Literature Review

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.

For AYAs with advanced cancer, study finds serious communication gaps about their care National Cancer Institute; by Daryl McGrath; 4/15/25 Many adolescents and young adults (AYAs) with advanced cancer don’t have discussions with their clinicians about how they want to approach palliative care until the final weeks of life, a study of medical records of nearly 2,000 young patients showed. ... Talking about care and treatment near the end of life is one of the most challenging aspects of caring for AYAs with advanced cancer, said Ashley Wilder Smith, Ph.D., M.P.H., of NCI’s Healthcare Delivery Research Program and co-leader of NCI’s Adolescent and Young Adult Oncology Working Group. ... “When a young person is faced with a disease that may lead to an early death, it’s vitally important to give them the opportunity to think about what’s most important to them and what happens to them in terms of care in the time they have left,” she said.

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...

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 ...]

Seeking human empathy, health insurers turn to AI Modern Healthcare; by Nona Tepper; 3/27/25 When Florida Blue wanted its call center employees to demonstrate greater emotional intelligence when dealing with customers, the nonprofit health insurance company enlisted a tutor incapable of emotion. A generative artificial intelligence, or genAI, chatbot instructs 30 Florida Blue customer service representatives on how to behave like human beings when interacting with other human beings. The chatbot guides workers on human behaviors, such as when to slow their speech, when to hasten a call to its conclusion and what to recommend to policyholders. The company plans to expand this pilot program to its entire 1,600-person call center team this year. [Continue reading ... access may be limited]Editor's note: Is this backwards? What happened to human kindness? Courtesy and core respect? I am a lifelong lover of new technologies. Still, I am surprised at this seemingly-backwards twist. For whatever works, may we learn and grow in "[behaving] like human beings when interacting with other human beings."

Duke University Health System CEO: 7 lessons learned from a complex transformation Becker's Hospital Review; by Craig T. Albanese, MD, CEO of Duke University Health System; 4/3/25 Change management is both the art and science of preparing, supporting and equipping individuals, teams and an organization to adopt and adapt to new beginnings. ... Unifying our organization over the past 21 months, as with most mergers, has been challenging and we are far from finished. ... Lessons Learned:

Hospices must ‘evolve’ to better support next generation of caregivers Hospice News; by Holly Vossel; 3/31/25 Individuals in the millennial and generation Z (Gen Z) age groups represent a swelling proportion of today’s family caregivers. They face unique challenges when providing support for hospice patients compared to others, recent research has found. ... Understanding the competing, complex priorities of these generations is pivotal for hospices’ ability to deliver quality care, according to Nicole McCann-Davis, senior client advisor and research director at Transcend Strategy Group. [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.

Managing oncology nurse burnout through peer support, emotional intelligence Oncology Nursing News; by Pattie Jackel, MN, RN, AOCN; 3/28/25 Debriefing after patient loss, supporting patients at the end of life, and finding outlets outside of work can help oncology nurses avoid burnout. ... Pattie Jakel, MN, RN, AOCN, spoke with Oncology Nursing News® about burnout in oncology nursing and ways to avoid it while providing palliative care to patients. ... You have to have a strong network and support. And my husband is…an architect, so medicine is not his thing, and in the beginning, he’d be like, “Pattie, I can only hear one sad story a week because I can’t hear all your sad stories.” ... "Working in acute care, I saw some horrific death and dying that occurred for our patients. We would definitely debrief afterwards, bring the group together 5 minutes. Sometimes we did longer ones." [Continue reading ...]

Hidden battles: Keeping cancer secret Harvard Health Publishing - Harvard Medical School; by Maureen Salamon; post is dated 4/1/25, retrieved from the internet 3/25/25 Some people choose to conceal their diagnosis and treatment. Here's why — and reasons that approach can sometimes backfire. ... [In addition to privacy motives, Cristina Pozo-Kaderman, a senior psychologist at Harvard-affiliated Dana-Farber Cancer Institute] says cancer patients may also wish to: