Literature Review

I went to a conference about death. Everyone was laughing. USA Today, Los Angeles, CA; by David Oliver; 12/2/25 Welcome to the EndWell Summit, a gathering of more than 700 caregivers, clinicians and advocates who've grieved, are grieving or are working with those at the end of their lives. Speakers included a pediatric palliative care physician, a global health economist and a prison hospice advocate, not to mention celebrities like Emma Heming Willis (Bruce Willis' wife) and Katherine LaNasa ("The Pitt"). It's an inviting space – ... --where casual conversations and formal talks about death are tear-jerking one second and laugh-out-loud funny the next. ... The conference's theme was "radical bravery." Don't get it twisted, though. Radical bravery is not about being fearless, but staying present even when dark clouds form above you.

How clinicians prenatally discuss management options and outcomes for congenital heart disease Journal of Pain and Symptom Management; by Samantha Syme, Kelsey Schweiberger, Judy C Chang, Ann Kavanaugh-McHugh, Nadine A Kasparian, Robert M Arnold, Kelly W Harris; 11/27/25 Online ahead of printA prenatal diagnosis of complex congenital heart disease (cCHD) introduces significant emotional, social, and financial stress for families. ... Fetal cardiology consultations offer an important opportunity to support families navigating uncertainty following a prenatal diagnosis of CHD. Clinicians approached these conversations with empathy and a focus on long-term outcomes, though discussions about management options varied. There is an opportunity for increased presentation and integration of palliative care consultants as a longitudinal, family-centered resource, regardless of mortality risk, which may enhance supports available to families during this highly emotional period.

Bridging the gap: A scoping review of clinical decision support systems in end-of-life care for older adults Journal of Palliative Medicine; by Susanny J Beltran, Lainey Dorris, Marie Hamel, Shanelle Harvey, Mustafa Ozkaynak, Kenan Sualp; 11/17/25 online ahead of print Background: ...  This scoping review maps the current landscape of clinical decision support (CDS) systems in EOL care, identifies key system types, and examines their effectiveness in guiding clinical decisions. ... Results: A total of 31 studies were included, categorizing CDS systems into prognostic tools, referral tools, and care informing tools. ...

Ethics: Electronic Health Record (EHR) evolution AMA Journal of Ethics; Nov 2025 issue ... This theme issue investigates which kinds of work EHRs should do—and for whom—and whose interests EHRs should serve when information is entered, organized, reviewed, responded to, extracted, or amended. This issue also investigates which values should inform EHR stewardship and innovation decisions and from whose perspectives the stakes of those decisions should be framed. [Articles include:

Shifting to online and telephone bereavement support provision during the COVID-19 pandemic: A mixed methods study of bereavement service provider perspectives and lessons learnt for current practice Palliative Medicine; by Lucy E Selman, Jenny Birchall, Eileen J Sutton, Tracey Stone, Renata Medeiros Mirra, Emma Gilbert, Mirella Longo, Kathy Seddon, Anne M Finucane, Alison Penny, Anthony Byrne, Emily Harrop; 11/24/25, online ahead of print Background: Provision of remote (online/telephone) bereavement support accelerated during the COVID-19 pandemic. However, the extent and impact of this change and lessons learnt are unknown. ...Conclusions: Remote delivery of bereavement support increased support capacity and can potentially reduce inequities in access. However, it needs to be carefully tailored, and is not appropriate for everyone. Staff and volunteers providing remote services require training and support.

Phoebe Sumter helps hospice patient say final goodbyes to "Moonshine" and "Cowboy," her beloved animals Phoebe Putney Health System, Americus, GA; Press Release; 11/14/25 ... Kate’s only wish was to see her horse, Moonshine. ... Kate’s close friend Sunday Laramore said, “She was an amazing horse trainer.  She had been doing that since very early adulthood.  She got Moonshine when he was 18 months-old; ... they had an amazing bond.” Kate’s condition was too unstable for her to return home to visit Moonshine, so the Phoebe Sumter care team began formulating a plan to bring Moonshine – and Kate’s dog, Cowboy – to the hospital to see her.  Less than an hour after the team learned of Kate’s desire to see her animals, the pets were loaded up and on the way to the hospital.

“I was horrified”: 34 surgeons and doctors recall their worst mistakes BoredPanda; by Justin Sandberg; 11/19/25 Someone asked “Medical professionals, what mistake have you made in your medical career that, because of the outcome, you've never forgotten?” and people shared their stories from fortunately comical to downright grim. ...#4.  I work in palliative care, ... I knew he wanted to be a DNR (do not resuscitate). I wrote it on my note. But I didn't re-fill out the hospital paperwork. The next day, I got to work to discover he'd been coded and was on a ventilator in the ICU. Instead of passing peacefully, his wife had to make the decision to turn off life support.  ...Editor's Note: Entry #20 comes from a hospice nurse describing a patient with severe bone pain started on morphine—then an out-of-town daughter arrived, shocked to see “Daddy on morphine.” What unfolded was realistic and tragic. This story highlights two timely essentials:

