Literature Review

Dying at home becomes more common for patients with history of ischemic stroke NeurologyToday; by Susan Fitzgerald; 5/15/25 In contrast to earlier studies showing a decline in stroke prevalence and mortality, a new study found that the rates are going up and more people, particularly Black Americans, are either dying at home or arriving to the hospital dead on arrival. Experts speculate that the trend may be driven by the lack of access to hospice services and care, in general.

Palliative and end-of-life care during critical cardiovascular illness: A scientific statement from the American Heart Association American Heart Association; by Erin A. Bohula, MD, DPhil, Michael J. Landzberg, MD, Venu Menon, MD, FAHA, Carlos L. Alviar, MD, Gregory W. Barsness, MD, FAHA, Daniela R. Crousillat, MD, Nelia Jain, MD, MA, Robert Page II, PharmD, MSPH, FAHA, Rachel Wells, PhD, MSN, and Abdulla A. Damluji, MD, PhD, MBA, FAHA on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing; 5/15/25 Abstract: Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

How grief transformed a psychiatrist’s approach to patient care MedPageToday's KevinMD.com [reposted in AAHPM's newsletter]; by Devina Maya Wadhawa, MD; 5/12/25It is a routine Saturday morning—I am sitting in my office, looking at the snowflakes dropping outside my window. As I sip on my cup of Earl Grey tea preparing my psyche for a busy day of managing an on-call shift on an acute care psychiatry floor, I am suddenly washed over by grief. A very similar Saturday a year ago, I was saying goodbye to my father as he was being taken off life support in the intensive care unit after suffering a massive posterior myocardial infarction and ending up with a cardiac arrest at the very young age of 62. The year has been nothing short of trying, a year of firsts. ...

In the wake of HICPAC: How APIC is leading the fight to preserve national infection prevention standards Infection Control Today, Branbury, NJ; by Tori Whitacre Martonicz; 5/13/25 The Trump administration has disbanded a federal advisory committee that guided efforts to prevent the spread of infections in health care facilities. The Healthcare Infection Control Practices Advisory Committee (HICPAC) established national standards for hand hygiene, mask-wearing, and isolating patients with infectious diseases that most US hospitals adhere to.Infection Control Today® (ICT®) spoke with Connie Steed, MSN, RN, CIC, FAPIC, an infection prevention consultant and former president of the Association for Professionals in Infection Control and Epidemiology (APIC), about HICPAC's disbanding and its implications for national standards in infection control.

Team work makes the dream work for hospice veteran Veterans Administration, VA.gov; by Douglas A. Etter; 5/12/25 When Marine Corps Veteran Ivson Shelley came to the Lebanon VA Medical Center for a follow-up visit with his oncologist, Suhail Ali, MD, the staff was concerned about how much the former New York resident had declined since his last appointment. They didn’t think he could be cared for at home any longer, so a decision was made with the family to admit him to the medical center’s hospice unit Thursday afternoon. Once there, the Marine shared a heartfelt wish with the staff – he wanted to marry his lifelong love, Wanda Rivera. The couple had dated more than 50 years ago and rekindled their relationship 10 years ago. Upon hearing the Vietnam Veteran’s wish, the VA team, lead by Hospice Nurse Manager Jessica Himes, RN and Hospice Social Worker, Erin Miller, MSW, LCSW quickly came together to make it happen. Palliative care nurse Melissa Buchinski, RN began to research what the requirements were to secure a marriage license for the couple. ... [Continue reading this inspirational story.]

A daughter’s cautionary elder care tale The Progressive Magazine - Book Review; by Bill Lueders; 5/12/25 The call that woke Judy Karofsky in the middle of the night on May 18, 2015, was from a hospice nurse, who got right to the point: “I’m calling to tell you that your mother has died.” Karofsky, deeply shaken by the unexpected news, managed to ask, “Did she struggle?” Karofsky’s important new book, DisElderly Conduct: The Flawed Business of Assisted Living and Hospice, does not mention the hospice nurse’s response to this question. But it does note that she called back a moment later to say: “I’m so sorry . . . . I called the wrong number. I’m at a different facility and I had the wrong file.” Karofsky’s mother, Lillian Deutsch, had not died at all. It was someone else’s mother. Apologies were made. This is just one of many stories Karofsky shares throughout the book about the final years of her mother’s life in Wisconsin. This particular anecdote strikes me as noteworthy not just as an example of the sort of awful things that can happen when facilities are understaffed and staff members are overworked, but also because Karofsky’s first reaction was to wonder whether she struggled.Editor's note: Though printed news typically lifts up the good, compassionate moments of hospice care, most all of us have experienced negative accounts--professionally and/or personally. While this book is sure to give significant insights, perhaps the most important lessons are waiting to be validated from your own family caregivers, employees, and volunteers. What stories are behind your lower-than-you-want CAHPS Hospice scores? Dig deeper. May we all listen, learn, and improve care.

