Literature Review

Hidden battles: Keeping cancer secret Harvard Health Publishing - Harvard Medical School; by Maureen Salamon; post is dated 4/1/25, retrieved from the internet 3/25/25 Some people choose to conceal their diagnosis and treatment. Here's why — and reasons that approach can sometimes backfire. ... [In addition to privacy motives, Cristina Pozo-Kaderman, a senior psychologist at Harvard-affiliated Dana-Farber Cancer Institute] says cancer patients may also wish to:

Why aging parents make DNR choices before crisis strikes Rolling Out 25; by Khalil Best; 3/17/25The conversation typically begins quietly. ... An aging parent mentions their desire for a Do Not Resuscitate order—commonly known as a DNR—and the atmosphere in the room shifts. For many adult children, this moment arrives unexpectedly, triggering complex emotions ranging from denial to grief. Yet these discussions, uncomfortable as they may be, represent one of the most meaningful exchanges families can share. Understanding why many elderly parents choose to sign DNR orders in advance illuminates not just practical healthcare concerns, but deeper values about dignity, autonomy, and what constitutes a meaningful life.

The twofold challenge of an older population — and how systems are adapting Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 2/21/25 In less than a decade, older Americans are projected to outnumber children for the first time in U.S. history, sparking conversations about the need for age-friendly healthcare.  At the same time, declining birth rates and longer life expectancies — half of babies born in 2020 are expected to live past 100 years — pose potential workforce challenges. Becker's connected with four health system leaders to explore the challenges this demographic shift presents and how they are preparing to address it. [Click on the title's link to continue reading.]

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

Care for patients with a history of immigrationJAMA; Margaret Wheeler, MS, MD; Juan Raul Gutierrez, MD; Alicia Fernandez, MD; 1/25Home to 20% of the world’s immigrants, the US is the leading destination for people leaving their birth countries, and the US Census estimates that almost 14% of the US population in 2022 was born outside the US. ... The 2023 US Preventive Services Task Force Guideline on screening for latent tuberculosis recommends screening for tuberculosis in patients from Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia because in 2020, 71% of cases of active tuberculosis in the US occurred among individuals from these areas. Assessment of clinically relevant premigration factors involves consideration of the epidemiology of disease, health care practices, and sociopolitical and environmental exposures in an immigrant’s country of origin. These factors can alter risk assessment in differential diagnoses; for example, neurocysticercosis should be considered in the differential diagnosis of seizures in a patient from Central America.

Truth-telling, and ethical considerations in terminal care: an Eastern perspectiveNursing Ethics; Qing Ma; Yi Wu; Ronghua Fang; 1/25 Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article focuses on nursing morality, ethics, norms, and philosophy in health care and discusses countermeasures taken by nurses in truth-telling decision-making in combination with Chinese Confucian culture. The analysis identifies key ethical strategies tailored to Chinese nurses’ practices, emphasizing individual autonomy, cultural sensitivity, and family dynamics in truth-telling decisions.

How a St. Louisan helps her community navigate death by filling out advance directives NPR - St. Louis on the Air; by Jada Jones; 1/28/25 When Vivial Lopez’s grandmother was on life support, her family was faced with many difficult decisions. Her grandmother did not have an advance directive, so her family did not know her final wishes. The experience of navigating her grandmother’s end-of-life plan without any direction led Lopez to advocate for families to prepare advance directives - especially those in Black and brown communities. Approximately only on ein three adults complete an advance directive for end-of-life care. Lopez works with the Gateway End-of-Life Coalition to empower members of the St. Louis community to navigate death through quality end-of-life care.  Editor's note: Click here for AARP - Find Advance Directives Forms by State, also available in Spanish.

