Literature Review

Why terminal cancer patients still receive aggressive treatment MedPageToday; by M. Bennet Broner; 7/31/25 Recently, researchers examined whether there had been any changes in the way terminal cancer patients died from 2014 to 2019, given the increased information available on hospice, palliative care, and advanced end-of-life planning (EOLP). They asked whether those who were terminal continued aggressive treatment until their demise. The authors anticipated a decrease in this, but found that the frequency of cancer patients who continued aggressive therapy had not declined. The study did not examine decision-making. Still, the researchers, based on other studies, theorized that the lack of change resulted from a confluence of physician and patient factors. ... [Physicians] might predict a more optimistic prognosis than justified, avoid discussing EOLP, support (over)intensive treatment, and/or overemphasize treatment effectiveness while minimizing its side effects. Oftentimes, given their statements, physicians will offer treatments they know to be of little value, believing that patients expect them to propose something rather than admit there was nothing realistic left to offer.Editor's Note: Pair this with our recent post, Doctors’ own end-of-life choices defy common medical practice.

Hearing loss, loneliness may contribute to cognitive decline in older adults McKnights Senior Living; by John Roszkowski; 7/28/25 Hearing loss and loneliness can contribute to dementia in older adults, and simple interventions to address hearing loss, such as hearing aids, may reduce cognitive decline in some cases, new research finds. ... Results of the study showed that higher levels and worsening self-reported hearing impairment were associated with steeper decline in episodic memory issues and executive functioning (verbal fluency). Further, the researchers found that individuals who were not socially isolated but still felt lonely saw their cognitive decline accelerate if they were deaf.

10 questions to help you plan for the end of life Time; by Angela Haupt; 7/21/25 Talking about death doesn’t have to be morbid. If you approach the conversation the right way, “it makes us more awake to our lives,” says Dr. Shoshana Ungerleider, founder of End Well, a nonprofit that aims to change the way people talk about and plan for the end of life.  “When we avoid this discussion, we rob ourselves of one of life's most clarifying forces—and that's the awareness that our time is finite.” There are other benefits to planning ahead. ... We asked experts to share 10 essential questions to ask yourself—and your loved ones—to plan for the end of life.

Caring for a difficult elderly parent during a transitionPsychology Today - Caregiving; "Personal Perspective" by Franne Sippel, EdD, LP; 7/21/25 I am the only child of an only child who lives in an assisted living facility thousands of miles away. I unofficially diagnosed Mom with obsessive-compulsive personality disorder after struggling for years with a relationship fraught with guilt and frustration. ... It’s difficult enough to care for a frail parent when their health is failing. However, the added OCD personality, with its micromanaging, rules, and demands, tests patience beyond compare.  ... A good friend suggested I call hospice to evaluate her. Jim, a hospice RN in his 70s, arrived and instantly assessed the situation with laser-like precision. ... I spend many months going back and forth between South Dakota and Arizona to see my mom. Hospice continues to visit her three to four times a week at the assisted living facility, and a dear family friend also visits her several times a week. ... Editor's Note: Keep reading this article to its end. The insightful, practical, sensitive care from these hospice clinicians generated life-long transformations for this burdened caregiver-daughter. 

Ok, please help calm my anxiety. My mother has drastically improved in the last couple of days since goin on hospice. Aging Care; by Oedgar23; 7/17/25 So in the hospital, my mother was in kidney failure. The last couple days after stopping vancomycin for about five days, her GFR had come up to 19. That’s the most recent Number and then they stopped drawing labs because we placed her on Hospice. We consulted with palliative care team. They wanted to do a feeding tube and we said no. They said she had advanced dementia. [Describes improvements since hospice.] ... What if she gets taken off hospice? ... What if she no longer qualifies for hospice, passes as normal cognitively, starts demanding to go home, does not qualify for long-term care, Medicaid, etc. ... But I am super unnerved because she looks a whole lot better than she has been looking. ...Editor's Note: Yes, we all know that the person can get better with hospice care, because of holistic person-centered care, caregiver education and support, and many more factors. This can be confusing. The dying trajectory may have been interrupted or simply calmed with better symptom management and quality of life. This daughter is asking normal, crucial questions which the hospice team needs to be addressing with her. Examine your live discharge data, Policies and Procedures, communication practices with the patient and family about recertifications, Incident Reports from upset caregivers/families, and CAHPS Hospice scores.

Hospice of the Ozarks: 2026 Pet Peace of Mind Calendar  KTLO.com, Mountain Home, AR; by Hospice of the Ozarks; 7/16/25 Hospice of the Ozarks is excited to continue our Pet Peace of Mind Pet Calendar. This tradition of an annual pet calendar continues to support the Hospice of the Ozarks Pet Peace of Mind Program. From July 10th to July 24th pet lovers will have the opportunity to upload a digital photo of their beloved companion to enter the contest for the 2026 wall calendar. Voting will be held between August 1st to August 15th. ... All funds raised will help support our Pet Peace of Mind Program. The Pet Peace of Mind’s mission is to enrich the quality of life and well-being of hospice patients and their families by caring for the pets they love.Editor's Note: What a creative, fun way to raise funds to support this extra program! Pet Peace of Mind is a registered trademark for Pet Peace of Mind, Inc. "the only national program providing a care model for the pets of seriously ill patients, including helping orphaned pets find a loving new home when necessary." Click here for its locations in 43 states (plus Washington DC) and the over 250 organizations they serve.

