Literature Review

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.  

[Australia] Practice recommendations for culturally sensitive communication at the end of life in intensive care: A modified eDelphi studyIntensive and Critical Care Nursing; Laura A Brooks, Elizabeth Manias, Bodil Rasmussen, Melissa J Bloomer; 2/25Clinicians need specific knowledge and skills to effectively communicate with patients and their family when a patient is dying in the ICU. End-of-life communication is compounded by language differences and diverse cultural and religious beliefs. Recommendations prioritising use of professional interpreters and nurse involvement in family meetings achieved near perfect agreement amongst participants. Recommendations to facilitate family in undertaking cultural, spiritual and religious rituals and customs, advocate for family participation in treatment limitation discussions, and clinician access to professional development opportunities about culturally sensitive communication also achieved high level consensus. These practice recommendations provide guidance for ICU clinicians in their communication with patients and families from culturally diverse backgrounds. 

Forget perks—leadership starts with asking employees what they need Forbes; by Benjamin Laker; 2/25/25 Employee well-being isn’t just a perk—it’s a business imperative. As organizations struggle with high turnover, burnout, and shifting workforce expectations, leaders must rethink how they engage and support employees. Research consistently shows that investing in well-being leads to measurable gains in productivity, retention, and performance. A recent study published by BMJ Leader examined how a structured, data-driven approach to improving workplace culture can yield transformative results—using the well-being initiative at Royal Free Hospital as a case study. ... The program, which was the focus of the BMJ Leader study, incorporated systematic conversations based on the Joy in Work Framework, identifying key challenges and implementing targeted solutions. Following implementation, workplace satisfaction surged by 76%, highlighting the significant impact of addressing staff concerns directly. Employees became more engaged in organizational initiatives, fostering a culture of active participation rather than passive compliance. 

‘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. 

Empowering employees to drive CX [Customer eXperience] innovation: A comprehensive path to successCustomerland; by Ricardo Saltz Gulko; 2/24/25 ... While it is widely recognized that employees play a crucial role in shaping customer experience (CX), their impact on innovation is often less clear. However, employees are the bedrock of innovation within any organization. They bring diverse perspectives, skills, and creativity that fuel the development of new products, services, and processes. This article delves into the significant ways employees influence innovation, providing a comprehensive analysis supported by ten key points. ...

[Turkey] Actual roles of Occupational Therapists in palliative and hospice care: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Güleser Güney Yılmaz, PhD, OT; Hülya Yücel, PT, PhD; Milda Gintiliene, MD; 1/25 Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

How music is rewriting end-of-life care The Daily Iowan; by Madison Schuler; 2/18/25 The form of therapy relieves not only patients but also family members. Over the years, music has been used to express emotions for some while creating connections and memories for others. Listening to a certain song can take people back to a specific moment. Whether it elicits joy, pain, anger, or sadness, music has a different effect on each individual. Music stays with people throughout their lives, always bringing forth those emotions or memories. For those in end-of-life care, music can do the same. ... Today, hospitals and hospice centers are seeing an increase in the use of music therapy, specifically in end-of-life care. [Click on the title's link to learn more.] Editor's note: Click here for the national directory of CBMT board certified music therapists. Click here for my 2005 book in Routledge's Series in Death, Dying and Bereavement, Music of the Soul - Composing Life Out of Loss.

Addressing overtreatment in end-of-life cancer care Medscape; by David J. Kerr, CBE, MD, DSc; 2/19/25 ... What do we mean by overtreatment? This means that many patients who are approaching the end of life receive treatments, like directed anticancer therapies, that are unlikely to provide clinically meaningful benefits and may do more harm than good. This is an expression that I use often in the clinic when I'm explaining to patients that we have reached the end of the road in active interventions, such as chemotherapeutic drugs, that will do more harm than good. It doesn't stop us from doing our very best to look after patients. We focus on improving the quality of life and maintaining that for as long as we can, while continuing to care and look after the patients. ... Overtreatment may even, one would argue, accelerate death when you consider those 1% or 2% mortality rates that can be associated with some treatments that we offer. ...

Cancer, aging, and meaning: Navigating psychosocial challenges The ASCO Post (Association for Clinical Oncology); by Ramy Sedhom, MD; 2/18/25 I’ve learned a lot about medicine over the years, but one thing I wasn’t taught was how to guide someone through the existential weight of dying. My education centered on diagnosing, curing, or at least managing disease—not on the delicate art of helping people and their loved ones cope with what cannot be cured. Now, several years into my career as an oncologist, primarily caring for older adults, I recognize that providing cancer care for the whole patient requires deep attention to their psychosocial health needs. ...

Death Matters: The gift of presence: Tips for visiting someone who is dying Squim Gazette, Squim, WA; by Jeanette Stehr-Green, Volunteer Hospice of Clallam County; 2/12/25 We sometimes avoid visiting friends or family members who are terminally ill. We make lots of excuses. We don’t know what to say. We don’t know how to act. We don’t want to be a bother. The hard truth is that dying, the final stage of life, can be a lonely experience without the presence of family and friends. A visit during this time can bring comfort to the dying person and their family. It can also provide an opportunity to share feelings, reminisce, and say goodbye. Visiting a dying person seems difficult because most of us lack experience. It only takes a little courage and a few ideas to create a meaningful moment. ... Editor's note: These excellent guidelines empower hospice patients' families and friends--and protect patients' vulnerable energies and emotions--in multiple settings across the trajectory of dying. How might you adapt these for your own patient/caregiver support and community outreach?

How to help caregivers of patients with dementia Physician's Weekly; by Linda Girgis, MD, FAAP; 2/13/25 Dr. Linda Girgis discusses how physicians can assist caregivers of patients with dementia, helping these critical caretakers avoid experiencing burnout. ... As doctors, we all have witnessed caregiver burnout. Often, it was a family member who bore the brunt of the responsibility, one for whom there were no vacation days or sick time available. Whatever specialty we practice, we know patients with dementia can present a significant problem. ... How can we assist caregivers of patients with dementia?

Bringing children home: Kentucky Children’s Hospital’s approach to pediatric end-of-life care American Hospital Association; 2/8/25 When parents have a child with a serious illness, all they want is for their child to get well. If that no longer becomes a possibility, often all they want is to bring their child home. Most — around 70% — of pediatric deaths related to illness occur in the hospital, but the Kentucky Children’s Health Pediatric Advanced Care Team offers some families the chance to transport their child home using life-sustaining technology. That’s not an easy feat; these patients are medically fragile, and the outcome can be unpredictable. A team made up of hospital administrators, hospice providers, coroner and the transportation team comes up with a plan. The child’s parents complete an informed consent procedure, recognizing that their child may not survive the journey home. The transportation team tries to ensure that the journey is as comfortable as possible, as well as planning what to do if the child’s condition deteriorates on the journey. If that happens, he or she will be supported as they pass without resuscitation efforts.