Literature Review

[Netherlands] Treatment satisfaction with nonoperative management of suspected hip fractures in nursing home patients with a Do-Not-Hospitalize directive: A prospective case series (NONU-HIP)Journal of Palliative Care; by Sverre A I Loggers, Romke Van Balen, Jeroen Steens, Hanna C Willems, Pamela Riezebos, Anja Wagenaar-Huisman, Michael H J Verhofstad, Esther M M Van Lieshout, Pieter Joosse; 9/25Some nursing home residents opt to forgo hospital admission in case of a suspected hip fracture due to the poor prognosis. This study assesses treatment satisfaction and quality of life in nursing home residents with a suspected hip fracture and a do-not-hospitalize directive. This study showed that nonoperative management of suspected proximal femoral fractures in nursing home patients that opted to forgo hospital admission, results in high treatment satisfaction, high quality of dying with good symptom control, and predictable short-term mortality rates. 

How to talk to your loved ones about end of life wishes Those Nerdy Girls; by Rebecca Raskin-Wish; 10/17/25 It’s important to have discussions about what you want the end of your time on earth to look like and have a healthcare proxy and an advance directive in place. When my sister and I were teenagers, my mom sat us down, and in a potentially more dramatic fashion than the moment called for, she said, “Girls, my death could happen any moment, and we need to talk about it.” ...

An age-old fear grows more common: ‘I’m going to die alone’ Miami Herald; by Judith Graham, Kaiser Health News; 10/17/25 This summer, at dinner with her best friend, Jacki Barden raised an uncomfortable topic: the possibility that she might die alone. “I have no children, no husband, no siblings,” Barden remembered saying. “Who’s going to hold my hand while I die?” ... It’s something that many older adults who live alone — a growing population, more than 16 million strong in 2023 — wonder about. ... More than 15 million people 55 or older don’t have a spouse or biological children; nearly 2 million have no family members at all.

Health Data Analytics Institute (HDAI) deploys innovative use of LLMs for summarizing and supporting patient preferences at a leading cancer center Bluegrass Live; by PR Newswire, Boston, MA; 10/20/25 An innovative new protocol called Better Real-time Information on Documentation of Goals of care for Engagement in Serious Illness Communication (BRIDGE-SIC) is being launched today at Dana-Farber Cancer Institute. BRIDGE-SIC uses Health Data Analytics Institute (HDAI) large language models (LLMs) to extract and summarize patients' goals of care conversations and their risk stratification tools for patient selection. The AI summaries identify and summarize prior goals of care conversations documented in patients' medical records and share them with inpatient and outpatient clinicians when patients with cancer are admitted to the hospital.

Teaching end-of-life care: A Q&A with Matthew Ellman, MD Yale School of Medicine; by Mahima Samraik, MS; 10/16/25 Every year, thousands of families sit in hospital rooms hearing words no one wants to hear: “We have done everything we can.” What happens next, whether doctors stay engaged or step away, can transform one of life's most difficult moments for patients and their families. ... We talked with Ellman about the importance of human connection in end-of-life care and how YSM is empowering the next generation of physicians to be actively present when their patients need them the most.

Letters without limits: Linda McDaniel The Johns Hopkins News-Letter; by Max Siauw and Linda McDaniel; 10/18/25 Letters Without Limits, founded by students at Johns Hopkins and Brown University, connects volunteers with palliative care and hospice patients to co-create “Legacy Letters.” These letters capture memories, values and lessons that patients wish to share, preserving stories that might otherwise be lost. By honoring these voices and preserving legacies, Letters Without Limits hopes to affirm the central role of humanism in medicine, reminding us that every patient is more than their illness and that their voices deserve to be heard. As you read these powerful Legacy Letters, we invite you to pause, reflect and recognize the beauty in every life.

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of lifeNutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.

Palliative care at the cutting edge: Recent updates in surgical palliative careJournal of Pain and Symptom Management; by Antoinette R Esce, T J Douglas, Elizabeth Gorman, Sophia Tam, Christopher D Woodrell, Ana Berlin; 9/25Surgical patients with serious illness often experience unique clinical trajectories, systems of care, and relationships with providers. In order to meet the needs of this patient population and their care teams, hospice and palliative medicine professionals should be familiar with evolving best practices in surgical palliative care. We present the case of a geriatric trauma patient with a new diagnosis of advanced cancer cared for in a surgical intensive care unit. This example highlights important new developments in defining and supporting the geriatric trauma population, improving and expanding surgical palliative care education, and identifying which seriously ill surgical patients benefit most from palliative care interventions.

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.

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. 

Stiff person syndrome in the hospice patient: A case report and discussion  Journal of Palliative Medicine; by Molly Svendsen, B Parker Layton, Shiri Etzioni, Mark Edwin; 10/13/25 Stiff Person Syndrome (SPS) is a rare, progressive autoimmune neurological disorder characterized by painful spasms, muscle rigidity, and heightened sensitivity to external stimuli. Management often relies on therapies that fall outside standard hospice formularies, creating challenges in end-of-life care for affected individuals. ... This case highlights the need for flexible, patient-centered approaches in hospice care for rare neurological conditions like SPS. Continuation of disease-specific therapies for symptom palliation can be ethically and clinically appropriate when integrated with clear goals of care. 

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.

What we get wrong about death, according to end-of-life workers Yahoo Lifestyle, originally appeared on HuffPost; by Monica Torres; 10/10/25 The one big thing that people have in common is that we all will die, and we likely will experience the death of someone we love, too. ... That’s why it can help to hear the insights of people who see death all the time, because understanding it now can help us better process grief about others and feel more at ease when thinking about our own mortality. ...