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
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
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
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