Every October, we do something bizarre. We cover our houses in skeletons, ghosts, and gravestones. We dress up as zombies. We tell creepy stories. We watch movies about death… for fun. And yet, bring up real death at the dinner table and suddenly everyone needs to “go check the laundry.
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,
In Buddhism, there is a powerful teaching story often referred to as “the bird on your shoulder.” A monk asks his students, “If a bird sat on your shoulder and whispered, ‘Today could be the day you die,’ how would you live?” The question is not meant to frighten—but
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
In palliative care, timely recognition of cognitive decline is essential for guiding treatment planning, supporting families, and aligning care with patient values. Recent research into the use of voice as a biomarker for dementia offers an exciting frontier: the ability to detect subtle cognitive changes years—sometimes a decade—before
It was 9:12 a.m. on a Friday when my cellphone rang. On the line was a primary care colleague—one of those overbooked, overworked, and too often undervalued physicians who quietly form the backbone of our healthcare system. For them to call me directly during a packed clinic
We spend much of our lives preparing for beginnings — birth, school, jobs, marriages — yet most of us arrive at life’s end with little understanding of what the process of dying actually looks like. For families, it can feel like a storm without a map. For clinicians, especially those outside
In a world driven by data, deadlines, and diagnostics, humanism in medicine can sometimes feel like a quiet whisper in a crowded room. Yet, in hospice and palliative care, humanism is not just present—it’s the pulse. At its core, humanism in palliative care is the unwavering belief that
Palliative and hospice care medicine has always centered around enhancing quality of life, prioritizing symptom control, preserving function, and supporting dignity in the face of serious, often terminal illnesses. While pharmacologic interventions are widely employed to manage pain, dyspnea, nausea, and agitation, nutritional and metabolic interventions have received comparatively less
The death of a spouse is universally recognized as one of life’s most devastating losses, often described as an emotional trauma akin to an amputation. For hospice and palliative care professionals, understanding the far-reaching impact of this loss is vital—not only for the grieving individual’s psychological well-being
Cannabis Use in Hospice and Palliative Care: Promise, Pitfalls, and Patient Education The use of cannabis for symptom management in hospice and palliative care patients is an evolving and often controversial topic. As families increasingly inquire about or even initiate cannabis use for their loved ones, healthcare providers must be
As frontline caregivers, hospice and palliative nurses often witness the body’s most profound transitions. One such transition is the sudden appearance of a Kennedy ulcer—a skin lesion that frequently serves as a visible marker of terminal decline. These ulcers, often misunderstood, carry clinical, emotional, and ethical significance. For
In the emotionally complex world of palliative and hospice care, clinicians regularly encounter patients who express a desire to die. For some, it’s a quiet longing for peace at the end of a long and burdensome illness. For others, particularly those with a history of mental illness or prior
In cardiology, national guidelines already recommend that every patient receiving a left ventricular assist device (LVAD) also receive a palliative care consult. The rationale is both evidence-based and deeply humane: when a person is about to commit to a complex, life-prolonging technology, they deserve the dignity of informed, values-based decision-making.
The loss of a loved one is a deeply personal and life-altering event, and the grieving process is never one-size-fits-all. Yet for same-sex partners and LGBTQ+ families, bereavement often carries additional burdens—those shaped by social stigma, lack of legal recognition, exclusion from rituals, and a long history of marginalization.
In the realm of serious illness and end-of-life care, connection often serves as a form of medicine. Whether it’s through family caregivers, close friends, or community networks, those with support systems tend to navigate palliative care more safely and meaningfully. But for many older LGBTQ+ adults, especially those who
Advance care planning is a cornerstone of high-quality palliative and hospice care, enabling patients to articulate their preferences, identify surrogate decision-makers, and maintain dignity throughout the dying process. However, for gay and lesbian patients—particularly older adults who came of age in an era of systemic exclusion—the process can
When I think back to my early days as a nurse—bright-eyed, bushy-tailed, and full of hope—I can’t help but smile. I was determined to take on the world’s problems and make every life a little bit better. And I still chuckle softly at that version of
In hospice and palliative care, our shared goal is to ease suffering, uphold dignity, and support patients and families through some of life’s most tender moments. Yet how we define comfort, dignity, and support is deeply shaped by culture, beliefs, and identity. Delivering high-quality, person-centered care means recognizing that
Introduction Parkinsonism, defined by bradykinesia, rigidity, resting tremor, and postural instability, is most commonly attributed to idiopathic Parkinson’s disease (PD). However, not all patients with parkinsonian features have classic PD. A notable subset, particularly among older adults with vascular risk factors, develops parkinsonism due to cerebrovascular disease. This condition,
Yoga is widely recognized for its numerous benefits, from improving flexibility and strength to reducing stress and anxiety. However, its impact extends far beyond just physical fitness. In the context of hospice and palliative care, yoga offers profound emotional, psychological, and spiritual support for both patients and their families, providing