Expert guidance on high-quality mentoring in hospice and palliative medicine research
Journal of Pain & Symptom Management; by Karleen F. Giannitrapani, Cati Brown-Johnson, Sarina R. Isenberg, Laura Petrillo, Erica C. Kaye, AAHPM Research Committee Writing Group; 9/26
Research in the field of hospice and palliative medicine (HPM) is necessarily interdisciplinary, requiring mentorship across diverse disciplines and methods to advance science. HPM research mentorship experts described key activities to improve HPM mentorship and support mentees, spanning multiple levels of action from intrapersonal to broad system change. Launching an independent HPM research career in a climate of limited funding can be supported by mentors who emphasize the joys and challenges of research, model work-life balance, and foster an environment supportive of broad collaboration and continuous improvement and support for mentor training and self-development.

Spirituality in end-of-life care: Tips and tools for all physicians
American Journal of Hospice & Palliative Medicine; by Derek Ross Soled, Sheila Cavanaugh, Anne Vandenhoeck, Michael Balboni; 9/26
Many physicians find themselves with patients when life’s final horizon is approaching but feel ill-equipped when they cannot take the suffering away. If a patient has no discernible chance of recovery, praying for healing seems disingenuous, and yet expressing condolences seems premature. Family and friends sometimes similarly grapple with how best to convey sincere emotion without amplifying any awkwardness. End-of-life situations are often protracted and can weary clinicians and families alike with the challenge of what to say. This article discusses practical tools for physicians navigating these situations with a focus on spirituality and the role of chaplains.

Admission surprise question response and its association with advance care planning documentation and palliative care consultation: A multisite propensity-matched cohort study
Journal of Palliative Medicine; by Ankita Agarwal, Kolby Johnson, Benjamin Verplanke, Lauren Messing, Heather Menzer, Veerawat Phongtankuel, Jesse Burk-Rafel; 9/26
The Surprise Question (SQ) asks providers, "Would you be surprised if this patient died in the next year?". It is a tool that was developed to help providers identify patients who would benefit from palliative care (PC) interventions. [In this study] patients with an SQ response of "No" on [hospital] admission had higher odds of having ACP [advance care planning] documentation or PC consultation ...  compared to those with a response of "Yes." In addition, patients with a "No" response had ACP documentation or PC consultation an average of 2.7 days earlier than those with a "Yes" response ...

Palliative care utilization in mesothelioma: Insights from the National Inpatient Sample (2016-2020)
Journal of Palliative Care; by Sangam Sangam, Tripti Jain, Pulkit Jain, Shorabh Sharma; 9/26
Mesothelioma is a rare and fatal cancer with a median survival of about 1 year after diagnosis. Palliative care (PC) becomes important in improving symptom control and quality of life in cancer patients. However, there is no literature regarding specific determinants of PC utilization in hospitalized mesothelioma patients. We studied the trends and determinants in utilization of PC, and its impact on hospital costs using the National Inpatient Sample. Inpatient PC use in mesothelioma remains low but is associated with lower hospitalization costs. These findings support the need for systematic early PC integration in Mesothelioma management in a hospital setting.

Bereaved parents' experiences of virtual Storytelling Through Music: A qualitative analysis
Journal of Pain & Symptom Management; by Carolyn S Phillips, Sue E Morris, Erin Rodriguez, Megan Hebdon, Jason Morris, Rev Brandon Morgan, Meera Singh, Amanda Maestro, Claudia Gruber; 9/26
Bereaved parents whose child died from cancer are at risk for prolonged and complicated grief, yet accessible, engaging bereavement interventions remain limited. Storytelling Through Music (STM) is a virtual, group-delivered expressive arts intervention that integrates reflective writing, psychoeducation, and therapeutic songwriting. Five interrelated themes characterized the STM experience: (1) connecting with peers and music, (2) benefits of coping through sharing, (3) expansive emotional experience ... , (4) graded exposure through the sequenced writing-storytelling-songwriting process, and (5) enduring legacy, with the final song functioning as a lasting keepsake and ongoing coping resource. STM appears to support multidimensional grief processing by combining social connection, narrative meaning-making, and music-based emotional engagement in a virtual format.

[UK & Northern Ireland] What AI could not hear - Reflections on AI-assisted end-of-life communication as an international ICU fellow
Journal of Cardiothoracic & Vascular Anesthesia; by Dr Nikita Thomas; 9/26
For an internationally trained clinician adapting to a new healthcare system, AI emerged as a potentially useful supportive tool during difficult conversations. By reducing cognitive overload and providing conversational structure, it created greater space to focus on listening, pacing, and the emotional flow of the interaction. The conversation also exposed the limitations of AI-supported communication. Meaningful communication depended on interpreting silence, hesitation, grief, pacing, and the need for reassurance. Respectful pauses and culturally shaped expectations surrounding death and family communication extended beyond what the AI-generated structure could interpret. Rather than replacing the human elements of communication, the experience suggested that AI may help create more cognitive space for them.

[Canada] Medical assistance in dying in patients with destination-therapy left ventricular assist devices
JACC Case Reports; by Jacqueline Carverhill, Michele Bertelli, Omid Kiamanesh; 9/26
Case summary: Two male patients with destination-therapy LVADs [left ventricular assist devices] received clinician-administered MAiD [medical assistance in dying]. One had refractory transfusion-dependent gastrointestinal bleeding and died in a community hospice; the other had refractory pain, anxiety, and existential suffering and died on an acute care ward. In both cases, intravenous medications were administered while the LVAD remained active, and the device was deactivated after unconsciousness and apnea were confirmed. These cases describe a practical approach to coordinating MAiD with LVAD deactivation in hospital and hospice settings. The process required advance agreement among the LVAD team, MAiD provider, and palliative care team regarding medication sequencing, responsibility for device deactivation, and anticipated alarms.
Assistant Editor's note: In this case "destination-therapy" refers to the pump device being permanent; the patient will have it until death. These patients are in the late stage of heart failure and are not candidates for heart transplant due to old age and/or severe comorbidities. When the pump is implanted as a temporaray treatment it is deemed a "bridge to transplant".

Try to be a rainbow in someone's cloud.  ~Maya Angelou