Literature Review

New Iowa law allows ‘adult close friend’ to make end-of-life medical decisions KCRG-9 ABC, Iowa City, IA; by Lacey Reeves; 5/28/26 Starting in July, a close adult friend can make end-of-life medical decisions for someone who is unable to make them themselves under a new Iowa state law. When a patient can’t make medical decisions for themselves, a hierarchy establishes who can make the decisions for them. Typically a spouse, adult child or adult sibling of the patient can make those decisions. “Not everybody has a family member who is available, willing, capable to make decisions for them,” said Sara Krieger, CEO of Iowa City Hospice. Iowa City Hospice said it has been working for years to add “close adult friend” to that list through legislation.

Early palliative integration for heart failure Medscape; by Karel De Pourcq, PhD; 5/27/26 ... Chronic conditions such as heart failure often bring relentless symptoms, repeated hospital admissions, and deep emotional and social effects for patients and their families. Bringing a palliative perspective into care widens the focus beyond disease-directed treatments to include ongoing symptom relief, emotional support, and help for overburdened caregivers. It also promotes early, shared planning about treatment intensity — deciding when worsening episodes can be managed at home vs when hospitalization is needed — and clarifying care goals as the illness progresses.

Ketamine for depression in serious illness: Evidence, safety, and practical approachesJournal of Pain & Symptom Management; by Paul Noufi, Joshua B. Borris, Danielle Chammas, Cara L. McDermott, Nneka N. Ufere, Jason A. Webb, Daniel Shalev; 4/26Patients with serious illness and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. Ketamine and esketamine [nasal spray] offer the strongest evidence among rapid-acting antidepressants and may be preferred when urgent symptom relief is needed. However, rigorous psychiatric trials in serious illness are lacking. Clinicians should consider prognosis, access to Risk Evaluation and Mitigation Strategies-certified esketamine programs or equivalent regulatory frameworks outside the US, and the need for an appropriate maintenance regimen when integrating ketamine into palliative care depression management.

Signs it’s time for in-home healthcare: 11 warning signs U.S. News & World Report News; by Barbara Sadick; 5/27/26 

Palliative care education boosts assisted living staff confidence, care quality for residents with dementiaMcKnights Senior Living; by Kimberly Bonvissuto; 5/27/26...  Most assisted living staff members currently say they lack the training to engage in advance care planning, according to the researchers. The National Institutes of Health, which funded [this] study, said that the palliative care education intervention studied has the potential to be delivered more broadly among assisted living communities and could be vital in addressing workforce challenges in providing high-quality palliative and end-of-life care there. 

The dying dream of the dead to be at peace with life DW; by Hannah Fuchs; 5/22/26 Many people have vivid dreams shortly before death. Research suggests the dreams are not a sign of confusion — but may help both the dying and their loved ones make sense of loss. Known as End‑of‑Life Dreams and Visions (ELDVs), they often occur as dreams during sleep, and sometimes as visions while a person is awake. For those experiencing them, they can feel more vivid and real than ordinary dreams — and for those observing them from the outside, it can be unsettling. Medicine long dismissed ELDVs as episodes of sudden confusion (delirium) or as side-effects of medication. But today, the thinking is shifting.

7 dog breeds that can sense when their owner is about to die Doggodigest; by Gargi Chakravorty; 5/20/26 ... Stories of dogs refusing to leave their owner’s side during their final days or acting strangely before a loved one passes away have fueled curiosity about whether dogs truly possess a sixth sense about death, and scientific research has begun to explore this phenomenon, revealing that dogs’ extraordinary senses may allow them to detect subtle biological and behavioral changes in humans. Science suggests dogs may sense approaching death not through psychic ability but through scent. What follows isn’t mythology. It’s a look at seven dog breeds whose sensitivity, emotional intelligence, and extraordinary olfactory wiring make them especially attuned to the moments most of us can’t yet perceive.

10 of the biggest regrets nurses hear from dying patients SavingAdvice.com; by Amanda Blankenship; 5/15/26 ... Hospice nurse Bronnie Ware famously documented several of the most common regrets she heard from patients nearing death, including working too much and failing to stay close to loved ones. These end-of-life regrets offer important lessons for anyone hoping to live with fewer disappointments and more peace.

Research spotlight: characterizing patient perceptions of palliative care in surgical settings Mass General Brigham | Patient Care; by Claire Morton, MD and Zara Cooper, MD, MSc; 5/19/26 ... Question: What did you find? Generally, patients were not familiar with palliative care. If they had heard of it, they often equated it with hospice or end-of-life care, leading to misconceptions about its scope and purpose. However, our observations revealed that patients frequently initiated discussions about concerns relevant to palliative care, such as social or psychological burdens they were experiencing during their visits with surgeons. This indicated an underlying interest in these domains, even if they were not explicitly aware of how palliative care could address them. ...Question: What are the real-world implications, particularly for patients? ...

Redwood Newsmakers: Hospice of Humboldt Palliative Care Program Redwood News; by Ross Rowley; 5/20/26 We’re here with Karen Ayres, nurse practitioner with Hospice of Humboldt, talking about home-based palliative care and the growing need for these services here in our community. Hospice of Humboldt started this program in 2022. ... “So we started this service called home-based palliative care,” she said. “While we are part of Hospice of Humboldt, we are one of the services they offer. We’re not hospice care, we’re palliative care. ..."

Research spotlight: characterizing patient perceptions of palliative care in surgical settings Mass General Brigham | Patient Care; by Claire Morton, MD and Zara Cooper, MD, MSc; 5/19/26 ... Question: What did you find? Generally, patients were not familiar with palliative care. If they had heard of it, they often equated it with hospice or end-of-life care, leading to misconceptions about its scope and purpose. However, our observations revealed that patients frequently initiated discussions about concerns relevant to palliative care, such as social or psychological burdens they were experiencing during their visits with surgeons. This indicated an underlying interest in these domains, even if they were not explicitly aware of how palliative care could address them. ...Question: What are the real-world implications, particularly for patients? ...

A husband’s story of end-of-life care at home MedPage Today's KevinMD.com; by Ron Louie, MD; 11/27/25... When my wife died at home, it wasn’t really a surprise. ... Over the previous few weeks, we had notified her primary care physician’s office of the need for a home hospice referral, but because of some snafu, the correct wording wasn’t used, and the paperwork stalled. ... Years before, we had already obtained a POLST (Portable Order for Life-Sustaining Treatment, our state’s “green form”), signed by a doctor, that made clear my physician wife’s choices in advanced directives: no CPR, tube feedings, or IV treatments. ... Since we didn’t have an active home hospice referral, I knew that firefighters could pronounce her death; my own license had lapsed in retirement. ... The firefighters left, but the police stayed quite awhile until they were cleared by the Medical Examiner’s office. ...Editor's Note: This caregiver story powerfully tells challenges experienced by a retired oncologist/spouse. Calling all leaders who are part of referral and admissions processes, pay attention to the problems caused by delays: firemen, police, and (not named) lack of bereavement care.