Literature Review

Scans tell us about the cancer. Functional status tells us about the patient. South Florida Hospital News and Healthcare Report; by Dr. Ileana Leyva; 8/1/26 In an era of precision oncology, we closely track biomarkers, imaging findings and treatment response. Yet one of the strongest predictors of how a patient is truly doing often receives less attention: functional status. When patients experience progressive fatigue, need more assistance with daily activities or spend more time in bed, clinicians and families may normalize these changes as expected consequences of cancer or treatment. Yet progressive functional decline is frequently the clearest indication that an illness trajectory is changing. It is often a signal that warrants a broader conversation about prognosis, goals of care and whether the current treatment plan still aligns with what matters most to the patient. As physicians, we routinely rely on objective measures to assess disease progression. While scans tell us how a tumor is behaving, functional status tells us how the patient is living. Both are essential to understanding prognosis and making care decisions that align with patient goals.Editor's Note: Read this phrase again, "While scans tell us how a tumor is behaving, functional status tells us how the patient is living." Whule this article is for oncologist, your hospice interdisciplinary teams' interactions with patients and caregivers provide rich, relevant, time-sensitive conversations, observations, and supportive interventions. What kinds of team coordination exist between your physicians and team members who visit regularly in the patient's home setting (aka, home/ALF/LTC)?

Poverty level affects end-of-life care in adolescent and young adult cancer patients  Cancer Therapy Advisor; by Liam Andrew DAvenport, MA; 7/24/26 Adolescent and young adult (AYA) cancer patients from high-poverty neighborhoods face disparities in end-of-life (EoL) care, according to research published in the Journal of the National Comprehensive Cancer Network. AYA patients from high-poverty neighborhoods have more emergency department visits and hospitalizations, and less hospice use, than their low-poverty counterparts, study researchers reported. ... Eligible patients had been diagnosed with cancer and died between 12 and 39 years of age, and were enrolled in one of the participant health systems for more than 90 days prior to their death. 

The effect of palliative care involvement in vascular patients at the end-of-lifeJournal of Vascular Surgery; by Angela McCarthy, Kristy Wrana, Emma Triantafyllou, Ya-Huei Li, Carol Strycharz, Lindsay Lynch, Edward D Gifford; 6/26Vascular surgeons frequently manage critically ill patients and support complex end-of-life decision-making. Despite well-documented benefits of palliative care in serious illness, prior studies report that only 25% of vascular patients near the end of life received such support. Those without a palliative consult were more likely to undergo a code (18.0% vs. 6.6% ... ). After palliative consultation, the proportion of patients with a code status of do-not-resuscitate increased from 50.0% to 77.4%, and the proportion with a full code designation decreased from 50% to 22.6%  ... Patients with the goal of care to allow natural death increased to more than half of the patients from 18.4% after the palliative consultation ... These findings highlight an opportunity for vascular surgeons to proactively integrate palliative care, improving alignment between clinical interventions and patient preferences.

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.

Difficult discussions: How UTC nursing faculty are using AI to teach the hardest conversations in care The University of Tennessee Chattanooga, Chattanooga, TN; by Chuck Wasserstrom; 7/20/26 Two University of Tennessee at Chattanooga College of Nursing faculty members recently shared their work on AI-assisted simulation with an international audience, leading a webinar on how the technology can help prepare graduate nurse practitioner students for difficult conversations in palliative care: Dr. Chris Doneski, director of UTC’s acute care nurse practitioner program and a simulation faculty member, and Dr. Rosebelle Peters, nursing simulation program director and senior lecturer. ... The presentation centered on a gap the two faculty members see in graduate nursing education. Doneski said students often receive training in procedures, prescribing and transition to practice, but communication training for difficult situations can be harder to build in meaningful ways. ... The recorded webinar is available through HealthySimulation.com. Users must register for a free account to view it.

Some kids come here for vacation. Others come to die. Either way, parents are grateful USA TODAY, San Leandro, CA; by Madeline Mitchell; 7/20/26 ... There are mainly two kinds of families who come to George Mark's Children's House. Some come for respite, entrusting their medically fragile but otherwise stable children to skilled nurses while parents leave for a much-needed break from around-the-clock caregiving. Others come for pediatric end-of-life care, a rare and essential service that changed the trajectory of CEO Shekinah Eliassen's life. These parents stay with their children at George Mark and can bring the patient's siblings, too, to soak in their last days together. "This type of service, I believe, should be part of the system of pediatrics," Eliassen says, adding that families never see a bill for their visits. Her son, Lars, died at George Mark when he was 21 days old, after he was born having seizures. 

“I wish to be in the same room as my wife so I can hold her hand”: CalvertHealth grants husband’s final wishThe Baynet, Calvert County, MD; by CalvertHealth; 7/19/26 It was one final wish Phillip “Phil” Pfanschmidt shared after learning he had terminal cancer. Just days earlier, his wife of more than 66 years, Joyce “Joy” Pfanschmidt, had entered hospice care at CalvertHealth Medical Center. Now, Phil had entered hospice as well. When members of the palliative care team asked about his wishes, he didn’t hesitate.He wanted to be with Joy.Caregivers across CalvertHealth worked together to make that wish a reality. Phil was reunited with Joy, and the couple spent precious moments together, hand in hand. Less than two hours later, Joy peacefully passed away with her hand resting on Phil’s arm.

Personal experience fuels Jeannie Meyer's commitment to helping the homeless die with dignity UCLA Health; by Sandy Cohen; 7/15/26  The UCLA Health palliative care nurse is a national advocate for recording end-of-life wishes for unhoused individuals. Jeannie Meyer, MSN, didn’t realize she was homeless as a child. She thought everyone moved from place to place, hotel to hotel, and never answered the phone or the door in case a bill collector was on the other side. “I knew what ‘eviction notice’ meant when I was 5 years old,” she says. Those childhood experiences made her empathetic, but it was the pain of learning that her alcoholic father died on Skid Row that inspired Meyer, a palliative care nurse at UCLA Health, to advocate for advance care planning for homeless people.

Restarting medications after deprescribing in adults discharged from hospital to skilled nursingJAMA Network Open; by Thomas J. Reese, Sandra F. Simmons, Eduard E. Vasilevskis, Emily K. Hollingsworth, Matthew S. Shotwell, Amanda S. Mixon; 6/26Question: Among older adults discharged to skilled nursing facilities (SNFs) after hospital-initiated deprescribing, what is the frequency and timing of medication restarts ...?  In this cohort study analyzing data from 2 randomized trials with a total of 598 participants, 15.9% of deprescribed medications were restarted. Higher health literacy and longer intervention exposure were associated with fewer restarts, whereas more prescribers, higher number of baseline medications, and fewer pharmacies were associated with medication restarts; restart during the SNF stay was associated with greater 90-day hospital readmissions. Conclusions: In this cohort study, approximately 1 in 6 deprescribed medications were restarted within 90 days, with nearly half occurring soon after SNF discharge. Patient factors and markers of care fragmentation were associated with restart, suggesting that enhancing transitional care and postdischarge support may improve the durability of hospital-initiated deprescribing.