Literature Review

[Sweden] Palliative medicine physicians' experiences using the Numeric Rating Scale for pain assessment in patients with advanced cancer: a qualitative study BMJ Open; by Lisa Martinsson, Margareta Brännström, Per Fransson, Sofia Andersson; 1/6/26 This study aimed to describe palliative medicine physicians' experiences performing pain assessment using the Numeric Rating Scale (NRS)-one of the most widely used pain assessment tools-for patients with cancer receiving specialised palliative care. ... The tool may seem simplistic, but, ... the physicians found interpreting the assessments challenging for the whole team. This complexity should be incorporated into future healthcare education and training within the palliative care area, where patients often have chronic pain conditions in combination with cognitive impairment. Future research needs to focus on developing reliable pain assessment methods for patients who are cognitively impaired because of the cancer.

[Netherlands] Pediatric advance care planning: a mixed-methods evaluation of documentation and sharing in current practice BMC Palliative Care; by Sophie Tooten, Rosella P.M.G. Hermens, Manel Verhoeven, Ellen M. Vierhoven, Fatima Boulakhrif, Jana M. Reintjes, Michel A.A.P. Willemsen, Judith L. Aris-Meijer, Jurrianne C. Fahner, Marijanne Engel, Marijke C. Kars, Inge M.L. Ahout & Esther Deuning-Smit; 1/29/26 Pediatric advance care planning (pACP) aims to align future care and treatment of children with life-limiting conditions (LLCs) with children’s and their families’ values, goals and preferences. Documenting and sharing pACP elements with healthcare professionals (HCPs) is essential for goal-concordant care. This study evaluates how pACP elements are documented in electronic health records of children with LLCs and shared with other HCPs.

Many in Pacific Northwest delay end-of-life paperwork, expert says NonStop Local Tri-Cities/Yakima, WA; by NonStop Local; 1/21/26 Experts are saying the beginning of the year is a great time to break the silence around one of life's most important, yet most avoided conversations: our wishes for the end of life. Research reveals that only one in three people have completed necessary paperwork like advanced directives, according to Meagan Williams of Compassion and Choices. This national nonprofit focuses on end-of-life healthcare planning and options. 

How do I tell my patient they’re dying? Medscape; by Lisa Mulcahy; 1/27/26 Ruth Parry, PhD, still remembers a conversation she mishandled as a junior National Health Service stroke rehabilitation physiotherapist many years ago. ... Since then, Parry has analyzed nearly 100 video consultations between practitioners and patients with poor prognoses in stroke and head injury and with terminal diagnoses. Her research explores a critical clinical dilemma: How do doctors navigate the delicate balance of providing fair, accurate information about dire prognoses while respecting a patient’s feelings and personal choices?

Improving timeliness of palliative care referrals within the ICU: A quality improvement project Dimensions of Critical Care Nursing (DCCN); by Stephanie Fiore, Simone O'Donovan, Kerry A Milner; 1/23/26 ... Using the Model for Improvement, this quality improvement project was conducted over 7 months, including a 4-month baseline phase and a 3-month implementation phase. ICU nurses used a PC screening tool to evaluate patients within 48 hours of admission. The project aimed to increase PC screenings to 75% and ensure PC referrals within 48 hours. ...  The implementation phase saw a significant increase in PC screenings, with compliance reaching 90.9% after process adjustments. 

Husband with Parkinson's was admitted into at-home hospice program and has dramatically improved. Have others experienced this? Aging Care; by Klwolf; 1/21/26 My DH has Parkinson’s that has been getting progressively worse for months. In early December we had him assessed for hospice and he was admitted. Since then, he’s improved dramatically. Has anyone else experienced dramatic improvement AFTER hospice enrollment? The hospice staff simply shrugs and says this sometimes happens and that we need to be prepared for him to revert back to his previous state. Editor's Note: Many clinicians have seen individuals improve after hospice enrollment, often due to better symptom control, reduced stress, or consistent interdisciplinary care. The concern here is not the improvement itself, but the hospice team’s reported response. A shrug can feel dismissive to families already living with uncertainty. How do we teach teams to communicate about improvement—honoring hope while preparing families with clarity, compassion, and trust?

