Literature Review

17 "Spooky" things that happened right before terminally-ill patients passed away, according to nurses who saw it first-hand BuzzFeed Staff; by Raven Ishak; 5/31/25 "At the beginning of my shift, my patient kept pointing to a corner of the room and said to me, 'Do you see them?" ... When medical professionals work closely with patients who may pass soon, a lot of "supernatural" things may occur. So we thought to ask the BuzzFeed Community, "Nurses with dying patients, share with us the most unexplainable things you've ever witnessed." Here's what they said below: ...

MLN Fact Sheet: Creating an efffective Hospice Plan of CareCenters for Medicare & Medicaid Services, Medicare Learning Network (MLN); 5/10/25 The hospice plan of care (POC) maps out needs and services given to a Medicare patient facing a terminal illness, as well as the patient’s family or caregiver. CMS data shows that some hospice POCs are incomplete or not followed correctly. This fact sheet educates on creating and coordinating successful hospice POCs. The primary goal of hospice care is to meet the holistic needs of an individual and their caregiver and family when curative care is no longer an option. To support this goal:

Primary mental health competencies for hospice and palliative medicine physicians: A Delphi studyJournal of Pain and Symptom Management; by Lisa Podgurski, Danielle Chammas, Keri O Brenner, Leah B Rosenberg, Neha G Goyal, Maria I Lapid, Sue E Morris, William F Pirl, Bridget Sumser, Benjamin W Thompson, Lindsey Wright, and Daniel Shalev; 5/20/25  Objectives: To establish and prioritize 'primary mental health competencies' for specialist hospice and palliative medicine physicians using expert consensus methods. Results: The expert panel proposed 68 competencies divided into: (A) psychological foundations of serious illness care, (B) diagnosis and management of mental health disorders in serious illness, and (C) systems-based practice. After first-round voting, 23 competencies were recirculated for a second vote. Following second-round voting, 32 competencies were included in the final list: 7 from part A, 20 from part B, and 5 from part C.

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

What is it like to die? University of Minnesota’s VR experience offers some answers. The Minnesota Star Tribune; by Richard Chin; 5/2/25 Our reporter returned from the Embodied Labs experience with some thoughts on what he’d like his last hours to look like. When the University of Minnesota offered to let me experience what it’s like to die, naturally I said yes. Aren’t we all morbidly curious about the undiscovered country, as Hamlet put it, from which no traveler returns? Except this time, happily, I would get to return because it would be a virtual death, an experience in a VR studio that’s part of the university’s Health Sciences Library system.

Exploring overlooked collaborative opportunities during end-of-life care Medical Xpress; by Institute of Science Tokyo; 5/14/25 [This study's researchers describe:] "Bereaved family members broadly recollected the mixed regretful actions and decisions that should have been taken during the end-of-life care process. Coordination and cooperation challenges that existed between health care professionals and family caregivers emerged as factors that impeded these actions at the time." [They identified three types of] unintended, percolated work (UPW). ...

Team work makes the dream work for hospice veteran Veterans Administration, VA.gov; by Douglas A. Etter; 5/12/25 When Marine Corps Veteran Ivson Shelley came to the Lebanon VA Medical Center for a follow-up visit with his oncologist, Suhail Ali, MD, the staff was concerned about how much the former New York resident had declined since his last appointment. They didn’t think he could be cared for at home any longer, so a decision was made with the family to admit him to the medical center’s hospice unit Thursday afternoon. Once there, the Marine shared a heartfelt wish with the staff – he wanted to marry his lifelong love, Wanda Rivera. The couple had dated more than 50 years ago and rekindled their relationship 10 years ago. Upon hearing the Vietnam Veteran’s wish, the VA team, lead by Hospice Nurse Manager Jessica Himes, RN and Hospice Social Worker, Erin Miller, MSW, LCSW quickly came together to make it happen. Palliative care nurse Melissa Buchinski, RN began to research what the requirements were to secure a marriage license for the couple. ... [Continue reading this inspirational story.]

What not to say to patients with serious illnesses Medscape; by Lambeth Hochwald; 4/30/25 Robert Den, MD, a radiation oncologist in Philadelphia, constantly reminds himself that while he’s in the ‘cancer world’ every minute of the day, his patients aren’t. “As oncologists, we may be meeting with the third patient that day with a newly diagnosed metastatic cancer, but for this individual, this is their first time hearing news like this,” Den told Medscape Medical News. That’s just one reason Den says words matter. ... [He identifies] "Five Things Docs Shouldn't Say" ...

From stigma to support: Changing the cancer conversation Oncology Nursing Society (ONS); by Anne Snively, MBA, CAE; 4/29/25 Certain treatments (palliative care, opioids) and diagnoses (lung cancer) are more prone to association with cancer-related stigma. Nurses can play a vital role in reframing these thoughts and promoting empathy. ... Caner-related stigma has wide-reaching effects across the care continuum, including poorer patient outcomes. ...

Prayer for patients? Readers and ethicists respondMedscape; by Alicia Ault; 4/24/25 ... In a recent Medscape column, Andrew N. Wilner, MD, related the story of a physician offering to pray for his wife at the conclusion of a routine visit. She had no previous relationship with the clinician and only a minor complaint. Wilner found the physician’s action disturbing and wrote in his column that while there might be situations where prayer would be appropriate, his wife’s visit did not fit in that category. Some readers took issue with Wilner’s response. ... He thinks there are a lot of considerations to weigh before a doctor should ask. “Prayer is very personal, and religious beliefs are very, very personal,” said Wilner, adding that “For some people, they’re profound.” Others might be agnostic, and it is not likely possible to know all of this if there is no prior patient-doctor relationship, said Wilner.

[Switzerland] Comforting styles of serious illness conversations: a Swiss wide factorial survey studyBMC Medicine; by Robert Staeck, Carsten Sauer, Steven M. Asch & Sofia C. Zambrano; 4/14/25 Background: Serious illness conversations can cause discomfort in patients, potentially impeding their understanding and decision-making. Identifying ways in which physicians can reduce this discomfort may improve care. This study investigates which physician communication styles and characteristics individuals perceive as comforting in physician–patient serious illness conversations. ...  Methods: We conducted a nationwide online factorial survey in German, French, and Italian with 1572 Swiss participants from the public (51.4% women) aged 16 to 94. ...Conclusions: Taking time, providing clear information, and ensuring continuity of care are pivotal in enhancing comfort. Also relevant are the expression of sadness, physician self-disclosure, and a prior relationship with the patient.

Special team at Norton Children's Hospital focused on giving the gift of life CBS WLKY-32, Louisville, KY; by Jennifer Baileys; 4/21/25 Caring for sick and dying children is a tough and heartbreaking job. One special group at Norton Children's Hospital is focused on helping these children and their families. ... "She's missing the left side of her heart," Kindra Edwards, patient mother, said. ... Edwards said there was one consistent source of strength and encouragement the Norton Pediatric Support Team. "They're always there. You know, coming in, checking on us when in our multiple stays at the hospital," Edwards said. The team is made up of pediatric and palliative care specialists, nurses, social services, therapist and pastoral care. ... [Through two decades,] pediatric palliative care has evolved. At Norton Children's Hospital it has grown into a team of almost a dozen people, specializing in not just treating, but caring for the sickest patients and their families.

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.