Literature Review

Embedding care in the ED: Liz Goldberg and Lauren Southerland GeriPal; podcast by Alex Smith with Dr. Liz Goldberg and Dr. Lauren Southerland; 2/12/26 The idea of embedding various forms of non-emergency care in the emergency department makes a WORLD of sense.  If an older adult comes into the ED with a fall, the minimum the ED has to do is address the fall injury and send them out. But many emergency providers realize this is often a band aid.  They see that patient again the next time they fall.  And again.  And again.  The same could be said for the patient who is malnourished and dehydrated and admitted for “failure to thrive,” again. And again. Our two guests today, Liz Goldberg and Lauren Southerland, both emergency medicine physician-researchers, have had enough.  ...

What can we learn from death in the age of longevity? Time; by Arianna Huffington; 2/16/26 ... Research on those at the end of life shows that our values change as death approaches. At the end, we don’t crave more status or more things, but more connection. A study on terminally ill patients found that common reflections include concern for loved ones, gratitude, and spirituality. Another found that the most commonly discussed topics included accepting one's imperfections, celebrating and appreciating what you have, giving, and service to others. And a study of hospice patients found that they showed “the desire to grow and change at this critical time.” If hospice patients can grow and change at the end of life, why not grow and change now? ... It is a surprising, but important, lesson to learn: bringing death into our lives is what paradoxically allows us to live more fully.  

Palliative external beam radiation therapy for dysphagia in a 101-year-old man with esophageal adenocarcinomaCureus; by Pericles J. Ioannides, Jester M. Odrunia, Gina N. Perez, Morgan Butow, Georg A. Weidlich; 1/26Esophageal adenocarcinoma in centenarians is rare, and treatment options in this age group are limited. We present the case of a 101-year-old male patient with symptomatic distal gastroesophageal junction (GEJ) adenocarcinoma who presented with progressive dysphagia, aspiration, and weight loss. The patient underwent palliative external beam radiation therapy (EBRT) ... targeting the obstructive esophageal mass with a margin using volumetric-modulated arc therapy (VMAT) technique. The treatment was well tolerated by the patient with no significant acute toxicity. After treatment, the patient reported clinically meaningful improvement in functional status, with improved swallowing, advancing from liquids to a soft diet, weight gain, and improved QoL. Moderate-dose palliative radiation can be a safe and effective treatment in a centenarian with obstructive GEJ adenocarcinoma, particularly when endoscopic interventions are not successful or durable.

Hospice doctor shares what happens in the moments immediately after death Good; by Adam Albright Hanna; 2/3/26 Throughout human history, one question has bewildered every civilization, society, and individual. What happens after we die? For some people, it is a question for science. For others, it is a question of faith. But for Dr. B.J. Miller, it is a question that he is totally fine not knowing the answer to. Miller is a hospice and palliative care physician at the University of California, San Francisco. He is one of the world's leading voices on dignified death, and for him, the end of life is actually about the living. ... "I’ve been around people who are just about to die," Miller said. "Bodies that have just died. And there is this lingering sense, it’s true. There’s a feeling. It’s a palpable... yeah, there’s a lingering." ... "I didn’t need to have control over everything, I didn’t need to know the answers anymore. I mean, I love not knowing. The answer’s unimportant. It’s just a sacred and gorgeous moment."Editor's Note: Having served in direct hospice patient care from 1993–2002, I was present with many persons during their active dying and in the moments just after death, including attending deaths as a chaplain. Over time—and especially through the intimate experience of my parents’ deaths—that sense of sacredness Dr. Miller describes remains real for me. So I find myself wondering and asking non-clinical leaders: when you look at Average Daily Census (ADC), Length of Stay (LOS), and other familiar metrics, what do you see? Numbers on a spreadsheet? Or living measures of something immeasurably human—something that truly matters?

[Canada] The quiet web of care: Hospitals, hospice, paramedics and community working as one The Millstone; Mississippi Mills area, Canada; 1/25/26 When we think about care, most of us picture the hospital: rooms, nurses, doctors, the moment a life changes. But real care in North Lanark is not anchored to a single building. It’s a living web the Mississippi River Health Alliance — Almonte General Hospital, Carleton Place & District Memorial Hospital, Fairview Manor, and Lanark County Paramedic Service — working alongside Home Hospice North Lanark and Houle Healthcare so neighbors can get the right help at the right time, in the place that matters most. ... They are parts of the same journey, passing the baton back and forth so patients, families and neighbors are not left to navigate alone.Editor's Note: Pair this with today's post, "Why patient flow will decide hospital performance in 2026."

