Literature Review

Portugal: Government signs contracts for 3,000 palliative care beds MacauBusiness.com; by LUSA; 4/18/25 The government on Thursday [4/17/25] signed 90 financing contracts worth €88 million with the private and social sectors to create 3,300 places in the National Network for Integrated Continuing Care (RNCCI). ... The government on Thursday signed 90 financing contracts worth €88 million with the private and social sectors to create 3,300 places in the National Network for Integrated Continuing Care (RNCCI). ... The minister added that “the government’s determination is not to slow down the pace of implementation of the RRP”, emphasising that another 800 contracts will be signed in the coming weeks, in different areas.

[Netherlands] A care ethical perspective on family caregiver burden and supportNursing Ethics; Maaike Haan, Jelle van Gurp, Marianne Boenink, Gert Olthuis; 3/25Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. The question is then whether self-sacrifice is a problem that nurses should immediately solve. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers from the situation but should support them in whatever overwhelms or drives them in standing-by their loved ones until the end.

[China] Asian family members' participation in advance care planning: An integrative reviewPalliative Medicine; Jing-Da Pan, Ka Yan Ho, Gui-Fen Guan, Min-Min Chang, Cui-Rong Tan, Xin-Yan Qiu, Hong-Li Liu, Ke-Lan Lin, Wen-Ting Xu, Shan Pan, Qi Liu, Ting Mao, Katherine Ka Wai Lam, Dong-Lan Ling; 3/25The willingness of Asian family members to participate in advance care planning is high, while their actual engagement remains low. Based on the barriers, facilitators, and Asian family members' roles influencing participation identified in our study, a six-dimensional conceptual model was developed: Asian family members' roles, problem-solving skills, communication, affective responsiveness, affective participation, and controlling behavior in advance care planning. Barriers to effective participation were identified: inadequate advance care planning legislation, insufficient public education, and influences from Confucianism or traditional beliefs. Additionally, filial piety was shown to have a paradoxical effect on Asian family members' participation in advance care planning in Asian countries. 

Global study finds 1 in 5 people with dementia receive no care McKnights Long-Term Care News; by Donna Shryer; 4/7/25 A comprehensive global study led by Yale School of Public Health researchers has revealed that at least 20% of people living with dementia receive no care helping them with daily living, regardless of their country’s wealth or development status. As the world’s population rapidly ages, this alarming care gap has persisted for years, creating what researchers describe as “a public health crisis.” The study analyzed data from over 10,000 individuals across the United States, England, 18 European nations, Israel and China. [Continue reading ...]

[Germany] Do we have a knowledge gap with our patients?-On the problems of knowledge transfer and the implications at the end of lifeInternational Journal of Environmental Research and Public Health; Nils Heuser, Hendrik Heers, Martin Gschnell, Fabian Urhahn, Severin Schrade, Christian Volberg; 2/25Cancer patients are often unaware of their exact diagnosis, stage of disease, and prognosis. In the patients observed, it was found that many of them were unaware of their stage of disease, which can have a huge impact on their end-of-life decisions, such as the type of treatment they want. Many patients were also unaware of their own treatment. There is a risk that false hopes of cure may be attached to therapies and that, as a result, patients may be less likely to opt for palliative care with a focus on maintaining quality of life.

Palliative Care ECHO on health system strengthening: Advancing global collaboration and integration ehospice; by Mark Stoltenberg, Clayton Richards, Chris Piromalli; 3/24/25The World Health Organization (WHO) Working Group on Palliative Care has introduced an innovative digital initiative utilising the ECHO Model to enhance global collaboration in palliative care. Officially launched on March 5, 2025, this programme will facilitate knowledge exchange and promote best practices for the integration of palliative care into health systems worldwide. The ECHO (Extension for Community Healthcare Outcomes) Model connects healthcare professionals globally in virtual communities of practice to support contextualised implementation of best-practice care through mentorship and guided practice.  [Continue reading ...]

[Switzerland] The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nursesSupport Care Cancer; by Christophe Pala, Claudia Gamond, Steffen Eychmuller, Francois Herrmann, Sophie Pautex; 3/17/25 Background: The use of artificial nutrition in the last month of life raises many concerns for patients, relatives, and healthcare professionals. Conclusion: Whereas decisions on artificial nutrition at the end of life are common they may be mostly guided by physicians and nurses' beliefs, and patients' requests more than by robust evidence. Fostering palliative care education is pivotal. Our results emphasize the need to improve physicians and nurses' awareness of the complex interplay between values and evidence when decisions concerning artificial nutrition are taken.

