Literature Review

Provision of end-of-life care in austere environmentsWilderness & Environmental Medicine; by Jason W. David, Hui Z. Feng, Danny Lammers, Russell Day; 6/25End-of-life care presents unique challenges in austere or resource-limited environments where traditional medical resources are scarce or absent. This review explores the complexities of providing end-of-life care under such constraints, including recognition of the dying patient and techniques to alleviate suffering and allow death with dignity in under-resourced or expeditionary environments. Moreover, it presents these techniques in an accessible manner for providers without formal hospice training to use. Based on a literature review of hospice and palliative medicine, insights from the body of literature in wilderness and austere medicine, and the authors’ experiences in practicing in austere environments, this paper discusses practical approaches to symptom management, ethical considerations in end-of-life decision making, and accessible interventions with limited resources.Publisher's note: An interesting article for all healthcare professionals to consider...

Granting permission: Toward embracing griefJournal of Social Work in End-of-Life and Palliative Care; by Rennie Bimman; 3/25Grief, unavoidable and often excruciating, is rarely sufficiently acknowledged or supported in Western society. It is not granted permission to exist without barriers. By considering and evaluating grief experiences through the lens of their access to permission, clinicians can collectively imagine and promote inclusivity in grief. Permission is presented as a conceptual framework and clinical tool, with broader micro- and macro-level applications for both professional and layperson engagement, offering a foundation for further implementation and research.

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancerOncology Practice; Jeremiah Bonnet, BA; Colin Cernik, MS; Hajime Uno, PhD; Lanfang Xu, MS; Cecile A. Laurent, MS; Lauren Fisher, MS; Nancy Cannizzaro, BA; Julie Munneke, BA; Robert M. Cooper, MD; Joshua R. Lakin, MD; Corey M. Schwartz, MD; Mallory Casperson, BA; Andrea Altschuler, PhD; Lawrence H. Kushi, ScD; Chun R. Chao, PhD; Lori Wiener, PhD; Jennifer W. Mack, MD, MPH; 5/25Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ... 

Palliative care program characteristics and end-of-life outcomes for patients with metastatic cancerJournal of Pain and Symptom Management; by May Hua, Ling Guo, Shuang Wang, R Sean Morrison; 6/25Although U.S. palliative care programs have substantial differences in their implementation, whether this heterogeneity impacts patient outcomes is unknown. Palliative care program characteristics largely were not associated with differences in end-of-life quality metrics for patients with metastatic cancer.

Saturday newsletters focus on headlines and research - enjoy!

Referral criteria for specialist palliative care for patients with dementiaJAMA Network Open; Yuchieh Kathryn Chang, DO; Jennifer Philip, PhD, MMed, MBBS; Jenny T. van der Steen, PhD; Lieve Van den Block, PhD, MSc; Allyn Yin Mei Hum, MD; Pedro E. Pérez-Cruz, MD, MPH; Carlos Paiva, MD, PhD; Masanori Mori, MD; Ping-Jen Chen, MD; Meera R. Agar, PhD, MPC, MBBS; Laura Hanson, MD, MPH; Catherine J. Evans, PhD, MSc, BSc; David Hui, MD, MSc; 5/25Dementia is an ever-growing public health issue with currently more than 55 million people worldwide living with this disease. Due to an aging global population, this number is projected to triple by 2050. As the number of people with dementia continues to grow worldwide, there is a need and an opportunity to collaborate and provide seamless integration of specialist palliative care with the primary palliative care already delivered to enhance the care of patients with dementia. To help advance this goal, the 15 major criteria identified here represent a first step toward clarification of primary and specialist palliative care roles and consideration for systematic screening of symptom and supportive care needs.

SpiriTrust Lutheran says Home Care & Hospice operations will wind down across three counties, end service on July 18th Tri-State Alert, Chambersburg, PA; Press Release; 5/29/25 Earlier on Thursday [5/29], News Talk 1037FM was alerted to a WARN notice from SpiriTrust Lutheran as to a closure of a portion of their business. Throughout the process, that notice has been narrowed down to their Home Care & Hospice (HCH), with the company announcing their plans to discontinue operations out of their Franklin County office which serves clients in Franklin, Adams and York counties. The official closure will be July 18, 2025. ... SpiriTrust Lutheran says that roughly 65 home care and hospice employees will be affected by the shutting, but  some are expected to be reassigned or offered positions within the SpiriTrust Lutheran family of Life Plan Communities ... SpiriTrust Lutheran officials cited the organization’s ongoing challenges mirrored those confronting many similar organizations nationwide – significant increases in the cost of delivering care due to staffing shortages; rising benefit expenses; and the escalating prices for medical supplies and pharmacy. 

Door remains closed on CMS forums as new rules, requirements are phased in McKnights Long-Term Care News; by Kimberly Marselas; 5/28/25 Four months into the new presidential administration, skilled nursing leaders have had no opportunity to hear directly from Centers for Medicare & Medicaid Services staff during traditional Open Door Forums or National Stakeholder Calls. Open Door Forums have been held three-to-five times annually in a practice that started more than 20 years ago. The online meetings give providers, vendors and other stakeholders an opportunity to learn more about regulatory and logistical changes being pursued by CMS, as well as providing question-and-answer sessions with policy architects. In addition to skilled nursing forums, CMS has in the past also hosted similar events for home health, long-term care services and supports, rural health and other provider types. But CMS in January cancelled a skilled nursing forum and all others planned for February and has yet to add any new forums or stakeholder calls — which often feature the administrator discussing major policy or clinical updates — to its calendar.

A ‘cloak of comfort’: an integrated approach to palliative care for cancer patients Sinai Health; 5/26/25 At Mount Sinai Hospital, palliative care is fully integrated into cancer care, providing comprehensive, person-centered support for those with advanced illness. Palliative care, derived from the Latin pallium meaning “cloak,” offers comfort and support to individuals with serious illnesses. Often misunderstood as solely end-of-life care, it actually provides relief at any stage of a life-threatening illness and can be provided in tandem with cancer treatment. This holistic approach addresses physical, emotional, and spiritual needs, aiming to improve quality of life for both patients and their families. In fact, early integration of palliative care can enhance symptom management, extend life and offer greater support to caregivers. Patients can receive care at Mount Sinai Hospital’s Cancer Care Clinic, at home through the Temmy Latner Centre’s home palliative care program, and in the palliative care unit at Hennick Bridgepoint Hospital.  

[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. 

Capito sees earmark results in hospice renovations CBS 13 WOWK, Charleston, WV; by Sarah Davis; 5/28/25 U.S. Senator Shelley Moore Capito (R-WV) visited the Hubbard Hospice House in Charleston Wednesday to see her congressionally directed spending in action. The senator got an exclusive tour of the renovations being made, including a new roof, HVAC system and a fresh paving job on the facility’s parking lot. The construction project is supported by Capito’s 2024 congressional directed spending, also known as an earmark, which she said is a necessary investment for the welfare of West Virginians.

Empathy meets efficiency: Voice AI in law, healthcare and debt collection Forbes; by Kumar Abhirup; 5/29/25 When a grieving daughter calls a probate firm at midnight or a worried parent rings a pediatric clinic after hours, the first voice they meet decides whether they stay or stray. As organizations adopt AI, especially voice and conversational AI, that voice is increasingly synthetic. A recent survey from the American Bar Association found that the share of firms using AI tools rose from 11% in 2023 to 30% in early 2025. Healthcare has sprinted even faster: The American Medical Association found 66% of physicians now use some form of AI, up from 37% two years earlier. Collections agencies are also hopping aboard this trend ...