Literature Review

Doctors’ own end-of-life choices defy common medical practice Medscape; by Cristina Ferrario; 7/29/25 A new survey revealed that most doctors would decline aggressive treatments, such as cardiopulmonary resuscitation (CPR), ventilation, or tube feeding for themselves if faced with advanced cancer or Alzheimer’s disease, choosing instead symptom relief and, in many cases, assisted dying. ... The researchers conducted a cross-sectional survey of 1157 physicians, including general practitioners, palliative care specialists, and other clinicians from Belgium, Italy, Canada, the US, and Australia. ... Over 90% preferred symptom-relief medication, and more than 95% declined CPR, mechanical ventilation, or tube feeding. Only 0.5% would choose CPR for cancer and 0.2% for Alzheimer’s disease. Around 50%-54% supported euthanasia in both cases.

Language, culture, and trust: Addressing gaps in palliative care for Hispanic patientsCAPC blog; by Rayna Ross, Brittany Chambers; 7/23/25CAPC recently released The Health Care Experience of Hispanic Patients with Serious Illness: A Literature Review. While the review outlines the challenges Hispanic patients face, we’ve also been working behind the scenes to identify ways to improve access to palliative care for this population. This new blog features insights from four community leaders who care for and represent Hispanic patients. They offer actionable recommendations for health care organizations, palliative care teams, and clinicians striving to drive meaningful change and ensure equitable access to high-quality care.

Nidal Rahal, MD: A quiet force in geriatric and hospice care CEOWorld Magazine; by Anna Papdopoulos; 7/27/25 In a time when healthcare is growing more complex, Dr. Nidal Rahal is staying focused on what matters: his patients. From private hospital rooms to long-term care units, he’s been quietly building a career defined by service, leadership, and long hours. Based in Germantown, Tennessee, Dr. Rahal now runs his own practice—Geriatrics and Palliative Care PLLC ... “I’ve always believed in showing up where I’m most needed,” he says. “For me, that’s meant working with the elderly, with families, and with people facing end-of-life decisions.” ... His practice is now a central hub for hospitalized patient follow-up, inpatient rehab, and palliative consults. He remains active at St. Francis Bartlett, where he’s part of the Medical Executive Committee and serves as an admitting rehab physician. Despite the move, Dr. Rahal still works closely with Hope Hospice and Unity Hospice, continuing a leadership role that spans over a decade.

Prairie Doc Perspective: Navigating spiritual pain and grief Rawlins Times - Prairie Doc Perspective, Rawlins, WY; by Rev. Kari Sansgaard, Avera Hospice; 7/23/25 After nearly 20 years of parish ministry, I entered the world of health care, which, I learned, abounds in acronyms. My first clue was in chaplaincy training, known as CPE (Clinical Pastoral Education), the required education for most hospital and hospice chaplains. CNA, SoB (Shortness of Breath), PRN, HoH (Hard of Hearing), and a myriad of other acronyms are now part of my own vernacular. QoL (Quality of Life) is the big one in hospice, sometimes called “comfort care.” When quantity of life becomes diminished, it’s all about quality. ... In hospice, when death is impending, spiritual pain can lead us to ponder existential questions, such as the following:

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. 

Changing funeral preferences: NFDA’s first-of-its-kind generational report now available National Funeral Directors Association (NFDA), Brookfield, WI; Press Release; 4/2/25 The National Funeral Directors Association (NFDA), the world’s leading and largest funeral service association, has released an unprecedented study examining consumer attitudes toward funeral service across generations. Available to funeral service professionals for download at no charge, Changing Consumer Preferences: A Generational Perspective on Attitudes Toward Funeral Service provides critical insights to help funeral service professionals adapt to evolving expectations and continue delivering meaningful memorial experiences. ... Key findings include:

Charlie’s Angels Quilting Group donates 2,000th quilt to hospice MIdland Daily News, Midland, MI; by Jhyrah DeLapp; 7/17/25 Charlie’s Angels Quilting Group has donated its 2,000th handmade quilt to United Hospice Service of Aspire Rural Health System. Since 2007, every quilt made by the group has been uniquely designed, featuring a wide variety of colors, patterns and textures. Each quilt bears a thoughtful label that reads: “May this blanket bring you peace and comfort.” ... The group is made up of dedicated men and women from Huron, Sanilac and Tuscola counties. It was founded 18 years ago by Brenda Miller of Bad Axe in memory of her brother, Charlie Kiehl, who received care at the Hospice Residence in Marlette. After Charlie’s passing in 2007, Brenda and her family were deeply touched to receive a handmade quilt from the hospice team. Inspired by that act of kindness, she began gathering friends and family to create quilts for future patients, launching what would become Charlie’s Angels Quilting Group.

