Literature Review

Palliative care consults for the oldest-old: A retrospective study of referral patterns, patient characteristics, and clinical outcomes Geriatric Nursing; by John Cameron, Kalli Stilos, Anita Chakraborty; 8/11/26Objective: This study describes the characteristics and outcomes of patients aged 90 and older (the oldest-old) receiving inpatient palliative care consultation at a tertiary care hospital, to identify gaps and opportunities to improve care. ... Conclusion: Referrals for specialist palliative care in the oldest-old occur late in hospitalization, predominantly among those with non-cancer illnesses and poor functional status. Systemic changes, including the use of prognostication tools and enhanced collaboration between geriatric and palliative care services, are needed. Nurses are pivotal in advocating for earlier advance care planning (ACP) and identifying patients who would benefit from timely palliative integration to ensure goal-concordant care.

Mom, 35, spent years helping others as a doula. Then, lupus left her on deathbed worrying about her kids’ futurePeople; by Toria Sheffield and Nicholas Rice; 8/1/26

Heart failure hospital-at-home program matches traditional hospital care on readmission Home Health News; by MK Manoylov; 7/28/26 At-home heart failure care can be a viable alternative for patients getting heart failure care, in terms of safety and quality. Patients with heart failure who received advanced medical care at home had similar post-discharge outcomes to the care found within brick-and-mortar hospitals, according to a new study published in JAMA Network Open. Researchers found that heart failure patients treated at home had no significant differences in hospital readmissions and mortality compared to patients treated in hospitals.

What hospice care really means to a grieving familyKevinMD.com; by Ton La, Jr., MD, JD; 8/3/26Before my grandfather entered hospice, I believed it was where physicians sent patients to die. I saw it as the end of treatment, a quiet admission that medicine had given up. It was only through watching my grandfather’s final years that I came to understand hospice differently: not as the abandonment of care, but as one of its most compassionate forms. ... On Christmas morning, my uncle called to tell me my grandfather had fallen into a coma. His physicians urged us to say our goodbyes. When I arrived, the room was filled with family members offering prayers, and our rabbi came. Sitting beside him, I held his hand and prayed with everyone else. He passed away, and my entire world fell apart. ...   

‘It felt like a home:’ Caring House hospice home, in Torrance, celebrates 10 years Daily Breeze, Torrance, CA; by Madeline Armstrong; 8/3/26 When Torrance resident Rick Willson, 65, learned his wife had Leukemia, he knew that her diagnosis was likely terminal. But three months later, when told she would require hospice care, Willson had no idea where to begin. ... That is when they found Caring House. Caring House is the only nonprofit hospice home in Los Angeles County and it just happened to be in the Willsons’ neighborhood. Caring House – an actual six bedroom, two-and-a-half bath home on El Dorado Street – is celebrating its 10th anniversary in Torrance this year.

Scans tell us about the cancer. Functional status tells us about the patient. South Florida Hospital News and Healthcare Report; by Dr. Ileana Leyva; 8/1/26 In an era of precision oncology, we closely track biomarkers, imaging findings and treatment response. Yet one of the strongest predictors of how a patient is truly doing often receives less attention: functional status. When patients experience progressive fatigue, need more assistance with daily activities or spend more time in bed, clinicians and families may normalize these changes as expected consequences of cancer or treatment. Yet progressive functional decline is frequently the clearest indication that an illness trajectory is changing. It is often a signal that warrants a broader conversation about prognosis, goals of care and whether the current treatment plan still aligns with what matters most to the patient. As physicians, we routinely rely on objective measures to assess disease progression. While scans tell us how a tumor is behaving, functional status tells us how the patient is living. Both are essential to understanding prognosis and making care decisions that align with patient goals.Editor's Note: Read this phrase again, "While scans tell us how a tumor is behaving, functional status tells us how the patient is living." Whule this article is for oncologist, your hospice interdisciplinary teams' interactions with patients and caregivers provide rich, relevant, time-sensitive conversations, observations, and supportive interventions. What kinds of team coordination exist between your physicians and team members who visit regularly in the patient's home setting (aka, home/ALF/LTC)?

Poverty level affects end-of-life care in adolescent and young adult cancer patients  Cancer Therapy Advisor; by Liam Andrew DAvenport, MA; 7/24/26 Adolescent and young adult (AYA) cancer patients from high-poverty neighborhoods face disparities in end-of-life (EoL) care, according to research published in the Journal of the National Comprehensive Cancer Network. AYA patients from high-poverty neighborhoods have more emergency department visits and hospitalizations, and less hospice use, than their low-poverty counterparts, study researchers reported. ... Eligible patients had been diagnosed with cancer and died between 12 and 39 years of age, and were enrolled in one of the participant health systems for more than 90 days prior to their death. 

The effect of palliative care involvement in vascular patients at the end-of-lifeJournal of Vascular Surgery; by Angela McCarthy, Kristy Wrana, Emma Triantafyllou, Ya-Huei Li, Carol Strycharz, Lindsay Lynch, Edward D Gifford; 6/26Vascular surgeons frequently manage critically ill patients and support complex end-of-life decision-making. Despite well-documented benefits of palliative care in serious illness, prior studies report that only 25% of vascular patients near the end of life received such support. Those without a palliative consult were more likely to undergo a code (18.0% vs. 6.6% ... ). After palliative consultation, the proportion of patients with a code status of do-not-resuscitate increased from 50.0% to 77.4%, and the proportion with a full code designation decreased from 50% to 22.6%  ... Patients with the goal of care to allow natural death increased to more than half of the patients from 18.4% after the palliative consultation ... These findings highlight an opportunity for vascular surgeons to proactively integrate palliative care, improving alignment between clinical interventions and patient preferences.

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.

Difficult discussions: How UTC nursing faculty are using AI to teach the hardest conversations in care The University of Tennessee Chattanooga, Chattanooga, TN; by Chuck Wasserstrom; 7/20/26 Two University of Tennessee at Chattanooga College of Nursing faculty members recently shared their work on AI-assisted simulation with an international audience, leading a webinar on how the technology can help prepare graduate nurse practitioner students for difficult conversations in palliative care: Dr. Chris Doneski, director of UTC’s acute care nurse practitioner program and a simulation faculty member, and Dr. Rosebelle Peters, nursing simulation program director and senior lecturer. ... The presentation centered on a gap the two faculty members see in graduate nursing education. Doneski said students often receive training in procedures, prescribing and transition to practice, but communication training for difficult situations can be harder to build in meaningful ways. ... The recorded webinar is available through HealthySimulation.com. Users must register for a free account to view it.

Some kids come here for vacation. Others come to die. Either way, parents are grateful USA TODAY, San Leandro, CA; by Madeline Mitchell; 7/20/26 ... There are mainly two kinds of families who come to George Mark's Children's House. Some come for respite, entrusting their medically fragile but otherwise stable children to skilled nurses while parents leave for a much-needed break from around-the-clock caregiving. Others come for pediatric end-of-life care, a rare and essential service that changed the trajectory of CEO Shekinah Eliassen's life. These parents stay with their children at George Mark and can bring the patient's siblings, too, to soak in their last days together. "This type of service, I believe, should be part of the system of pediatrics," Eliassen says, adding that families never see a bill for their visits. Her son, Lars, died at George Mark when he was 21 days old, after he was born having seizures.