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. 

'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, ...

[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. 

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). 

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. ...

World Hospice and Palliative Care Day Theme 2025 ehospice; by the Worldwide Hospice and Palliative Care Alliance (WHPCA) team; 2/18/25 Every year the second Saturday of October marks World Hospice and Palliative Care Day (WHPCD). This year WHPCD will be on Saturday 11 October 2025. Each year the WHPCD campaign has a theme that is carefully thought through and selected by the Worldwide Hospice and Palliative Care Alliance (WHPCA) team.  The theme for 2025 is Achieving the Promise: Universal Access to Palliative Care.... More than 60 million people both adults and children need palliative care services every year with over 80% living in low-middle-income countries (LMIC’s) countries. WHPCA has estimated that over half of the need for palliative care is being met in high-income countries while only 4% of the bigger need is met in LMICs, a continuing and shocking disparity.Editor's note: What can you do to help "Achieve the Promise" in your corner of our world? Click here for more information from ehospice/WHPCA.

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.]

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.]

Writing book, getting tatoos Cowboy State Daily, Casper, WY; by Dale Killingbeck; 3/1/25 One of many tattoos on her left forearm is a dandelion in seed stage ready to blow in the wind. Deanna Cotten calls it “the wish flower” because in Texas where she was born that is its name. And like a seed ready to fly, Cotten finds herself in her last days on Earth and understands existence here is temporal. She considers each dawn a blessing. ALS, also known as Lou Gehrig’s disease, has already claimed a lot of ability from the 43-year-old Glenrock, Wyoming, wife and mother of four. ... With the help of a friend, she is completing a book she started writing for her business clients that has morphed into a book for people in similar circumstances who are facing some sort of crisis and end. ... In November, she entered hospice treatment at home where a team ... from Central Wyoming Hospice & Transitions cared for her and offered assistance to her family at their Glenrock home. 

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.

Aging With Adventure: The challenge of caring Daily Hampshire Gazette, Northampton, MA; by Eric Weld; 2/28/25 I made a mistake. I took a hiatus from writing in this space about aging with adventure because I thought I was taking a hiatus from adventure. Boy, was I wrong. I errantly thought that spending more than a year caring for my elderly mother in her final time on earth was taking me away from adventure. I am honored to have enabled my mother’s final days spent at home — not her home, but my sister’s private home — instead of in a public or private nursing facility. ... I assumed, in taking on the role of her co-caretaker, I would temporarily preempt my semi-retirement modus operandi of striking out on great adventures. To the contrary, what I learned from spending nearly two years co-caring for my aging mother is that end-of-life care is, indeed, every bit an adventure on many levels. And of course, it’s certainly about aging. [Click on the title's link to continue reading this inspirational caregiver story.]

WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award WVU Today - West Virginia University, Morgantown, WC; Press Release; 2/26/25 Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones. With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care. ... Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.

Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study BMC Palliative Care - Part of Springer Nature, Open Acces; by Annica Lagerin, Christina Melin-Johansson, Bodil Holmberg, Tove Godskesen, Elin Hjorth, Lena Junehag, Carina Lundh Hagelin, Anneli Ozanne, Johan Sundelöf & Camilla Udo; 2/19/25... This study aimed to gain an in-depth understanding of healthcare professionals’ (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model. ... To emphasize the importance of ethical competence for quality patient care, particularly in PC, a combination of care ethics, clinical proficiency, relational skills and effective communication is essential. ... The potential obstacles we identified that require attention include the need for managers ... to support HCPs by allowing time for reflection, developing new routines, and providing education focused on existential conversations in PC. However, the main contribution of this study is the description of the interdisciplinary strategies HCPs used to establish meaningful, existential conversations by maintaining presence, as this paved the way for trusting conversations with patients and next-of-kin. Editor's note: Pair this with today's article, "Why being trustworthy is a leadership hack that drives success."