Literature Review

A rapid review of states' Portable Medical Order forms and the National POLST Paradigm for Advanced Care PlanningJournal of Hospice and Palliative Nursing; by Tracy Fasolino, Megan Pate, Nancy Dias, Rikki Hooper, Lena Burgess, Megan Golden, Savannah Horvick, Jamie Rouse, Elizabeth Snyder; 8/25Hospice and palliative care nurses initiate goals of care conversations with patients and family members while advocating for the completion of advance directives. As leaders in these conversations, nurses must have a working knowledge of the various forms, such as portable medical orders. The National Physician Orders for Life-Sustaining Treatment (POLST) Paradigm calls for the standardization of portable medical orders to ensure goal-concordant care that can cross all healthcare settings. This rapid review provides an overview of state-level portable medical order forms, compares and contrasts them with the National POLST form, and proposes policy recommendations for hospice and palliative care nurses to advocate within their state, territory, or tribal nation. 

Serious illness communication in homecare nursing: A concept analysisJournal of Hospice and Palliative Nursing; by Christine S Davidson, Olga Ehrlich, Toni L Glover; 8/25Many seriously ill patients receive nursing care at home to manage their illness [and] there is a growing overlap between homecare and palliative or hospice care. In the homecare setting, nurses may be uncertain about their role and responsibility for engaging in "serious illness communication." The term "serious illness communication" is sometimes used ambiguously, overlapping with other terms such as goals of care discussions or end-of-life conversations. Proponents of serious illness communication emphasize the need for a shift from traditional advance care planning toward a real-time, patient-centered dialogue adaptive to the evolving nature of serious illness.

Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.

The best end-of-life care begins with TRUTHProfessional Case Management; by Julie-Kathryn E Graham, Christina Kelley, Gabriella Malagon-Maldonado; 9/25For decades, research has recommended truth and transparency in end-of-life care discussions with patients, families, and family-centered care. This study demonstrated that, in practice, this is often not done, resulting in further traumatization to families at the end of life ... [which] makes information processing and decision-making very difficult. At end-of-life, person-centered care is family-centered care. A person's individuality is inextricable from who they are to their family. If we do not care for the family, we do not care for our patients. 

[Spain] First-ever global ranking of palliative care: 2025 World Map under the new WHO frameworkJournal of Pain & Symptom Management; by Vilma A. Tripodoro, Jesús Fernando López Fidalgo, Juan José Pons, Stephen R. Connor, Eduardo Garralda, Fernanda Bastos, Álvaro Montero, Laura Monzón Llamas, Ana Cristina Béjar, Daniela Suárez, Carlos Centeno; 8/25This study presents the first comprehensive global assessment of PC [palliative care] development, utilising the WHO Conceptual Framework as a multidimensional tool to monitor progress. Results reveal stark inequities: more than half of the global population lives in countries with Emerging or Progressing PC levels, while fewer than one-fifth are in Advanced systems. Despite methodological updates in 2025, the number of Advanced-level countries remains unchanged from 2017, suggesting limited progress. This is consistent with downgrades in countries such as Israel, Spain, Canada, Liechtenstein, Romania, and Mongolia, which may reflect data gaps, methodological shifts, or actual declines.

Fulfilling end-of-life dreams: A scoping review of bucket lists in palliative and hospice care Palliative Supportive Care - Cambridge University Press; by Swasati Handique, Michael Bennett and Scott D Ryan; 9/12/25 Results: Four major themes were established using thematic content analysis: (1) impact on holistic well-being, (2) role of family in wish fulfillment, (3) cultivation of gratitude, and (4) collaborative leadership in wish fulfillment. In wish fulfillment, the results significantly pointed to the need for more intricate evaluation among patients and interventions that cover beyond the physical aspect. Significance of results: Palliative and hospice care settings should work toward securing sustainable funding for structured wish-fulfillment programs to address existing accessibility gaps and further enhance the holistic nature of care in these settings. Editor's Note: For hospice organizations that can receive donations, setting up a Wish/Bucket LIst fund makes for a meaningful, easy-to-demonstrate ROI on donated gifts. You need to have some type of discretionary review/approval process in place, with assurances of confidentiality when important to the person and/or family.

Are we growing leaders? Exploring leadership training in hospice and palliative medicine fellowshipJournal of Pain & Symptom Management; by Lynn A Flint, Greg Wallingford, Paul Tatum, Julie Bruno, Helen Fernandez, Elise C Carey; 8/25The purpose of this study was to characterize the current state of leadership curricula in HPM fellowships and understand which leadership topics fellowship program directors (PDs) consider to be most important to include in a leadership curriculum for fellows. Respondents rated leadership topics as important for training, yet many topics are not included in fellowship curricula. Six topic areas related to communication and self-management were rated as having great need or were included in existing curricula by more than 60% of respondents. PDs identified ten topics to be of great need for fellows, all but one of which were included in at least 40% of programs' curricula. Negotiation was the exception being included in only 20% of programs' curricula.

