Literature Review

[Canada] 'Getting everyone on the same page': Long-term-care nurses' experiences with advance care planningInternational Journal of Older People Nursing; Preetha Krishnan, Susan McClement, Genevieve Thompson, Marie Edwards, Philip St John; 3/25Ensuring comfort for LTC [long-term care] residents at the end-of-life or during acute events by getting everyone on the same page is a complex process. The ability of nurses to downgrade or upgrade the ACP [advance care planning] level to orchestrate comfort for LTC residents involves many factors related to the resident, family, healthcare providers and the context in which the ACP discussions take place. Providing ACP/dementia information in LTC admission packages and through informational sessions can raise family awareness of these topics and dementia's complications. Clinical rotations in LTC facilities for medical, nursing, and paramedic students could also improve their understanding of the sector's complexities.

[UK] Supporting the bereaved child in the adult ICU: A narrative reviewIntensive Care Medicine; Annelies Rowland, Carole Boulanger, Louise Dalton; 2/25Childhood bereavement is a significant issue globally, affecting millions of children each year, with incidence rates significantly increasing following the COVID-19 pandemic. The loss of an important adult, particularly in the ICU environment, can lead to lasting psychological and behavioural challenges for children. Both families and healthcare professionals (HCPs) often feel unprepared and uncomfortable engaging in honest, supportive conversations with children about bereavement, further complicating children's grief processing. This narrative review examines the pivotal role ICU HCPs can play in facilitating child-centred bereavement support, focusing on promoting honest communication, supportive visitation practices, creating a child-friendly and humanised ICU environment, and encouraging child involvement during end-of-life care. The review also advocates for specialised training to equip ICU staff with the necessary skills to support grieving children and families.

[England] Hospices receive multi-million pound boost to improve facilities Department of Health and Social Care, United Kingdom; by HM Treasury an Stephen Kinnock MP; 2/26/25Hospices will begin receiving £25 million for facility upgrades and refurbishments from today as part of the biggest investment into hospices in a generation. The cash will be distributed immediately for the 2024/25 financial year, with a further £75 million to follow from April. More than 170 hospices across the country will receive funding, including those run by Marie Curie and Sue Ryder, as well as independent hospices like Zoe’s Place in Liverpool. ... Minister for Care Stephen Kinnock said:  "This is the largest investment in a generation to help transform hospice facilities across England. ..."

[Korea] 9 in 10 Koreans support ending life-prolonging treatment: study The Korea Times; by Kim Hyun-bin; 2/24/25 More than nine out of ten Koreans think that they would opt to forgo life-prolonging treatment if they were terminally ill, a new study has found, highlighting shifting attitudes toward end-of-life care in the country. According to a report released by the Korea Institute for Health and Social Affairs on Sunday, 91.9 percent of respondents expressed they would choose to discontinue life-sustaining treatment if they were diagnosed with a terminal illness or were nearing the end of life, based on a survey conducted last April and May on 1,021 men and women. 8.1 percent stated they would prefer to continue such treatment.

[UK - St. Christopher's Hospice] Woman with rare brain disease dances with husband for first time in yearsReposted in Daily Journal from Talker News, Tupelo, MS; by Isobel Williams; 2/20/25 This is the touching moment an elderly woman living with a rare brain disease slow danced with her husband - for the first time in years. Constance Bartholomew, 69, has progressive supranuclear palsy (PSP), a neurological condition which has left her struggling to walk. The disorder - which is estimated to affect around 4,000 people in the UK - can cause problems with balance, movement, vision, speech and swallowing. Constance began physiotherapy at St. Christopher's Hospice in Sydenham, south-east London in September last year - at which point husband Dennis, 72, joked he would pay a million pounds to dance with her again. Upon hearing the remark, rehab assistant Ralitsa Angelova ... made it her mission to make it happen.  ... “She is unable to walk, to articulate, her eyesight has failed. It’s a terrible condition. I wouldn’t wish it on anyone. But she is fully aware. There is absolutely nothing wrong with her memory or comprehension. ..." The video has been released as hospices in London come together to change perceptions of hospice care and highlight the vital importance of gifts in wills to their holistic palliative care services for adults and children in their communities. The hospices are taking part in the This is Hospice Care campaign, a national collaboration of 143 hospices across England, Scotland and Wales, brought together by Hospice UK.Editor's note: St. Christopher's Hospice--founded by Dame Cicely Saunders--is the home for modern day hospice care.  Click here for a YouTube video of Constance and Dennis. Click here for the article we posted on 2/21 about the UK's "This Is Hospice Care" initiative.

[UK] Efficacy of music-based intervention for people living with dementia in an inpatient setting: A pilot studyJournal of Alzheimer's Disease; Neha Abeywickrama, Mel N Ellul Miraval, Hari Subramaniam, Qadeer Arshad, Stephanie Pollard, Geeta Chauhan, Shifa Jussab, Elizabeta B Mukaetova-Ladinska; 1/25Pharmacological treatment of behavioral and psychological symptoms of dementia is of limited benefit. The addition of non-pharmacological interventions is often essential for optimal symptom control. Clinical professionals can successfully deliver music-based intervention to inpatients with advanced dementia to help manage their behavioral symptoms in the short term. Music-based interventions' use for inpatient wards must be further investigated as an economical and personalized non-pharmacological therapeutic tool for patients with dementia.

