Literature Review

Carolyn Hax: Does sibling love justify traveling to abusive mom’s deathbed?The Washington Post, Washington, DC; 3/24/25 Sister asks the letter writer to join her at their dying mom’s bedside — despite their PTSD-inducing childhoods. [The rest of this article may require a subscription to The Washington Post.]Editor's note: Even if you're not able to access the full article, what does this question stir in you? Be aware that many family caregivers (or simply family members) face complex, conflicted relationships with the persons they are tending--or in this case, even considering visiting or not. Be attuned to these common, everyday occurrences that your direct care interdisciplinary team members regularly navigate. What family systems' education and support do you provide for them?

Dr. Sean O’Mahony aims to expand UTMB’s Division of Palliative Care UTMB Health - The University of Texas Medical Branch at Galveston;  3/18/25 Palliative care should be more accessible, bridge gaps in health care environment. ... Dr. Sean O’Mahony, director of the Palliative Medicine division, came to UTMB in June, having served as professor and Director of Supportive Oncology and Section Chief at Rush University Medical Center in Chicago, and in key roles at Albert Einstein College of Medicine and Memorial Sloan-Kettering Cancer Center. ... O’Mahony said, “I was attracted to UTMB’s commitment to underserved patients, its prison health population, and its large population of underinsured patients. I’m also interested in the opportunity to develop palliative medicine from the ground up in the mainland hospitals.” ... 

Why aging parents make DNR choices before crisis strikes Rolling Out 25; by Khalil Best; 3/17/25The conversation typically begins quietly. ... An aging parent mentions their desire for a Do Not Resuscitate order—commonly known as a DNR—and the atmosphere in the room shifts. For many adult children, this moment arrives unexpectedly, triggering complex emotions ranging from denial to grief. Yet these discussions, uncomfortable as they may be, represent one of the most meaningful exchanges families can share. Understanding why many elderly parents choose to sign DNR orders in advance illuminates not just practical healthcare concerns, but deeper values about dignity, autonomy, and what constitutes a meaningful life.

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

The path to excellence: How nursing education can propel your career WFMA-TV 69 News; Allentown, PA; by Valencia Jasira; 3/11/25 ... Why higher education matters in nursing: Expanding expertise beyond the basics is becoming more essential in the medical profession. Institutions and employers now prefer staff members with comprehensive training and credentials. This trend is largely due to evolving regulations, technological advancements, and the push for better service quality. ...

Leverage collaboration, detailed notes to improve end-of-life care Home Helath Line; by MaryKent Wolff; 3/13/25 Educate your hospice staff on monitoring symptoms that could indicate a patient is nearing the end of life. Agencies that manage these symptoms early and take the time to prepare and comfort caregivers and families for the transition could see these successes reflected in their CAHPS Hospice survey scores. [Subscription required for more content.]

[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:

Nursing students gain valuable insights into global palliative care and cultural perspectives UConn Today, University of Connecticut; by Grace Fontanarosa; 3/11/25 School of Nursing assistant clinical professor Amisha Parekh de Campos, Ph.D., MPH, RN, CHPN, along with senior nursing students Gillian Fulton ’25 (NUR) and Abigail Schwartz ’25 (NUR) recently returned from the End-of-Life Experiential Global Learning (EGL) spring program in Belgium. ... In such an intensive program, there is much to process. Parekh de Campos and her students regularly debriefed to address questions and embrace openness to other cultural beliefs and perspectives. “Going in, we were very focused on the medical aspect of palliative care, and this program shifted our focus to the psychosocial aspects of end of life,” say Fulton and Schwartz. 

Trends in Pediatric Palliative Care Research (TPPCR) 2025; Issue #2 Siden Research Team; Commentary by Kim Mooney-Doyle, MD; 3/6/25Kim Mooney-Doyle – University of Maryland School of Nursing, MD, USA: I am a nurse scientist dedicated to advancing family health in serious pediatric illness. I have studied parent-sibling relationships and the social ecological factors that impact it for the past decade. ... Siblings are special and, too often, invisible in the care of seriously ill children, adolescents, and young adults. Two articles in this month’s collection bring the needs and experiences of siblings into focus using a family lens. A key take-away from this important work is that while siblings want to communicate with their parents about their brother’s or sister’s illness, it can be hard to initiate such conversations. As clinicians and researchers, we can work with families to devise strategies that foster these conversations, such as providing prompts or a scripted conversation guide to help a parent engage the sibling.  

Local pharmacist advising Ohio health director on palliative care Herald-Star, Steubenville, OH; by Christopher Dacanay; 3/10/25 A local pharmacist hopes to “expand utilization” of palliative care in Jefferson County and increase patients’ quality of life from her new position as an adviser to the Ohio Department of Health director. Steubenville resident Mary Mihalyo, doctor of pharmacy, was appointed Dec. 10 to the Palliative Care and Quality of Life Interdisciplinary Council. Bringing her own expertise, Mihalyo joins a diverse, 20-person group of professionals with experience in the provision of palliative care. ... Mihalyo, who founded Steubenville’s A&B Pharmacy with her husband, is the former CEO of Delta Care Rx LLC. She now serves as chief clinical officer for the company, which has been rebranded as Dragonfly Health. ... Her professional work, since [1999], has focused on serving hospice and palliative care patients locally and nationally as part of interdisciplinary teams. ... [Council members] ... actively consult with and advise the director on palliative care initiatives in the state, identify standards of practice, pinpoint initiatives at the state or national level integrating palliative care into the healthcare system and developing its practice and lay out patient identification guidelines for health care providers.

Understanding a patient’s AI medical journey The Hastings Center; by Ian Stevens, Erin William, Jean-Christophe Bélisle-Pion, and Vardit Ravitsky; 3/5/25As artificial intelligence becomes increasingly integrated into U.S. health care, patients should know the ways in which AI is being used in their care, concludes a new paper, “Bring a ‘Patient’s Medical AI Journey’ to the Hill.” Transparency is crucial for interactions between health care providers and individual patients, as well as for systemic level uses of AI, including:

Suspect armed with rifle shoots at hospice nurse, points weapon at deputies The Orange Leader, Orange County, CA; by Staff Reports; 2/28/25 A person was taken into custody after allegedly shooting at a fleeing hospice nurse and pointing a rifle at law enforcement Thursday. Orange County Sheriff’s Deputies responded to the 5600 block of Rebel Road after a hospice nurse reported to 911 that while attempting to provide care to one of her patients she was confronted by an occupant of the home. The occupant followed the nurse out of the home with a rifle, and shot at her as she fled the property.  A single bullet struck the nurse’s vehicle, according to information from OCSO. Upon arrival, Orange County Deputies established communication with the suspect who remained inside the residence with the rifle.  The suspect reportedly pointed the rifle toward the deputies while he remained in close proximity to the hospice patient.  

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services.