Literature Review

[England] Developing a palliative care service for the homeless community Nursing Times; by Mark Pedder; 6/18/25 To help address inequalities in the provision of palliative care, a hospice set up a service focusing on the unique care needs of Luton’s homeless community. The outreach initiative addresses the logistical and emotional barriers that often prevent homeless individuals from seeking care. Initially conceptualised as a weekly outreach clinic, the service evolved into a more flexible model that adapts to the unpredictable nature of the community it serves. By reframing the conversation and addressing the stigma surrounding homelessness, the service aims to improve health outcomes and extend life expectancies for this vulnerable population, while avoiding unnecessary hospital attendances and improving end-of-life conversations.

Dr. Anne Merriman obituary: doctor known as ‘mother of palliative care in Africa’ The Times, London, England; 6/18/25 Dr. Anne Merriman revolutionised palliative and end-of-life care in Africa after developing a cheap form of oral morphine with a Singapore hospital pharmacist. ... Universally known as “Dr. Anne”, she said: “It’s easier than baking a cake.” She developed the pain-controlling recipe after seeing terminally ill patients discharged from hospital because “nothing more could be done for them”. Many died at home in severe and prolonged pain. “A wild, undisciplined schoolgirl” who became a nun and a doctor, Merriman founded the pioneering Hospice Africa Uganda (HAU) in 1993 at the age of 57. Palliative care was largely unknown in Africa when she started her work in Uganda. HAU has treated more than 35,000 patients and trained more than 10,000 healthcare professionals from 37 African countries in the so-called Merriman model. ... Anne Merriman, doctor, was born on May 13, 1935. She died from respiratory failure on May 18, 2025, aged 90.

[Canada] The discourse of medical assistance in dying and its relationship with hospice palliative care in Canada: An integrative literature reviewJournal of Advanced Nursing; Jennifer D Dorman, D Shelley Raffin Bouchal, Eric Wasylenko, Shane Sinclair; 5/25Three themes identified from the data were the relationship between MAiD [medical assistance in dying] and HPC [hospice pallaitive care], suffering in the context of MAiD, and moral distress and moral uncertainty in providing or not providing MAiD. The discourse around the relationship between MAiD and HPC is complex and contextual. Personal and professional understandings of end-of-life care differ and influence perspectives on how and whether MAiD and hospice palliative care can be reconciled. Findings consider how the concepts of end of life, MAiD, HPC, suffering, and moral distress influence and are influenced by the discourse of dying. 

Corby boy, 10, set for Arctic trek in tribute to fatherBBC News, by Kate Bradbrook & Brian Farmer; 2/2/24, published in our newsletter 2/2/24 and 12/24/24A 10-year-old boy once told he might never walk can look forward to days of "wonder" as he prepares to trek in the Arctic in memory of his late father. Caeden, who has cerebral palsy, was born 12 weeks early. But Caeden, of Corby, Northamptonshire, has climbed Ben Nevis and is now set to meet the Arctic challenge. Mountain guide John Cousins said the "biggest danger in such conditions comes from the cold". Caeden is due to travel to Sweden on Monday with mother Lisa, brother Ashton, 12, and sister Khya, 14.

Palliative care advocacy at the World Health Assembly 2025 ehospice; by Stephen Connor, Executive Director WHPCA; 6/5/25 Once again, palliative care advocates ensured that the voice of palliative care was heard at the premier event for global health, the World Health Assembly (WHA). The WHA is the governing body of the WHO where resolutions are passed that direct the Global Programme of Work for WHO. ... This year there were resolutions and actions involving non-communicable disease, cervical cancer, lung health, the pandemic response, mental health and social connection, the healthcare workforce, women’s health, universal health coverage, health emergencies, and so forth. WHO’s funding has been significantly reduced due to withdrawal of the US from WHO and global health funding generally. However, during the meeting other countries are stepping up to support WHO. 

[Kazakhstan] Mechanisms of chronic pain in Alzheimer's Disease: A narrative reviewCurrent Medicinal Chemistry; Roman Konovalov, Mina Aubakirova, Dmitriy Viderman; 4/25AD [Alzheimer's Disease] causes structural and functional alterations in the affected brain, including shrinkage of gray matter volume and disruptions in brain network connectivity. Besides memory loss, pain is a significant yet often neglected symptom. Effective pain management in AD is challenged by the adverse effects of pain-relief medications and communication difficulties, especially as the disease progresses. Pharmacological options include opioids, nonsteroidal anti-inflammatory drugs, paracetamol/acetaminophen, and adjuvant pain relievers like antidepressants and antiepileptic medications, though these are not officially approved for pain relief in AD. Non-pharmacological strategies, such as exercise therapy, music therapy, Reiki, reflexology, and behavioral therapy, are preferred to prevent the side effects of medication. The review highlights a crucial link between neurological changes in AD and the perception of pain, underscoring the need for customized pain management approaches for this population.