Grateful patient finds strength and support through UConn Health’s ALS Program UConn Today; by Jennifer Walker; 11/17/25 ... ALS, also known as Lou Gehrig’s disease, is a progressive neurodegenerative disorder that affects the nerve cells in the brain and spinal cord responsible for muscle movement. ... Originally conceptualized by Dr. Amanda Hernandez, division chief of Neuromuscular Medicine, the UConn Health ALS and MD Program provides a “one-stop shop” for patients with progressive neuromuscular diseases that often require coordination across multiple specialties. ... “Our social worker meets every patient,” said Viguera Altolaguirre. “We address caregiver stress, financial barriers, and emotional coping. Palliative care helps patients navigate difficult decisions about feeding tubes, ventilation, and future planning—always at their own pace and comfort level.” 

Q&A: Prognostic preferences ‘a swinging pendulum’ for older adults with end-stage kidney disease (ESKD)Healio; by Lucas Laboy and Annie Liu, DO, MPH, MS; 11/17/25 Older adults with end-stage kidney disease and their care partners expressed dynamic prognostic preferences over time, according to study findings published in Clinical Journal of the American Society of Nephrology. Serious conversations with patients with ESKD can be difficult for nephrologists, according to Annie Liu, DO, MPH, MS, associate physician at Mass General Brigham, and colleagues. ... Key themes included:

Reducing moral distress through interdisciplinary collaboration: the impact of a weekly palliative care and neonatology conference BMC Palliative Care; by Kirthi Devireddy, Riddhi Shukla, Rachel Boren, James E Slaven, Rebecca A Baker, Jayme D Allen, Karen M Moody; 11/11/25 Conclusion: A neonatal intensive care unit (NICU) and palliative care-weekly-collaborative conference resulted in significantly decreased moral distress among NICU staff. Qualitative data revealed that both prolonging life with life-sustaining medical therapies (LSMTs) and ending it by withdrawing LSMTs in the context of prognostic uncertainty and institutional constraints creates significant moral distress among staff. Palliative care and NICU programs should consider implementing regular interdisciplinary collaborative conferences to address this distress.

Achieving goal-concordant care with goals of care consultations in the Emergency Department American Journal of Hospice and Palliative Medicine; by Stacy Nilsen, PhD, RN, Diane Wintz, MD, Kelly Wright, MSN, MBA, RN, Debra Poeltler, PhD, MPH, RN, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA; 10/24/25 Introduction: Time constraints may be prohibitive to adequate goals of care (GOC) discussions and could delay critical decision making in urgent or emergent situations. ... Method: A retrospective record review was conducted for patients 65 and older at a single community hospital between January and December 2023. Included patients had at least one GOC documented discussion with a nursing team called Advanced Illness Management (AIM) and were admitted or placed in observation. ... 3377 patients met the inclusion criteria. ... Conclusions: There were positive findings in LOS, ICU, and cost with AIM consultation within 24 hours of presenting to the ED, when compared to waiting for a later consultation, supporting consideration of forward-placement of GOC discussion.

The sliver of light after losing a child: Personal perspective - a child's loss can provide elusive and rare gifts. Psychology Today; by David R Patterson PhD, ABPP; by 11/10/25 I have often said that working with patients who are dying has brought an ironic, but transient, feeling of exhilaration to my life. Most care providers who work in hospice will explain to us that people who are aware of their impending mortality have a sense of being in the present that those of us who are not so close to that inevitability can only admire from a distance. ... I don’t know whether this resonates with other parents that have lost a child, but I can say that a very clear impact of my son’s loss has been to become acutely aware of my own mortality. ... After living with my son’s death for three years, I am only just beginning to grasp the lessons that his death is teaching me.

"The Wounded Generation": Bearing the invisible scars of war CBS News; by Lesley Stahl; 11/9/25 In 1984, President Reagan commemorated the 40th anniversary of the invasion of Normandy, and paid tribute to the World War II soldiers known as "The Greatest Generation." ... But in his new book, historian David Nasaw calls them "The Wounded Generation." "They are the Greatest Generation, but they returned from war, bringing wounds home with them that are invisible; they're psychic wounds," he said. "Now we know that a lot of those wounds were PTSD. But PTSD was not diagnosed for 40 years after the return of the World War II veterans. ... Nasaw said [of his own father,] "He came home smoking three or four packs of Luckys a day. He came home with a heart condition from the war. He dies at age 61. And I had never had the chance to find out what happened in Eritrea, what he went through. So, what do I do as a historian? I can't find out his story, so I jumped in to find out the story of his generation."Editor's Note: While most World War II veterans are now gone, many of today’s hospice patients—particularly those who served in combat—carry similar invisible scars. Their psychic wounds, once unnamed, often resurface in life’s final chapter. This story also echoes in their adult children, who now seek to understand the unspoken pain that shaped their families. For more insight and support—especially regarding post-9/11 veterans—see the Wounded Warriors Project.