Literature Review

Doctors’ own end-of-life choices defy common medical practice Medscape; by Cristina Ferrario; 7/29/25 A new survey revealed that most doctors would decline aggressive treatments, such as cardiopulmonary resuscitation (CPR), ventilation, or tube feeding for themselves if faced with advanced cancer or Alzheimer’s disease, choosing instead symptom relief and, in many cases, assisted dying. ... The researchers conducted a cross-sectional survey of 1157 physicians, including general practitioners, palliative care specialists, and other clinicians from Belgium, Italy, Canada, the US, and Australia. ... Over 90% preferred symptom-relief medication, and more than 95% declined CPR, mechanical ventilation, or tube feeding. Only 0.5% would choose CPR for cancer and 0.2% for Alzheimer’s disease. Around 50%-54% supported euthanasia in both cases.

Targeted palliative care may cut older adults’ risk of readmissions after elective surgeries: study McKnights Long-Term Care News; by Alicia Lasek; 7/27/25 Older adults with serious illness before elective surgery are at double the risk of extended hospital stays, readmissions, emergency department visits and costs, a new study has found. Targeting four key palliative care needs before surgery may help make the recovery period less burdensome for these patients and the healthcare system, the authors say. The study, published in the Journal of the American College of Surgeons, looked at seriously ill older surgical patients to see what palliative care interventions might help reduce the need for excess healthcare use post surgery. Among 2,499 older adults undergoing major elective surgery, [researchers reported] 63% were seriously ill, and 79% had four key palliative care needs:

Tell us more: Episode 1-Dr. Betty FerrellJournal of Palliative Medicine; podcast by Betty Ferrell, Yilong Peng, William E Rosa, Richard E Leiter; 7/22/25The Journal of Palliative Medicine'sTell Us More: The Palliative Care Oral History Project" seeks to tell the story of hospice and palliative care through informal interviews with pivotal leaders in the field. In each episode, hosts Drs. Ricky Leiter and Billy Rosa, along with research assistant Dr. Yilong Peng, sit down with an Hospice and Palliative Care luminary and do what our field does best-ask questions, listen, and reflect. In the first episode, Drs. Leiter and Rosa interviewed Dr. Betty Ferrell, Director of Nursing Research and Education, and a Professor at City of Hope Medical Center in Duarte, California. Editor's note: Listen now to this inspiring interview with Dr. Betty Ferrell.

Carter, Bera introduce bill to strengthen palliative and hospice care workforce United States Representative Buddy Carter, Washington, DC; Press Release; 7/17/25Reps. Earl L. “Buddy” Carter (R-GA) and Ami Bera, M.D. (D-CA) today introduced the Palliative Care and Hospice Education and Training Act (PCHETA), bipartisan legislation to invest in training, education, and research for the palliative care and hospice workforce, allowing more practitioners to enter these in-demand fields. ... "As a pharmacist, I understand the toll burnout takes on the health care industry, and I am committed to bolstering the workforce so nurses, doctors, and all health care workers can continue to pursue their passion for helping others,” said Rep. Carter. "As a doctor, I know how important it is to provide patients with comfort, clarity, and support when they’re facing serious illness,” said Rep. Bera. “The Palliative Care and Hospice Education and Training Act is a smart, bipartisan step to ensure more health care professionals are trained to deliver this kind of care."Editor's Note: Bravo to this pharmacist and physician bipartisan team for introducing this bill. Go to the article and scroll down to this press release's long list of "Supporting Organizations."

CDC reports rise in unintentional fall deaths among older adults JAMA; by Samantha Anderer; 7/11/25 The US Centers for Disease Control and Prevention (CDC) reported that deaths from unintentional falls among adults aged 65 years or older increased over the past 2 decades. Falls are currently the leading cause of injury for older adults, reaching 70 per 100 000 in 2023. As age increases, so does the likelihood of death due to a fall. And data from the National Vital Statistics System indicate that from 2003 to 2023, adults aged 85 years or older experienced the greatest increase in fall deaths. Rates for men, who are more likely to die from an unintentional fall, doubled from 178 to 373 per 100 000 people among those 85 years or older. For women in the same age group, deaths from falls increased 2.5 times, from 129 to 320 per 100 000. 

