Literature Review

Compassionate care, measurable impact: Evaluation of embedded physician-led palliative care in a community oncology practiceJCO Oncology Practice; by Haibei Liu, Jillian Hellmann, Jessica Heintz, Geoffrey Daniel Moorer, Karen Miller; 10/25This analysis indicates that embedding palliative care physicians within a community oncology practice significantly increases hospice enrollment and LOS [length of stay] greater than 3 days. These findings support a cooperative care model as a practical strategy for integrating palliative care physicians into community-based oncology practices to improve patients’ EOL outcomes. 

Love, loss and last wishes fulfilled at Duke HomeCare & Hospice: Staff members regularly make miracles happen Duke Today, Durham, NC; by Working@Duke; 10/29/25 The bell chimed three times at Hock Family Pavilion, and everyone knew what it meant. Duke HomeCare & Hospice nurses and workers stepped into the hallway of Duke’s 12-person inpatient hospice facility, solemnly waiting in silence. Anthony Wilkie, a Duke Clinical Nurse, had been bracing himself for the moment with a mixture of sorrow and humility. When a bell rings three times at Hock Family Pavilion, a patient has just died and a ritual is about to begin. ...

Updated opioid prescribing guidelines: Implications for nurse practitioners The Nurse Practitioner / Lippincott; by Rhond Winegar, PhD, DNP, APRN, FNP-BC, CCRN, CPN; Tara Martin, MSN, RN, CPN; Zhaoli Liu, PhD, FNP-C, CPPS; November 2025 issue. The opioid epidemic remains a significant public health challenge in the United States. Nurse practitioners (NPs) play a crucial role in addressing this crisis. This article discusses the implications for NPs of the Centers for Disease Control and Prevention 2022 updated clinical practice guideline on opioid prescribing, focusing on four key areas: 1) deciding whether to initiate opioids, 2) determining appropriate opioids and dosages, 3) determining treatment duration and follow-up, and 4) implementing risk assessment and mitigation strategies. Adhering to this guideline enables NPs to optimize opioid prescribing practices and deliver patient-centered care that aligns with public health priorities to combat the opioid crisis.

Post-biographical dignity in the age of artificial intelligence: Narrative, ePROMs and ethical challenges in end-of-life care Palliative & Supportive Care; by Abel García Abejas, David Geraldes Santos, Helder Mota-Filipe, Àngels Salvador Vergés; 10/27/25 Significance of results: End-of-life care in the age of AI must move beyond autonomy-focused ethics to encompass the narrative, relational, and posthumous dimensions of dignity. A critical, philosophically informed ethics is essential to prevent depersonalisation in digitally mediated care.

How to manage financial caregiving for an aging parent AOL.com; by Kerry Hannon; 10/25/25Steering end-of-life financial decisions for an aging parent is not a job many of us would choose. But we do — and feel our way through the messy emotions as best we can. ...[From an interview:] "[Your mom] was rejected for hospice care, which is covered by Medicare. Can you elaborate on that?""That was just such a slap in the face because it's a hard decision to go to hospice. ... My mom made that decision for herself, but my brother, the doctors, and me had to be on board with it in order for her to do it. The only reason they rejected her is because they thought she would be too costly. They do a cost-benefit analysis of how long that person is going to last— how much [in] resources is she going to consume? They decided that her diagnosis was too murky to justify putting her on hospice at that point. I finally found another hospice company to accept her. And she died in two weeks."

Pumping irony: When the hospice is inhospitable Experience Life; by Craig Cox; 10/22/25 ... University of Michigan researchers, reviewing the health records of some 139,000 hospice patients diagnosed with dementia, found that nearly half of them were given benzodiazepines, a class of drugs designed to relieve agitation and anxiety. ... The results, in many cases, were deadly. ... “For patients who are not actively dying, patients and families may prioritize preserving cognition, communication, and function — goals that may be compromised by sedating medications,” she writes. “This further underscores the need for dementia-specific hospice interventions to help offer scalable, nonpharmacologic approaches, to equip hospice clinicians with effective alternatives.”

Hospice social worker and nurse perceptions of the usability of a hospice live discharge protocol (LDP)American Journal of Hospice & Palliative Medicine; by Stephanie P. Wladkowski, Susan Enguídanos, Tracy A. Schroepfer; 9/25Live discharges from hospice are often distressing for patients, caregivers, and hospice providers alike, disrupting care continuity and leading to emotional and logistical challenges. Despite Medicare’s discharge planning requirement, no standardized process currently exists for hospice-initiated discharges, resulting in variable quality of care transitions.  An explicit Live Discharge Protocol has strong potential to enhance the quality and consistency of a live discharge from hospice care. The LDP provides a framework to help smooth the transition from hospice care and provides patients and families with post-discharge support. Feedback from hospice professionals affirmed the relevance and usability of each step within the LDP, while also identifying opportunities for refinement for future implementation.