The grave outlook for hospice family caregivers Hospice News; by Holly Vossel; 7/10/25 The state of family caregiving in the United States has reached a critical tipping point amid rising demand for end-of-life care and insufficient resources. Many family caregivers are ill-equipped to navigate the complexities of supporting a loved one with a terminal illness, according to Dr. Arul Thangavel, CEO of the advance care planning company WiserCare. Thangavel is also an attending physician at the University of California, San Francisco (UCSF). Among the issues is that conversations about the end of life and goals of care are often brought up far too late in a disease trajectory, Thangavel said. This trend leaves families grappling with uncertainty, moral distress, guilt and compounded grief in the decision-making process, he stated. 

Avera Medical Minute: Family shares their experience with hospice care Dakota News Now, Sioux Falls, SD; by Dakota News Now staff; 6/30/25 Hospice care is more than just medical support. At the Dougherty Hospice House, it can be considered a home away from home, where staff aim to offer patients and their families the assistance and comfort they need during this difficult time. In this Avera Medical Minute, one Sioux Falls family shares how, thanks to the hospice team, they were able to focus on spending time with their loved one. Craig Lloyd was known as a development leader in the Sioux Falls community, building homes and more throughout the city. “He had a big heart, so he just kept trying to improve things, his thought was always ‘God put me on this Earth to make it better,’” said Craig’s wife, Pat Lloyd. ... Craig was also in Florida at the time when he needed hospice care and Pat credits the work of Avera and the hospice team in making a smooth transition for Craig from there to home in Sioux Falls and then to Dougherty Hospice House.

[Bogota, Columbia] Anxiety, depression, and quality of life of caregivers of palliative care patients with cancerRevista Cuidarte; by Alejandra María Alvarado García, Lina María Vargas-Escobar, Mauricio Arias-Rojas, Carlos Javier Avendaño-Vásquez, Cesar Antonio Consuegra-Pareja; 2/25Caregivers with moderate or severe depression were more likely to report symptoms of sadness, punishment feelings, self-dislike, suicidal thoughts or wishes, indecisiveness, irritability, changes in appetite, concentration difficulty, and tiredness or fatigue. Among caregivers with mild depression, loss of interest in sex, agitation, and past failure were identified. Strategies for psycho-emotional counseling, education, and support for caregivers are needed.

When the caregiver is gone: The hidden crisis in aging servicesMcKnight's Senior Living; by Derek Dunham; 6/23/25Families need to think beyond a single caregiver. A network of support — whether made up of family, friends, professional caregivers or senior living communities — is essential. Here’s what that looks like in practice:

Short notice, long love: A hospice wedding full of heart Citrus County Chronicle, Inverness, FL; by Mike Arnold; 6/16/25 Brendan Malone and Vanessa Rodriguez made a snap decision that would change their lives – and touch the hearts of everyone around them. The couple were driving up from Estero in the early afternoon of June 5 to visit Malone’s father, Michael “Big Mike” Malone, who had recently moved into Citrus Health and Rehab in Inverness and was also receiving care from Vitas Hospice. [Already engaged,] ... they made the decision to get married the next morning, at Citrus Health and Rehab. There were no tuxedo fittings, no cake tastings, no invitations sent. There was no time. There were flowers, guests, toasts, bubbles – and love. And “Big Mike” had a front row seat. Brendan Malone didn’t want to get married without the man who had been his biggest supporter by his side. ... What followed was a whirlwind of compassion, planning, and action from the staff at the nursing facility and the local hospice team. Within hours, they coordinated decorations, arranged courtyard seating, and made sure Michael could be present in his wheelchair for the ceremony.

Families demand end to Medicare waiting period for early-onset Alzheimer’s patients Washington Examiner; by Elaine Mallon; 6/15/25 Jason Raubach was diagnosed at 50 years old with early-onset Alzheimer’s disease — a diagnosis that affects nearly 200,000 Americans. He received the diagnosis in 2018, completely upending life for his family. His youngest child was just a freshman in high school. ... Shortly before receiving an official diagnosis, Jason Raubach lost his job, having to move his family onto a consolidated omnibus budget reconciliation act health plan, or COBRA plan, which allows a person to keep their health insurance even after losing their job. “It wasn’t cheap,” Elizabeth Raubach said.However, once diagnosed, Jason Raubach had to wait two and a half years before he could receive coverage under Medicare, health insurance for those 65 years and older or those with qualifying disabilities. But Elizabeth Raubach, along with dozens of other caretakers for people diagnosed with Alzheimer’s, called on Congress in a letter to eliminate the 29-month waiting period required for those under the age of 65 to receive coverage under Medicare. ...

Nurse practitioners step in as geriatrician ranks shrink The Washington Post; by Jariel Arvin; 6/15/25 On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient’s home to the next, seeing eight people in all. Pregnant with her second child, she schleps a backpack instead of a traditional black bag to carry a laptop and essential medical supplies ... “Our patient isn’t just the older adult,” Johnson said. “It’s also often the family member or the person helping to manage them.” Johnson isn’t alone. Today, nurse practitioners are increasingly filling a gap that is expected to widen as the senior population explodes and the number of geriatricians declines. The Health Resources and Services Administration projects a 50 percent increas in demand for geriatricians from 2018 to 2030, when the entire baby boom generation will be older than 65. ...