Literature Review

Improving community-based palliative care explanations: Insights from persons declining servicesAmerican Journal of Hospice & Palliative Care; by Kira G Sheldon, Kathryn H Bowles, Elizabeth A Luth; 8/25Beneficiaries and caregivers had mixed understandings of palliative care, including: no knowledge, belief that it was the same as or pre-hospice, and accurate, but often one-dimensional understandings of it. Participants recommended providing individualized, tailored explanations focused on the person's health concerns in simple language with follow-up materials to improve engagement with palliative care. Small adjustments to how palliative care is explained may increase understanding among older adults and caregivers, particularly among those with limited or inaccurate knowledge. Among those familiar with palliative care, providing accessible and clear explanations customized to the person's specific care needs can further broaden understanding and increase perceived relevance.

Benefits and burdens of research participation: A mixed methods systematic review in palliative and end-of-life careJournal of Hospice and Palliative Nursing; by Cara L Wallace, Stephanie P Wladkowski, Ruaa Al-Juboori, Anna Wingo, Kathryn W Coccia, Rebecca Hyde, Verna Hendricks-Ferguson; 8/25Research participation of hospice and palliative care patients and family caregivers is essential to develop and test best practices. Yet, healthcare professionals are often hesitant to ask patients and caregivers to participate in research, fearing it is too intrusive or unethical during a sensitive time. This review focused on the motivating factors, benefits, and burdens of research participation for patients with serious illness and their family caregivers. For clinicians and researchers, connecting patients and caregivers to palliative and end-of-life research may be both beneficial as a contribution to scientific literature and as an additional source of ongoing support.

Top ten tips palliative care clinicians should know about intensive care unit consultationJournal of Palliative Medicine; by Ankita Mehta, Karen Bullock, Jillian L. Gustin, Rachel A. Hadler, Judith E. Nelson, William E. Rosa, Jennifer B. Seaman, Shelley E. Varner-Perez, Douglas B. White; 8/25Critical illness and ICU stays can be extremely distressing for patients and their loved ones. Providing palliative care in the ICU, although a standard component of comprehensive care delivery, involves understanding the individual culture of each specific ICU, collaboration with multiple providers, and interfacing with surrogate decision makers while patients may not be able to communicate and are undergoing interventions that are unfamiliar to them and loved ones. These top ten tips aim to support palliative care clinicians providing consultation in ICUs. Specifically, these tips address initial relationship building with ICU clinicians and teams to foster effective collaboration, establishing goals of care by assessing health-related values, explaining treatment options, individualizing prognostic discussions, and managing end-of-life symptoms for patients while in the ICU and throughout ICU discharge transition.

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.

Behavioral symptoms in patients with dementia are associated with care partner abusive behaviorsJournal of Elder Abuse & Neglect; by Emily LeRolland, Francesca Falzarano, Karen L. Siedlecki; 8/25Abuse of older adults with dementia is an increasingly prevalent public health concern in the United States. The current study examined whether care recipient behavioral symptoms (e.g. aggressive or agitated behaviors) predicted abusive behaviors by care partners. Results indicate that most participants reported engaging in at least one abusive behavior toward their care recipient. Behavioral symptoms in care recipients were a significant predictor of abusive behavior perpetrated by the care partner, even after controlling for a large number of covariates. Care partner depressive symptoms significantly mediated the relationship between care recipient behavioral symptoms and care partner abusive behavior. Our results suggest that physician screening for depression in care partners and referral to appropriate resources may be one avenue for decreasing the risk of abuse toward care recipients. 

Palliative care plays an essential role in heart failure care Cardiovascular Business; by Michael Walter; 8/13/25 Palliative care should play a significant role in the day-to-day management of heart failure (HF) patients, according to new recommendations from the Heart Failure Society of America (HFSA). HF patients are associated with high mortality and a considerably worse quality of life, the group wrote. Care teams should be doing everything in their power to help patients control their symptoms and live the best lives possible. The HFSA guidance is available in full in the Journal of Cardiac Failure. ... “When using a guide, conversations are more likely to be feasible, acceptable and associated with positive experiences for both patients and clinicians,” the authors wrote.