EV0034 Palliative pain relief: A case study of high-frequency spinal cord stimulation in an end-of-life cancer patientNeuromodulation: Technology at the Neural Interface; P. Majedi, Dominic Bailey; 1/26A significant proportion of patients with cancer will experience cancer-related pain at some point during their illness. The treatment approach for cancer-related pain is often multifaceted and may necessitate the use of advanced interventional methods, including spinal cord stimulation (SCS). Recent studies have demonstrated the utility and efficacy of SCS techniques in the treatment of cancer-related pain and chemotherapy induced neuropathy. Here, we present a case report on a patient receiving high frequency SCS at 10 kHz for end-stage cancer-related pain.

[Austria] Hospice nurses' views about the necessity for palliative sedation in existential sufferingPain Management Nursing; Dana Hagmann, Susanne Fleckinger, Piret Paal; 1/26Disagreements between nurses and doctors regarding the assessment and management of existential suffering in terminally ill patients represent a critical challenge in palliative care, particularly in the context of inpatient adult hospices. The study highlights the limited involvement of nurses in decision-making processes regarding palliative sedation despite their critical insights into patients' existential suffering. The findings emphasize the need for interdisciplinary collaboration and the integration of nurses' perspectives to achieve more holistic and ethically sound care in inpatient hospices.

DaVita’s strategic investment in Elara Caring aims to transform home-based kidney care Market Chameleon; Press Release; 2/3/26 DaVita has announced a major new partnership, joining forces with Ares Management to invest in Elara Caring—one of the nation’s leading home health providers. ... A standout feature of this partnership is the plan for DaVita and Elara to co-develop a specialized, kidney-focused in-home care model. Leveraging DaVita’s expertise in kidney health and Elara’s reach in home care, the initiative seeks to cut preventable hospitalizations and lower costs for high-acuity patients. For the growing population living with chronic kidney disease, this could open new, personalized options for treatment and stability at home—addressing a consistent challenge in value-based care.

Many patients with advanced blood cancers delay hospice to keep access to blood transfusionManaged Healthcare Executive; by Briana Contreras; 2/4/26Key Takeaways:

How to responsibly use AI in palliative care and hematologic malignancies CancerNetwork; podcast by Ram Prakash Thirugnanasambandam, MBBS; 2/2/26 In a conversation with CancerNetwork®, Ram Prakash Thirugnanasambandam, MBBS, discussed the evolving roles that artificial intelligence (AI)–based tools may play in palliative care and the management of different hematologic malignancies. ... According to Thirugnanasambandam, implementing AI into one’s workflow may help accurately predict disease subtypes and burdens among patients with leukemia, lymphoma, or multiple myeloma. ... Thirugnanasambandam also discussed some of the ethical considerations surrounding the growth of AI-based tools, highlighting information privacy concerns and potentially biased datasets as notable issues with these platforms. Although AI may assist with decision-making, Thirugnanasambandam stated that it ultimately cannot replace a human’s nuanced clinical judgment and empathy.

Retired VA Nurse shares what she learned from over 10,000 dying veteransTampa Bay 28-ABC, Tampa Bay, FL; by Wendy Ryan; 1/30/26“Everything I've learned that has really mattered, I learned from the dying. Perspectives shift dramatically as death approaches. The day before you're given a terminal diagnosis, you take your life for granted. The day after, you wake up,” said Deborah Grassman, reading her book ‘Soul Injury.’ For over three decades as a VA hospice nurse practitioner, Deborah Grassman helped over 10,000 veterans take their final breath in peace. In those sacred moments, she began to see something they all carried. She calls it a “Soul Injury”, a wound that quietly haunts you. ... 

[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.

Integrating psychiatric and hospice services: Legal and clinical considerations for involuntary commitment in multimorbid end-of-life care American Journal of Hospice and Palliative Medicine; by Ilana Marmershteyn, BS, Darian Peters, BS, Victor Milev, BS, Mario Jacomino, MD, MPH, and George Luck, MD, FAAHPM; 1/28/26  Multimorbid patients at the end-of-life face complex medical, psychosocial, and psychiatric challenges. Hospice care aims to address physical, emotional, and spiritual needs; however, psychiatric comorbidities, particularly acute crises, remain under-recognized and inconsistently managed. The intersection of psychiatric intervention, hospice care, and legal frameworks such as involuntary commitment presents significant clinical and ethical challenges.