Literature Review

She has a young hospice patient who can’t financially afford the $2,400 to die ChipChick; by Emily Chan; 12/17/25 Most people worry about how they’ll live, not how much it costs to die. But for TikToker Jordan ..., who is a hospice nurse, one heartbreaking conversation with a young patient exposed a reality that many people don’t want to think about. She has a young patient who is dying and needs to make plans for the end of her life. She was looking into cremations because those are usually cheaper than caskets. Still, they are expensive, and this patient told Jordan that she cannot financially afford to die.

'Music makes everything better': Austin doctor spins vinyl to give patients a sense of home KUT 90.5, Austin, TX; by Olivia Aldridge; 12/16/25 Lying in her bed at Dell Seton Medical Center, 64-year-old Pamela Mansfield sways her feet to the rhythm of George Jones’ “She Thinks I Still Care.” Mansfield is still recovering much of her mobility after a recent neck surgery, but she finds a way to move to the music floating from a record player that was just wheeled into her room. “Seems to be the worst part is the stiffness in my ankles and the no feeling in the hands,” she says. “But music makes everything better.” Mansfield was being visited by the ATX-VINyL program, a project dreamed up by Dr. Tyler Jorgensen to bring music to the bedside of patients dealing with difficult diagnoses and treatments. He collaborates with a team of volunteers who wheel the player on a cart to patients’ rooms, along with a selection of records in their favorite genres.

My patient was gone. I had to help his family see it: The art of medicine means sitting with families’ grief and hope Stat10 - First Opinion; by Raya Elfadel Kheirbek; 12/15/25 Bullets tore through Michael Thompson’s car at a stop sign, ending the life of a 35-year-old father in an instant. Just minutes earlier, he had dropped his 8-year-old daughter, Emma, at dance class, her pink tutu bouncing as she waved goodbye. Now, in the ICU, his young body lay tethered to machines — ... a ventilator’s hiss forcing his chest to rise. ... His family’s grief filled the room, raw and heavy, as I prepared to document our meeting. On the screen, a pop-up appeared: “Patient is deceased; do you want to continue?” Its cold bluntness paled against their pain. Michael looked alive. His chest rose and fell with the ventilator. ... Medicine isn’t just tests or machines. It is presence — sitting with families in their grief, faith, and love. Our tools should support that presence, not interrupt it with cold prompts. ... Most U.S. hospitals lack clear guidelines for these situations, leaving families and clinicians alike in limbo. They also worried about organ donation — a decision fewer than 1% of families consent to after brain death, often because the body still looks alive.Editor's Note: We thank the palliative care physicians, nurses, social workers, and chaplains who provide sensitive presence with families in the unbearable spaces between hope and loss, especially when life support decisions arise. In this season, may we pause to honor those who carry this sacred work—and remember the families who have had to accept harsh truths while machines still “breathe.”

Hospice chaplain gets prison for sexual assault at facility in Sacramento County The Sacramento Bee, Sacramento, CA; by Rosalio Ahumada; 12/8/25A judge on Thursday [12/4] sentenced a man who worked as a hospice chaplain last year when he sexually assaulted a woman living in an elder care facility in Sacramento County.  ... [The chaplain] worked for a company that was contracted by care facilities, and the elderly woman was sexually assaulted within a week before the arrest. ... The District Attorney's Office did not include the name of the company or the care facility in the news release.

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.

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. ...

Shepherd’s Cove Hospice: Children’s Activity Garden Sand Mountain Reporter, Albertville, AL; by Mary Bailey; 11/22/25 Shepherd’s Cove Hospice in Albertville lives by the words of community, compassion and connection. On Tuesday morning they opened the doors of the community room for a free breakfast and then held a ribbon cutting for their new “Children’s Activity Garden” located at their facility. With one in nine children in Alabama experiencing a loss of a parent or sibling by age 18, Shepherd’s Cove Hospice saw a need and wanted to help. The Children’s Activity Garden is space where children and teenagers can come to deal with their emotions but also have the freedom and space to still be a child and play. 

Unique ethical dilemmas occur in long-term care settings: Staff need ethics resources  Medical Ethics Advisor; by Stacey Kusterbeck; online ahead of print 12/1/25 issue ... “The position paper was developed in response to concerns from our members about the ethical challenges of the changing environment in long-term services,” says Jason M. Goldman, MD, MACP, president of the American College of Physicians. ... Discharge disposition, communication issues (either among the clinical team or between clinicians and parents), behavior problems, and goals of care were the top ethical issues reported. Lack of caregiver support was another frequent unique ethical concern. Editor's Note: Your hospice is in a unique role to provide ethics trainings for end-of-life care, and thus building trust, clinical best practices, and referrals. The CMS Hospice Conditions of Participation require: Hospices That Provide Hospice Care to Residents of a SNF/NF or ICF/MR (§ 418.112) (f) Standard: Orientation and training of staff. Finally, this rule requires a hospice to assure the orientation of SNF/NF and ICF/MR staff caring for hospice patients. Staff orientation must address the following topics: hospice philosophy; hospice policies regarding patient comfort methods, pain control, and symptom management; principles about death and dying; individual responses to death; patient rights; appropriate forms; and record keeping requirements.

“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:

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:

Home-based psilocybin-assisted therapy for a patient with advanced cancer: A case reportPalliative & Supportive Care; by Houman Farzin, Benjamin Koren, Héléna Ferrier, Justin J Sanders, Nicolas Garel; 10/25 Psychospiritual distress affects many patients with cancer, contributing to diminished quality of life, decreased survival and a desire for hastened death. The current standard of care, which primarily consists of antidepressants and psychotherapy, has demonstrated only modest benefits. Psilocybin-assisted therapy (PAT) has shown evidence of rapid, durable, and significant effects on measures of both depression and anxiety in this patient population. A 51-year-old man diagnosed with metastatic lung cancer, referred to palliative care (PC) with a prognosis of less than 6 months, experienced depression and anxiety in the context of demoralization and existential distress. PAT was well tolerated, with significant decreases in both anxiety and depression [and] the patient subjectively reported a sustained reduction in suffering and improved well-being at 2 months post-intervention. 

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.

The human cost of health care automation MedPageToday's KevinMD.com; by Christie Mulholland; 11/8/25 AI is rolling out in medicine faster than most of us can process. Ambient scribes documenting visits. Clinical decision support algorithms. Automated prior authorizations. The promises are compelling: reduced clerical burden, more face-time with patients, less burnout. I wanted this. As a palliative care doctor and director of physician well-being at my institution, ... [when] AI tools promised relief, I advocated for them. ...