Teaching end-of-life care: Q&A with professor of medicine Medical Xpress; by Mahima Samraik, Yale University, edited by Sadie Harley; 10/20/25 Every year, thousands of families sit in hospital rooms hearing words no one wants to hear: "We have done everything we can." What happens next, whether doctors stay engaged or step away, can transform one of life's most difficult moments for patients and their families. Unfortunately, for too many patients, the shift from curative care to end-of-life care leaves them feeling stranded. ... "But it doesn't have to be this way," says Matthew Ellman, MD, professor of medicine (general medicine) at Yale School of Medicine (YSM) and director of Medical Student Palliative and End-of-Life Care Education. Ellman has spent decades at patients' bedsides and now teaches medical students about death and dying. In his recent essay in Academic Medicine, he draws from his personal experiences as a physician and encourages fellow doctors to embrace difficult conversations around end-of-life care.

[England] Ambulance team uses advanced ultrasound to help frail patients avoid hospital trips Emergency Services Times; by James Devonshire; 10/16/25 The East of England Ambulance Service (EEAST) is using cutting-edge medical technology to help elderly and end-of-life care patients receive treatment in their own homes, reducing the need for hospital admissions. The service’s advanced practice (urgent care) team has introduced point of care ultrasound (POCUS)—a portable diagnostic tool previously reserved for critically ill patients—to assess bladder and urinary conditions safely and effectively in community settings. Using the handheld Butterfly ultrasound device, paramedics can perform scans and interpret results via software on iPads, allowing for faster and more accurate diagnoses.

Study examines biological causes of cancer deaths: Tumors invading large blood vessels may be to blame, UTSW researchers say UT Southwestern Medical Center, Dallas, TX; by Newsroom; 10/16/25 The ultimate cause of death from cancer may not be metastatic disease, as researchers have long surmised, but an infiltration of tumors into major blood vessels that cause blood clots and multiorgan failure, a one-of-a-kind clinical study led by UT Southwestern Medical Center suggests. These findings, published in Nature Medicine, could spur interventions that extend the lives of patients with advanced cancers. 

Stories from an accidental Hospice Nurse by Shawn Brast, MSN, RN, CHPN ehospice; by Shawn Brast, Clinical Education Manager at Gilchrist Hospice in Baltimore; 10/9/25 ...  The strangest thing happened: after 30+ years in healthcare, I found my calling as a hospice nurse. Routinely, I am granted special access to some of the most intimate moments in patients’ and families’ lives. With my short experience as a hospice nurse, I have come across some awe-inspiring moments that have provided life lessons that must be shared for the greater good. ... [Shawn describes several hospice stories with his insights.] These types of “Aha!” moments continued since these three experiences, but it was these three experiences that set my direction to answer my calling. In doing so, I am becoming a better person, clinician, educator, researcher, student, husband and father.

AdventHealth saves $47.5M with redesigned nurse career ladderBecker's Clinical Leadership; by Mariah Taylor; 10/9/25 AdventHealth’s redesigned career ladder has prevented the departure of more than 700 nurses and saved the system an estimated $47.5 million in 2024. The Professional Excellence Program launched in 2022 to keep nurses at the bedside and counter the notion that they had to migrate into leadership, quality or safety roles to progress in their career. “Historically, to advance, nurses often felt they had to step away from the bedside because those roles didn’t fully recognize the specialized competencies they bring,” Trish Celano, RN, system chief nurse executive for the Altamonte Springs, Fla.-based system, told Becker’s. “The clinical ladder changes that.” 

Common hospice medications linked to higher risk of death in people with dementia EurkAlerts! American Association for the Advancement of Science (AAAS); by Michigan Medicine - University of Medicine; 10/14/25 ... [For] the growing number of Americans with dementia who enter hospice, their course is often long and unpredictable — making it especially important to ensure treatments align with each person’s goals and stage of illness. A new University of Michigan study published in JAMA Network Open finds that medications commonly prescribed to ease symptoms such as agitation, anxiety, and delirium — benzodiazepines and antipsychotics — may carry major unintended risks for people with dementia receiving hospice care. Among more than 139,000 nursing home residents with Alzheimer’s disease and related dementias enrolled in hospice between 2014 and 2018, those who began taking a benzodiazepine or an antipsychotic after enrollment were 41% and 16% more likely to die within six months, respectively, than very similar hospice patients with dementia who did not receive these medications.