Literature Review

Experiences of hospice staff beyond the frontlines during COVID-19: A qualitative secondary analysis study Journal of Palliative Care and Social Practice; by Thanga Harini Sundaramoorthy, John I MacArtney, Abi Eccles; 4/12/25Three main themes were identified: (1) Blurred margins: Participants discussed facing difficulty separating work and home life and taking stresses and thoughts about work home. (2) Isolation, loneliness and social interactions ...  (3) Disruption to family and personal commitments: Some staff felt unable to see or support their parents, partners and children during the pandemic subsequently impacting their psychological and emotional well-being. Conclusion: Hospice staff compromised aspects of their personal life and family responsibilities during the pandemic to carry out their role at work. Workplaces and organisations should aim to support hospice staff more broadly to help with managing work-related pressures and balancing personal commitments in future emergency periods.Editor's note: Use this evidence-based research with your Emergency Disaster Preparedness Plans. Click here for the CMS.gov Emergency Preparedness Rule. Click here for Wisconsin's CMS Emergency Preparedness Rule Toolkit: Hospices.

Kidney transplant fast track and likelihood of waitlisting and transplant-A nonrandomized clinical trialJAMA Internal Medicine; Larissa Myaskovsky, PhD; Yuridia Leyva, MS; Chethan Puttarajappa, MD; Arjun Kalaria, MD; Yue-Harn Ng, MD; Miriam Vélez-Bermúdez, PhD; Yiliang Zhu, PhD; Cindy Bryce, PhD; Emilee Croswell, BA; Hannah Wesselman, PhD; Kellee Kendall, MPH; Chung-Chou Chang, PhD; L. Ebony Boulware, MD; Amit Tevar, MD; Mary Amanda Dew, PhD; 3/25Although it is a seemingly intuitive solution to enabling more patients to complete the evaluation process and be added to the waitlist, to our knowledge, few transplant centers use a health care system–facilitated approach like KTFT [Kidney Transplant Fast Track]. In this nonrandomized clinical trial of 1,118 patients with end-stage kidney disease (ESKD) who underwent KTFT and a historical control group of 1,152 patients with ESKD undergoing evaluation for kidney transplant, the KTFT group had a higher likelihood of waitlisting and transplant than the historical control group. Unlike the historical control group, the KTFT group had no significant differences in kidney transplant by race or ethnicity.

Prevention of acute hospital transfers for long-term care residents at the end of life American Journal of Hospice and Palliative Medicine (AJHPM); by Kirsten Lanpher, DMS, MSPA, PA-C and Kirsten Brondstater, DMS, MSPAS, PA-C; 3/24/25 Findings: Long-term care residents are a vulnerable population with advanced comorbidities who often require high acuity care and are subject to preventable transfers to the hospital at the EOL. These disruptions in EOL care cause harm and complications, negatively impacting quality of care. The consequences of these events can be mitigated with early advance care planning to include documentation of EOL care goals, onsite medical clinicians to make critical decisions and provide care within LTC facilities, and adequate staffing with proper palliative and hospice care training. Conclusion: Immediate action is needed to advocate for this high risk population and implement interventions to prevent hospital transfers at the EOL, therefore improving quality of care and positively influencing LTC residents’ EOL experience.

Belief in an afterlife is increasing in the United States: Even among the non-religious The Association of Religion Data Archives (The ARDA); by Ryan Burge; 4/17/25 This post has been unlocked through a generous grant from the Lilly Endowment for the Association of Religion Data Archives (ARDA). The graphs you see here use data that is publicly available for download and analysis through link(s) provided in the text below. ... I wanted to dig a bit deeper on the variations in those belief metrics today, with a question that I haven’t really probed a whole lot. The General Social Survey, which is available on the Association of Religion Data Archives website, contains a really straightforward question, “Do you believe there is a life after death?” And it has an even simpler set of response options - yes or no. It’s been asked with regularity since 1973, so we have nearly five decades of data on this one specific question. ... Even today, the share of Americans who believe in life after death is 82%. When people ask me, “Is the United States a religious country?” This is the stat that I’m going to trot out.

TIEC, trauma capacity, and the moral priority of surrogate decision makers in futility disputesThe Journal of Clinical Ethics; Autumn Fiester; Spring 2025In the past 15 years, trauma-informed care (TIC) has evolved as a new paradigm in healthcare that recognizes the impact of past traumas on patients' and families' healthcare experience while seeking to avoid inducing new trauma during clinical care. A recent paper by Lanphier and Anani extends TIC principles to healthcare ethics consultation (HEC) in what they label "trauma-informed ethics consultation" (TIEC), which calls for the "addition of trauma informed awareness, training, and skill in clinical ethics consultation." While Lanphier and Anani claim that TIEC is "novel, but not radical" because it builds on the approach to HEC endorsed by the American Society for Bioethics and Humanities, I believe that TIEC has radical implications, particularly regarding ethical obligations to surrogate decision makers (SDMs). Given what I call the SDM's "trauma capacity," I argue that TIEC accords moral priority to SDMs over patients in certain types of end-of-life cases, particularly futility disputes, which is a radical departure from the conventional HEC approach to SDMs.

