Literature Review

Gaps in the coordination of care for older adults with or at risk for cardiovascular disease The American Journal of Managed Care; by Lisa M. Kern, MD, MPH,Joselyne E. Aucapina,Samprit Banerjee, PhD, Joanna B. Ringel, MPH, Jonathan N. Tobin, PhD, Semhar Fisseha, MPH, Helena Meiri, MA, RN, Madeline R. Sterling, MD, MPH, Kurt C. Stange, MD, PhD, Monika M. Safford, MD, Paul N. Casale, MD, MPH; 6/3/25 ... To determine whether older adults with cardiovascular disease (CVD) or CVD risk factors perceive gaps in communication among their providers and whether they consider those gaps to be consequential, we conducted a cross-sectional survey of Medicare beneficiaries 65 years and older with CVD or CVD risk factors and highly fragmented ambulatory care (reversed Bice-Boxerman Index score ≥ 0.85).

Hawai'i Pacific University alumni join forces to build a pioneering palliative care team for student excellence Special to The 'Ohana - HPU's Daily News, Honolulu, HI; 6/3/25 A group of HPU alumni from the nursing, social work, public health and business administration programs ... will be working towards steering a newly established palliative care team at HPU to assist nursing students, social workers and public health students to play an important role in understanding palliative care, hospice and communication with family and survivors. The team will play a role in setting up clinical placements in the community at St. Francis Palliative Care Units and Hospice, to give our nursing students invaluable hands-on experience in providing compassionate care for patients with serious and life-limiting illnesses. HPU Assistant Professor Joy Bliss, Ph.D., will also be designing simulations for “effective listening and communication skills,” to enhance student’s performance and skills in grief and this specialty of nursing. ... This initiative is not only an opportunity to strengthen the clinical training of nursing students, but also an essential step forward in improving the availability and quality of palliative care in Hawaiʻi. 

Remove barriers that restrict hospice care, Alliance offers in new report McKnights Home Care; by Adam Healy; 5/28/25 Hospice providers can boost quality and patient satisfaction with a focus on transparent, culturally sensitive communication with clients, according to a new report by the National Alliance for Care at Home. ... For the report, the Alliance surveyed 2,000 adults who either recently experienced the death of a loved one or have been involved in healthcare decisionmaking for a person with a serious illness. Respondents included individuals of a variety of ages, income levels, ethnicities and educational backgrounds. ... . For many seniors, one of the largest barriers to care is ineffective communication, the survey found. Language barriers are a significant hurdle for non-English speaking older adults, particularly those who are first generation immigrants, it noted. Many seniors are also less comfortable with technology-based communication than younger people, and prefer face-to-face conversation over text messages.

"You're next": People are sharing the last words they heard someone say as they were dying, and they're not all inspiring BuzzFeed; by Mike Spohr; 5/21/25There's so much we don't understand about the end of life. Recently, we shared a post where Quora users shared their experiences being present for the final moments of someone's life...and hearing their last words. Well, as it turns out, BuzzFeed's readers wanted to share their experiences hearing someone's last words too, so we rounded them up here:

6 ways to successfully implement clinical communication tools Forbes; by Judit Sharon; 5/19/25 In the high-stakes environment of healthcare, communication breakdowns can have life-or-death consequences. Yet too often, hospitals and healthcare systems assume that simply deploying new clinical communication and collaboration (CC&C) tools will solve the problem. The reality is more complex: Successful implementation depends just as much on operational alignment, cultural change and thoughtful execution as it does on the technology itself. To turn communication tools into real transformation, here are six ways to drive successful CC&C adoption.

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). ...

Honey, Sweetie, Dearie: The perils of elderspeakKFF Health News, originally published by The New York Times; by Paula Span; 5/9/25 A prime example of elderspeak: Cindy Smith was visiting her father in his assisted living apartment in Roseville, California. An aide who was trying to induce him to do something —  Smith no longer remembers exactly what — said, “Let me help you, sweetheart.” “He just gave her The Look — under his bushy eyebrows — and said, ‘What, are we getting married?’” recalled Smith, who had a good laugh, she said. Her father was then 92, a retired county planner and a World War II veteran; macular degeneration had reduced the quality of his vision, and he used a walker to get around, but he remained cognitively sharp. People understand almost intuitively what “elderspeak” means. “It’s communication to older adults that sounds like baby talk,” said Clarissa Shaw, a dementia care researcher at the University of Iowa College of Nursing ... “It arises from an ageist assumption of frailty, incompetence, and dependence.” Its elements include inappropriate endearments. “Elderspeak can be controlling, kind of bossy, so to soften that message there’s ‘honey,’ ‘dearie,’ ‘sweetie,’” said Kristine Williams, a nurse gerontologist at the University of Kansas School of Nursing ...

It's time to talk about LGBTQ+ elder care Psychology Today - Caregiving; by Stephanie Sarazin, M.P.P.; 5/6/25 A once-hidden story is helping us think about queer kinship and caregiving. Key points:

Breaking with the status quo in end-of-life care through de-implementation Journal of Internal Medicine; by Chetna Malhotra and Ellie Bostwick Andres; 4/17/25... In the realm of serious illness, many patients undergo interventions that may marginally prolong life but often sacrifice quality of life and entail significant costs. These interventions, categorized as ‘low-value care’, often involve complex procedures, frequent hospitalizations and intense medical management, leading to considerable discomfort, reduced functional ability and overall decreased well-being and calling into question the efficiency and effectiveness of current end-of-life (EOL) care practices. ... How to conduct de-implementation in EOL contexts:

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.

5 things every leader can learn from Pope Francis  Inc., by Suzanne Lucas; 4/21/25 He led the world’s largest organization with humility and a willingness to engage with different groups and hear different viewpoints. ...  [Pope Francis' death marks] the end of a papacy that influenced far more than just the Catholic Church. In his 12 years as pope, he led with a style that offers enduring leadership lessons for anyone in a position of authority, especially in business. ... While I’m not Catholic, I have followed his work in the 12 years he’s served as pope, and there are plenty of things you can learn about his leadership of the Catholic Church and apply in your life and business.

Why are we so afraid to talk about our own death? Deseret News; by Holly Richardson; 4/21/25 We are more than comfortable with true-crime and first-person shooter games, but a lot of us do not want to talk about our own mortality. ... ... A whopping 84% of the U.S. population over age 13 ... consumes true crime media, according to Edison Research. It’s the most common topic among top-ranked podcasts. First-person shooter video games are the most popular genre. ... So why is it so hard to talk about our own mortality? Maybe we think we can live forever. ... A survey done last year explored reasons why people are uncomfortable talking about death. The top reason given (37%) was that people did not want to upset others, and the second (34%) was that it is too depressing to think about. About one in five say they’ll “cross that bridge when they come to it” or that they are afraid of dying. Ten percent are afraid that talking about death will somehow make it more likely to happen.Editor's note: While this data gives insights into communication with patients and families, Advance Directives, and community outreach, I find myself reflecting those of us who have chosen palliative, hospice, and/or grief care as our vocations. Do we protect ourselves from facing our own mortality by staying in "helper" roles, and avoiding our own human vulnerabilities? What conversations have you had with your family? What Advance Directives and legal plans do you have in place (or not)? 

[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.