Literature Review

Caring with confidence: A guided approach to end-of-life careJournal of Pain & Symptom Management; Laura Maldoon, Stacy L. Nilsen; 6/26Nurses may face uncertainty when caring for dying patients due to inadequate education and experience. This uncertainty coupled with varying practices for end-of-life care may affect both care quality and nurses’ attitudes. In nurses caring for hospitalized End-of-Life patients, does having a guided End-of-Life template and care resources, compared to current practices, improve registered nurse attitudes in providing individualized end-of-life care? Two inpatient nursing units received a 30-minute End-of-Life educational intervention utilizing the City of Hope’s Comfort, Airway, Restlessness and Delirium, Emotional and Spiritual Support (CARES) toolset as a standard resource to assess and prioritize end-of-life symptom management and family communication. This project suggests improved comfort and confidence among RNs in providing end-of-life care with the use of the CARES toolset. Nurses also demonstrated increased interest in seeking additional education.

Exploring the relationship between usage of a digital mindfulness app and perceived stress among caregivers of persons living with dementiaAging & Mental Health; by Michael P. Williams, Morgan Seward, Elizabeth M. Allen, Raquel G. Tatar, Darby M. Simon, Jennifer Huberty, Ana-Maria Vranceanu, Evan Plys; 6/26Mindfulness digital health interventions (DHIs) can support stress management among caregivers of persons living with dementia (PLWD), yet few studies investigate dose-response relationships. This study is a secondary analysis of a feasibility randomized controlled trial of Healthy Minds Program for Caregivers (HMP-C), a mindfulness DHI to reduce stress among caregivers of PLWD, against an educational podcast control (Wellness App [WA]). Participants were instructed to use HMP-C or WA 10 min per day. Every 10 min of HMP-C usage per week was significantly associated with a decrease in perceived stress by 0.7 ... Higher baseline stress and anxiety were related to lowered usage in active control ... , but not in HMP-C.

The ASCENT Consortium - Two Requests for Applications are now open!ASCENT Consortium press release; 7/22/26The ASCENT Consortium is pleased to announce two Requests for Applications (RFA) are now open, with letters of intent due 8/10/26:

New $11.8M federal grant will launch Dartmouth Health’s aging research center Valley News, New Hampshire Public Radio; by Olivia Richardson; 7/23/26 Dartmouth Health has received nearly $12 million to create a program to study the needs of people aging with serious illnesses. The $11.8 million federal grant comes from the Centers of Biomedical Research Excellence program, through the National Institute of General Medical Sciences. The program helps states that have historically received less National Institutes of Health funding to expand their research capacity. Close to $3 million has been included in the award to help fund Dartmouth’s Geisel School of Medicine’s participation in the program. Dartmouth Health has named its aging study program the Center for Aging with Serious Illness. The grant will allow the center to collaborate with other research institutions, support early-career clinician-scientists, and broaden the Dartmouth Health research community focusing on older adults with serious illness.

Restarting medications after deprescribing in adults discharged from hospital to skilled nursingJAMA Network Open; by Thomas J. Reese, Sandra F. Simmons, Eduard E. Vasilevskis, Emily K. Hollingsworth, Matthew S. Shotwell, Amanda S. Mixon; 6/26Question: Among older adults discharged to skilled nursing facilities (SNFs) after hospital-initiated deprescribing, what is the frequency and timing of medication restarts ...?  In this cohort study analyzing data from 2 randomized trials with a total of 598 participants, 15.9% of deprescribed medications were restarted. Higher health literacy and longer intervention exposure were associated with fewer restarts, whereas more prescribers, higher number of baseline medications, and fewer pharmacies were associated with medication restarts; restart during the SNF stay was associated with greater 90-day hospital readmissions. Conclusions: In this cohort study, approximately 1 in 6 deprescribed medications were restarted within 90 days, with nearly half occurring soon after SNF discharge. Patient factors and markers of care fragmentation were associated with restart, suggesting that enhancing transitional care and postdischarge support may improve the durability of hospital-initiated deprescribing.

