Literature Review

The essential role of Speech-Language Pathologists in end-of-life swallowing intervention: A narrative reviewASHA Perspectives; by Sanora Yonan; 9/25Speech-language pathologists (SLPs) are essential in the intervention of dysphagia, particularly at the end of life (EoL), where their guidance can significantly improve patients' comfort and quality of life. However, despite a growing recognition of their importance in this palliative setting, SLPs continue to face obstacles for consistent involvement on the palliative care team. Three primary themes emerged [from this study]: diet texture adjustment, compensatory swallowing strategies, and patient and caregiver education. The review also identified significant barriers to SLP involvement, including inconsistent practices, limited resources, legal concerns, and a lack of interdisciplinary integration.Assistant Editor's note: In my experience, SLPs were rarely, if ever, utilized with hospice patients. However, this article clearly describes ways that SLPs could be helpful for patients with swallowing difficulties. SLPs can also be very useful for patients with speech difficulties. I think the IDT simply does not think of it-does not think of how a SLP could be helpful. Maybe it is also partly due to lack of knowledge of their value. Perhaps, both hospice and palliative care teams might consider arranging for an inservice from a SLP so that team members can learn more about how such therapy could be helpful in improving the quality of life of patients.

Impact of the Affordable Care Act on palliative and hospice care utilization among patients with gastrointestinal cancers: An interrupted time series analysisJournal of Palliative Medicine; by Eshetu Worku, Selamawit Woldesenbet, Mujtaba Khalil, Timothy M Pawlik; 9/25The Affordable Care Act (ACA) aimed to expand insurance coverage, improve health outcomes, and reduce costs. We assessed the impact of the ACA on hospice or palliative care utilization among [Medicare] patients with stage IV gastrointestinal (GI) cancer. Patients from minority racial groups ... and those in moderate ... and high ... Social Vulnerability Index (SVI) counties were less likely to use palliative care in both pre- and post-ACA eras. Palliative care use was associated with $2,633 lower total expenditure. Conclusion: ACA implementation did not improve palliative care utilization for racial minorities and high SVI groups.

[Finland] Management of dyspnea with high-flow nasal air or fan-A randomized controlled crossover trialJournal of Pain and Symptom Management; by Sirpa Leivo-Korpela, Heidi A Rantala, Lauri Lehtimäki, Reetta P Piili, Hannele Hasala, Tarja Korhonen, Juho T Lehto; 9/25[This study aimed to] assess the effect and feasibility of HFNT [high-flow nasal therapy] with air compared to fan therapy in relieving dyspnea among non-hypoxemic patients with incurable cancer. The effect of airflow through HFNT or fan on dyspnea did not differ in non-hypoxemic patients with advanced cancer. Both therapies seemed to give slight relief on dyspnea without significant adverse events. Thus, the choice between HFNT with air or fan should be made according to the patient´s preferences.

The Center to Advance Palliative Care and the National Kidney Foundation make the case for the integration of palliative care into kidney disease management PR Newswire, New York; by The Center to Advance Palliative Care; 10/8/25 Despite facing high rates of distressing symptoms—including fatigue, pruritus, and pain—people living with advanced kidney disease are far less likely than those with cancer to receive appropriate pain and symptom management. And fewer than 10% of older adults receiving dialysis report having had conversations about their goals of care. These are two of the many important statistics highlighted in The Case for Palliative Care in Kidney Care, a new publication from the Center to Advance Palliative Care (CAPC) and the National Kidney Foundation (NKF), which emphasizes the critical need to integrate palliative care services into the treatment of patients with advanced kidney disease. 

‘A good death’: How compassionate care helps people navigate the end of life YaleNews - Health & Medicine, New Haven, CT; by Meg Dalton; 10/13/25Palliative and hospice care both focus on improving the quality of life of people with serious illness. In a Q&A, Shelli Feder discusses the future of compassionate care in the U.S. — and what it means to have a “good death.” The hospice movement got its start in the United States right here in New Haven.  In the late 1960s, former Yale School of Nursing (YSN) Dean Florence Schorske Wald attended a speech given by hospice pioneer, Dr. Cicely Saunders, at Yale School of Medicine. ...

Palliative care remains underused among young adults with advanced cancer in U.S. American Cancer Society, Chicago, IL; 10/10/25 Although palliative care use has increased over time among young adults with advanced cancers in the United States, new research led by the American Cancer Society (ACS) found that utilization still remains very low. Palliative care focuses on improving the quality of life for individuals with serious or life-limiting illnesses. ... Researchers, led by Kewei (Sylvia) Shi, MPH, at the American Cancer Society, used the National Cancer Database to identify patients aged 18-39 who were newly diagnosed with stage-IV cancers. ... The study included a total of 76,666 patients. The percentage receiving any palliative care increased from 2.0% in 2010 to 4.8% in 2023.

