Literature Review

Reconsidering neuraxial analgesia at end of life: Clinical, ethical, and socioeconomic perspectivesInterventional Pain Medicine; Sanjeet Narang , Jason Yong , David Hao, 9/25Pain is one of the most prevalent and distressing symptoms experienced by patients nearing end of life, particularly among those with cancer. While systemic opioids are the mainstay of treatment, their limitations necessitate consideration of alternative strategies. Neuraxial analgesia, including epidural and intrathecal drug delivery systems, offers targeted pain relief with reduced systemic burden. Yet despite supportive data, these interventions remain underutilized due to clinical, ethical, logistical, and socioeconomic barriers. This article examines the complex decision-making involved in offering neuraxial analgesia at the end of life, weighing risks and benefits, shifting patient goals, and the challenges of care coordination.

Christmas for Lorie: Carmel neighborhood lights up August NBC WTHR-13, Carmel, IN; by Scott Swan; 8/21/25 On a warm August night, Christmas lights are twinkling on a street in Carmel. "One of our favorite traditions on Windbush is to decorate every house as much as possible," said neighbor Emily Clem. We may be 125 days away from Christmas, but for the family in this house, the beauty of the holiday needs to happen now. "When I saw the lights go up last Thursday or Friday, my heart sunk because I knew what it was," said Brady Young, who lives nearby. Lorie Graves, a 50-year-old wife and mom, is on home hospice as she battles ovarian cancer. "We did the Christmas decorations in the front yard because we have a very special neighbor right down the road who is battling cancer," said Shane Best. ... And so did the neighbors.

Why palliative care is more than just end-of-life support MedPageToday's KevinMD.com; by Dr. Vishal Parackal; 9/1/25 ... Palliative care as a system requires strong interpersonal and cross-specialty communication for smooth functioning, as patients may require expert opinions from different fields to optimize their treatment plan. Patient education for systemic follow-ups and establishing a baseline of knowledge regarding their diagnosis and potential danger signs helps create a better environment for holistic care. While we focus on the physical aspects of care and diagnosis, we often fail to realize the psychological and mental impact that such conditions can have on the patient and their family. ... The opportunity to make a meaningful difference in patients’ lives by easing their suffering and enhancing their quality of life is profoundly fulfilling. ... Editor's Note: Excellent descriptions of palliative care.

Palliative care and liver disease: Understanding hepatitis and beyond Ashland LocalTownPages, Aubrey, TX; by Press Services; 9/1/25 Sovereign Hospice, a woman-led hospice care provider serving the Dallas-Fort Worth Metroplex, offers specialized liver disease support programs. The organization also provides targeted hospice home care services and palliative care programs designed specifically for patients facing hepatitis and other advanced liver conditions throughout North Texas.

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.

[Iceland] Medication causes and treatment of delirium in patients with and without dementiaBrain and Behavior; by Anita Elaine Weidmann, Rut Matthíasdóttir, Guðný Björk Proppé, Ivana Tadić, Pétur Sigurdur Gunnarsson, Freyja Jónsdóttir; 7/25This summary offers the most detailed summary of medication-related information for delirium in patients with and without dementia to support prescribing decisions. While the detailed results can be used to support a multicomponent approach to delirium care, they also support the call for categorizing delirium into distinct etiological subgroups. The effect of medication on gut microbiome diversity and composition should be considered.

Chicago woman wounded in mass shooting at her 25th birthday party is going to hospice care CBS News; by Sara Machi; 8/17/25 After being critically wounded in a mass shooting in Chicago's Portage Park neighborhood that killed her father and two others, Mariah Vera's body has held on for two and a half years. But her family says that time is running out, and they need help from the public. Vera's family is preparing to move her to hospice care at Advocate Illinois Masonic Medical Center ... Family members said Vera was shot while trying to protect her father after an uninvited partygoer caused trouble at her 25th birthday party.

