30-Second Takeaway
- ED-initiated, video-enhanced ACP increased documentation and goal-concordant care in older and seriously ill adults.
- Financial hardship in cancer correlates with more intensive, higher-cost end-of-life care and inpatient death.
- New tools and interventions clarify how to measure palliative experience and strengthen caregiver coping and mood.
- Unguided digital psychoeducation showed limited benefit, emphasizing the need for supported, tailored e-health approaches.
- Ageing, assisted dying, and survivorship highlight palliative roles beyond the last months of life.
Week ending April 25, 2026
Aligning care with values while supporting caregivers: concise updates for palliative practice
ED-initiated, video-enhanced ACP improves documentation and goal-concordant care
In three EDs, 598 older or seriously ill adults were randomized to video-enhanced ACP plus conversation and EHR notification versus usual care. At 3 months, ACP documentation was higher with the intervention (45.6% vs 31.3%; rate difference 14.3%, 95% CI 6.6%-22.0%). Documentation advantages persisted at 6 months, and ACP knowledge and engagement scores were higher in the intervention arm. Among 94 decedents, goal-concordant care scores were substantially higher in the intervention group (median 10 vs 7; P < .001).
Adverse financial events predict more intensive, higher-cost end-of-life cancer care
This cohort linked SEER cancer registry data, claims, and credit records for 10,826 patients with solid tumors who died between 2013 and 2019. New adverse financial events within two years before death were associated with more ED or inpatient visits in the last 3 months (OR 1.41, 95% CI 1.22-1.62). Patients with financial hardship were more likely to die in hospital (OR 1.50, 95% CI 1.30-1.75). Adjusted mean health care costs were higher for those with adverse financial events in both the last 3 and 6 months of life.
PCES: a brief, validated scale for palliative care experience in China
Investigators developed the 13-item Palliative Care Experience Scale (PCES) using patient and family narratives plus Delphi expert review. PCES has two domains—security and belonging, and purpose and significance—explaining 79.26% of variance. In 380 patients across two cohorts, confirmatory factor analysis supported a stable two-factor structure with excellent internal consistency (total Cronbach’s α 0.937). Defined measurement error thresholds (SEM 1.50, MDC95 4.16) allow detection of real changes in perceived palliative care experience.
Telehealth CBT improves caregiver mood via coping and self-efficacy
In an RCT of 120 caregivers of patients with primary malignant brain tumors, six-session telehealth NeuroCARE improved anxiety and depression versus usual care at 11 weeks. This analysis tested whether changes in coping and self-efficacy mediated NeuroCARE’s mood benefits. Improved coping from baseline to 11 weeks mediated reductions in both anxiety and depression, with significant bootstrapped indirect effects. Increased self-efficacy similarly mediated improvements in both anxiety and depression symptoms.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.