[Brazil] Integrating holistic communication into psychedelic-assisted therapies in hospice and palliative care: An approach based on Peplau's theoryJournal of Holistic Nursing; by Ana Cláudia Mesquita Garcia, Felipe Teixeira, Lucas Oliveira Maia; 9/25 Psychedelic-assisted therapy (PAT) has shown promising results in alleviating psychological and existential suffering among individuals with serious illnesses. This article explores the application of Peplau's Theory of Interpersonal Relations (PTIR) as a foundation for holistic communication in PAT, particularly in hospice and palliative care. We examine how PTIR's core concepts (person, health, environment, and nursing) along with its articulation of therapeutic roles, phases of the nurse–patient relationship, and the concept of anxiety as a signal of unmet needs, can be integrated into PAT's preparation, dosing, and integration phases. Drawing on a fictional case study involving a patient with advanced cancer, we illustrate how nurses can use PTIR to support emotional processing, foster insight, and promote personal growth during psilocybin-assisted therapy.

Telepalliation creates a sense of security: A qualitative study of patients with cancer receiving palliative carePalliative Medicine; by Jarl Voss Andersen Sigaard, Elisabet Dortea Ragnvaldsdóttir Joensen, Una Rósa Birgisdóttir, Helle Spindler, Birthe Dinesen; 10/7/25 ... The aim of this study was to explore patients' experiences with the functionality of the Telepalliation program while receiving specialized palliative care. ... Results: Four key themes emerged: "Sense of coherence," "Telepal platform," "Roles of spouse/partner and relatives," and "Cross-sector collaboration." The program improved patients' sense of security and coherence by enhancing communication with healthcare professionals. ... The platform also successfully integrated relatives into the care process. Editor's Note: While this research was conducted in Denmark, it surely resonates with patient care in the US. Reference articles in the uncertainties of government shutdowns, legislative needs to extend telehealth, and more: 

Life lessons from a palliative care psychologist - and how to support a dying loved one HELLO! onMSN; by Pilar Hernán; 10/5/25 ... Psychological support becomes a fundamental pillar for providing comprehensive and humane care, from managing emotional pain to adapting to the new reality. MD Anderson Cancer Centre psycho-oncologist Fátima Castaño helps us understand the process, explaining how we can support a loved one in palliative or end of life care, and shares the powerful life lessons she has learned through her work.

Surgeon perspectives on palliative care: Are we the barrier to better care?The Journal of Clinical Ethics; Sean J Donohue, Baddr A Shakhsheer, Peter Phung, Anthony W Kim, Monica Zell, Sean C Wightman; Fall 25Surgeons face numerous perioperative challenges when caring for patients with life-threatening or chronic diseases. Palliative care has been associated with an average reduction of $3,237 per admission, as well as reduction in emergency department visits, hospital admissions, and hospital length of stay. For patients within the intensive care setting, palliative interventions have shown a 26 percent relative risk reduction in intensive care unit length of stay and overall alignment of patients' and families' goals of care. It remains pervasive in surgical culture that operative intervention and palliation are mutually exclusive and occur sequentially, rather than concurrently. Preoperative palliative care consultations in surgical patients occur less than 1 percent of the time. Preoperative palliative care may serve to help explore, clarify, and document quality-of-life values and preferences, in hopes of better promoting goal-concordant care.

Not everything is delirium at the end of life: A case reportAnnals of Palliative Medicine; by Daniel Gilbey, Eduardo Bruera, Patricia S Bramati; 9/25In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Case description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.

Instilling hope: A comprehensive model of cancer care for younger adults Targeted Oncology; by Andrea Eleazar, MHS and Shane Dormady, MD, PhD; 9/29/25 In the past decade, the incidence of numerous cancer types has increased, particularly among younger adults under age 50. For younger adults, many of whom are primary breadwinners of their households or in the height of their educational or professional careers, a cancer diagnosis at this life stage can be unexpected and jarring. ... In an interview with Targeted Oncology, Shane Dormady, MD, PhD, medical director of El Camino Health Cancer Center, describes the unique needs and challenges of younger adults, outlines El Camino Health’s comprehensive care strategy, and offers insights and considerations for treating and interacting with this patient population.

Alzheimer's Association: New telenovela series highlights Alzheimer’s in Hispanic and Latino communities Alzheimer's Association, Chicago, IL; Press Release; 9/15/25In conjunction with National Hispanic and Latino Heritage Month, the Alzheimer’s Association is premiering "Memories of My Grandfather" ("Recuerdos de mi abuelo"), a five-episode mini telenovela aimed at encouraging Hispanic and Latino families to have open discussions about memory loss, diagnosis and caregiving across generations. The series, available in both English and Spanish, follows the emotional journey of a multigenerational Hispanic family in the United States after their grandfather’s Alzheimer’s diagnosis. The telenovela will be screened during two webinars hosted by the Alzheimer’s Association: one in English on Sept. 30 and one in Spanish on Oct. 7. Both webinars will feature a moderated discussion hosted by actress, film producer and Telemundo news anchor Gabi Del Moral. ... Both webinars are free and open to the public. Register for the English-language webinar or the Spanish-language webinar.