Illinois plan calls for annual report on hospice, palliative care for prisoners WAND TV News, Springfield, IL; by Mike Miletich; 5/8/25 The Illinois House Restorative Justice & Public Safety Committee passed a bill Thursday [5/8] to require the Illinois Department of Corrections report data on hospice care available for prisoners. Over 1,000 Illinois prisoners are 65 or older, and a growing number of those people are in need of end-of-life care and support services. The Department of Corrections does not have a formal hospice program, as end-of-life care is provided on a prison-by-prison basis. Although, sponsors and advocates said this has led to inconsistent care for prisoners diagnosed with terminal illnesses or who are expected to reach the end of their life.

It's time to talk about LGBTQ+ elder care Psychology Today - Caregiving; by Stephanie Sarazin, M.P.P.; 5/6/25 A once-hidden story is helping us think about queer kinship and caregiving. Key points:

How to survive Mother’s Day when your mom is gone Psychology Today - Dementia; by Deborah Carr, PhD; 5/8/25 ... By age 50, about half of us have mourned the death of our mother. More than 4 million older women in the U.S. have dementia, and most have children who are witnessing their cognitive declines. Whether your mother has died or slipped into the grip of late-stage dementia, Mother's Day can be hard, although the sharp pangs of sadness tend to fade with time after a mom's death. So, how do you survive Mother’s Day when your mom isn't here to celebrate with you?

HOSPICE: Daughter embraces mom’s hospice journey  City Sun Times, Phoenix, AZ; by Lin Sue Flood; 3/25/25  As a nurse, Robin Benton is used to caring for people who are ill. But it’s different when your mother is the one who is sick. Her mom, Charlotte Brewer, a former nurse herself, has multiple myeloma, a rare type of blood cancer. In March 2024, the 80-year-old Valley resident decided to stop curative treatments in favor of comfort care with Hospice of the Valley, where she worked for over 10 years, before retiring in 2007. ... Charlotte’s Hospice of the Valley nurse, Kelly Langston, admires the way the family is living this stage of life with great intention, creating new ways to deepen their love for each other. “They came up with an idea for a hug shirt,” shared Kelly. “Everyone in the family painted their arms then took turns hugging each other — stamping an imprint of encircled arms on the shirts. It’s a way to feel each other’s hugs even when they aren’t together.” [View this creative shirt.]

CAREGIVING: For 27 years, I had minimal contact with my abusive mother. Then she moved in with me. HuffPost; by Carole Brodsky; 1/20/25  ... Living with my mom was the last thing I ever thought I’d be doing as an adult. Perhaps I accepted her back into my life because there were no other options available. Perhaps it was because I was the daughter of someone who in today’s vernacular would be called a “tiger mom,” and I’d been taught caring for an aging parent was what “good daughters” did.  ... As a child, my mother was abusive.  ... [Now, as] Mom’s verbal skills declined, we had to use our eyes, guts and hearts to discern the needs of a person whose tether to this world was fraying before our eyes. ... My partner has a saying: I always forgive, but I never forget. I have unequivocally forgiven my mother for everything. I have tried, with varying degrees of success, to let the vestiges of her abuse die with her and not invade the lives of my children, grandchildren and now, great-grandchildren. The work on forgiving myself will continue for the rest of my life.

When they don’t recognize you anymore: Dementia study looks at loved ones’ responses Penn Live - Nation & World News; by Paula Span, KFF Health News; 5/4/25 It happened more than a decade ago, but the moment remains with her. Sara Stewart was talking at the dining room table with her mother, Barbara Cole, 86 at the time, in Bar Harbor, Maine. Stewart, then 59, a lawyer, was making one of her extended visits from out of state. ... “She said to me: ‘Now, where is it we know each other from? Was it from school?’” her daughter and firstborn recalled. “I felt like I’d been kicked.” Stewart remembers thinking, “In the natural course of things, you were supposed to die before me. But you were never supposed to forget who I am.” Later, alone, she wept.

‘I want to pat dogs until I die’: End-of-life planning should be more than just Living Wills Healthy Debate; by Kathy Kastner; 5/4/25 France Légaré, Canada Research Chair in Shared Decision-Making and Knowledge Mobilization, wants to have stimulating conversations and be able to move around with her dog until she dies. Daneil Martin, the Chair of the Department of Family and Community Medicine at Women’s College Hospital, wants to “smell chocolate until I die.” The two doctors are among the 200+ who took the time to fill in the blank on a whiteboard, “I WANT TO__ UNTIL I DIE,” an initiative I undertook after tuning in to a hospice and palliative care medicine Twitter chat in the good old days of Twitter. As a layperson who became an entrepreneur in the health space, I was intrigued by the lament of health-care professionals on the chat: If only people talked about end-of-life wishes more, much grief could be avoided.