Literature Review

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing studentsState Nurses Associations - Kansas State Nurses Association; by Shelby True, MSN, RN; Libby Rosen, PhD, RN, IBCLC; Ashley Seematter MSN, RN; Jeri Harvey & Karly Lauer, MSN, RN; 2/20/25Many baccalaureate nursing programs throughout the United States thread concepts of bereavement and end-of-life care throughout their curriculum. However, a standardized education program for nursing students that increases the knowledge, confidence level, and application of skills a nurse must possess when providing perinatal bereavement care is often absent from the curriculum (Sorce & Chamberlain, 2019).  Perinatal loss can have a profound impact on parents and their loved ones, leading to emotional, psychological, physical, and spiritual trauma that deeply affects the lives of those involved. The nursing care each parent receives at the time of the loss may be remembered for years to come and is crucial to determining the nature of the grieving process (Sorce & Chamberlain, 2019). ... To improve the knowledge, confidence, and skill level of nurses providing perinatal bereavement care, a role-play perinatal bereavement simulation was developed and implemented in two Midwestern universities’ baccalaureate nursing programs in the maternal/newborn courses. Editor's note: Having served our hospice's Pediatrics Team for four years, the grief of parents, grandparents, siblings affected me deeply. I remember vividly a young mom unable to physically leave her baby's body with the hospital's nurse. Gently, we held her baby together. Over the course of about 15 minutes, the mother gradually shifted the weight of holding her baby over to me, before the hardest task of her life--leaving the hospital without her child. (It was Christmas week. I bawled when I got home.) Visiting them at the funeral home and after in their home, I experienced horrible, disenfranchised comments and attitudes from others (especially a local preacher). Leaders: tune into your pediatric hospice and palliative team members. What specialized support and education do they need? And, we never know what personal stories of perinatal bereavement those around us continue to carry. 

Staffing shortages weighing on hospice executive’s minds in 2025 Hospice News; by Holly Vossel; 2/19/25 Hospice leaders have lost sleep over workforce pressures plaguing the industry for several years running, a trend that is not anticipated to abate anytime soon. Staffing challenges were cited as the leading concern among 35% of 112 hospice professionals who participated in this year’s Outlook Survey by Hospice News and Homecare Homebase. This represented an 18% decline compared to the 2023 survey results. ...

New insights into older hearts  The New York Times; by Paula Span; 2/15/25 It turns out that the Isley Brothers, who sang that 1966 Motown hit “This Old Heart of Mine (Is Weak for You),” were onto something when they linked age to an aching and flagging heart. Heart disease, the nation’s leading cause of death and disability, has been diagnosed in about 6 percent of Americans ages 45 to 64, but in more than 18 percent of those over 65, according to the Centers for Disease Control and Prevention. ... [In] recent years, dramatic improvements in treatments for many kinds of cardiovascular conditions have helped reduce both heart attacks and cardiac deaths. ... That can complicate decision-making for heart patients in their 70s and beyond, however. Certain procedures or regimens may not markedly extend the lives of older patients or improve the quality of their remaining years, especially if they have already suffered heart attacks and are contending with other illnesses as well. “We don’t need to open an artery just because there’s an artery to be opened,” said Dr. Alexander, referring to inserting a stent. “We need to think of the whole person.” ...

Witnessing a living funeral Parkview Health; by Tim O'Sullivan, MA, Spiritual and Social Services Supervisor, Parkview Hospice; 2/16/25 ... Rather than planning services after they pass and miss out on a gathering of the people who are most precious to them, some are choosing to schedule a "funeral" while they are still living so they can be a part of the ceremony. These events are known as Living Funerals. As a hospice caregiver, I have seen a rise in the number of these pre-death celebrations of life. While this may not be for everyone, it can be a meaningful experience for those who have chosen to remember a life in this way. I was invited to one of these events and witnessed firsthand the power of acknowledging death while fully living in the moment. ... [Click on the title's link to continue reading.]

How to help caregivers of patients with dementia Physician's Weekly; by Linda Girgis, MD, FAAP; 2/13/25 Dr. Linda Girgis discusses how physicians can assist caregivers of patients with dementia, helping these critical caretakers avoid experiencing burnout. ... As doctors, we all have witnessed caregiver burnout. Often, it was a family member who bore the brunt of the responsibility, one for whom there were no vacation days or sick time available. Whatever specialty we practice, we know patients with dementia can present a significant problem. ... How can we assist caregivers of patients with dementia?

