Literature Review

Assistive intelligence: A framework for AI-powered technologies across the dementia continuumJournal of Ageing & Longevity; by Bijoyaa Mohapatra, Reza Ghaiumy Anaraky; 1/26While traditional [dementia] care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability.

Sociodemographic disparities and impact of palliative care utilization during end-of-life hospitalizations in patients with gastric cancerJournal of Palliative Medicine; by James Lee, Jasmine Lee, Rahul Tripathi, David Stein, Ballakur Rao, Daniel Jamorabo, Lisa Fisher; 1/26Gastric cancer is frequently diagnosed at an advanced stage and is associated with high symptom burden. Among 13,435 weighted hospitalizations [among gastric cancer patients who died during hospitalization] ..., 57.6% received palliative care. Black patients had 32% lower odds of receiving palliative care than White patients ... Higher palliative care use was associated with greater income, large hospitals, urban teaching hospitals, and private/other insurance. In adjusted analyses, palliative care was linked to a $36,240 reduction in hospital charges ..., with no significant difference in LOS [length of stay]. Palliative care was associated with higher odds of DNR status ... and lower odds of CPR, mechanical ventilation, transfusion, and vasopressor use.

Presence experiences after loss: Prevalence and relational meaning in a diverse urban sampleOmega; Claire White, Anna Mathiassen, Ronald Fischer; 1/26Presence experiences-the sense that a significant person who has died is nearby or perceptible-are common after bereavement but remain underexamined in grief research. This study ... [revealed that] ... over two-thirds of participants reported having ever experienced a presence, with nearly half reporting at least one occurrence in the past two weeks. These experiences were most commonly reported as a general feeling of presence, rated as both significant and welcome. Participants frequently interpreted encounters as meaningful attempts at contact and preferred disclosing these experiences to close social connections rather than institutional figures. These findings highlight presence experiences as common, relationally shaped, and culturally interpreted aspects of bereavement.

Palliative external beam radiation therapy for dysphagia in a 101-year-old man with esophageal adenocarcinomaCureus; by Pericles J. Ioannides, Jester M. Odrunia, Gina N. Perez, Morgan Butow, Georg A. Weidlich; 1/26Esophageal adenocarcinoma in centenarians is rare, and treatment options in this age group are limited. We present the case of a 101-year-old male patient with symptomatic distal gastroesophageal junction (GEJ) adenocarcinoma who presented with progressive dysphagia, aspiration, and weight loss. The patient underwent palliative external beam radiation therapy (EBRT) ... targeting the obstructive esophageal mass with a margin using volumetric-modulated arc therapy (VMAT) technique. The treatment was well tolerated by the patient with no significant acute toxicity. After treatment, the patient reported clinically meaningful improvement in functional status, with improved swallowing, advancing from liquids to a soft diet, weight gain, and improved QoL. Moderate-dose palliative radiation can be a safe and effective treatment in a centenarian with obstructive GEJ adenocarcinoma, particularly when endoscopic interventions are not successful or durable.

Advance care planning for patients with hematologic malignancies: A narrative reviewAmerican Journal of Hospice & Palliative Medicine; by Olivia M. Seecof; 1/26Advance care planning (ACP) completion rates are higher in patients with serious illness compared to the general population, however, ACP is overall under-utilized and sub-optimal, especially for patients with hematologic malignancies. This patient population can experience unique and significant physical and psychological symptoms due to their illness and the treatment, resulting in high rates of aggressive end of life care. This high healthcare utilization pattern often triggers ACP conversations and documentation, often facilitated by specialty palliative care clinicians. This review article examines existing literature about ACP for patients with hematologic malignancies with the intent to inform future prospective research to improve values-based patient care.

Positive experiences of seriously ill lesbian, gay, bisexual, transgender, and queer persons and their partners with healthcare providers: Project Respect American Journal of Hospice and Palliative Medicine; by Cathy Berkman, PhD, MSW, Gary L. Stein, JD, MSW, Noelle Marie Javier, MD, Kimberly D. Acquaviva, PhD, MSW, David Godfrey, JD, Sean O’Mahony, MD, Shail Maingi, MD, Carey Candrian, PhD, Christian González-Rivera, MUP, Imani Woody, PhD, and William E. Rosa, PhD; 1/24/26 Results: There were numerous reports of respectful, affirming, and competent care, including: healthcare providers who were open about discussing a respondent’s LGBTQ+ identity and their specific health concerns; intake and assessment forms that included pre-specified choices for sexual orientations and gender identities; using correct names, pronouns, and gender; healthcare providers who identified as LGBTQ+ or signaled being an ally; and treating spouses, partners, and widows respectfully and including them in decision-making.

