Literature Review

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.

Ethics of overtreatment and undertreatment in older adults with cancerBMC Medical Ethics; by Clark DuMontier, William Dale, Anna C. Revette, Jane Roberts, Ameya Sanyal, Neha Perumal, Eric C. Blackstone, Hajime Uno, Mary I. Whitehead, Lewis Mustian, Tammy T. Hshieh, Jane A. Driver, Gregory A. Abel; 7/25This modified Delphi study convened a panel of experts in biomedical ethics and reached consensus that the principles of beneficence, non-maleficence, and autonomy are related to our previously proposed definitions of over- and undertreatment in older adults with cancer. The panel also reached consensus that, in most cases, it is unethical to make a treatment recommendation without (1) formal assessment of patient frailty (e.g., via a geriatric assessment) and (2) the opportunity for a patient to share their values, goals, and/or preferences. The panel did not reach consensus regarding the relationship between justice and over-/undertreatment; however, the panel concluded that justice applies to undertreatment when an oncologist withholds potentially beneficial cancer treatment in an older patient based on their age alone.

How one man’s dying wish was denied by the health care system Synopsi, from MedPage Today; by Caitlin E. Morh, MD; 8/5/25 “This is Dr. Mohr.” I answered a number I didn’t recognize. “It’s Irving,” said the frantic voice. “He collapsed. The paramedics are working on him now.” “They’re doing compressions? Stop! Put the paramedic on the phone!” My father-in-law, Irving, the stoic Danish-American Navy veteran, had been on hospice for 3 months. His POST (physician order for life sustaining treatment) form was on file with the hospice agency and his custodial care facility: DNR/DNI, comfort measures only. ... “I’m Irv’s daughter-in-law. I’m a physician. He’s a DNR, he’s on hospice. Stop doing compressions.” 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 ... I listened to the ACLS algorithm unfold in the background. ...

Tennessee plans to execute inmate amid concerns his heart implant will shock him repeatedly CNN; by Dakin Andone; 8/4/25 Tennessee plans to execute Byron Black on Tuesday for the 1988 murders of a woman and her two young daughters, despite concerns from his attorneys that a device implanted to restore his heartbeat could repeatedly shock him as he’s put to death. The device – an implantable cardioverter-defibrillator, or ICD – is at the center of a court battle that has been unfolding for several weeks. Black’s attorneys want the device deactivated at or immediately before his lethal injection Tuesday morning. If it isn’t, they say the effects of the lethal injection drugs will cause the ICD to shock Black’s heart, perhaps repeatedly, in an attempt to restore it to a normal rhythm. This will cause Black a prolonged and torturous execution, the attorneys argue, violating Eighth Amendment protections against cruel and unusual punishment.Editor's Note: Though this is not a hospice case, this traumatic scenario for persons with implantable cardioverter-defibrillator being repeatedly shocked--even after death--is crucial for the hospice interdisciplinary to know. Clinical, ethical, and legal issues abound. Click here for Shocked at End-of-Life: An Educational Video for Hospice Workers about Implantable Cardioverter-Defibrillators, research published by the Journal of Pain and Symptom Management, May 2024.

The treatment of chemotherapy-induced peripheral neuropathy: A review of current management options and a potential role for scrambler therapyFrontiers in Pain Research; by Hassan Aboumerhi, Henry Vucetic, Andrew Gruenzel, Bahar Moftakhar, Mona Gupta, Santosh K Rao, Michael D Staudt; 7/25Chemotherapy-induced peripheral neuropathy (CIPN) presents a growing medical and financial burden on patients and the healthcare system alike. This has been treated with conservative and interventional care limited by efficacy, side effects, and lack of coverage. As such, there is an unmet treatment need for effective non-invasive or minimally invasive therapies for the treatment of CIPN. Scrambler therapy (ST) is a peripheral, non-invasive neuromodulation technique, which uses transcutaneous electrical stimulation to modulate pain signals. ST has shown mixed results in clinical trials; while some patients report symptom relief, more robust evidence is required before it can be widely recommended.

