Literature Review

HMN 2025: What are the obstacles to opiod accessibility for severely ailing sufferers Health Medicine Network; by The Mount Sinai Hospital; 4/22/25 In a research published in NEJM Catalyst, researchers on the Icahn School of Medicine at Mount Sinai describe how measures to curb opioid overdoses within the normal inhabitants have compromised a crucial cornerstone of palliative care. ...  “The opioid disaster of overdose deaths stays omnipresent; nonetheless, a brand new menace has emerged amongst susceptible populations who want these medicines as first-line remedy for his or her ache, which will be extreme,” says lead writer Rebecca Rodin, MD, Assistant Professor of Geriatrics and Palliative Medicine, Icahn Mount School of Medicine at Mount Sinai, who makes a speciality of palliative drugs. “We hope our findings will lay the muse for deeper dialog to revive stability between opioid extra and entry.”

Belief in an afterlife is increasing in the United States: Even among the non-religious The Association of Religion Data Archives (The ARDA); by Ryan Burge; 4/17/25 This post has been unlocked through a generous grant from the Lilly Endowment for the Association of Religion Data Archives (ARDA). The graphs you see here use data that is publicly available for download and analysis through link(s) provided in the text below. ... I wanted to dig a bit deeper on the variations in those belief metrics today, with a question that I haven’t really probed a whole lot. The General Social Survey, which is available on the Association of Religion Data Archives website, contains a really straightforward question, “Do you believe there is a life after death?” And it has an even simpler set of response options - yes or no. It’s been asked with regularity since 1973, so we have nearly five decades of data on this one specific question. ... Even today, the share of Americans who believe in life after death is 82%. When people ask me, “Is the United States a religious country?” This is the stat that I’m going to trot out.

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.

Lonely planet: How the world is fighting social isolation Medscape Medical News; by Deborah Brauser; 3/25/25 Loneliness/social isolation isn’t just a transient emotion or situation, it’s turned into a global crisis with serious public health consequences. In 2023, then–US Surgeon General Vivek Murthy, MD, sounded the alarm, declaring loneliness an epidemic and citing seminal research equating its harmful effects to smoking 15 cigarettes a day. The numbers tell a stark story: Recent research has linked chronic loneliness to depression, dementia, and even early death.Editor's note: Pair this with our recent post, Risk factors for and health status of socially isolated adults.

Stroke deaths and their racial disparities increased over last 20 years EurekAlert! - American Association for the Advancement of Science (AAAS); by Peer Review Publication; 4/9/25 Over the last two decades, ischemic stroke mortality rates in the U.S. have grown, with almost 3 in 10 deaths occurring at home, and increases particularly among racial minorities and rural residents. These growing disparities were among the findings of a new study publishing April 9, 2025, in the open-access journal PLOS One by Jason Lim of Georgetown University School of Medicine, U.S., and colleagues. ...  The analysis included 237,617 recorded ischemic stroke deaths. The study found that age-adjusted ischemic stroke mortality rates, after years of decline, have increased across all urbanization levels since 2009, with the most pronounced rises in non-metropolitan areas. Additionally, there has been a noticeable shift in the place of death, with more people dying at home instead of in hospitals or other medical facilities. From 1999 to 2020, the percentage of at-home deaths increased from 8.44% to 29.31%.Editor's note: Pair this research with ongoing shut-downs of rural hospitals, rural emergency room access, and more. This ongoing increase is one of many, ongoing alarms. Ethics. Integrity. Mission. It's past time to improve patient care.

Strong social connections improve older adults’ well-being regardless of setting, study finds McKnights Long-Term Care News; by Donna Shryer; 4/7/25 Social connections, trust in others in their community and community cohesion significantly improve elderly well-being whether seniors live at home or in nursing facilities, according to a new comparative study published in BMC Public Health. However, researchers found that nursing home residents generally reported lower subjective well-being compared to their community-dwelling counterparts, even after accounting for health status and demographic factors. ... According to the authors, these findings “indicate the necessity for tailored interventions that address the unique needs of each care environment to promote healthier aging experiences. [Continue reading ...]

Navigating the intersection of heart failure and palliative care: A holistic approach to improving quality of life Cureus; by Awanwosa V. Agho, Fatimot Disu, Efeturi M. Okorigba, Okelue E. Okobi, Safiyya Muhammad, Toheeb Bakare, Chioma Ezuma-Ebong, Nneka Muoghalu; 3/30/25 ... Historically, palliative care has often been perceived as a last-resort option, introduced only when curative treatments have failed, creating a false dichotomy between life-prolonging therapies and symptom management. However, modern palliative care frameworks emphasize its integration throughout the disease trajectory, particularly for chronic, progressive illnesses like heart failure. ... Palliative care should ideally be initiated at diagnosis of advanced heart failure or with early signs of significant symptom burden to ensure timely, patient-centered support, as recommended by ACC, AHA, and HFSA guidelines

Shingles vaccine tied to lower dementia risk, study finds McKnights Long-Term Care News; by Kristen Fischer; 4/2/25 Older adults who were vaccinated against shingles were 20% less likely to develop dementia over the next seven years compared with people who didn’t receive the shot, a study shows. The report was published Wednesday in Nature. [Continue reading ...] Editor's note: Related articles ...

Study raises questions about GUIDE model’s helpfulness for caregivers of loved ones with dementia McKnights Home Care; by Adam Healy; 4/1/25 The Guiding an Improve Dementia Experience may need to be fine-tuned to better serve caregivers of those living with dementia, according to a new study published in Alzheimer’s & Dementia. The researchers identified 565 older adults and 555 caregivers eligible for GUIDE using data from the 2022 National Health and Aging Trends Study and National Study of Caregiving. They found that approximately half of GUIDE-eligible people with dementia received care from two or more caregivers, and about a third of these caregivers reported experiencing high caregiving strain. [Continue reading ...] 

White House cuts $12B in health funds: 5 updates Becker's Hospital Review; by Madeline Ashley and Kristin Kuchno; 3/26/25 HHS has abruptly canceled more than $12 billion in grants to state health departments that supported efforts to track infectious diseases, expand mental health services and modernize outdated systems, according to The New York Times. Late March 25, state health departments started receiving notices that $11.4 billion in grants from the CDC and roughly $1 billion in funds from the Substance Abuse and Mental Health Services Administration were being canceled immediately. “No additional activities can be conducted, and no additional costs may be incurred, as it relates to these funds,” the notices said, according to the Times. [Continue reading ...]

Avoidable mortality rises in US, bucking global decline Becker's Clinical Leadership; by Mackenzie Bean; 3/26/25 Avoidable mortality has increased in the U.S. for more than a decade, contrasting decreases seen in many other high-income countries, according to a study published March 24 in JAMA Internal Medicine. For the study, researchers at the Brown University School of Public Health analyzed mortality data from the CDC and World Health Organization for people 74 and younger between 2009 and 2021, spanning all 50 states and 40 high-income countries. Avoidable mortality includes deaths that could have been prevented through effective public health measures or timely, high-quality healthcare. [Continue reading ...]

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

Less wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."