In palliative and hospice medicine, opioids remain the cornerstone of pain and symptom management. Morphine, codeine, hydromorphone, oxycodone, and other agents provide profound relief from pain, dyspnea, and certain distressing symptoms at the end of life. Yet, many patients arrive with their medical record littered with “opioid allergy” labels. These
As the hospice community deepens its commitment to equity and trauma-informed care, clinicians are increasingly caring for individuals who have experienced incarceration. These patients bring with them a lifetime of medical, psychological, and existential burdens shaped not only by disease, but by the enduring imprint of trauma, stigma, and institutionalization.
Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases that track controlled substance prescribing and dispensing. While they were originally designed as a tool to combat the opioid epidemic, PDMPs are now an expected part of safe, compliant medical practice in nearly every setting—including palliative care and hospice. For
Smiling is one of the most basic human expressions, universally recognized and deeply tied to emotion, social connection, and quality of life. In the palliative and hospice setting, providers often witness the gradual fading of a patient’s ability to smile. While at first glance this may seem like a
Introduction For many people—especially women, older adults, and those with chronic health conditions—recurrent urinary tract infections (UTIs) can feel like an endless cycle. Antibiotics may clear the infection temporarily, but the relief is often short-lived. Over time, repeated antibiotic exposure can lead to resistance, side effects, and a
When we think of aging, most people imagine wrinkles, thinning hair, or skin changes. Yet the most insidious change is less visible: the gradual loss of muscle mass, strength, and function known as sarcopenia. Beginning as early as age 30, we lose 3–8% of muscle mass per decade, accelerating
Sleep disturbance is one of the most pervasive and distressing symptoms in patients living with advanced illness. Families worry when their loved one is awake at night, clinicians search for safe non-opioid strategies to settle nighttime agitation, and patients often ask for something “natural” to help them sleep. For many
Trauma is not just an emotional experience—it is a physiological and neurological event that leaves lasting imprints on the brain. For palliative care providers, understanding these changes is vital. Patients in our care may carry a history of trauma, whether from childhood adversity, war, intimate partner violence, medical interventions,
October is Down Syndrome Awareness Month—a time to celebrate the lives, stories, and strengths of individuals with Down syndrome and the families who love and support them. It's a moment to pause, learn, and reflect on what it truly means to be inclusive, to embrace diversity in
In hospice and palliative care, we often stand at the intersection of life’s most profound questions. Patients and families ask us what truly matters at the end of life and what makes life meaningful. Remarkably, one of the longest-running studies in the world gives us answers that echo what
Alzheimer’s disease disproportionately affects women. Nearly two-thirds of all patients living with Alzheimer’s are female, and while increased life expectancy explains part of this difference, it does not tell the full story. Emerging research suggests that biological factors—including differences in brain lipid metabolism—play a critical role
Introduction As palliative care providers, we often encounter patients whose decline seems sudden or inexplicable. A seemingly healthy older adult—with normal cholesterol, reasonable blood pressure, and an active lifestyle—may present with memory lapses, slowed thinking, or difficulties with daily tasks. When imaging reveals extensive white matter changes and
