Literature Review

When words matter: NFDA releases groundbreaking communication guide for funeral professionals National Funeral Directors Association (NFDA), Brookfield, WI; Press Release; 10/27/25 The National Funeral Directors Association (NFDA) has released “When Words Matter: A Funeral Director’s Guide to Clear and Compassionate Communication,” a groundbreaking, research-driven resource designed to bridge the growing language gap between funeral professionals and the families they serve. ... Available now as a free download at NFDA.org/Research, this new guide is grounded in original NFDA research conducted earlier this year with more than 1,100 U.S. consumers across four generations. ... While funeral professionals have long used terms like “funeral,” “memorial service” and “celebration of life,” the new study revealed that families often define – or misunderstand – these terms in radically different ways. Editor's Note: Basic decisions about burial versus cremation usually need to be made before the death. Your interdisciplinary team members need to be up-to-date with this NFDA communication guide, for consistent family information and planning.

Religious traditions and grief in the USA: When it's less about G-d and more about the peopleJournal of Religion & Health; by Emily Scheinfeld, Cassidy Taladay-Carter, Kelly Tenzek; 9/25Many turn to religion or spirituality for personal meaning, purpose, and guidance throughout our lifetime, including in the context of death and dying. Through the qualitative analysis of 159 open-ended survey responses from adults in the USA who had experienced the death of a parent, we examined the types of religious traditions, practices, and/or rituals that participants engaged in during their bereavement. We then explored how those practices were helpful, harmful to, or revealing of emergent interfaith family dynamics throughout their grief journeys. By better articulating the communicative role of religion in death and dying, we broaden the understanding of religion and grief in these important sociocultural contexts. We discuss implications for families and religious communities alike.

[Netherlands] Treatment satisfaction with nonoperative management of suspected hip fractures in nursing home patients with a Do-Not-Hospitalize directive: A prospective case series (NONU-HIP)Journal of Palliative Care; by Sverre A I Loggers, Romke Van Balen, Jeroen Steens, Hanna C Willems, Pamela Riezebos, Anja Wagenaar-Huisman, Michael H J Verhofstad, Esther M M Van Lieshout, Pieter Joosse; 9/25Some nursing home residents opt to forgo hospital admission in case of a suspected hip fracture due to the poor prognosis. This study assesses treatment satisfaction and quality of life in nursing home residents with a suspected hip fracture and a do-not-hospitalize directive. This study showed that nonoperative management of suspected proximal femoral fractures in nursing home patients that opted to forgo hospital admission, results in high treatment satisfaction, high quality of dying with good symptom control, and predictable short-term mortality rates. 

How to talk to your loved ones about end of life wishes Those Nerdy Girls; by Rebecca Raskin-Wish; 10/17/25 It’s important to have discussions about what you want the end of your time on earth to look like and have a healthcare proxy and an advance directive in place. When my sister and I were teenagers, my mom sat us down, and in a potentially more dramatic fashion than the moment called for, she said, “Girls, my death could happen any moment, and we need to talk about it.” ...

Health Data Analytics Institute (HDAI) deploys innovative use of LLMs for summarizing and supporting patient preferences at a leading cancer center Bluegrass Live; by PR Newswire, Boston, MA; 10/20/25 An innovative new protocol called Better Real-time Information on Documentation of Goals of care for Engagement in Serious Illness Communication (BRIDGE-SIC) is being launched today at Dana-Farber Cancer Institute. BRIDGE-SIC uses Health Data Analytics Institute (HDAI) large language models (LLMs) to extract and summarize patients' goals of care conversations and their risk stratification tools for patient selection. The AI summaries identify and summarize prior goals of care conversations documented in patients' medical records and share them with inpatient and outpatient clinicians when patients with cancer are admitted to the hospital.

From mom-care to action: Identifying the crises in eldercare Minnesota Women's Press; by Amy Gage; 10/15/25 “I didn’t set out to write a book,” author Judy Karofsky said. ... “My mom was my inspiration.” ... DisElderly Conduct: The Flawed Business of Assisted Living and Hospice (New Village Press, 2025) ... began as a notebook of jokes and one-liners that her mom would toss off during their time together. A one-time amateur comedienne, Lillian Deutsch “was an amazing personality,” Karofsky says. DisElderly Conduct walks readers through Karofsky’s journey through six assisted living facilities and eventual hospice care before her mother’s death in 2018. Several themes emerge in the well-researched book:

Beyond bars: Evaluating end-of-life care and surrogate decision-making for hospitalized incarcerated personsJournal of Palliative Medicine; by Zack Watson, Julie Brown, Abhinav Vyas, Stacey Tillman, Sumi Misra, Rajiv Agarwal, Cheryl Gatto, Allison McCarthy, Mohana Karlekar; 9/25Incarcerated persons (IPs) retain the constitutional right to health care, yet they face unique challenges in accessing palliative care (PC) and designating surrogates, especially when incapacitated. We present two cases of hospitalized IPs with life-limiting illnesses who experienced significant barriers in identifying and engaging surrogates. Both cases underscore the effect of delays in communication with surrogates and restricted end-of-life (EOL) visitation due to correctional policies. These delays limited the delivery of optimal interdisciplinary PC and bereavement support. Despite clear legal guidance under the Tennessee Health Care Decisions Act, misinformation and procedural ambiguity among medical and correctional staff impeded timely and appropriate care.

