Literature Review

The dying dream of the dead to be at peace with life DW; by Hannah Fuchs; 5/22/26 Many people have vivid dreams shortly before death. Research suggests the dreams are not a sign of confusion — but may help both the dying and their loved ones make sense of loss. Known as End‑of‑Life Dreams and Visions (ELDVs), they often occur as dreams during sleep, and sometimes as visions while a person is awake. For those experiencing them, they can feel more vivid and real than ordinary dreams — and for those observing them from the outside, it can be unsettling. Medicine long dismissed ELDVs as episodes of sudden confusion (delirium) or as side-effects of medication. But today, the thinking is shifting.

Research spotlight: characterizing patient perceptions of palliative care in surgical settings Mass General Brigham | Patient Care; by Claire Morton, MD and Zara Cooper, MD, MSc; 5/19/26 ... Question: What did you find? Generally, patients were not familiar with palliative care. If they had heard of it, they often equated it with hospice or end-of-life care, leading to misconceptions about its scope and purpose. However, our observations revealed that patients frequently initiated discussions about concerns relevant to palliative care, such as social or psychological burdens they were experiencing during their visits with surgeons. This indicated an underlying interest in these domains, even if they were not explicitly aware of how palliative care could address them. ...Question: What are the real-world implications, particularly for patients? ...

The professional guest: Ethical challenges in home-based end-of-life care among interprofessional teamsNursing Ethics; Inbal Halevi Hochwald, Gila Yakov, Moran Weiss, Liron Inchi, Inbal Mayan, Ron Sabar; 4/26Home-based end-of-life palliative care presents unique ethical challenges that differ fundamentally from those in institutional settings. Healthcare professionals navigate the complex role of being both clinical experts and guests in patients' domestic environments, operating in a context where professional authority is continuously negotiated rather than institutionally established. Home-based palliative care places professionals at the intersection of clinical responsibility and domestic sovereignty, a position for which existing frameworks offer insufficient guidance. Addressing these structural and relational challenges requires both individual-level preparation, including training in ethical decision-making in low-control environments, and systemic policy reform.

Closing the gender gap in medicine: 5 ways to support women physicians CAPC | Center to Advance Palliative Care; by  Laurel Kilpatrick, MD, FAAHPM and Sonia Malhotra, MD, MS, FAAP; 4/27/26 From allyship to advocating for systemic change, learn how you can you champion women physicians so they can lead and thrive. Having more women physicians in medicine isn’t just a matter of equity—it’s important for patient outcomes. ... The strategies outlined at the end of the blog apply to all female health care professionals, not just physicians. 

Communication processes and priorities in Medical Aid in Dying conversations: A cross-sectional qualitative study of multidisciplinary cancer cliniciansCancer Medicine; by Meghan McDarby, Alix Youngblood, Megan Miller, William E Rosa, Haley Buller, Betty R Ferrell; 4/26Medical aid in dying (MAiD) is a practice that enables eligible individuals with a terminal, life-limiting illness to end their lives in a self-directed way. Multidisciplinary care teams play a vital role in facilitating discussions and patient decision making about MAiD in cancer care settings. Four themes were identified as communication priorities and processes critical for multidisciplinary teams when discussing MAiD with cancer patients: (1) addressing complexity of MAiD ... ; (2) thorough palliative care assessment; (3) strategies for clinicians and healthcare systems to optimize MAiD discussions; and (4) person-centered care that de-stigmatizes MAiD. Findings underscore the distinct complexity of MAiD discussions in oncology and highlight the need for tailored, person-centered approaches that go beyond standard end-of-life communication.

The importance of communication in pediatric and perinatal palliative care Catholic Exchange; by serenella Verduchi; 4/20/26 The word “communicate” comes from the Latin communicare, which means “to share,” “to make known,” or “to bring together.” ... The etymology of this word prompts us to reflect on how communication is more than just a space for interaction or a duty; it is a gift. Just as we strive to pay attention to the details when offering a gift, so too must we show care for others when choosing our words, because the power of words is great—they can give hope and transform a person’s life for the better, or they can linger and affect the person for the worse.