PEMF therapy: A non-invasive approach to enhance cancer treatmentHope 4 Cancer Treatment Centers; by Antonio Jimenez, Subrata Chakravarty; 2/25The Earth’s magnetic field, a constant presence in our environment, has a subtle yet profound impact on human health. Operating at extremely low frequencies and low intensities, it is generated by electric currents in the Earth’s conductive iron-rich core. This magnetic field serves as a protective shield, deflecting solar wind—charged particles from the sun— that could devastate life on Earth. Beyond its protective role, It also helps regulate circadian rhythms and supports cellular function. Our cells exist within this dynamic electromagnetic environment, and by harnessing its properties, we can actively enhance cellular health, physiological balance, and overall well-being.Publisher's note: Hope 4 Cancer is a naturalistic / neuropathic healing center in Mexico exploring innovative cancer treatments. Additional articles readers might be interested in include Treating cancer with sound waves: An overview of sonodynamic therapy and Modulated TRPC1 expression predicts sensitivity of breast cancer to doxorubicin and magnetic field therapy: Segue towards a precision medicine approach.

Pacemaker and defibrillator deactivation in competent hospice patients: an ethical considerationAmerican Journal of Hospice and Palliative Care; by Jennifer M Ballentine; 1/05In 2003, a Colorado hospice provider asked the DCBC for assistance in developing a policy on deactivation of pacemakers and defibrillators in competent hospice patients. The hospice had encountered concerns from some physicians and cardiac care clinicians that deactivating such devices treads the fine line between legitimate withdrawal of burdensome treatment and assisted death... This article summarizes contributions from the committee's discussion, as well as independent research undertaken by the author.Publisher's note: This older, yet still relevant and helpful, article recently came across my desk.

Concordance of 30-day mortality and in-hospital mortality or hospice discharge after sepsisJAMA Network; by Hallie C. Prescott, Megan Heath, Namita Jayaprakash, Raymund B. Dantes, Chanu Rhee, Patricia J. Posa, Scott A. Flanders; 4/9/25In this all-payer, multihospital cohort of patients with community-onset sepsis, the proportion of hospitalizations ending in death or hospice discharge was similar to 30-day mortality and substantially higher than in-hospital mortality alone. Concordance between this composite outcome and 30-day mortality was high and greater than in-hospital mortality alone at the encounter level. These data suggest that the composite outcome of in-hospital mortality or hospice discharge may be a useful measure for national benchmarking of sepsis outcomes. While not identical to 30-day mortality, this composite outcome is available in real time for all patients and appears to have minimal systematic bias from variable hospital discharge practices.Publisher's note: An interesting study that includes "hospital discharge to hospice" as an important variable for consideration.

[Netherlands] A care ethical perspective on family caregiver burden and supportNursing Ethics; Maaike Haan, Jelle van Gurp, Marianne Boenink, Gert Olthuis; 3/25Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. The question is then whether self-sacrifice is a problem that nurses should immediately solve. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers from the situation but should support them in whatever overwhelms or drives them in standing-by their loved ones until the end.

Prospects for artificial intelligence in health policy and practiceJAMA Health Forum; John Z. Ayanian, MD, MPP; Zirui Song, MD, PhD; 3/25Solving complex diagnostic challenges is a natural application of AI [artificial intelligence] in health care and a compelling way to benchmark its capabilities. The more extraordinary test of AI will be its ability to unravel the ordinary—the everyday needs and struggles faced by patients and clinicians. Which words and what tone should a clinician use to motivate a patient to smoke less, exercise more, or adhere to medications? In these routine, imperfect moments, when the science of medicine morphs into an art of trust, and that art is an inherently human endeavor of caring, how could AI help clinicians choose the words, body language, and tone to deliver better care? The mystery no longer resides in putting together puzzle pieces of data, but rather in piecing together emotions, intuition, and tradeoffs. Improved chronic disease management, more efficient use of societal resources, and better quality of life are among the potential pots of gold at the end of the AI rainbow.  

Ambiguous loss: Implications for perinatal and neonatal nursesNeonatal Network; Rachel A Joseph, Mary Highton; 3/25Ambiguous loss, a term coined by Pauline Boss, is a state in which there is no actual "death" and, therefore, no "grieving" or closure associated with it. Pregnancy is a happy event most of the time; however, the loss of pregnancy can be distressing to the parents. While the birth of a child is expected to be a joyful event, premature birth and subsequent admission to the NICU for prolonged periods with fluctuating conditions force the parent to be in a constant crisis mode where the outcome is unknown. This can mentally, physically, and emotionally drain the parents and may cause depression or other mental health challenges. Perinatal and neonatal nurses are uniquely positioned to recognize the warning signs of emerging grief crises in the parents and support them appropriately.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, MD, MHA, CMD; Benjamin E. Canter, OTD; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.