Literature Review

The expanding role of family medicine in Alzheimer's Disease and other dementias Patient Care; by Grace Halsey; 10/7/25 [From the 2025 Family Medicine Experience conference] Family medicine's unique position in dementia management spans initial diagnosis through end-of-life care. ... Dementia Staging: Clinical Assessment and Hospice EligibilityFor practical bedside assessment and hospice determination, the Functional Assessment Staging Tool (FAST) proves particularly valuable.1 The FAST scale includes 7 main stages, progressing from no impairment (stage 1) through severe dementia requiring total care (stage 7). Stage 7 breaks down further into substages (7a-7f) that capture specific functional losses including ambulation, independent sitting, smiling, and head control. Eligibility for hospice care generally requires FAST stage 7c or beyond, indicating ... [continue reading this important criteria] Editor's Note: Leaders must understand hospice eligibility criteria when setting census goals, guiding teams, and communicating with families. Getting it wrong risks fraudulent billing, angry caregivers when live discharges occur, or too little care that comes too late. Getting it right ensures dignity, humanity, and meaningful final moments amid dementia's long goodbyes—true measures of compassionate hospice dementia care.

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.

Cancer patients are living longer than ever. Pain drugmakers haven’t kept up. Biopharma Dive; by Jacob Bell; 9/25/25 Decades of slow-moving research, along with broader failures of the healthcare system, have left millions of people in daily pain. Doctors fear that’s bound to continue. ... More than 2 million people in the U.S. alone are diagnosed with cancer each year. Conservative estimates hold that between 20% and 50% experience related pain, though that figure can climb as high as 80% for patients with advanced disease. Despite the large number of patients and the need for more therapies, drugmakers have mostly shied away from pain altogether, fearing that its complicated biology makes for too risky a research investment.  ... Opioids remain the core of many treatment regimens. This lack of drug choices is aggravated by much broader failures of the healthcare system. 

The role of the palliative medicine and supportive oncology APP Oncology Nursing News; by Antonia Corrigan, MSN, ANP-C; 9/22/25 ... A cancer diagnosis can bring an avalanche of psychosocial and physical obstacles for patients to navigate. ... Advanced practice providers (APPs) are key in providing quality supportive care. ... The American Society of Clinical Oncology (ASCO) guidelines recommend that patients with cancer be referred to interdisciplinary palliative care teams within 8 weeks of diagnosis. Early palliative referral benefits patients with high symptom burden, both physical and psychosocial, and enhances caregiver support. 

AI can aid in end-of-life care decisions, but can't replace human teams MarylandToday; by Fid Thompson; 9/19/25 “Would I be surprised if this person were not alive 12 months from now?”  This so-called “surprise question,” combined with clinical risk calculators, helps doctors make decisions about care for patients near the end of life. Increasingly, clinicians also use artificial intelligence (AI) models to predict remaining life expectancy and better inform palliative care decisions. In a recent study out in the Journal of Palliative Medicine, a University of Maryland researcher sought to understand what palliative care teams think about these AI tools that give an estimated life expectancy or prognosis in end-of-life care, and found mixed reactions. 

Early palliative care intervention improves end-of-life care in ovarian cancer Medscape; by Maurie Markman, MD; 9/18/25 ... This particular study asked an important question: Is there a relationship between that timing when palliative care is introduced to the ultimate end-of-life aggressiveness of care (emergency room use, use of intensive care, and hospitalization)? ... The outcome was timing, or introduction, of palliative care with emergency room use, hospitalization, and intensive care use within the last 30 days of life and chemotherapy in the last 14 days of life, as well as the risk of death occurring in the hospital.  ... The investigators found that any palliative care or any use of a palliative care physician called in as a consult earlier than 3 months before the death was associated with a lower risk of aggressive end-of-life care. 

Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.

Wound care marketing can create confusion around hospice relatedness Hospice News; by Jim Parker; 9/16/25 Hospices provide wound care to many patients, but confusion can arise over questions of relatedness to the terminal illness. The goals of palliative wound care include primarily symptom management, comfort and dignity, but it does not always focus on healing the injury, a 2023 study indicated. This differs from general wound care, which does target healing. Palliative wound care is essential for hospice patients and most of the time should be considered related to the patient’s terminal condition, according to Felicia Walz, director of hospice quality for Colorado-based provider HopeWest. “Providing wound care to hospice patients is always appropriate,” Walz told Hospice News.

How a novel coaching intervention is building resilience and hope in adolescents and young adults with advanced cancer: A conversation with Abby R. Rosenberg, MD, MS, MA The ASCO Post; by Jo Cavaloo; 9/15/25 Each year, nearly 90,000 adolescents and young adults (AYAs; aged 15–39) are diagnosed with cancer, and approximately 9,300 die of the disease. ... AYAs are at increased risk for developing adverse long-term side effects from cancer and/or its treatment, including chronic conditions, secondary cancers, infertility, poor psychosocial health, and financial toxicity. ... The findings from a recent randomized phase III clinical trial investigating a novel resilience coaching intervention for AYA patients with advanced cancer are showing promising results in improving feelings of resilience and hope, as well as longer-term improvement in quality of life for these patients. ... In a wide-ranging interview with The ASCO Post, Dr. Rosenberg discussed the psychosocial impact of cancer on AYA cancer survivors, the results of the PRISM-AC study, and how AYA survivors are able to cope with having a terminal prognosis.