Medical Aid in Dying and our ethical duties—Call to actionJAMA Health Forum; by Yesne Alici, Liz Blackler, Julia Danielle Kulikowski, Amy Scharf; 1/26Medical aid in dying (MAID) is legal in 11 US states and Washington, DC, and is being actively considered in 18 additional states ... In all jurisdictions where MAID is legal, hospital systems have the option to opt out of providing MAID services but are legally obligated to share information about where patients can access resources. We maintain that all hospital systems and individual clinicians have an ethical responsibility to go beyond simply sharing information. Patients are going to ask about MAID, and institutions are ethically obligated to establish comprehensive policies that empower and encourage their clinical staffs—primarily physicians but also nurses and advanced practice clinicians—to purposefully and thoughtfully respond. Here, we describe the experience of our institution, Memorial Sloan Kettering Cancer Center (MSK), in developing policies and procedures to fulfill this responsibility and highlight lessons for other health care organizations and oncology practices seeking to accomplish similar goals.

Preparing for the inevitable: a scoping review of death and dying education in U.S. medical schoolsAcademic Medicine; by Logan Patterson, Autumn Decker, Angelique King, Anna Roman, Cory Bolkan, Raven H Weaver; 1/26There remains a sizeable gap in evidence-based medical education related to knowledge, skills, and abilities pertaining to end-of-life care. The authors offer next steps for developing, implementing, and measuring evidence-based interventions to improve end-of-life care competency. The authors advocate for continued implementation of evidence-based educational interventions, regardless of anticipated specialty area, throughout all preclinical and clinical years.

Researchers identify new blood markers that may detect early pancreatic cancer; NIH-funded, four-marker panel could one day help catch one of deadliest cancers at more treatable stagesNIH press release; 1/30/26National Institutes of Health (NIH)-supported investigators have developed a blood test to find pancreatic ductal adenocarcinoma, one of the deadliest forms of cancer. The new test could improve survival rates from pancreatic cancer, which tends to be diagnosed at late stages when therapy is less likely to be effective. The findings were published in Clinical Cancer Research. Overall, only about 1 in 10 pancreatic cancer patients survive more than five years from diagnosis. However, experts expect that when the cancer is found and treated at an earlier stage, survival would improve. While finding the cancer early is key, there are no current screening methods to do so.

Hospice clinicians' approaches to terminal restlessness: A qualitative analysisJournal of Pain & Symptom Management; Andy Jan, Molly Turnwald, Susan Maixner, Thomas O'Neil, Lauren Gerlach; 1/26Terminal restlessness is frequently observed in hospice, yet it lacks a consistent definition, diagnostic framework, and treatment approach. Five themes emerged [from this study]: (1) Diagnostic challenge-clinicians reported difficulty distinguishing terminal restlessness from delirium, pain, or medication side effects; (2) Common symptom profile-agitation, confusion, hallucinations, and constant movement; (3) Temporal association with active dying process-terminal restlessness was viewed as a sign of imminent death; (4) Ruling out reversible causes-pain, urinary retention, or other modifiable factors; and (5) Treatment variability-approaches varied, though most clinicians were more comfortable using sedating medications once death was perceived to be imminent.

Medicare hospice use patterns among patients with Alzheimer’s disease or related dementias compared to those with other terminal diagnoses (Issue Brief).ASPE; Frank, J., Huessard, K., Broyles, I., Frazier, L., Oliveira, I., Haltermann, W., III, Lamont, H., Okafor, M., & Blanco, M.; 9/25Key Points:

Comment on the 2025 Global Map of Palliative Care: Data clarity and consistencyJournal of Pain & Symptom Management; by Guangwei Ji, Jin Ke, Fei Sun; 12/25We read with great interest the findings from the "First-Ever Global Ranking of Palliative Care: 2025 World Map Under the New WHO Framework" published in November 2025. As the first comprehensive review post the COVID-19 pandemic, this article provides an updated mapping of palliative care development worldwide. The use of a new WHO framework in 201 countries and territories, offers an invaluable overview on the global state of palliative care, particularly inspirational for countries that are launching palliative care policies or programs.

Concurrent care and equity: Addressing palliative care gaps for African American men in rural communities with a serious respiratory illnessAmerican Journal of Hospice & Palliative Medicine; by Cathy L. Campbell; 12/25Hospice and palliative care are often hard to access for African Americans (AA) living in rural areas with serious respiratory illnesses. Under the Medicare Hospice Benefit, patients must stop curative or life-sustaining treatments for their terminal illness, which limits options for concurrent care. This is a major challenge for AA men, whose average life expectancy is 67.8 years—about 10 years shorter than the national average. They also experience more care transitions in the last 6 months of life compared to White and Hispanic patients. These frequent transitions show how fragmented the health system is and how it often fails AA families. Using intersectionality and a vignette, this paper explores how overlapping factors—lived experience as AA man, rural location, and serious illness—affect access to palliative care.