Patient-and caregiver-identified goals for advance care planning in patients with dementia or cognitive impairmentDementia; by Kristin L Rising, Angela M Gerolamo, Nazanin Sarpoulaki, Venise J Salcedo, Grace Amadio, Robin Casten, Anna Marie Chang, Alexzandra T Gentsch, C Virginia O'Hayer, Barry Rovner, Brooke Worster; 8/25Despite an aging population and acknowledged importance of advance care planning (ACP) for persons living with cognitive impairment, few engage in ACP. Most existing tools to facilitate ACP discussions focus on medical outcomes, despite research documenting that persons with cognitive impairment often have quality of life outcomes as primary goals. This qualitative study engaged persons with mild cognitive impairment (MCI) or dementia and their carers to identify outcomes that are most important to inform development of a tool to guide ACP interventions with this population. Participants identified 23 outcome categories for ACP interventions within the following six domains: social life, family involvement, current lifestyle, physical independence, financial independence and healthcare goals. Of the 23 outcome categories, the majority (86%) were quality of life goals and only a small fraction (14%) were healthcare specific.

The role of PMHNPs in palliative psychiatry: An ethical framework for care when remission is unattainableJournal of Hospice and Palliative Nursing; by Trae Stewart; 8/23Patients with serious and persistent mental illness may experience intractable suffering despite exhaustive treatment, challenging the dominant curative paradigm in psychiatry. Palliative psychiatry offers an emerging alternative-prioritizing comfort, dignity, and quality of life when remission is no longer attainable. This article presents a comprehensive ethical and clinical framework for integrating palliative psychiatry into psychiatric-mental health nurse practitioner (PMHNP) practice. Drawing parallels with somatic palliative care, the author explores the theoretical foundations, diagnostic complexities, and ethical imperatives guiding palliative psychiatry. Legal challenges, such as hospice eligibility criteria and involuntary treatment statutes, are also examined, with recommendations for practice and policy reform. Assistant Editor's note: As I search for pertinent articles to add to this newsletter, I am delighted to find so many that address a variety of aspects of palliative care. I see articles on palliative care in the ED, palliative care for special populations, palliative care for transplant patients, and as highlighted in this article, palliative care in psychiatry. It makes me think that maybe, just maybe(!), the many benefits of palliative care are finally being recognized and embraced by mainstream health care.

Clinicians who practice primarily in nursing homes and the quality of care for residents with Alzheimer Disease and related dementiasJAMA Health Forum; by Hyunkyung Yun, Mark Aaron Unruh, Yuting Qian, Yongkang Zhang, Hye-Young Jung; 8/25In this cohort study, receipt of care from a SNFist [skilled nursing facility specialist] vs a non-SNFist was associated with a 7% decrease in the odds of a hospitalization and a 7% decrease in the odds of an emergency department visit for an ambulatory care–sensitive condition among residents with dementia. Findings of this cohort study suggest that the use of SNFists by NHs [nursing homes] may enhance the quality of care for residents with ADRD [Alzheimer disease and related dementias].

[UK] Does non-beneficial nasogastric tube feeding occur during end-of-life care? An audit of outcomes for those with a malnutrition universal screening tool score of 2Journal of Palliative Medicine; by Ross Andrew James Webster, Moitree Banerjee, Rachel King, Rosana Pacella, Antonina Pereira; 8/25The consideration of artificial nutrition and hydration (ANH) is recommended for individuals with reduced nutritional intake. However, placing long-term nonoral feeding tubes is not appropriate in those with advanced dementia or if the individual is likely to die imminently—“within hours or days”. In some instances, the provision of ANH in the weeks leading up to death may be considered a “Non-Beneficial Treatment.” In [this study a] total [of] 40 (47.6%) of 84 NGT [nasogastric tube]-flagged individuals were deceased within six months. Conclusions: NGT insertions in this cohort have a high likelihood of being considered “non-beneficial.”

Benefits and burdens of research participation: A mixed methods systematic review in palliative and end-of-life careJournal of Hospice and Palliative Nursing; by Cara L Wallace, Stephanie P Wladkowski, Ruaa Al-Juboori, Anna Wingo, Kathryn W Coccia, Rebecca Hyde, Verna Hendricks-Ferguson; 8/25Research participation of hospice and palliative care patients and family caregivers is essential to develop and test best practices. Yet, healthcare professionals are often hesitant to ask patients and caregivers to participate in research, fearing it is too intrusive or unethical during a sensitive time. This review focused on the motivating factors, benefits, and burdens of research participation for patients with serious illness and their family caregivers. For clinicians and researchers, connecting patients and caregivers to palliative and end-of-life research may be both beneficial as a contribution to scientific literature and as an additional source of ongoing support.

[France] Palliative care for solid organ transplant candidates and recipients: A scoping reviewTransplantation Reviews; by Liesbet Van Bulck, Fiona Ecarnot, Mathilde Giffard; 8/25Solid organ transplant patients experience high morbidity and mortality before and after transplantation. International guidelines recommend integrating palliative care into the management of patients with advanced organ failure, including transplant candidates and recipients, as it supports advance care planning, enhances communication and improves symptom management. This scoping review shows that palliative care for organ transplant has received little attention heretofore.