Video palliative care improves symptoms but not outcomes in rural hospitals, study reveals McKnights Long-Term Care News; by Donna Shryer; 7/15/25 Researchers from the University of Alabama at Birmingham recently studied whether video consultations could improve palliative care for patients age 55 and older in small hospitals lacking specialized end-of-life services. Participants had an average age of 73. The study, published in JAMA Network Open, found that culturally tailored video consultations — designed with community input to reflect patients’ cultural values and communication preferences — led to a clinically meaningful but not statistically significant reduction in symptom distress. ... [The] video consultations had little effect on hospital readmissions or emergency department visits. The research addressed a critical healthcare gap, as the study notes that only 70% of the Deep South has access to palliative care services, compared to 85-94% in other US regions. This disparity particularly affects rural communities where specialized end-of-life care is often unavailable. 

Alphabet soup: replacing BMI with BRI The Courier, Findlay, OH; by Aidan Hester and Karen Kier; 7/12/25 ... A recent change in how we measure obesity involves a new acronym. Most medical professionals use body mass index (BMI) to assess weight and obesity. ... BMI considers a patient’s weight and height but does not account for fat distribution. It does not take into consideration a person’s muscle mass or different types of fat throughout the body. ... A recent study published by JAMA Open Network used a patient’s BRI to measure potential mortality. ... Patients in the Q1 group were considered underweight and Q4 and Q5 were evaluated as overweight. Patients in the Q1, Q4, and Q5 groups were found to have an increased risk of death. So, both being underweight and overweight were risk factors for death. Those in Q5 were 50% more likely to pass away, while Q1 and Q4 were 25% more likely when compared to Q2 and Q3.

CDC reports rise in unintentional fall deaths among older adults JAMA; by Samantha Anderer; 7/11/25 The US Centers for Disease Control and Prevention (CDC) reported that deaths from unintentional falls among adults aged 65 years or older increased over the past 2 decades. Falls are currently the leading cause of injury for older adults, reaching 70 per 100 000 in 2023. As age increases, so does the likelihood of death due to a fall. And data from the National Vital Statistics System indicate that from 2003 to 2023, adults aged 85 years or older experienced the greatest increase in fall deaths. Rates for men, who are more likely to die from an unintentional fall, doubled from 178 to 373 per 100 000 people among those 85 years or older. For women in the same age group, deaths from falls increased 2.5 times, from 129 to 320 per 100 000. 

Health equity starts at home: Renewing the heart of nursing  Minority Nurse; by Michelle Cortez Adams; 7/10/25 ... I started my nursing career in the ICU, told (as many of us are) that hospital experience was a must. And while the work was meaningful, it wasn’t fulfilling. My patients were often unconscious. My goal was to stabilize and transfer them. I never got to know their stories, their families, or whether they ever found healing beyond discharge. That changed when I moved into home hospice and then home health care. This shift taught me that home nursing is not only a career path—it’s a calling. I saw the impact of my work every day. I helped clients reach personal goals, not just clinical benchmarks. I was welcomed into their lives by name. I wasn’t just preserving life—I was restoring it. Home health care reminded me why I became a nurse in the first place: to form real connections, to bring comfort and dignity, and to care for the whole person—body, mind, and spirit.

Study: New method successfully measures whether seriously ill patients receive care matching their wishesMcKnight's Long-Term Care News; by Donna Shryer; 7/8/25A study has developed a reliable way to measure whether seriously ill hospitalized patients receive medical care that aligns with their personal goals. The research, involving 109 seriously ill patients with a median age of 70, found that using electronic clinical notes to measure goal-concordant care is feasible. The study identified variation in whether treatment matched patients’ stated goals. Researchers found that only half of all treatment phases were goal-concordant — with medical treatment matching patients’ documented preferences. Nearly one in five phases was goal-discordant, where treatment contradicted stated wishes, while roughly one-third remained uncertain due to unclear or missing goal discussions.