Literature Review

End-of-life care in the austere military environmentMilitary Medicine; by Jason David, Stevan Fairburn, Hayden Fogle, Nicholas Dulin, Russell Day; 9/25Throughout the Global War on Terror (GWOT), the U.S. military built a revolutionary capacity to deliver life-saving care-even in austere environments-through rapid evacuation, far-forward providers and resources, and advances in prehospital and trauma-critical care. However, the operational reality of future Large Scale Combat Operations (LSCO), as evidenced by wars in Ukraine, Sudan, and Gaza, will be marked by high casualty rates and limited medical resources. [This review] ... explores how medical providers must shift from curative to comfort-focused care, often without formal palliative training, and how end-of-life care protocols must be integrated into doctrine, triage systems, and commander education. We offer pragmatic guidance on clinical decision-making, communication strategies with both medical and non-medical leaders, and the delivery of pain relief, emotional support, and dignity at the end of life-even in forward-deployed, under-resourced settings.

LGBTQ+ history project: The need to preserve LGBTQ+ histories of rural America Watermark Out News; by Lauren Rowello; 10/14/25 ... Resources importantly emerged as people formally organized — bringing critical health care and hospice networks during the HIV/AIDS crisis, for instance, and launching LGBTQ+ voices into expansive advocacy careers. Across the US, some of the most impactful voices for change have come from rural regions. ... Editor's Note: For more on this interface with the birth of hospice care in the US, examine "The AIDS Epidemic’s Lasting Impact on Hospice Care for LGBTQ+ Populations," by Holly Vossel, Hospice News, 6/28/24. Pair these with today's post, "Inside the hospice that feels like home: How Omega House catches those who fall through the cracks." 

Bridging gaps in palliative care for undocumented immigrants using the social determinants of health frameworkAmerican Journal of Hospice and Palliative Medicine; by Lisa Cross, Rachael Salguero; 9/25Systemic policies and inequities, rather than immigration status itself, create barriers to health. In the United States, an estimated 11 million individuals live without legal authorization, a population that faces profound challenges in accessing equitable care. These barriers pose particular difficulties for palliative care nurses in recognizing and addressing the needs of undocumented immigrants. Identifying nursing interventions in this manner aligns with the overarching goals of the American Nurses Association and reflects the principles of ethical compassionate palliative nursing.

Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 years of improving quality for older veteransINQUIRY: The Journal of Health Care Organization, Provision, and Financing; by Andrea Wershof Schwartz, Shivani K. Jindal, Kimberly A. Wozneak, Robert E. Burke; 9/25The Age-Friendly Health Systems initiative (AFHS) was developed to spread principles of high-quality care for older adults using the 4Ms Framework: What Matters, Medications, Mentation and Mobility. In 2020, the Veterans Health Affairs (VA) set a goal to become an AFHS, given nearly half of Veterans are over aged 65. In conclusion, this paper demonstrates that the first 5 years of Age-Friendly Health Systems initiative within the VA have resulted in significant spread of the 4Ms, reaching hundreds of teams and thousands of Veterans over a broad geographic area and multiple care settings. However, much work remains to continue to spread and study AFHS within the VA, an urgent priority given the aging Veteran population who deserve person-centered care focused on what matters to them. The early results of AFHS implementation in the VA offer a promising model for implementing Age-Friendly care within a large health care system.

How personalized medicine empowers patients and cuts healthcare costs Becker's Hospital Review; by Mary Sirois; 10/1/25 ... How do we unlock a new era of healthcare excellence? The answer lies in a fundamental shift: personalized care delivered within a truly patient-centered framework that improves satisfaction for patients and clinicians while enabling better clinical, operational, and financial outcomes across the healthcare ecosystem. ... Imagine a healthcare system where:

What makes a good death? GeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith with Karen Steinhauser, Rasa Mikelyte and Edison Vidal; 9/18/25What is a “good death”? How should we define it, and who gets to decide? Is the concept of a “good death” even useful? ... In today’s podcast, we are honored to have Karen join us to discuss this pivotal study and the nature of a “good death”. We are also joined by Rasa Mikelyte and Edison Vidal, co-authors of a recent study comparing the perspectives of people with dementia in the UK and Brazil on what constitutes a good death. In addition to exploring the nature of a good death and their individual studies, we will discuss:

Developing competencies to advance health care access and quality for Latino, Hispanic, and Spanish origin populations-A consensus statementJAMA Network Open; by Débora H. Silva, John A. Davis Rodríguez, Hector Rasgado-Flores, Pilar Ortega, Deion Ellis, Fernando Sánchez Mendoza, Victor Cueto, Fabiola Quintero-Rivera, Norma Iris Poll-Hunter, Minerva Romero Arenas, Kenneth Lee Dominguez, Juan Emilio Carrillo, José E. Rodríguez, John Paul Sánchez; 8/25Question: What competencies and milestones are essential for advancing health equity for Latina, Latino, Latinx, Latine, Hispanic, and Spanish Origin (LHS+) populations? Since the 1970s, the LHS+ population has increased 6-fold and grown to be the largest ethnic or racial group in the US and accounts for approximately 20% of the US population. The LHS+ health equity competencies and milestones resulting from this study add to prior work by creating a blueprint for standardization and broader application of such educational experiences on a national level. As a tool to enhance CBME [competency-based medical education ] efforts aligned with care for LHS+ populations, the competencies may aid educators and institutions through an LHS+–informed lens in conducting gap analyses for the development of local curricula, developing teaching and assessment materials, supporting the professional development of learners and faculty, and facilitating educational scholarship. 

Serious illness and end of life in LGBTQIA+ older adultsDelaware Journal of Public Health; by Sarah Matthews; 7/25Gender-affirming care is just as important during serious illness and end of life. Typically, gender-affirming hormone therapy is maintained throughout life to provide masculinizing or feminizing effects as desired. At end-of-life, it may be the person’s wish to continue hormones even if the medication poses additional risk. Whenever possible, gender expression preferences of LGBTQIA+ elders should be honored. TRANSforming Choices Healthcare Decisions Starter Guide is an excellent resource for transgender, gender-diverse, and gender-expansive people to make choices about their healthcare including gender-affirming care. Funeral directives are available to ensure that LGBTQIA+ elders’ funeral wishes are followed, including name, pronouns, and presentation of the body.

The Faith Care Family Project: A pilot intervention for African American dementia family caregiversAmerican Journal of Alzheimer's Disease and Other Dementias; Noelle L Fields, Ling Xu, Ishan C Williams, Fayron Epps, Samantha Tinker; 8/25The Faith Care Family (FCF) Project was a telephone based, volunteer-led intervention for African American Alzheimer’s disease and related dementias (AD/ADRD) family caregivers that was piloted in one predominantly African American church. Church volunteers indicated overall significant improvements knowledge of AD/ADRD after the training as well as after the intervention. Quantitative results indicated that caregivers increased their knowledge of dementia, reported improved coping skills, and reported increased positive aspects of caregiving. Feeling a connection, normalizing the challenges of caregiving, gaining or reinforcing knowledge, and sharing community resources were themes from qualitative interviews with the family caregivers.

NorthStar Care Community announces partnership with Beads of Courage Fox 17 - West Michigan;by Nicole Stoner; 8/19/25 Beads Of Courage is an organization that helps pediatric patients document their health journey through beads of different sizes, shapes, and colors. ... NorthStar Care Community, already established for their compassion in pallative and hospice care, has announced a partnership with Beads Of Courage. This time, the partnership honors patients entering hospice care through their own treatment stages, milestones, and moments of courage. ... In addition, the Carry A Bead Initiative invites the public to support these patients on their journey during end-of-life care by carrying a NorthStar Bead with them, then returning it with a message of encouragement. The bead is then gifted to someone in hospice care, ensuring that these patients are not alone in their health journey.

Opportunities and barriers to artificial intelligence adoption in palliative/hospice care for underrepresented groups-A technology acceptance model–based reviewJournal of Hospice and Palliative Nursing; by Xu, Tuzhen; Rose, Gloria M.; 8/25Underrepresented groups (URGs) in the United States, including African Americans, Latino/Hispanic Americans, Asian Pacific Islanders, and Native Americans, face significant barriers to accessing hospice and palliative care. Factors such as language barriers, cultural perceptions, and mistrust in healthcare systems contribute to the underutilization of these services. Recent advancements in artificial intelligence (AI) offer potential solutions to these challenges by enhancing cultural sensitivity, improving communication, and personalizing care. However, barriers such as limited generalizability, biases in data, and challenges in infrastructure were noted, hindering the full adoption of AI in hospice settings.

Black and white older adults’ end-of-life experiences: Does hospice use mitigate racial disparities? The Journals of Gerontology; by Clifford Ross, Brina Ratangee, Emily Schuler, Zheng Lian, Benmun Damul, Deborah Carr, Lucie Kalousová; 7/25Racial disparities in end-of-life care are well documented, but less is known about how these inequalities shape assessments of death quality. Proxies for Black decedents reported higher perceived death quality than those for White decedents, despite evidence of greater structural disadvantage. However, perceived care concordance was significantly lower among Black decedents. Hospice care was associated with improved perceived death quality for Black decedents but not for Whites. When accounting for socioeconomic and death experience controls, hospice care did not moderate perceived care concordance.