Palliative care staff attitudes toward music therapy for hospitalized adult patientsAmerican Journal of Hospice & Palliative Medicine; by Katherine A. Carney, Rachel M. Wiste, Susanne M. Cutshall, Christina Wood, Rachel C. Gentes, Brianna E. Larsen, Nana A. Tiwaa, Amelia E. Tetlie, Regina M. Mackey; 12/25There is emerging evidence that music therapy (MT) is an effective tool within palliative care to manage patients’ complex needs. This performance improvement project aimed to assess palliative care staff members’ attitudes toward the current utilization of MT within the institution’s hospital-based interdisciplinary practices. Top reasons for MT referral were psychosocial support, pain and symptom management, and coping. The most common symptom-focused indications were anxiety, mood, and existential distress. In this single-institution performance improvement project, staff attitudes were highly favorable toward MT for palliative care patients. MT is utilized for a variety of reasons, can be highly effective for improving patients’ quality of life, and may also be of direct benefit to staff.

Integrating compassion and policy: Highlights from IAHPC Advocacy, 2025Palliative Medicine in Practice: by Katherine Irene PettusIn 2025, the International Association for Hospice and Palliative Care (IAHPC) advanced advocacy for palliative care as an ethical, clinical, and human rights imperative. As a non-state actor in official relations with the World Health Organization (WHO), the association worked across policy, faith, and professional domains to integrate palliative care into universal health coverage frameworks. This report summarizes IAHPC’s global activities from February to November 2025, including engagement at the 78th World Health Assembly (WHA), collaboration with WHO and the International Narcotics Control Board (INCB), the launch of the Leadership and Advocacy Development (LEAD2) program, and new interfaith and educational initiatives.Assistant Editor's note: As I peruse peer reviewed journals to bring you relevant and current summaries of research, I am amazed at the large number of articles published now about palliative care. It wasn't this way just a few years ago. As a long-time hospice and palliative care nurse, I am delighted to see the ground swell of interest in the principles, the need, the value, and the effectiveness of palliative care. I feel like 'We Have Arrived' (finally!). Kudos to all of you who have worked tirelessly over many years to educate professionals and the public at large, about palliative care and its virtues. I know we are not done; there is more to do. But we've come a long way baby!

‘Death Cafe’ will explore end-of-life issues, over refreshments OC Register, Orange County, CA; by Teri Sforza; 1/21/26 The Orange County Deathworkers Alliance wants to chat about your inevitable demise. Yes, members say, they’re a blast at parties! The Alliance is not a grief support group exactly, but a collection of caregivers, doulas, doctors, organizers and the like who help folks get a grip on the details attendant to their own mortality, and/or the mortality of loved ones. ... Death Cafés are a global movement, allowing people to discuss the oft-taboo thoughts and questions they have about the end of life. Organizers say the format encourages folks to share personal stories, explore their feelings and/or simply listen to other perspectives in a supportive atmosphere.

Patients' perceptions of autonomy in palliative care: Two patient interview exemplars Palliative Care and Social Practice; by Kristen Tulloch, Julia Acordi Steffen, John P Rosenberg; 1/19/26 Results: Four themes were identified: (a) my involvement in healthcare decisions, (b) change to my autonomy during illness progression, (c) self-assessing my abilities to exercise autonomy and (d) my coping mechanisms for loss of autonomy. Palliative care patients perceived and managed their autonomy amidst their illnesses, revealing a sense of loss of autonomy extending beyond healthcare into many daily activities. Participants wished to exercise autonomy in nuanced ways, varying in intensity across many aspects of their lives, underscoring the importance of recognising and respecting individuals' wishes for autonomy.Editor's Note: The authors’ focus on coping with loss of autonomy is essential. As illness progresses, autonomy can erode not only in medical decisions but across daily life, identity, and meaning—losses that are too often overlooked in clinical care. The frequently misapplied “Five Stages of Grief” can further blur this reality, reducing complex, personal experiences to linear expectations not supported by contemporary grief research. Understanding how patients adapt to loss of autonomy is foundational to truly person-centered palliative care.

Advance care planning in patients nearing the end of life: A pre-intervention study of racial disparities and provider factors Journal of General Internal Medicine | Springer; by Vedha Penmetcha BA, Mia Marcotte BA, Yashaswani Chauhan MD, Malathi Srinivasan MD, Adrian M. Bacong PhD, Amelia Sattler MD; 1/19/26 The pre-intervention study of Advance Care Planning (ACP) in patients nearing the end of life highlighted significant racial disparities and the impact of provider factors on ACP documentation. The study found that Asian patients were least likely to have ACP documentation in their charts, and minorities who had ACP conversations were less likely to have documentation. This suggests that ACP conversations are often not documented in the electronic health records of these patients, indicating a need for targeted interventions to improve ACP documentation rates. The study also revealed that providers may struggle to identify who and when to engage in ACP conversations, which can be a barrier to effective ACP.