Second-generation antipsychotics for depression in serious illness: A first-line augmentation strategyJournal of Pain & Symptom Management; by Gregg Robbins-Welty, Mia Pattillo, Danielle Chammas, Karolina Sadowska, Cara L McDermott, Nneka Ufere, Jason A Webb, Daniel Shalev; 3/26Depression in serious illness is common, disabling, and often requires rapid improvement. In the psychiatric literature, SGA [second-generation antipsychotics] augmentation improves response and remission rates ... , with onset of improvement within 1-2 weeks. Monotherapy is less well tolerated and not guideline-recommended. No RCTs have evaluated SGAs specifically for depression in serious illness, but numerous cancer trials support their safety for nausea, appetite, and other symptoms. Despite the absence of serious illness-specific psychiatric trials, SGAs have the strongest evidence base among augmentation options and may offer meaningful benefits when prognosis or symptom severity necessitates rapid improvement. Low-dose augmentation should be considered early, rather than only after multiple failed antidepressants, particularly when SGAs can also target co-occurring physical symptoms relevant to palliative care.

End-of-life guidelines [in the ICU] emphasize unified care American Association of Critical-Care Nurses, in "Clinical Voices April 2026"; 4/21/26 New guidelines for end of life (EOL) care in the ICU call for clearer communication with families, stronger support for decision making and coordinated teamwork across disciplines to align treatments with what patients can realistically achieve and reduce suffering. “Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU ,” in Critical Care Medicine, highlights the need for standardized processes, including identifying legal surrogates, using shared decision making tools and adopting protocolized withdrawal pathways. Additional priorities include early palliative care involvement, spiritual support and focused education to reduce conflict. Recommendations are summarized in three major areas:

Engaging bereaved parent educators in pediatric end-of-life workshops: A trauma-informed onboardingJournal of Pain & Symptom Management; by Kayla Solstad, Dannell Shu, Kelly McManimon, Stacy Remke, Susan O'Conner-Von, Anne Woll, Joseph M Miller, Miriam C Shapiro, Johannah M Scheurer; 3/26Recognizing that pediatric end-of-life (EOL) scenarios occur infrequently and are distressing for trainees and other healthcare team members, our group created pediatric end-of-life care skills (PECS) simulation-based workshops to improve trainee competence for these skills. We  ... provide interprofessional workshops, including trainees from the pediatric residency program, graduate school of nursing, and graduate school of social work. Since creation of the workshops, the group and curricula have benefited immensely from including the expertise of bereaved parent educators (BPEs), who have experienced the death of their own infant or child and have been integral team members ... from workshop creation through facilitation. Research shows that families who have experienced the death of a child appreciate an interdisciplinary approach to their care and communication at the EOL. When parents of pediatric patients were asked about priorities in EOL care, they highlighted the importance of communication, emotional expression and support by staff, and ready access to multi-disciplinary staff.

Your wishes, your voice: Ochsner doctors encourage families to plan ahead for National Healthcare Decisions Day NOLA.com; by Amanda McElfresh; 4/12/26 Every year on April 16, National Healthcare Decisions Day serves as a reminder that medical emergencies rarely arrive with warning. When they occur, the decisions surrounding treatment often must be made within minutes. For healthcare providers, including those in Ochsner emergency departments, the day highlights a simple yet powerful message: Conversations about medical wishes should happen long before a crisis unfolds.

Connecting palliative care and age‑friendly care to support what matters most Institute for Healthcare Improvement; by Marian Grant; 4/8/26 ... The 4Ms Framework of an Age-Friendly Health System identifies the core subjects that should drive the care of older adults. The 4Ms (What Matters, Medication, Mentation, and Mobility) align with the approach of palliative care teams and are part of their comprehensive assessment. Age-friendly leaders and team members can use the expertise of palliative care colleagues to implement the 4Ms. Editor's Note: Click here for a great graphic of this "4Ms Framework." It states, "For related work, this graphic may be used in its entirety without requesting permission. Graphic files and guidance at www.ihi.org/AgeFriendly.

How does Parkinson’s progress? End-stage symptoms and what to expectMass General Brigham; by Todd M. Herrington, MD, PhD; 4/7/26 The journey with Parkinson’s disease looks extremely different from person to person. ...