Knoxville nurses bring wedding to UT Medical Center for bride’s dying mother WATE Knoxville, TN; by Molly O'Brien; 1/15/25 Nurses on the Progressive Care Unit at UT Medical Center planned a wedding for one of their patient’s daughter. Samantha Barry and her now husband, Phillip Bastelica, were supposed to get married in a few months. Barry, like most daughters, always planned on her mother being at her wedding day. Her mother, Lynn, is battling a terminal illness and was recently released from the Progressive Care Unit to hospice. ... It seemed unlikely that Lynn would be able to attend the wedding planned for August, so Barry and Bastelica decided to move the day up. ... The nurses who cared for Lynn jumped into action to plan a wedding for Barry.

Helping Korean Americans with end-of-life planning is her passion Penn Medicine News; by Daphne Sashin; 12/10/24 Eunice Park-Clinton, DNP, MSN, MBE, is standing before a crowd of Korean American senior citizens, and she wants to talk about the end of life. ... Park-Clinton, a nurse case manager in the Hospital of the University of Pennsylvania’s Emergency Department and an assistant nursing professor at West Chester University, is undeterred. Speaking in Korean, she takes a kind but frank approach as she walks the seniors through life-sustaining treatments they might be offered in their final days and the need to decide what they will—and won’t—want for a dignified end of life.  ... As a Korean American herself, Park-Clinton’s passion for culturally sensitive planning comes from her personal familiarity with the community and its norms. In her work as a nurse, she has personally witnessed older Korean and other Asian immigrants experience health disparities due to their lack of knowledge of the concept.

New Health Equity Guide from Center to Advance Palliative Care provides a roadmap to transform care for black patients with serious illness Cision PRWeb; by Center to Advance Palliative Care; 11/13/24 Having medical concerns dismissed, not being believed when reporting pain, and facing multiple barriers to care are just three of the experiences reported to Center to Advance Palliative Care (CAPC) in a focus group of Black patients with serious illness. In fact, when Black people in the United States are living with a serious illness like cancer, heart failure, or dementia, they experience disproportionately high suffering compared to white patients—often due to poor pain management, low-quality communication from their care teams, and high family caregiver burden. To address these inequities, CAPC has released a new, comprehensive guide, Advancing Equity for Black Patients with Serious Illness, to equip palliative care leaders and health equity change agents with practical tools to implement meaningful change. Drawn from research, examples of health equity initiatives from across the country, and the wisdom of health equity leaders, the guide provides a practical roadmap for transforming care for Black patients, and their families and caregivers.

Local veteran continues to serve by visiting hospice veterans Lundington Daily News, Lundington, MI; by Shanna Avery; 11/9/24 With love of service to their country, some veterans continue to find ways to serve and make a difference, and Ludington veteran Dick Gregaitis does just that when he visits other veterans as they approach the end of their lives. Gregaitis has been volunteering with Hospice of Michigan in the local area for eight years, where he visits veteran patients. Gregaitis served in the U.S. Navy from Aug. 1962 to 1965, then the U.S. Air Force until he retired in 1986 as senior master sergeant. Gregaitis said he has been around this area, and met his wife of 55 years at Round Lake. He traveled all over while in the military. It is through his own experiences, he shares a bond with other veterans. “To me, it is a way to give back to the community,” he said. “A lot of veterans don’t get people stopping by or talking. They like someone there that knows about the military. I even designed a badge that says, ‘military outreach.’ It is a win/win. I like to do it and I have the time to do it, and they like someone to say hi to.”

Asian American diversity and representation in the health care workforce, 2007 to 2022JAMA Network Open; Michelle Ko, MD, PhD; Kevin Dinh, MS; Sarah Iv, BS; Monica Hahn, MD; 10/24In this serial cross-sectional study of American Community Survey 1-year estimates from 2007 to 2022, Filipinx Americans had consistently high representation among registered nurses and nursing assistants; Indian, Pakistani, and Chinese Americans predominated among physicians, whereas Hmong and Cambodian American representation in medicine remained substantially below general population representation. Bangladeshi and Chinese American representation grew among home health aides over the study period. These findings suggest that aggregation of Asian American subgroups into a single racialized group erases substantial inequities in health workforce diversity.