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.

Critical care physicians’ perspectives on nudging in communicationJAMA Network Open; by Derek R. Soled, Christy L. Cummings, Laura M. Berbert, David N. Williams, William B. Feldman, Robert D. Truog, Emily B. Rubin; 9/25Our qualitative study on the experiences and perspectives of nudges by critical care physicians identified multiple themes relating to the appropriate use and ethics of nudging patients in clinical decision-making. In the decision-making context, a nudge is defined as “any aspect of the choice architecture [the intentional arrangement and presentation of options to subtly guide people towards certain choices] that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives.” While nudges preserve a person’s choice set without restricting options, they make it more likely that a person will choose some particular option by triggering decision-making heuristics and biases. Many physicians described nudging as an inevitable and natural part of communication—but one that must be used thoughtfully for it to be ethically justifiable. Assistant Editor's note: As a clinician, I can see where nudging may be appropriate at certain times, and when the clinician knows the values, concerns and goals of the patient/family. However, often the critical care clinician does not have that intimate knowledge of their preferences. In these situations, a better choice than nudging might be to request a palliative care consult, so that goal concordant decision making can be explored. 

The Family Caregiver Act—Safeguarding the human care chainJAMA Pediatrics; by Eli Y. Adashi, I. Glenn Cohen; 9/25On August 9, 2024, Jay Robert Pritzker, governor of Illinois, signed into law House Bill (HB) 2161 (Public Act 103-0797), likely the nation’s leading caregiving antidiscrimination legislation. The new law, which took effect January 1, 2025, prohibits employment discrimination against individuals saddled with family caregiving responsibilities. It is by dint of the enactment of HB 2161 that Illinois became the sixth state or district to legally require some form of this employee protection. Alaska, Delaware, Maine, Minnesota, New York, and Washington, DC, precede it, though some of these limit their protection to parents. Moreover, HB 2161 defines personal care as activities wherein a family member assumes responsibility for one or all of the basic needs of an ailing relative, replete with the provision of emotional support and/or transportation to medical appointments. A covered family member may include a child, stepchild, spouse, domestic partner, sibling, parent, mother-in-law, father-in-law, grandchild, grandparent, or a stepparent.Assistant Editor's note: "The Human Care Chain"--what a wonderfully descriptive title this is to describe the Illinois law. Those words evoke strong images of connectedness, humanness, caring, compassion, dedication, goodness, and love. As end-of-life and serious illness care providers, we understand the tremendous value, comfort and necessity of The Human Care Chain.

Adult Protective Services work with clients at the end of life: Challenges and support needsJournal of Elder Abuse and Neglect; by Wei-Lin Xue, Joy Swanson Ernst, Pi Ju Liu; 9/25Adult Protective Services (APS) professionals frequently interact with clients who are seriously ill or dying as they investigate cases of elder abuse and self-neglect. This study explored the unique challenges and support needs of APS workers in these end-of-life contexts. Thematic analysis identified two overarching domains: (1) challenges – including family conflict, limited caregiver preparedness, client self-determination, challenges to service access, and emotional strain on professionals; and (2) support needed – such as improved interagency collaboration, peer and organizational support. Participants emphasized the emotional toll of witnessing client decline and death, and highlighted gaps in training, coordination, and workplace support. Findings highlight the need for targeted policy and practice reforms to better equip APS professionals addressing elder abuse and self-neglect at the end of life.

Not everything is delirium at the end of life: A case reportAnnals of Palliative Medicine; by Daniel Gilbey, Eduardo Bruera, Patricia S Bramati; 9/25In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Case description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.

Instilling hope: A comprehensive model of cancer care for younger adults Targeted Oncology; by Andrea Eleazar, MHS and Shane Dormady, MD, PhD; 9/29/25 In the past decade, the incidence of numerous cancer types has increased, particularly among younger adults under age 50. For younger adults, many of whom are primary breadwinners of their households or in the height of their educational or professional careers, a cancer diagnosis at this life stage can be unexpected and jarring. ... In an interview with Targeted Oncology, Shane Dormady, MD, PhD, medical director of El Camino Health Cancer Center, describes the unique needs and challenges of younger adults, outlines El Camino Health’s comprehensive care strategy, and offers insights and considerations for treating and interacting with this patient population.