Literature Review

Bridging the differences in care for grieving people: Worden's differentiation between grief counseling and grief therapyDeath Studies; by Mark D de St Aubin, William G Hoy; 2/26Worden's (1982, 2018) landmark textbook on caring for bereaved individuals differentiated grief counseling from grief therapy, defining the former as the efforts of both professional and lay caregivers to support bereaved people in normal grief. Grief therapy, he posited, is the more structured intervention offered by credentialed caregivers to support individuals coping with a more complicated experience of mourning. In this article, the authors explain Worden's perspective, describe his types of complicated mourning for which grief therapy might be warranted, and offer clinical application to the approaches Worden takes.

Executive Summary: Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICUCritical Care Medicine; by Mary Faith Marshall, F Daniel Davis, Patricia A Fogelman, Simon Oczkowski, Julie C Reid, Daniel Arellano, Rebecca A Aslakson, Joshua Campbell, Katherine Courtright, Katarine Egressy, Elizabeth Epstein, Ebonye Green, May Hua, Preeti R John, Erin K Kross, Niels D Martin, Bethany A Melo, Susanne Muehlschlegel, Silvia Perez-Protto, Ben Roberts, Daniel Shalev, Jennifer Wescoe Singley, Shawna L Strickland, Karen A Korzick; 12/25[Recommendations include:]

Use of nebulized tranexamic acid (TA) in combination with nebulized recombinant coagulation factor VIIa to treat hemoptysis in pediatric patients with cancer at end-of-life (EOL)Journal of Pain and Symptom Management; by Santosh Yatam Ganesh, Nelda Itzep, Eduardo Bruera; 2/26Hemoptysis is a distressing symptom for both patients and families at end of life (EOL). In the acute care setting, this can be managed surgically or medically. However, research regarding interventions, such as nebulized tranexamic acid (TA) and nebulized factor VIIa, for palliative management of hemoptysis at EOL is limited. In our case series, we found that combination of nebulized recombinant factor VIIa and nebulized TA relieved hemoptysis in both pediatric cancer patients at the end of life. This case series highlights the potential use of this combination to reduce suffering and distress secondary to hemoptysis in the palliative setting.

Values considerations in telemedicine: Pause before shiftingJournal of Pain and Symptom Management; by Meaghann S. Weaver, Kenneth A. Berkowitz; 12/25As a contingency standard of care, telemedicine use surged during the COVID-19 pandemic. The Medicare telehealth flexibilities introduced during the COVID-19 pandemic expired in September 2025. Any ongoing sustained pivot to telemedicine warrants purposeful attentiveness to ethical considerations and not just technology use as an end unto itself. Telemedicine has the potential to complement face-to-face care practices and enhance clinical interactions when its use is based on shared values. Values such as access, equity, justice, compassion, autonomy, and dignity warrant thoughtful use of telemedicine. Patients and families need to be able to trust that clinicians and health systems will place patient welfare and shared values above technical convenience. As demonstrated in this case description, upholding values fundamental to the practice of medicine in telemedicine can enhance patient connection and foster trustworthy postpandemic practices.

Dementia, taboo, and the need for a cultural reckoningJournal of Aging Studies; Kelly Marnfeldt; 3/26Dementia is one of the most feared and misunderstood conditions of our time. Even as public awareness has increased, people living with dementia continue to face exclusion, moral disregard, and systemic neglect. Decades of advocacy, education, and contact-based interventions have sought to reduce stigma. [This study] proposes that dementia becomes stigmatized not only because it is misunderstood, but because it violates cultural expectations of personhood, consistency, and intelligibility. The paper concludes by proposing culturally grounded provocations that imagine what it might look like to reframe how dementia is seen, told, and recognized, both socially and culturally.

John Bowlby’s theory of attachment and separation: revisiting his original visions after 50+ years, what we know today, and where to go from here?

Trends and disparities in left ventricular failure mortality in The United States: A 1999-2020 analysisJournal of Cardiac Failure; by Abdalhakim Shubietah, Hasan Munshi, Emmanuel Olumuyide, Muath Baniowda, Abdallah Hussein, Mohammad Alqadi, Qutaiba Qafisheh, Majd Oweidat, Omar Hamadi, Mohammad O Abdelhafez; 1/26 Left ventricular failure (LVF) is a significant cause of cardiovascular mortality in the United States. Despite advances in heart failure management, mortality rates have shown a notable increase over time, particularly in recent years. This study examines trends and disparities in LVF-related mortality using data from the CDC WONDER database from 1999 to 2020. LVF-related mortality has increased significantly over the past two decades, particularly after 2010, highlighting a growing public health concern. Disparities persist across sex, race, age groups, urbanization, and geographic regions. The high burden of deaths outside medical facilities suggests a need for enhanced outpatient and palliative care strategies.

Palliative care utilization and timing for patients undergoing solid organ transplantation in a large multicenter cohortTransplantation; by Matthew W Kenaston, Ryan Baldeo, Tyler K Murphy; 1/26Palliative care ... referrals in transplant programs are infrequent, often reactive, and the benefits remain unclear. We retrospectively studied 12,676 heart, liver, lung, and kidney transplants across 3 Mayo Clinic sites (2018-2024). PC encounters were classified as pretransplant (≤1 y before admission), peritransplant (during hospitalization), or posttransplant (≤1 y after discharge). Only 8.3% engaged PC, with patterns varying by organ and timing. Timing of inpatient consultation showed a strong positive correlation with hospital length of stay, and pretransplant PC coincided with higher rates of goals-of-care discussions and fewer hospital interventions. Adapting screening criteria to focus on high-risk recipients, PC was associated with fewer short-term readmissions for heart and lung recipients.

A qualitative study with patients, care-partners, clinicians, and bioethicists to identify ethical considerations of artificial intelligence tools in palliative carePalliative Medicine; by John Y. Rhee, Paul Miller, Zachary Tentor, Amanda Reich, Alexi A. Wright, Charlotta Lindvall; 1/26The use of artificial intelligence (AI) in medicine has surged. Given the sensitive nature of palliative care, it is crucial to apply AI tools in a patient-centered and ethical manner. From the interviews we extracted five main themes: (1) Primacy of the doctor-patient relationship over AI performance; (2) Humans have intuition and nuance that AI lacks; (3) Agreement about the importance of oversight of AI tools; (4) New AI technologies should include a process for patient education; and (5) AI increases efficiency, scalability, and a more unified approach to serious illness. When building and implementing AI-based tools, we recommend: establishing oversight committees; reflecting on the unique contributions of humans to care; proactively educating patients and contextualizing the tools; and ensuring data use is restricted to clinical care.