Asking older adults with impaired cognition and care partners about serious illness experiences can elicit goals of care during advance care planning Americn Journal of Hospice and Palliative Medicine; by Glory H. Thai, BS, Valecia Hanna, MS, Peiyuan Zhang, MSW, Chase Mulholland Green, MPH, John Cagle, PhD, MSW, Jennifer L. Wolff, PhD, and Martha Abshire Saylor, PhD, RN; 8/13/25 Older adults with cognitive impairment and their care partners were able to respond to serious illness experience questions, with responses eliciting a spectrum of goals of care. Integrating such questions into advanced care planning (ACP) for older adults with cognitive impairment may clarify goals of care and improve decision-making for patients and families. 

Opportunities and barriers to artificial intelligence adoption in palliative/hospice care for underrepresented groups-A technology acceptance model–based reviewJournal of Hospice and Palliative Nursing; by Xu, Tuzhen; Rose, Gloria M.; 8/25Underrepresented groups (URGs) in the United States, including African Americans, Latino/Hispanic Americans, Asian Pacific Islanders, and Native Americans, face significant barriers to accessing hospice and palliative care. Factors such as language barriers, cultural perceptions, and mistrust in healthcare systems contribute to the underutilization of these services. Recent advancements in artificial intelligence (AI) offer potential solutions to these challenges by enhancing cultural sensitivity, improving communication, and personalizing care. However, barriers such as limited generalizability, biases in data, and challenges in infrastructure were noted, hindering the full adoption of AI in hospice settings.

She wanted her dad to give her away at her wedding. A Niagara hospice made it happen NiagaraThisWeek.com - Grimsby Lincoln News; by Mark Newman; 8/10/25 Ron Oliver got to see his daughter get married. When the 67-year-old Grimsby resident moved into McNally House Hospice for end-of-life care on Wednesday, his daughter Alissa mentioned to hospice staff she wanted her father to see her get married and to give her away as part of the matrimonial ceremony before he dies. McNally House staff went to work, and 48 hours later Alissa was walking along an outdoor patio at the hospice with her father behind her in a wheelchair holding her hand.

Field notes from the end of life: My thoughts on living while dying Texarkana Gazette, Texarkana, TX; 7/26/25 As friends are quick to tell me, we are all living with dying. True enough. Especially because I'm 76, or, as my late husband, Alec, would say, "too old to die young." But it's still disturbing to get official notice of your imminent demise. ... In a series of stories, I'll be sharing my field notes as I make my way from here to there, in the hope that others might find it useful. ... When I start feeling grim about my situation, I'm finding it useful to take a "Would it help?" moment to consider whether my response can improve the situation or help me cope. 

Sovereign Hospice highlights nutrition's role in hospice home care services News Channel Nebraska (NCN), reprinted from Aubrey, TX; Press Release; 8/8/25 Eating becomes more than a necessity during serious illness—it becomes a part of daily care that supports comfort, strength, and emotional connection. At Sovereign Hospice in Aubrey, Texas, nutrition is integrated into the services hospice offers, especially for patients receiving hospice at home services. The goal is to use food as a gentle tool to improve quality of life. Serious illnesses can change how patients eat. Appetite loss, difficulty swallowing, and taste changes are common, but they can be managed through small adjustments. 

Palliative delays associated with increased length of stay in older traumatic brain injury patientsThe Journal of Trauma & Acute Care Surgery; by Sarah A Hatfield, Parima Safe, Cleo Siderides, Anjile An, Cassandra V Villegas, Nicole Goulet, Robert J Winchell, Elizabeth Gorman; 7/25Trauma Quality Improvement Program guidelines recommend early goals of care discussions (≤72 hours) for older patients with severe injuries. Patients (55 years or older) with moderate to severe TBI [traumatic brain injury] ... were retrospectively identified at a level I trauma center (2020-2022). Conclusions: Delayed PI [palliative intervention] is associated with increased LOS [length of stay] in older TBI patients, with no survival difference compared with early PI. Palliative interventions should be introduced early to reduce morbidity in patients with potential poor prognosis.