The green ICU: how to interpret green? A multiple perspective approach Critical Care; by Elisabeth Smale, Heather Baid, Marko Balan, Forbes McGain, Scott McAlistar, Jan J. de Waele, Jan Carel Diehl, Erik van Raaij, Michel van Genderen, Dick Tibboel & Nicole Hunfeld; 2/18/25Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. ... To put this challenge of achieving quality care standards with sustainable use of resources into perspective, the current paper pinpoints a three-step approach towards a green ICU by (I) measuring environmental sustainability, (II) outlining strategies to improve sustainability and (III) elaborating on how to communicate results to create a synergy of sustainability initiatives within ICUs. Editor's note: With its focus on care for critically ill patients, how might this three-step approach be applied to hospice GIP settings?

[England] Hundreds protest amid fears of hospice closure BBC News, Liverpool, England; by Suzanne Hailey & Rumeana Jahangir; 2/15/25 Hundreds of people have attended an emotional protest against the potential closure of a Marie Curie hospice. The 26-bed inpatient unit at the site in Woolton, Liverpool, has been temporarily shut since July amid shortages in specialised nursing staff. ... [Independent] councillor Lucy Williams, who worked at the hospice as a palliative care nurse for two years, told BBC North West Tonight the charity's management said on Friday "they were considering closure" as one of their options. At a protest outside the hospice on Saturday many people held up pictures of loved ones who had died, with some saying they were "angry" about the current state of uncertainty. Ms Williams said: "Marie Curie are going to be met with the wrath of Liverpool. The whole community is going to get behind this."

Over 80% of healthcare cost in the final year of life spent on hospitalsNuffield Trust press release; 2/5/25[UK] New research from the Nuffield Trust and the Health Economics Unit, commissioned by leading end of life charity Marie Curie, finds that UK public expenditure for people in the last year of life across healthcare, social care and social security is in the region of £22 billion. Over half (53%) of this public spending in the final year of life is spent on healthcare. Hospital care represents the largest share of healthcare spending, accounting for 81% of total healthcare spend. More than half of this healthcare spend (56%) goes on emergency hospital care... In contrast, public spending on primary and community healthcare makes up only 11% of health expenditure for people in the last year of life, with less than 4% spent on hospice care.

Truth-telling, and ethical considerations in terminal care: an Eastern perspectiveNursing Ethics; Qing Ma; Yi Wu; Ronghua Fang; 1/25 Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article focuses on nursing morality, ethics, norms, and philosophy in health care and discusses countermeasures taken by nurses in truth-telling decision-making in combination with Chinese Confucian culture. The analysis identifies key ethical strategies tailored to Chinese nurses’ practices, emphasizing individual autonomy, cultural sensitivity, and family dynamics in truth-telling decisions.

[United Kingdon] Christmas tree collection raises £45,000 for Jersey Hospice Care Soleil Radio; by Jersery News; 1/20/25 Jersey Hospice Care's annual Christmas Tree Collection has raised more than £45,000 for the local charity. Every year in early January, volunteers give their time to collect Christmas trees from all around the island in exchange for a small charity donation. 2000 trees were collected in the 2025 new year period, which were taken to the green waste team at La Collette and converted into soil improver for Jersey farms and gardeners. The £45,000 raised in the annual tree collection and recycling project will cover a month's worth of care in the hospice's in-patient unit.

[Sweden] The process of pain assessment in people with dementia living in nursing homes: A scoping reviewPalliative Care and Social Practice; Caroline Kreppen Overen, Maria Larsson, Adelheid Hummelvoll Hillestad, Ingela Karlsson, Siren Eriksen; 1/25Studies have documented a pain prevalence in people with dementia living in nursing homes of 35%–43%, but a possible prevalence of 60%–80%. This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. Self-reported information is the most appropriate when assessing pain, as symptom experience is subjective and highly personal. However, for people with dementia living in nursing homes, self-reporting represents a challenge due to cognitive impairment, including difficulties with language and communication. People with dementia might express pain with different behavioural expressions or signs, such as agitation, apathy, restlessness or wandering. Numerous observational assessment tools targeting pain in people with dementia have been developed and evaluated and systematic use of standardized observational tools has been recommended.

[Canada] Qualitative bereavement experiences and support in community-dwelling older adults: A scoping reviewOmega-Journal of Death and Dying; Samantha Teichman, Barbara A. Mitchell, Indira Riadi, Habib Chaudhury, Albert Banerjee, William Odom; 12/24This scoping review examines qualitative studies on bereavement experiences and support mechanisms for community-dwelling older adults. This area of research is especially timely given rapid population aging and the interplay of heightened vulnerability, cumulative losses, shrinking support systems, and the critical need for bereavement support. Such support not only acts as a preventative health measure but can also serve as a catalyst for fostering meaning-making and navigating grief in later life. Through a scoping search and synthesis of relevant qualitative studies ..., the findings reveal four key themes: the impact of grief on wellbeing, grief perceived as an individual issue, challenges in seeking and receiving support, and positive support experiences and transformations. This discussion contributes to developing targeted bereavement support strategies for community-dwelling older adults.