Literature Review

A daughter’s cautionary elder care tale The Progressive Magazine - Book Review; by Bill Lueders; 5/12/25 The call that woke Judy Karofsky in the middle of the night on May 18, 2015, was from a hospice nurse, who got right to the point: “I’m calling to tell you that your mother has died.” Karofsky, deeply shaken by the unexpected news, managed to ask, “Did she struggle?” Karofsky’s important new book, DisElderly Conduct: The Flawed Business of Assisted Living and Hospice, does not mention the hospice nurse’s response to this question. But it does note that she called back a moment later to say: “I’m so sorry . . . . I called the wrong number. I’m at a different facility and I had the wrong file.” Karofsky’s mother, Lillian Deutsch, had not died at all. It was someone else’s mother. Apologies were made. This is just one of many stories Karofsky shares throughout the book about the final years of her mother’s life in Wisconsin. This particular anecdote strikes me as noteworthy not just as an example of the sort of awful things that can happen when facilities are understaffed and staff members are overworked, but also because Karofsky’s first reaction was to wonder whether she struggled.Editor's note: Though printed news typically lifts up the good, compassionate moments of hospice care, most all of us have experienced negative accounts--professionally and/or personally. While this book is sure to give significant insights, perhaps the most important lessons are waiting to be validated from your own family caregivers, employees, and volunteers. What stories are behind your lower-than-you-want CAHPS Hospice scores? Dig deeper. May we all listen, learn, and improve care.

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" ...

Increasing timely code status discussions in hospitalized children with medical complexityJournal of Hospital Medicine; James Bowen MD; Laura Brower MD, MSc; Daniel Kadden MD; Jasmine Parker BS; Alexandra Delvalle BSN; Andrew Krueger MD; Kristin Todd MSW; Rachel Peterson MD; 4/25Children with medical complexity (CMC) have an increased risk of hospitalization and clinical deterioration. Documentation of code statuses concordant with family goals is rare, increasing the risk of serious unintended consequences. We aimed to increase the percentage of patients with documentation of timely code status orders (CSOs) from 5% to 80% over 6 months. Multiple plan-do-study-act cycles were performed focusing on interventions aimed at key drivers, including increasing knowledge in performing code status discussions (CSDs) and improving understanding of institutional policies. The average percentage of patients who received a CSO placed in their chart within 72 h of admission to the CCT [complex care team] increased from 5% to 61% over 6 months.

Think you know what nursing research looks like? Think again Boise State News, Boise, ID; 4/30/25 “Research” doesn’t just mean generating new discoveries through experimentation. Boise State supports Boyer’s model of scholarship, which expands the definition of research and creative activity to include applying and integrating knowledge into other settings, as well as teaching it. ... [An] interdisciplinary team is working to improve hospice and palliative care for refugees. ... Clinicians and refugees often do not share common cultures, languages or communication norms, so [Kate] Doyon has been building a community advisory board to create a communication guide. They’re working with stakeholders–including refugees and providers–to develop prompts that will enhance the care refugees receive, starting on the level of communication. Ornelas said the refugees they interviewed “gave us a lot of insight on different cultures and how we can go about and make prompts.” The prompts are short phrases to remind the healthcare team of best ways to interact with refugees and productively approach conversations.

Small acts of kindness can change someone’s world MedPageToday's KevinMD.com; by Jake Rattner; 4/26/25 So much of the world is centered around looking out for ourselves. We get caught up in our own problems, our own routines, and sometimes, we forget to stop and think about what someone else might be going through. ... But when we step outside of our own lives, even just for a moment, we start to see the bigger picture. ... In the end, it’s the simple things that matter. A conversation, a smile, a moment of recognition—these things can change someone’s entire day, even if you don’t realize it. ... Because sometimes, the best medicine isn’t even medicine—it’s just knowing that someone cares.

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.

