Literature Review

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:

31 shocking confessions people made to their doctors and nurses on their deathbed BussFeed; by Hannah Marder; 11/12/25 Being on your deathbed puts everything into perspective, and sometimes, the dying have something big to get off their chests. No one knows this better than those who work with the dying, who bear witness to these disturbing confessions. ...Editor's Note: This BuzzFeed feature compiles unverified, anonymous accounts of “deathbed confessions” shared by clinicians online. While written for popular appeal, it touches a truth familiar to hospice and palliative professionals: dying patients often reveal deeply held truths when facing the end. We share it as a reminder that such moments call for clinical steadiness, ethical awareness, and the presence of board-certified chaplains—those uniquely trained to meet these revelations with compassion and care.

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. 

Hospice of the Valley launches support group for people with mild cognitive impairment Lovin' Life; by Lin Sue Flood; 11/2/25 Living with mild cognitive impairment (MCI) can be an isolating experience, but a new program from Hospice of the Valley offers a welcoming space for connection and support. GATHER is a peer-led group where individuals diagnosed with MCI can share their experiences, navigate emotions, and discover new coping strategies together. ... GATHER provides a safe environment for members to lead their own discussions. Unlike traditional support groups, members are empowered to guide conversations toward topics that are most relevant to them. This novel format models successful programs in Europe. 

Clinician and parent perspectives on essential psychosocial care in pediatric cancerJAMA Pediatrics; by Kimberly S. Canter, Anne E. Kazak, Natalie Koskela-Staples, Michele A. Scialla, Kimberly Buff, Emily Pariseau, Victoria A. Sardi-Brown, Julia B. Tager, Lori Wiener; 10/25The Standards for Psychosocial Care for Children With Cancer and Their Families provide guidelines for evidence-based psychosocial care for children with cancer and their families. The Implementing the Standards Together: Engaging Parents and Providers in Psychosocial Care (iSTEPPP) study extends the standards through innovative collaborative research between clinicians and patient and family advocates, with the goal of widespread clinical implementation of standards that clinicians and parents or caregivers agree to be priorities. The 3 standards prioritized by parents and clinicians in this study offer insight into shared priorities for psychosocial care in pediatric cancer. However, misalignment on other priority standards (parental mental health, palliative care, and neurocognitive monitoring) highlights the differences in perception between parents and clinicians. Areas lacking agreement are a stark reminder of potential challenges when working to meet the holistic needs of children with chronic diseases and their families, as clinicians and parents may not agree on which needs are most important.

Love, loss and last wishes fulfilled at Duke HomeCare & Hospice: Staff members regularly make miracles happen Duke Today, Durham, NC; by Working@Duke; 10/29/25 The bell chimed three times at Hock Family Pavilion, and everyone knew what it meant. Duke HomeCare & Hospice nurses and workers stepped into the hallway of Duke’s 12-person inpatient hospice facility, solemnly waiting in silence. Anthony Wilkie, a Duke Clinical Nurse, had been bracing himself for the moment with a mixture of sorrow and humility. When a bell rings three times at Hock Family Pavilion, a patient has just died and a ritual is about to begin. ...

Stitched with love: Allied’s memory bears offer comfort to grieving families in Northeast Pennsylvania WVIA News - PBS/NPR, Scranton, PA; by Lydia McFarlane; 10/27/25 Barbara Rushinski received a bear made of her partner’s pajamas after he passed in hospice care at Allied Services. She was so moved, she put her sewing skills to good use and joined the team of volunteers making the bears for grieving families in Northeast Pennsylvania. ... Allied offers its memory bears to grieving families whose loved ones died in hospice. ... Joyce Wizda started the program at Allied more than six years ago when she joined the healthcare system as a social worker. ... She estimates the volunteers make about 150 bears a year. ... Wizda encourages families to send in clothing items from their loved one’s closet to ease their grieving journey.

How to manage financial caregiving for an aging parent AOL.com; by Kerry Hannon; 10/25/25Steering end-of-life financial decisions for an aging parent is not a job many of us would choose. But we do — and feel our way through the messy emotions as best we can. ...[From an interview:] "[Your mom] was rejected for hospice care, which is covered by Medicare. Can you elaborate on that?""That was just such a slap in the face because it's a hard decision to go to hospice. ... My mom made that decision for herself, but my brother, the doctors, and me had to be on board with it in order for her to do it. The only reason they rejected her is because they thought she would be too costly. They do a cost-benefit analysis of how long that person is going to last— how much [in] resources is she going to consume? They decided that her diagnosis was too murky to justify putting her on hospice at that point. I finally found another hospice company to accept her. And she died in two weeks."

Pumping irony: When the hospice is inhospitable Experience Life; by Craig Cox; 10/22/25 ... University of Michigan researchers, reviewing the health records of some 139,000 hospice patients diagnosed with dementia, found that nearly half of them were given benzodiazepines, a class of drugs designed to relieve agitation and anxiety. ... The results, in many cases, were deadly. ... “For patients who are not actively dying, patients and families may prioritize preserving cognition, communication, and function — goals that may be compromised by sedating medications,” she writes. “This further underscores the need for dementia-specific hospice interventions to help offer scalable, nonpharmacologic approaches, to equip hospice clinicians with effective alternatives.”

Hospice social worker and nurse perceptions of the usability of a hospice live discharge protocol (LDP)American Journal of Hospice & Palliative Medicine; by Stephanie P. Wladkowski, Susan Enguídanos, Tracy A. Schroepfer; 9/25Live discharges from hospice are often distressing for patients, caregivers, and hospice providers alike, disrupting care continuity and leading to emotional and logistical challenges. Despite Medicare’s discharge planning requirement, no standardized process currently exists for hospice-initiated discharges, resulting in variable quality of care transitions.  An explicit Live Discharge Protocol has strong potential to enhance the quality and consistency of a live discharge from hospice care. The LDP provides a framework to help smooth the transition from hospice care and provides patients and families with post-discharge support. Feedback from hospice professionals affirmed the relevance and usability of each step within the LDP, while also identifying opportunities for refinement for future implementation.

What we get wrong about death, according to end-of-life workers Yahoo Lifestyle, originally appeared on HuffPost; by Monica Torres; 10/10/25 The one big thing that people have in common is that we all will die, and we likely will experience the death of someone we love, too. ... That’s why it can help to hear the insights of people who see death all the time, because understanding it now can help us better process grief about others and feel more at ease when thinking about our own mortality. ...