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.

Caregiver-reported barriers and facilitators to hospice enrollment for persons with dementia: A systematic review of qualitative evidencePalliative Medicine; by Oonjee Oh, Connie M Ulrich, Lauren Massimo, George Demiris; 7/25Despite the increasing prevalence of dementia, persons with dementia often receive suboptimal care near the end of life. Dementia caregivers experience intrapersonal, interpersonal, emotional, logistical, and physical challenges in ensuring quality end-of-life support for their loved one (e.g. limited understanding of end-stage dementia, gatekeeping providers, and family conflicts). The unique needs of caregivers caring for a seriously ill family member with dementia are not being fully addressed by the current available services and policies.

Communication and end-of-life care in dementia: insights from a close family member working in healthcare British Journal of Community Nursing; by Jennifer M Hadley; 7/31/25 There is very little documented evidence on the experiences of healthcare professionals caring for their own family outside of their role. This article explores the differences in the care received as the author shares her perspectives of caring for her mother, who was diagnosed with dementia. The author reflects on the care received and the impact of communication, as well as the ethical limitations of caring for a member of her own family. Significant references to communication barriers already exist within the literature, relating to end-of-life conversations. The presence of a relative who has a healthcare background may further impact the communication approach of healthcare professionals.

Palliative delays associated with increased length of stay in older traumatic brain injury patientsThe Journal of Trauma & Acute Care Surgery; by Sarah A Hatfield, Parima Safe, Cleo Siderides, Anjile An, Cassandra V Villegas, Nicole Goulet, Robert J Winchell, Elizabeth Gorman; 7/25Trauma Quality Improvement Program guidelines recommend early goals of care discussions (≤72 hours) for older patients with severe injuries. Patients (55 years or older) with moderate to severe TBI [traumatic brain injury] ... were retrospectively identified at a level I trauma center (2020-2022). Conclusions: Delayed PI [palliative intervention] is associated with increased LOS [length of stay] in older TBI patients, with no survival difference compared with early PI. Palliative interventions should be introduced early to reduce morbidity in patients with potential poor prognosis.

Vet to Vet Cafe brings veterans together Tribune Chronicle, Warren, ; by Bob Coupland; 7/26/25 Veterans looking for a casual place to gather for fellowship, conversation, snacks and education can visit the newly formed Vet to Vet Cafe at the Warren SCOPE Senior Center. The new program, which started this summer, runs from 2 to 4 p.m. the second Thursday of each month at the senior center, ... John Bower, chaplain for Grace Hospice, said there are educational programs focused on veterans, including assistance with therapy access, acquiring necessary items such as hearing aids and utilizing services offered by the Veterans Association.  “We started in June as an opportunity to get veterans together for conversation or educational programs,” Bower said. ... Autumn Lopez, administrator for Grace Hospice, expressed enthusiasm for organizing the Vet to Vet Cafe with participating veterans. “The goal is to connect veterans with the services and programs that are out there to help them,” she said.

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.

How to perform a Regret Audit: A simple question that can help you live with purpose and have fewer regrets. Psychology Today; by Jordan Grumet, MD; 7/20/25 As a hospice doctor, I’ve spent countless hours sitting at the bedsides of dying patients, listening to the echoes of lives well-lived and those haunted by regret. As Bronnie Ware described in The Five Regrets of the Dying, many end-of-life reflections center around missed chances to live more authentically, joyfully, and meaningfully. But we don’t have to wait until our final moments to face these truths. I’ve long advocated for the hospice life review as a proactive tool. It’s a structured set of questions used by hospice professionals to help patients process their lives and find peace. The questions are simple but profound: