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These findings support that previous work noting many patients experience dyspnea at end of life. Despite national guidelines, health care providers may still be underrecognizing and likely not optimally treating dyspnea at the end of life in the hospital. Collaboration with palliative medicine providers may improve assessments and treatments for quality end-of-life care for hospitalized patients.

Older adults compose a large portion of patients with persistent pain. Opioid analgesics are widely used to treat acute and persistent pain in cancer and end-of-life care, but their use in other types of persistent pain in older adults is controversial. Clinicians and regulators must work together, balancing the legitimate medical need for opioids while acknowledging increasing opioid misuse and morbidity and mortality related to opioids.

The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.

Persistent pain is a challenging problem in the elderly and is not a normal process in aging. Successful management of persistent pain can be achieved through comprehensive assessment, use of routine pain medication and careful monitoring of medical functional status.

Persistent pain is a challenging problem in the elderly and is not a normal process in aging. Successful management of persistent pain can be achieved through comprehensive assessment, use of routine pain medication and careful monitoring of medical functional status.

Medical students face professional experiences of death and loss during their formative training years. Personal experiences of death and loss are unique to each individual student. Surprisingly little is known about how medical students conceptualize loss or death. We sought to explore the responses of third year medical students to a selfreflection exercise focused on loss. We conducted a qualitative analysis of 127 third year medical school students responses to identify common and uncommon themes and language used by medical students to discuss and conceptualize loss. These findings may allow educators to tailor education programs on end of life care and mindfulness in a real and relevant manner. In addition, the wide breadth of student perspectives will inform appropriate support and resources required as physicians-in-training face loss during their training.

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