[England] Mother, 79, excited to skydive for hospice BBC; by Susie Rack; 3/22/25 A 79-year-old woman planning a skydive to raise funds for a hospice charity that is caring for her friend said she was not "scared at all." Adventure-seeker Shirley Warnes, from Rugby, Warwickshire, who said she loved rock climbing and helicopter rides, described the jump for Myton Hospice as a "bucket-list challenge." ... She has already raised more than £600 for the charity, which supports people with life-limiting illnesses across Coventry and Warwickshire, to thank them for providing respite care for her friend Gordon, who has motor neurone disease.

[UK] Why we need to consider frailty in the assisted dying debateAge and Aging; Sarah A Hopkins, Annabel Price, Simon N Etkind; 2/25Assisted dying/assisted suicide (AD/AS) is legal or decriminalised in several countries and Bills to legalise it are currently being considered by the UK and Scottish Parliaments. Older adults living with frailty make up an increasing proportion of those who die, yet the possible implications of AD/AS for these individuals are relatively unexplored. Frailty complicates AD/AS in relation to eligibility because of ambiguity over whether frailty constitutes a terminal illness, challenges in accurately predicting prognosis, and difficulty determining reversibility of suffering. Frailty also blurs the distinction between terminal illness and disability, in contrast to the clear-cut language of current proposed legislation where those with a terminal illness are eligible, but those with disability are not. Further consideration is needed regarding eligibility, safeguards in the context of relational autonomy and for those who already feel a burden, and how to mitigate risks of further entrenching ableist and ageist attitudes.

[International] Healthcare on the brink: Palliative Care Unit and Late Shift The 75th Berlin International Film Festival - Part 7, wsws.org; by Martin Nowak and Bernd Reinhardt; 3/16/25 Two films, the drama Late Shift (Heldin) and the documentary Palliative Care Unit (Palliativstation), featured at this year's Berlin International Film Festival, addressed the current situation in German and Swiss hospitals. The sold-out festival screenings reflected the burning public interest in this topic. This is particularly remarkable bearing in mind that Palliative Care Unit has a running time of more than four hours. ... [In the] documentary Palliative Care Unit by Philipp Döring, shot at the Franziskus Hospital in Berlin, ... [the] camera quietly observes the daily routine, staff consultations and the constant empathy of the head of the ward towards employees and seriously ill patients, who usually spend their last weeks here. The very calm, always discreet images emphasise the necessity of sufficient time for care and reflection when making life-critical decisions. ... How can the highest possible quality of life be achieved? The high ethical standard of treating incurable patients as active human beings ... is admirable and makes a lasting impression throughout the film.

[UK] Exploring the challenges experienced by patients and families using palliative and end-of-life care services: A qualitative focus group studyPalliative and Supportive Care; Gina Kallis, Gary Hodge, Hannah Wheat, Tomasina M Oh, Susie Pearce; 3/25In the UK, access to dignified and compassionate palliative care is increasingly being reported as inadequate. A range of challenges were identified at different stages of the patient and family carer journey near the end-of-life. These included issues related to the delivery of care, such as communication challenges, a lack of out of hours care, and also a lack of personalized care. Patients and families also experienced everyday challenges due to the impact of living with a life-shortening condition and altered family dynamics as family members became carers. There were also some traumatic experiences of death and a sense of abandonment when care could not be accessed. 

[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care - Saif Mohammed ehospice; by Saif Mohammed; 3/10/25[Personal Story] ... "Reflecting on this experience, I realize that caregiving is deeply embedded in tradition and culture, a natural extension of communal life." Caregiving is as old as humanity itself. One of the earliest known cases of palliative care dates back 45,000 years to Shanidar 1, a Neanderthal male found in present-day Iraq. His skeletal remains indicated severe injuries, yet he had survived for decades, suggesting that his community had cared for him. This example highlights that palliative care is a deeply human and historical practice, far predating modern medicine. Cultures around the world continue to recognize the importance of caregiving, often embedding it in traditions and religious beliefs. ... In some societies, the emphasis on independence can make caregiving more complex, as patients may refuse assistance to maintain self-sufficiency. ... Palliative care workers must be equipped to understand and respect the cultural traditions of the communities they serve. This requires training in cultural competence, which involves:

[UK] Coming to terms with dying: Advance care planning as a conduit between clinicians, patients, and conversations about death and dying - A qualitative interview studyPalliative Medicine; Rowena Jane Eason, Lisa Jane Brighton, Jonathan Koffman, Katherine Bristowe; 2/25Advance care planning elicits multiple complex thoughts, emotions, and behaviours, with responses ranging from the procedural to the profound. Discussions empowered and instilled confidence, promoted openness with relatives, encouraged people to make the most of their time remaining, and sometimes contributed to coming to terms with their mortality. Factors influencing experiences of discussions reflected the complexity and diversity in participants' lives, personalities, and life experiences, with discussions exposing the realities of living with terminal illness.