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.

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. ... 

Bereavement support for oncology nurses caring for patients and families Journal of Hospice & Palliative Nursing; Tami Borneman, RN, MSN, CNS, FPCN, Paige Hayward, and Haley Buller, MSHSC; 10/28/25 Six themes emerged from the open-ended question that asked participants to share case studies describing a patient or family member that they had cared for who was experiencing grief and nurse interventions: (1) treatment failure/out of options, (2) unexpected death or recent loss, (3) impending death, (4) multiple or overlapping losses, (5) coping, and (6) anticipatory grief. 

Bearing witness in home hospice: Ethical reflections on caring for Asian American patients American Journal of Hospice and Palliative Medicine; by Tuzhen Xu, PhD, APRN, FNP-C and Dan Song, PhD, RN This narrative aims to examine the ethical and cultural challenges faced by home hospice nurses when caring for Asian American patients in culturally diverse home-based environments. Drawing on personal experiences as a hospice nurse case manager and director, it explores how cultural practices such as avoiding direct discussions about death, prioritizing family-centered decision-making, and hesitating to use professional interpreters can conflict with hospice principles of patient autonomy and informed consent. 

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. ...

Peaceful acceptance of illness among older adults with advanced cancer Journal of Pain and Symptom Management; by Sule Yilmaz, Elizabeth Gilbride, Sofiia Hryniv, William Consagra, Supriya G Mohile, Eva Culakova, Beverly Canin, Arul Malhotra, Rachael Tylock, Judith O Hopkins, Jane Jijun Liu, Jamil Khatri, Marissa LoCastro, Maya Anand, Allison Magnuson, Kah Poh Loh; 10/23/25 Context: Peaceful acceptance of illness is associated with lower psychological distress and increased engagement in advance care planning among adults with advanced cancer. Limited data exist on factors influencing illness acceptance in older adults. ... Conclusion: Patient psychological health, perceived prognosis, and caregiver education were linked to PEACE. Triadic interventions addressing these factors may enhance end-of-life care for older adults with advanced cancer.