Confronting global inequities in palliative care BMJ Global Health; by Anna Peeler, Oladayo Ayobami Afolabi, Katherine E Sleeman, Maha El Akoum, Nahla Gafer, Asmus Hammerich, Richard Harding; 5/15/25

French lawmakers approve assisted dying bill Le Monde with AP and AFP; 5/27/25France's Assemblée Nationale adopted a bill on Tuesday, May 27, to allow adults with incurable illnesses to take lethal medication, the initial step in a lengthy process that could grant patients medical assistance to end their lives in clearly defined circumstances. The bill received 305 votes in favor and 199 against, after all parties in parliament allowed their lawmakers a free vote on the issue. It will now be sent to the Sénat for further debate. A definitive vote on the bill could take months to be scheduled. In parallel, another bill on palliative care, meant to reinforce measures to relieve pain and preserve patients' dignity, was also adopted on Tuesday, unanimously. 

[Canada] Strengthening hospice care through strategic partnerships Investors Hangout; by Addison Perry; 5/29/25 HealthPRO Canada is making waves in the healthcare sector with an important new collaboration that promises to enhance the quality of care provided by hospices in Ontario. The strategic partnership with Hospice Palliative Care Ontario (HPCO) seeks to benefit over 140 hospice programs across the region by leveraging HealthPRO’s extensive buying power. This initiative is set to bolster operational efficiency and support hospices in delivering high-quality services to families in need.Editor's note: Trends continue. 

[United Kingdom] Hospice cuts staff and beds to secure its future BBC News, Yorkshire, UK; by Alex Moss; 5/23/25A hospice in Huddersfield has announced it has made 19 staff redundant and reduced the number of inpatient beds in order to save its future. The Kirkwood provides end-of-life care to about 2,000 patients each year but its chief executive Michael Crowther said it had faced a "perfect storm" of rising operational costs over the past few years. ... He said: "This has been the single hardest decision we have ever had to make." Another nine staff members have agreed to cut their hours and several others have decided to retire to help reduce the annual costs by £1.7m, the hospice added. ..."As you can imagine, this has been one of the most difficult periods in The Kirkwood's history. ..."Editor's note: Read more--directly from The Kirkwood--at "Securing Our Future Together: A New Way Forward." 

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

[Australia] Overtreatment of older people near end of life: A qualitative scoping review of modalities, drivers, and solutionsOmega-Journal of Death and Dying; Samantha Fien, Emily Plunkett, Daniel Wadsworth, Magnolia Cardona; 4/24This study aimed to understand the drivers better to help minimise further risks of overtreatment for older people near the end of life (dysthanasia). Determinants included healthcare system factors, patient-centered care, family and caregiver, and clinician perspectives. This review confirms that despite almost two decades of recognition of the potential harms of overtreatment near the end of life, society, patients, and health systems have a role to play in reducing and addressing the determinants. We offer a range of solutions for clinicians, health service managers, and members of the public to consider.

[Australia] New study amplifies rural voices to improve palliative care at end-of-life NewsWise; by University of South Australia; 5/13/25  ... [A] new study from the University of South Australia is shining a light on the experiences of rural South Australians who are navigating end-of-life care, in the hope of improving access to palliative care services and supports in rural and country areas. ... “People living outside of major cities are notoriously under-supported and underserviced when it comes to health care – and palliative care is no different,” Associate Professor Gunn says. “More than seven million Australians, almost 30% of the population, live in rural communities, yet only 16% of the palliative care workforce live and work in these areas. “Research tells us that earlier referral to palliative care services gives patients and families more control, helping them maximise their quality and quantity of life. Yet patients living in country or rural areas have less opportunity to receive specialist palliative care, and this can negatively affect their wellbeing, and the wellbeing of their family members."Editor's note: Sound familiar? Click here for "Rural Hospice and Palliative Care - Resources," from the Rural Health Information Hub.