Older adults spending excess time in ED, putting hospitals at risk of failing to meet new guideline, analysis finds McKnights Long-Term Care News; by Donna Shryer; 7/1/25 A new national analysis of hospital data shows that older adults in the United States increasingly are spending more time in emergency departments (EDs) than federal guidelines recommend — delays that can be harmful to aging patients. The findings come as hospitals prepare to comply with new Medicare rules aimed at improving emergency care for older adults. ... Among patients who were admitted to the hospital, more than one-third (36%) waited more than three hours after the decision was made to admit them, a delay known as boarding. These benchmarks — eight hours in the ED and three hours to admission — are part of the new Age-Friendly Hospital Measure introduced by the Centers for Medicare & Medicaid Services (CMS). As of January 2025, hospitals are required to confirm they have procedures in place to meet these time goals.

New data and insights from the National Alliance for Care at Home: Alarming delays and declining access to Medicare home health contribute to worse outcomesNational Alliance for Care at Home press release; 6/23/25Medicare beneficiaries are waiting longer — and too often going without — the home health care they were referred after a hospital stay. This growing gap in access harms vulnerable seniors, is associated with highermortality, leads to more preventable ER visits and hospital readmissions, and increases Medicare costs.Publisher's note: Access may require membership login.

How thanatology is driving hospice care innovation Hospice News; by Holly Vossel; 6/13/25 Thanatologists examining dying and grief practices have uncovered significant trends shaping hospice and bereavement care models in recent years. Thanatology is derived from the Greek word for death, “thanatos.” It is commonly described as the study or description of death, dying and loss and the psychological, social, cultural, biological and spiritual aspects of these processes. Editor's Note: Unfortunately, this article failed to identify the first and leading thanatology organization for end-of-life care professionals, ADEC, the Association for Death Education and Counseling: the thanatology association, at www.adec.org, celebrating its 50th anniversary in 2026. Though this article says "several studies have examined ...," ADEC's 50 years of leaders and members have included countless groundbreaking, prolific researchers, authors, academicians, and clinicians throughout our hospice field: William Worden (a founding member), Robert Neimeyer, Ken Doka, and so many more. When you see the "FT" or "CT" credential, you can know that this person has earned the professional credential "Fellow in Thanatology" or "Certified in Thanatology."

Research study participation, 6/7/25

IU Health gets $20M gift for clinical innovation institute  Becker's Hospital Review; by Madeline Ashley; 5/20/25 Indianapolis-based Indiana University Health has received a $20 million donation from Sarah and John Lechleiter and Deborah and Randall Tobias to create the Tobias-Lechleiter Institute for Clinical Innovation. IU Health will match the donation, bringing the investment in the institute to $40 million, according to a May 20 news release shared with Becker’s. ... The institute plans to recruit 75,000 residents yearly in advanced medical studies; enroll 300,000 patients in the Indiana Biobank initiative over five years to aid research into genomic risk factors pertaining to Indiana’s population; attract and retain top fellows, students and faculty; enhance research resources; and increase the impact and pace of statewide medical research.

‘Marathon’ effort to refine end-of-life wound coding runs on McKnights Long-Term Care News; by Kimberly Marselas; 5/28/25 Two key wound care groups are finalizing a proposal for new codes that would help skilled nursing providers avoid newly created diagnoses gaps for end-of-life skin breakdown that could lead to missed reimbursement and potential liability risks. The push comes a year and a half after nursing homes won the right to stop coding wounds that occur as part of dying as pressure injuries, which can hurt their quality ratings. But they also lost any way to code or acknowledge treatment of such skin failure in the Minimum Data Set. ...

Yes, you can die from a broken heartMedscape; by F. Perry Wilson, MD, MSCE; 5/14/25 A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: [graphic]. As a doctor, if you see this, you’re calling the cardiac cath lab. This is an ST-elevation myocardial infarction — the big one — indicative of a blood clot blocking blood flow to a large section of the heart. The sooner you get that blood clot out, the better chance the patient has to survive. So the patient is rushed to the cath lab, and they find… nothing. Clear coronaries. No blood clot. Further questioning reveals that the patient, an older woman, lost her husband recently. This is stress-induced cardiomyopathy, medically known as Takotsubo cardiomyopathy (TC). It’s the pathophysiologic manifestation of a broken heart. First described in 1991, Takotsubo syndrome occurs in the setting of deep psychological, emotional, or physical stress.