Literature Review

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.”

'Get out of my house': 84-year-old man shoots son in the face for not visiting mother in hospice care, police say Law & Crime, Palm Bay, FL; by Conrad Hoyt; 12/12/25 An elderly man is accused of shooting his son in the face because he and his spouse did not visit the older man's wife over the weekend while she was in at-home hospice care. William Nowak, 84, has been charged with attempted murder, according to an arrest affidavit reviewed by Law&Crime. Nowak was at his home ... in Palm Bay, Florida, where he lived with his wife and their disabled daughter. His wife had recently been put on in-home hospice care, "and William has been taking care of both of them," ... The defendant's son and his wife came over to the house to visit, something she said they did "on a weekly basis." After they arrived around 6 p.m., "William began to express how he was upset they did not visit over the weekend." According to authorities, an argument between the father and son ensued.

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.

Volunteer vocalist has provided solace to hospice patients for 23 years The Atlanta Journal-Constitution; by Danielle Charbonneau;  Kevin Dunn has been a volunteer vocalist at Wellstar West Georgia Hospice in LaGrange for 23 years, providing solace to hospice patients and their families through his music. ... Dunn's voice has been a source of comfort for many, including Kitty Matthews Crawford, who experienced a moment of peace when her grandfather's face softened after hearing his voice. Dunn has sung at roughly 250 funerals and has never charged a fee for his services. His dedication to music and hospice care has made a significant impact on the lives of those he serves. [Access may be limited by paywall]

Palliative care improves outcomes in patients with sickle cell disease (SCD), with Crawford Strunk, MD Consultant Live; by Crawford Strunk, MD; 12/8/25 Incorporating a palliative care team into a comprehensive sickle cell disease (SCD) care center substantially reduced inpatient length of stay and improved outpatient pain management, according to a recent study. ...  Additionally, the study authors noted plans to continue examining the efficacy of palliative care regarding cost savings and broader applicability outside of SCD patients.

[Australia] Navigating grief in the aged care system

How clinicians prenatally discuss management options and outcomes for congenital heart disease Journal of Pain and Symptom Management; by Samantha Syme, Kelsey Schweiberger, Judy C Chang, Ann Kavanaugh-McHugh, Nadine A Kasparian, Robert M Arnold, Kelly W Harris; 11/27/25 Online ahead of printA prenatal diagnosis of complex congenital heart disease (cCHD) introduces significant emotional, social, and financial stress for families. ... Fetal cardiology consultations offer an important opportunity to support families navigating uncertainty following a prenatal diagnosis of CHD. Clinicians approached these conversations with empathy and a focus on long-term outcomes, though discussions about management options varied. There is an opportunity for increased presentation and integration of palliative care consultants as a longitudinal, family-centered resource, regardless of mortality risk, which may enhance supports available to families during this highly emotional period.

A geriatrician explains: Supporting loved ones through end-of-life care BlackDoctor; by Jasmine Smith with video by Dr. Cheryl E. Woodson; 11/30/25 In this video, Dr. Cheryl E. Woodson shares why clear, thoughtful planning is not about how someone wants to die—it’s about understanding the conditions under which living is still meaningful to them. End-of-life decisions should not fall on distraught family members in crisis; they should be guided by the person’s own values, documented long before these decisions ever need to be made.

'It has made my life a lot easier': New Ohio program pays people to care for their loved ones at homeWTOL-11, Columbus, OH; by Kevin Landers; 11/24/25 Mark Straub, of Delaware County, started caring for his 93-year-old mother about two years ago. As much as he loves to have his mother at home instead of a nursing home, caring for a loved one 24/7 brings with it stress, both emotional and financial. ... The average cost of in-home care in Ohio is $60,238, according to CareScout. The average cost of nursing home care is $108,500 a year, or about $9,000 per month. Thanks to a new program in Ohio, those who care for a loved one at home are about to get financially easier. It’s called Structured Family Caregiving, or SFC. Currently, at least 11 states have formal Medicaid SFC programs that pay family members. “I didn’t believe it at first, until I got that first paycheck and I really wanted to cry, “ said Tsavaris.

Bridging the gap: A scoping review of clinical decision support systems in end-of-life care for older adults Journal of Palliative Medicine; by Susanny J Beltran, Lainey Dorris, Marie Hamel, Shanelle Harvey, Mustafa Ozkaynak, Kenan Sualp; 11/17/25 online ahead of print Background: ...  This scoping review maps the current landscape of clinical decision support (CDS) systems in EOL care, identifies key system types, and examines their effectiveness in guiding clinical decisions. ... Results: A total of 31 studies were included, categorizing CDS systems into prognostic tools, referral tools, and care informing tools. ...

Rediscovering purpose in the hardest moments of cancer care Medscape; by Mark A. Lewis, MD; 11/7/25 ... I'm a GI oncologist, and about a quarter of my patients have metastatic pancreatic cancer. Treat that awful disease often enough and, believe me, you start to doubt your own abilities as a supposed healer. I mean, talk about overpromising and underdelivering. ... When you judge your worth by your outcomes, especially longevity, imposter syndrome sets in like dry rot, and feelings of ineffectiveness lead to therapeutic nihilism in the very caregiver that patients look to for hope. It turns out, though, the best antidote to self-pity is right in front of me every day: my patients. ...

Shifting to online and telephone bereavement support provision during the COVID-19 pandemic: A mixed methods study of bereavement service provider perspectives and lessons learnt for current practice Palliative Medicine; by Lucy E Selman, Jenny Birchall, Eileen J Sutton, Tracey Stone, Renata Medeiros Mirra, Emma Gilbert, Mirella Longo, Kathy Seddon, Anne M Finucane, Alison Penny, Anthony Byrne, Emily Harrop; 11/24/25, online ahead of print Background: Provision of remote (online/telephone) bereavement support accelerated during the COVID-19 pandemic. However, the extent and impact of this change and lessons learnt are unknown. ...Conclusions: Remote delivery of bereavement support increased support capacity and can potentially reduce inequities in access. However, it needs to be carefully tailored, and is not appropriate for everyone. Staff and volunteers providing remote services require training and support.

Coordinating at-home care, enhancing quality of life as a hospice nurse case manager Grand Haven Tribune; by Emmanuel Hospice; 11/19/25 Throughout her career, Brittany Rickert has explored nursing jobs in various settings but keeps getting drawn back to hospice. For her, there's little out there that offers such a unique and rewarding experience. "There are landmarks throughout our lives and death is one of them," says Rickert, a nurse of 15 years. "It is very special to be allowed into that sacred space with patients and their loved ones, to support them through such a pivotal portion of their life." ... She defines her position as the "coordinator of the patient experience altogether," working alongside an interdisciplinary team to bring supportive services directly to patients, wherever they call home.