension, chronic kidney disease, diabetes, and obesity. “Almost by definition, most people that have HFpEF have multiple comorbidities,” Hummel said. “You have to account for a lot of them when you’re thinking about how to help the patient best.” This population also has higher chances of developing dementia and frailty, which affect 35% of adults age 90 and older and 31% of octogenarians, respectively. Older adults hospitalized for HF also have a high likelihood of polypharmacy; 68% take 10 or more medicines.

Most Americans prefer to die at home, but the US healthcare system often prevents it ArcaMax; by Karen Lutfey Spencer; 7/14/26 Ask people what they want at the end of their lives, and overwhelmingly the answers will revolve around comfort, dignity and time at home with loved ones. Yet the U.S. healthcare system often thwarts these wishes. Most Americans say they want to die at home, but only one-third do. What could be an intentional last chapter may instead become a roller coaster of hospitalizations and decisions made with incomplete information. News headlines reflect the challenges of facing the end of life in crisis mode. ... Unfortunately, these crisis scenarios are happening to millions of families each year.

The Healing Page: how Akron Children's combines clinical care with narrative medicine poetry WOSU Public Media | NPR/PBS, Akron, OH ; by Jeff St. Clair; 7/13/26 The written word has healing power. That’s the idea behind narrative medicine, an emerging branch of healthcare that adds creative writing to the clinical toolkit. Akron Children’s Hospital is a leader in narrative medicine, and all this week, Ideastream Public Media is highlighting the program's writers in our series "The Healing Page." Dr. Sarah Friebert is director of Akron Children's palliative care center ... said when sick kids write about what they’re going through, “We tap into an inner spring of wellness and spirituality and wholeness ..." Friebert likened a critical diagnosis to a bomb going off in a family. Her program considers the blast radius of a diagnosis by extending services to impacted family members who are encouraged to write about their experiences and feelings.

Relationships between advance care planning engagement, patients’ religious practices, and spirituality American Journal of Hospice and Palliative Medicine; by Robyn M. Axel-Adams, MS, MDiv, BCC, HEC-C, Emily Fox Ludden, MDiv, MGS, and Alexia M. Torke, MD; 7/2/26Background: Research has shown that people who consider themselves religious have a lower advance directive (AD) completion rate. However, advance care planning (ACP) includes a broader range of activities that are important in determining medical treatments. ... Conclusions: In contrast to prior findings of lower AD completion in more religious individuals, this study found that higher religiosity and spirituality are associated with higher ACP engagement. These results suggest ACP opportunities offered for religious congregations or spirituality focused communities may be especially successful.

The meaning of TIME HSJ Online; by Todd Grimes; 7/8/26 I would argue that when it comes right down to it, all any of us have is TIME. What we choose to do with the TIME we are given is up to each of us as individuals. Some days we might wish for TIME to speed up - yet on others we might wish for TIME to slow down. Most of us have even had moments - here and there - that we wish could stand still. ... It was about 50 months ago - lying in my hospital bed - when I learned of my pancreatic cancer diagnosis. ... TIME has become more a state of being and less about where the hands on a clock might be positioned. ...

Dignity therapy: What matters most in end-of-life care? Medscape; by Irene Salvetti, MD; 7/7/26 ... Many patients, especially in advanced stages of illness, express the fear of no longer being themselves, of becoming a burden, or of losing their sense of meaning, role, and memory. In these experiences, suffering is not merely physical but also related to identity, relationships, and spirituality. The way patients perceive themselves as viewed by others is an important determinant of their sense of dignity. Dignity therapy was developed to give voice to this often-overlooked aspect of the experience of illness. ...  Harvey Max Chochinov introduced dignity therapy as a brief psychotherapeutic intervention for individuals with advanced or terminal illness, with the goal of preserving a sense of personal dignity during times of frailty, dependence, and the approach of death.