How to live when you know you are dying Equity Atlas; 2/11/25 Living with the knowledge of impending death is an incredibly challenging and emotional experience. Whether facing a terminal illness or a life-threatening situation, the idea of living when you know you are dying can be overwhelming. However, it is possible to find peace, acceptance, and even joy in the midst of such difficult circumstances. In this article, we will explore how to navigate this journey with grace and courage. ... How does one navigate this difficult journey? We turned to professionals in the field for their insights on how to live when you know you are dying.

What we talk about, or not, when talking about death Enumclaw Courier-Herald; by Wire Service; 2/9/25 Death is a guarantee for everyone, so why do people shy away from talking about it and using words like death and dying? ... As a death doula and grief coach, Kathleen Putnam hopes that providing care to those who are grieving can help change the language surrounding death. ... Putnam explains that in present society, people want to avoid grief and pain. With medical advancements and industries and marketing systems focusing on keeping people alive, the rhetoric surrounding dying has become negative. Putnam also pointed out that instead of using phrases like “they died” or “they’re dying,” other phrases like “pass away” and “they went to sleep” have become popular when talking about a loss.

New report details financial, emotional toll of Parkinson’s on family caregivers McKnights Home Care; by Foster Stubbs; 2/4/25 A new report sheds a light on the unique challenges faced by family caregivers who care for loved ones with Parkinson’s disease (PD). The report, Parkinson’s Disease Caregiving in the US, features insights from secondary analysis and supplementary interviews with 10 PD caregivers. These caregivers average 31 hours of unpaid care per week; half of interviewed caregivers exceed 100 hours each week, according to the report. The National Alliance for Caregiving (NAC), with support from The Michael J. Fox Foundation for Parkinson’s Research (MJFF) and Arcadia University, released the report.  

What can we learn from the dying? Newscastle's News Letter Journal (NLJ), Newcastle, WY; by Kelly Evans-Hullinger, MD; 1/26/25 For the last five years, I have had the great privilege of serving my local health system as Medical Director for Home Hospice. Every week I sit in a meeting with the multidisciplinary caretakers on this team ... Patients facing their own deaths want to talk about their lives. Our staff frequently tries to facilitate what they call a “life review” in which a patient can openly talk about their childhood, family, career, service, and sometimes their regrets. This is therapeutic for the dying patient and their loved ones.  ... I have recently thought about this particular human need – to reflect and remember one’s life. I take this as a reminder to both seek those stories from my own loved ones (I wish I had asked my grandmother more questions about her life) and, perhaps, to tell and write about the things in my own life I would want to be remembered after I am gone. For if there is another thing I’ve learned serving patients on hospice, it is that my death is also inevitable; but, I think, life’s finality is what gives it beauty and meaning. 

If you’ve overcome these 9 challenges in life, you’re more resilient than you think Personal Branding Blog; by Lucas Graham; 1/21/25 Resilience isn’t always about being unshakable or invincible. Sometimes, it’s just about surviving the chaos, picking yourself up after the mess, and somehow finding the courage to keep going. In the moment, it’s hard to see how strong you really are—you’re just trying to make it through. But when you pause and look back, you realize the grit it took to get here. ... [If] you’ve been through these nine challenges and made it out, you’re way more resilient than you give yourself credit for.

At United Hospice good leadership makes all the difference Mid Hudson News, Goshen, NY; by Mid-Hudson News Staff; 1/19/25 In the world of healthcare, there are few environments as emotionally charged and delicate as hospice care.  Here, patients face the final chapter of their lives, and their families must grapple with the profound weight of grief and impending loss. It’s a space that requires not only clinical expertise but also an extraordinary level of compassion, empathy, and resilience. At the heart of it all is leadership—a factor that can profoundly shape the quality of care, support, and comfort patients and families receive during this challenging time. [Cara Pace, United Hospice CEO] noted that leadership in hospice care is not about wielding authority or simply managing logistics. It’s about embodying a vision of compassionate, patient-centered care that resonates throughout the organization. A good hospice leader knows how to create a culture of empathy, where every member of the team understands the profound impact their work has on the lives of patients and families.