"Reconciling"- conceptualising the grieving process of family members involved in assisted dying: A grounded formal theoryBMC Palliative Care; by Jonathan Bayuo, Prince Kyei Baffour, Elisha Baafi Oduro, Deborah Adedibu; 6/26While theoretical frameworks for understanding the grieving process are well-established, the advent of assisted dying presents a novel and under-examined context for grief and bereavement. Thus, this study sought to generate a theory explaining the grieving process of family members involved in assisted dying. Reconciling, as a mid-range theory, extends existing grief models by demonstrating that bereavement in assisted dying involves a proactive, ethically charged negotiation of autonomy, suffering, and relational responsibility; dimensions not accounted for in stage-based or oscillation models. The grieving process in assisted dying is best understood as Reconciling, a dynamic, iterative negotiation of autonomy, suffering, love, and loss. Families move through ambivalence, anticipation, transition, and aftermath in ways that blend emotional complexity with profound meaning-making.

Serious illness and health care threats to personal legacy goalsThe Permanente Journal; by Marlaine Figueroa Gray, Matthew P Banegas, Nora B Henrikson; 6/26High-quality care for people with serious illness requires understanding what matters most. Although goals-of-care conversations may emphasize values and treatment preferences, patients hold goals related to identity, relationships, and legacy; how they wish to be remembered and what they hope to leave behind. Five themes emerged [from the participant interviews]: 1) participants actively planned for legacy, with legacy goals often clarified by serious illness; 2) illness and its care introduced threats to legacy goals; 3) financial strain and insurance coverage were major threats; 4) participants believed their care would differ if teams understood their legacy goals; and 5) participants wanted to communicate their legacy goals to their care teams. Integrating legacy-related conversations into palliative care may enhance person-centered care by addressing identity, relationships, and meaning alongside medical preferences.Assistant Editor's note: This article summary describes a very important aspect of end-of-life planning. Exploring with patients their legacy goals is as important as discussing their preferences surrounding their care. Including legacy goals as an integral component of goals of care and advance care planning discussions would yield a greater understanding of what kind of care would most honor the patient.

Implementation of a serious illness conversation program in a health system: A retrospective observational studyJournal of Palliative Medicine; by Glen Varns, Abbey Sidebottom, Katy Hentges, Sandra Castro-Pearson, Jan Richardson, Emily Downing; 6/26Serious illness conversation (SIC) is a structured conversation framework designed to improve shared decision making and promote goal-concordant care with patients anticipating end-of-life care decisions. Objective: Examine reach, timeliness, and quality of SIC implementation across a health system after implementation of a SIC Program (SICP) [and] examine factors associated with SIC completion for eligible patients. Factors associated with SIC included palliative care visits ... , a primary care provider in the system ... , and an inpatient admission with discharge to home care ... Patients with dementia ... were less likely to have SIC. Conclusion: Systemwide implementation of an SICP engaged [only] half of eligible patients; many of those had multiple documented conversations prior to death.

Impact of specialized pediatric palliative care on bereaved parents' mental and physical healthJournal of Pain & Symptom Management; by Claudia Delgado-Corcoran, Huong D. Meeks, Sarah E. Wawrzynski, Barry P. Markovitz, Brandy Harman, Jasmine R. Masih, Kuan Li, Mark Harousseau, Dominic Moore, Jacob Wilkes, Stefanie G. Ames; 6/26Pediatric death can lead to long-term adverse effects on parents’ health. [In this study] of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC [specialized pediatric palliative care] consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child’s death ... Conclusions: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child’s death.

Palliative care for older adults with hip fracture: An explanatory sequential mixed-methods studyJournal of Pain & Symptom Management; by Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall, Zara Cooper; 6/26After hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Among 1,433 hip fracture admissions, GOCC [goals of care conversations], hospice discussions, and specialty PC were documented in view on their role in GOCC. Conclusion: Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.