Effect of a multi-component palliative care intervention on goals of care discussions for critical patients in the emergency departmentInternal & Emergency Medicine; by Julia Murray, Zacharia Grami, Katherine Benson, Christopher Hritz, Samantha Lawson, Corita Reilley Grudzen, Allison Cuthel, Lauren Talanda-Fath Southerland; 7/25Goals of care (GOC) discussions are vital to understanding patients' values and preferences during serious illness, but they occur infrequently during Emergency Department (ED) care. We report a single site sub-study of a stepped wedge pragmatic trial of a multi-component intervention of primary palliative care in the ED (PRIM-ER), focused on GOC conversations. The intervention did not change the proportion of patients receiving a GOC conversation in the ED ... [however patients] presenting with a cancer-related complaint ... or a respiratory emergency ... were associated with increased odds of a GOC conversation occurring. Of the 60 GOC conversations that occurred, 76.7% ... resulted in a change in code status, patient care plans, hospice, or updated advance care planning documents. While the intervention did not increase this secondary outcome of GOC conversations, the discussions that did occur frequently impacted ED care.Assistant Editor's note: This study concluded that the intervention employed in the ED did not increase the proportion of patients receiving GOC conversations. Yet the study also concluded that almost 77% of the patients who DID receive the conversation had a change in code status, care plan, hospice or advance care planning documents. This study clearly reminds us that GOC conversations, employed even in the ED, can help patients embrace a palliative approach to care when faced with serious illness.

Targeted palliative care may cut older adults’ risk of readmissions after elective surgeries: study McKnights Long-Term Care News; by Alicia Lasek; 7/27/25 Older adults with serious illness before elective surgery are at double the risk of extended hospital stays, readmissions, emergency department visits and costs, a new study has found. Targeting four key palliative care needs before surgery may help make the recovery period less burdensome for these patients and the healthcare system, the authors say. The study, published in the Journal of the American College of Surgeons, looked at seriously ill older surgical patients to see what palliative care interventions might help reduce the need for excess healthcare use post surgery. Among 2,499 older adults undergoing major elective surgery, [researchers reported] 63% were seriously ill, and 79% had four key palliative care needs:

Casting hope: A last wish by the water The Citizen, Fayette County, GA; by Compassus Hospice; 7/27/25 For Compassus hospice patient Gerry Higginbotham of Fayetteville, GA, the simple act of casting a line into the ocean had long been a dream—one that felt just out of reach. But thanks to a compassionate care team and the support of the Angel Foundation, that dream became a reality. ... The Hospice Angel Foundation generously covered the cost of lodging near Tybee Island, GA. But transportation and food expenses remained a challenge. That’s when the Compassus Fayetteville hospice team did something extraordinary: they personally donated funds to cover the remaining trip costs, ensuring Gerry and his daughter could make the journey. ... This wasn’t just a trip—it was a moment of peace, purpose and joy for someone who had given so much of himself to others. 

How health care systems shape end-of-life care—A step toward transparencyJAMA Network Open; by Jacqueline M. Kruser, Gordon D. Rubenfeld; 7/25Our health care systems, in all their multifaceted complexities, are more influential in shaping the delivery of care than individual human effort or error. Influential system-level factors span many different domains: how we are paid, the buildings we work in, the technology around us, who and how many we have on the team caring for patients, our workload, and our local social networks of influence. One pragmatic first step in addressing the problem of invisible, inaccessible, and/or inflexible patterns of end-of-life care is to build awareness of and foster transparency about the current patterns and their default orientation. Building from this deeper understanding of how our everyday routines and practice patterns influence care, we can then take the bigger step of intentionally designing our routine clinical practice patterns to be systematic yet flexible in their support of patients with serious illnesses.

Healthy days at home and prognosis of older adults with cancer and non-cancer serious life-limiting illnessesBMC Geriatrics; Oluwaseun J. Adeyemi, Nina Siman, Allison M. Cuthel, Keith S. Goldfeld, Corita R. Grudzen; 7/25Approximately 75% of U.S. older adults with serious life limiting illnesses visit the emergency department (ED) in the last six months of life, with three quarters of these individuals being admitted to the hospital. In this context, Healthy Days at Home (HDaH) and prognosis have emerged as important concepts for assessing and guiding care among older adults with serious life-limiting illnesses. HDaH is a patient-centered outcome measure that captures the number of days individuals spend at home without hospitalizations or ED visits. Among US older adults with serious life-limiting illnesses, worse prognosis is associated with fewer HDaH. Increasing age is associated with fewer HDaH, with substantial variability by race/ethnicity. In contrast, cancer is associated with more HDaH.Assistant Editor's note: "Healthy Days at Home (HDaH)" is such a fabulous concept, and so in keeping with the intent and goals of palliative care. Perhaps a HDaH is a quality measure that palliative care providers might consider using.