Professor teaches student physicians how to use art to connect with end-of-life patients Thomasville Times-Enterprise, Moultrie, GA; by Staff Reports; 4/23/25Richard Curtis of Thomasville teaches art classes at Thomas University, but he’s also an end-of-life doula who volunteers with patients through Archbold Hospice, integrating his artistic skills into his volunteer work. Earlier this month, Curtis showcased his blend of art, medical care, and human interaction during a session of the Medical Humanities course at PCOM South Georgia. Led by faculty member Thomas Last, PhD, the course aims to help student physicians transcend the science of medicine. “The Medical Humanities course supports students’ growth into humanistic, socially conscious physicians by providing reflective opportunities and meaningful experiences that deepen their understanding of diverse patient perspectives,” Dr. Last said.Editor's note: Do you dismiss this? Does it seem too "out there"? For stronger context, Sandra Bertman, PhD, FT pioneered Arts Medicine with medical students and other healthcare clinicians. For most of her career, Bertman was Professor of Humanities in Medicine at the University of Massachusetts Medical School and Graduate School of Nursing, where she founded and directed the Program of Medical Humanities and Arts in Healthcare. (More personally, I've been blessed to know Sandra as my colleague and friend.) Dr. Bertman was awarded the Robert F. Kennedy Award for Social Justice (2018). Her primary publications include ...

I’m a hospice physician. There’s one thing I dread telling my patients. Slate; by Charlotte Grinberg; 4/22/25 Tom was dying, and managing his condition at home was increasingly difficult. ... His wife Sue was in survival mode. A few sleepless nights turned into weeks without rest, during which she was constantly trying to manage Tom’s symptoms and take care of his basic needs. I’m a hospice physician, and it’s at junctures like this that I can offer a life vest that completely changes the end-of-life experience. ... I told Sue that I thought Tom should transfer to our inpatient hospice facility. “You have done everything possible for Tom at home, it’s too much to ask of you or anybody,” I said. “He needs a higher level of care.” ... Getting a devoted spouse to agree to move their dying partner out of the home isn’t always easy. But a few days after Tom arrived at the inpatient hospice facility, Sue cried tears of appreciation describing the daily baths the caretakers there gave him. 

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.

The power of film to change medical culture: A Q&A with a physician-filmmaker about her latest documentary MedPage Today; by Genevieve Friedman; 4/15/25... We spoke with Jessica Zitter, MD, a critical care and palliative care physician in California, about shifting her career beyond clinical medicine and into the world of film-making. Zitter has produced three documentaries that use storytelling to inspire healthcare providers to connect to their work with purpose, community, and compassion, and in 2022, she founded the production company Reel Medicine Media. Her latest documentary, "The Chaplain & The Doctor," explores her relationship with Betty Clark, a chaplain on Zitter's palliative care team, and the value that can grow from an unlikely partnership.

Conversations today to empower tomorrow: VITAS Healthcare elevates National Healthcare Decisions Day VITAS Healthcare; Press Release; 4/7/25 Only one in three adults in the United States have a written advance directive, a document critical in providing guidance to medical teams regarding one’s end-of-life wishes. As a pioneer and national leader in hospice and palliative care, VITAS Healthcare advocates for National Healthcare Decisions Day (April 16) and advance care planning––regardless of a person’s age or health status....  On April 16, VITAS will host a free webinar, Advance Directives and Advanced Care Planning, exploring the history, application and types of advance directives. VITAS Regional Medical Director Heather Veeder, MD, will provide practical advice to help healthcare professionals engage in difficult but necessary conversations with patients and families/caregivers. [Continue reading ...]

Federal legislation would mandate hospice education upon hospital discharge McKnights Home Care; by Adam Healy; 4/2/25 A bill under consideration in Congress would require hospitals to educate patients about hospice care options upon discharge. HR 2437, introduced Thursday by Rep. Erin Houchin (R-IN), would amend Medicare policy to mandate that hospitals “provide information on available hospice programs to certain individuals upon discharge,” according to the bill. Although hospitals are not necessarily required to provide patients with information on available hospice programs upon discharge, they are encouraged to do so. [Continue reading ...]

Palliative care in the intensive care unit: An integrative review of intensive care unit health care professionals' views and experiences Dimensions of Critical Care Nursing (DCCN); by Berit Lindahl and Susan Kirk; May-Jun 2025 ... Our findings suggest there is variation in how palliative care in the ICU is conceptualized and interpreted. Intensive care unit professionals need enhanced competencies and training to develop their confidence in providing palliative care and improve role clarity. Such training should focus on serious illness conversations with patients/families and interdisciplinary teamwork. Integration of palliative consultants into the ICU could be further developed.