Literature Review

6 symptoms of dying of lymphoma verywellhealth; by Julie Scott, MSN, ANP-BC, AOCNP, medically reviewed by Gagandeep Grar, MD; 2/28/25Recognizing the signs and symptoms that signal the coming of the end of life for people with lymphoma can help their loved ones prepare and provide the right care. The exact signs and symptoms differ from person to person. However, common symptoms of dying from lymphoma include extreme fatigue, breathing changes, and loss of appetite. 

Mardi Gras is a reminder to live life in full color. ~ Unknown Call out, celebrating the Louisana-Mississippi Hospice and Palliative Organization, located in New Orleans!

[UK] 'Rising costs mean difficult decisions' - hospices BBC News, Somerset, UK; by Bea Swallow; 3/1/25 Hospice charities have warned "difficult decisions" could be on the horizon unless changes are made to "restrictive" government funding. On Wednesday, the government announced the release of £25 million for hospices across England, but this is reserved for facility upgrades and refurbishments only. ... Facing a "significant rise" in demand and costs, hospices across the country have been rallying for a more sustainable, long-term funding solution for the sector. ... Penny Agent, chief operating officer for Dorothy House, said unless it received support with staffing costs, it would have no choice but to cut back on services. 

Medicaid health plans failing to pay hospices for nursing home room and board Hospice News; by Jim Parker; 3/3/25 ... Medi-Cal, California’s Medicaid program, is among the states that shifted management of its safety net health coverage to health plans. Under this system, Medi-Cal pays the health plans who then pass payments on to the providers. However, due to confusion among managed care plans that oversee Medicaid in most states, those hospices are not getting those dollars back, according to Craig Dresang,  CEO of YoloCares. This has caused hospices to lose thousands to millions of dollars in some cases. “Managed health care plans are saying they’re denying the claims, and they’re tying them up so that they age out. So the due date has passed and we can no longer bill,” Dresang told Hospice News. [Click on the title's link to continue reading.]

Charges dismissed against chef accused of trying to kill his Monterey county mother KSBW Action News-8, Monterey, CA; by Felix Cortez; 2/28/25 A popular San Francisco area chef who was arrested along with his sister and charged with trying to kill their mother more than two years ago has had attempted murder charges dismissed against him. “In over 30 years of practice, this was one of the saddest cases I have ever seen and one of the most incompetent investigations by the Monterey County Sheriff’s Department that I have ever seen,” said Juliet Peck, the attorney for James Stolich. ... The mother was terminally ill and lived on a ranch off Highway 68 outside Salinas. “James’ mother’s only wish was to die at home without pain, surrounded by her daughter, son, and pets,” Peck said. But that never happened; Tinker died about a week later in a hospice facility, never to see her children again, because an emergency protective order obtained by the sheriff’s office prevented the children from visiting their dying mother. ... According to court documents, the daughter, Whitney, was the “agent designated to make all health care decisions for her mother,” which included administering medication to help alleviate her mother’s pain. ...The original criminal complaint alleging attempted murder charges said Whitney or a co-conspirator “crushed up pills with a mallet.” A close friend of Tinker was willing to testify that Whitney had no intent to kill her mother but was simply following her mother’s “directive to provide effective and sufficient palliative care even if it hastened her death.”Editor's note: This case raises numerous issues, including but not limited to community education (including law enforcement), Advance Directives, patient and caregiver education and support, MAiD (Medical Aid in Dying) or the End Of Life Option Act (EOLOA) in California, ethics, and the dying process (note that "the mother died about a week later in a hospice facility). 