The hidden healthcare workforce: why family caregivers are essential to the future of care Healthcare Business Today; by Lance A. Slatton; 7/7/26 Healthcare leaders across the United States are confronting a convergence of challenges unlike any in recent memory. Workforce shortages, rising healthcare costs, increasing patient complexity, chronic disease management, and a rapidly aging population are placing unprecedented demands on healthcare systems. As organizations search for solutions to improve outcomes, reduce costs, and maintain quality of care, one of the most important components of the healthcare ecosystem continues to be overlooked. Family caregivers. ... In many cases, they serve as the connective tissue holding an entire care plan together.

'A big win' | Georgia expands medical cannabis access with new law, boosting patient treatment options WMAZ-13 CBS; Macon, GA; by Maggie Fitzgerald; 7/3/26 Georgia’s medical cannabis program is expanding under the newly enacted Putting Georgia’s Patients First Act, a law that supporters say significantly broadens patient access while reshaping how medical cannabis is produced, distributed and dispensed across the state. The law, which took effect July 1, overhauls several core parts of Georgia’s medical cannabis framework. It eliminates the state’s previous 5% THC concentration cap and instead regulates products by the total amount of THC they contain and how much a registered patient can purchase over a given period.

Guardianship and hospice care fail dying patients MedPage Today's KevinMD.com; by Kirsten Engel, MD & Madha Tripathi; 6/3/26 “Mr. L” is alone, lying flat on his back in a slightly inclined bed, eyes squeezed shut, hands raised in the air as immobile fists. He has not spoken in weeks. ... The medical team calls it catatonia, a severe psychiatric syndrome that has rendered him mute, immobile, and medically fragile. The psychiatric care team has recommended comfort measures, and our hospice team is ready to accept him. ... Mr. L cannot access hospice because an overworked stranger appointed by the court has not yet returned the hospital’s calls. This is a guardian, a professional fiduciary who has never met Mr. L, who must sign the papers first. So we wait for the court to hold a hearing to approve the order. And Mr. L, still, silent, and suffering, waits with us.

Carolina Caring Community Counseling Program expands services to anyone who has experienced loss Carolina Caring, Newton, NC; Press Release; 7/1/26 For many individuals, addressing the mental health concerns tied to grief and loss can feel overwhelming, complicated, or out of reach. Recognizing the profound impact that loss can have on one’s wellbeing, Carolina Caring has expanded a Community Counseling Program to support individuals who have experienced a major loss of any kind. ... Traditionally, organizations like Carolina Caring provide bereavement services to families of hospice patients for up to 13 months. But the Community Counseling Program is different from this traditional model. Through the expansion, the Community Counseling Program redefines what it means to provide compassionate care to the whole person, both physically and emotionally.

Remembrance Walk brings grieving families together The Alamosa Citizen, Alamosa, CO; by The Citizen; 6/29/26 A Friday morning breeze came in handy at San Luis Valley’s inaugural Remembrance Walk at Blanca Vista Park. A quiet 1.5-mile Pelican Trail became a place for shared memories, tears, and community healing. Organized by Hospice del Valle, the June 26 event brought together community members from across the Valley, each taking a lap around the lake for someone no longer able to walk beside them. ... Lori Taylor and her family were at the park to celebrate her mother, Judy, who passed away in December. Even though her mother was in hospice care for a single day, Taylor said the nonprofit’s grief support groups made a massive difference for her family.

Supporting mental health in end-of-life care – associate professor Sarah Yardley ehospice; by Dr. Sarah Yardley; 6/29/26 [Based on hospice observations described earlier in this article] ... I propose several ideas that support relationship centered care:

Are physicians and nonphysician clinicians interchangeable? MedPageToday's KevinMD.com; by Gus W. Krucke, MD; 6/24/26 ... Teamwork is necessary in medicine. But it is not equivalence, and shared work is not shared responsibility. This essay does not argue against team-based care or the work of nurse practitioners, physician assistants, and nonphysician clinicians. It argues against the unsupported conclusion that overlapping work, outcomes, and workforce pressure establish equivalence in training, judgment, and final accountability between physicians and nonphysician clinical providers.