'Shouldn't be something that's feared': She helps people face the end of life with dignity News Chief, part of the USA TODAY Network, Lakeland, FL; by Thomas R. Oldt; 3/2/25 Allow me to introduce a perfectly lovely person you may not wish to meet. She’s fostered rescue dogs, advocated for domestic violence victims, volunteered for foreign medical missions and worked emergency rooms throughout Central Florida. She is exceptionally empathetic, intensely focused and candid to a fault. She is also highly conversant in a subject most of us prefer to avoid. For the past seven years, Dr. Danielle Christiano has been staff physician at Good Shepherd Hospice in Auburndale where – in contrast to most other places – death is not a verboten subject. ... [Question:] What do you say or do to alleviate fears that accompany the end of life? [Answer:] It depends on your definition of hope. And it depends on what you want out of this. My general prescription is very different from most doctors because I embrace joy. I want people to seek out the things that bring them joy, ...

45% of end-of-life cancer patients potentially overtreated: 5 study notes Becker's Hospital Review; by Elizabeth Gregerson; 2/28/25 Almost half of all Medicare enrollees with cancer nearing end of life receive aggressive overtreatment as opposed to supportive palliative or hospice care, according to a study published Feb. 21 in JAMA Health Forum. Here are five things to know from the study:

How much does end-of-life care generally cost? 50 Plus Finance; by David Leto; 3/3/25 [For the public] ... Knowing how much end-of-life care generally costs can help you manage and prepare your finances appropriately to ease the burden on you and loved ones when the time comes. ... The cost of end-of-life care can vary widely depending on the services required. On average, however, Americans spend between $10,000 and $70,000 on such care, with the majority of expenses often occurring in the last year or month of life. These costs can stem from hospital stays, at-home care, or nursing facility care. Hospice, which focuses on comfort and pain management, typically costs less than intensive medical treatments but still averages several thousand dollars each month, or around $150 a day with insurance. Understanding these figures helps you set realistic financial expectations and prepare for them. ...

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

19-year-old says home hospice is a gift, not doom and gloom Keloland Media Group, Sioux Fall, SD; by Tom Hanson; 2/27/25 ... Cheyenne may be 19, but she is wise beyond her years, especially when it comes to something doctors discovered when she was 11. “I have stage 4 Metastatic Osteosarcoma, which is bone cancer in my lungs and It hasn’t responded very well to treatment, so that’s so I’m on hospice, but not because, I’m not on hospice because its the end right now, I’m on hospice because just so I have that extra support,” she said. Cheyenne knows people often misunderstand what hospice is all about. “It’s like doom and gloom and it’s like the end, there’s nothing they can do and that’s just not the case, she said. She was able to go on her road trip because Sanford’s Home Hospice team, including Becky Jibben, helped plan the trip and organize support teams along the way if Cheyenne needed help.

VITAS’ 'powerhouse’ growth in hospice hitting ‘all-time highs’ Hospice News; by Holly Vossel; 2/27/25 Florida-based VITAS Healthcare is anticipating fruitful hospice growth on its horizon. The Chemed Corp. (NYSE: CHE) subsidiary has seen record-highs in patient census volumes and is ramping up strategic plans to expand its geographic footprint across its home state. Acquisitions and de novos will make up an important mix of VITAS’ expansion, Chairman and CEO Nick Westfall said in Thursday’s earnings call. The company is optimistic about future opportunities in the Southeast, executives indicated. [Click on the title's link to continue reading.]

Suspect armed with rifle shoots at hospice nurse, points weapon at deputies The Orange Leader, Orange County, CA; by Staff Reports; 2/28/25 A person was taken into custody after allegedly shooting at a fleeing hospice nurse and pointing a rifle at law enforcement Thursday. Orange County Sheriff’s Deputies responded to the 5600 block of Rebel Road after a hospice nurse reported to 911 that while attempting to provide care to one of her patients she was confronted by an occupant of the home. The occupant followed the nurse out of the home with a rifle, and shot at her as she fled the property.  A single bullet struck the nurse’s vehicle, according to information from OCSO. Upon arrival, Orange County Deputies established communication with the suspect who remained inside the residence with the rifle.  The suspect reportedly pointed the rifle toward the deputies while he remained in close proximity to the hospice patient.