Literature Review

Ethics of overtreatment and undertreatment in older adults with cancerBMC Medical Ethics; by Clark DuMontier, William Dale, Anna C. Revette, Jane Roberts, Ameya Sanyal, Neha Perumal, Eric C. Blackstone, Hajime Uno, Mary I. Whitehead, Lewis Mustian, Tammy T. Hshieh, Jane A. Driver, Gregory A. Abel; 7/25This modified Delphi study convened a panel of experts in biomedical ethics and reached consensus that the principles of beneficence, non-maleficence, and autonomy are related to our previously proposed definitions of over- and undertreatment in older adults with cancer. The panel also reached consensus that, in most cases, it is unethical to make a treatment recommendation without (1) formal assessment of patient frailty (e.g., via a geriatric assessment) and (2) the opportunity for a patient to share their values, goals, and/or preferences. The panel did not reach consensus regarding the relationship between justice and over-/undertreatment; however, the panel concluded that justice applies to undertreatment when an oncologist withholds potentially beneficial cancer treatment in an older patient based on their age alone.

[Italy] End-of-life cancer patients’ dignity perception before and during COVID-19 pandemicAmerican Journal of Hospice and Palliative Medicine; by Andrea Bovero, Francesca Cotardo, Erika Tuberosa, Sara Carletto, Francesco Oliva; 8/25The safety and restriction regulations implemented to contain the COVID-19 pandemic significantly impacted people’s quality of life compromising the perception of dignity. Preserving dignity for end-of-life patients remains a paramount objective in palliative care. This study aimed to compare dignity levels in terminal cancer patients between pre- and during-pandemic periods... Existential Distress, Loss of Purpose and Meaning, Physical Symptoms and Dependency, Social Support PDI subscales and PDI Total score were higher in the during-pandemic group... Social isolation and other restrictions put in place to contain the COVID-19 pandemic may have had a negative impact on the perception of dignity in cancer patients at the end of life.

Estimating the number of services & patients receiving specialized palliative care globally in 2025 Journal of Pain and Symptom Management; by Stephen R Connor, Eduardo Garralda, Vilma A Tripodoro, Carlos Centeno; 7/28/25 online ahead of print ... In 2025, the estimated number of specialized palliative care service delivery teams worldwide reached approximately 33,700 - representing a 32.7% increase from the 25,000 identified in 2017. Service delivery expanded across all WHO regions except Africa. The estimated number of patients served rose from 7 million in 2017 to approximately 10.4 million in 2025. This figure represents roughly 14% of the total global need for palliative care. ... Despite notable growth in service availability, significant disparities persist, particularly in low- and middle-income countries. While over half of the need appears to be met in high-income countries, only 4.4% is addressed by specialist provision in low and middle-income countries. 

Hospice volunteers recognize local floral donors Uvalde Leader News, Uvalde, TX; 7/27/25 Uvalde Memorial Hospital hospice volunteers recently recognized the Flower Patch and Uvalde H-E-B for their weekly donations of fresh flowers for hospice patients. Hospice volunteers deliver the gifts, valued at approximately $1,950 annually from each business, to patients, brightening their homes and hospital rooms while providing emotional comfort during difficult times.

Enloe Health picks Butte Home Health and Hospice for post-hospital care in Chico Action News Now, Chico, CA; by Will Anderson; 8/6/25 Enloe Health has announced a new partnership with Butte Home Health and Hospice to enhance care for patients moving from hospital to home. Officials say this change comes as Enloe Health plans to close its own Home Health and Hospice programs by Oct. 31, 2025. Butte Home Health and Hospice, based in Chico, will now be the preferred provider for skilled nursing, rehabilitative care, and hospice services for Enloe Health patients.

Attorney General Bonta launches public awareness campaign to protect Californians and prevent abuse within hospice care system – says, “Our message is simple: hospice care should be about compassion, not corruption” Sierra Sun Times, Oakland, CA; 8/6/25 California Attorney General Rob Bonta today announced the launch of a new initiative aimed at educating the public and providing vital reporting resources to individuals and families who may have been impacted by hospice fraud. This initiative includes a comprehensive suite of resources to empower individuals and families with the knowledge and support they need to protect themselves from hospice fraud. Its goal is to ensure that individuals and families understand their rights, recognize red flags in hospice care, and know where and how to report if they suspect fraudulent activity. 

Study: Most Medicare seniors with advanced cancer still do not receive palliative care McKnights Long-Term Care News; by Donna Shryer; 8/6/25 A large national study of Medicare beneficiaries who died from advanced cancers found that although use of specialty palliative care has increased in recent years, most older adults still don’t receive this kind of care before death. The findings were published July 24, 2025, in JAMA Network Open and based on an analysis of 1.5 million Medicare fee-for-service enrollees who died between 2018 and 2023. In this study, researchers focused on palliative care delivered outside of hospice settings.

Social Media Watch 8/8/25

Lorazepam reduced restlessness, agitation in cancer patients with delirium: Patients were also less likely to require any rescue medications MedPage Today; by Mike Bassett; 8/5/25Use of lorazepam-based regimens reduced persistent restlessness and agitation associated with end-of-life delirium in cancer patients, a randomized study showed.Key Takeaways:

How one man’s dying wish was denied by the health care system Synopsi, from MedPage Today; by Caitlin E. Morh, MD; 8/5/25 “This is Dr. Mohr.” I answered a number I didn’t recognize. “It’s Irving,” said the frantic voice. “He collapsed. The paramedics are working on him now.” “They’re doing compressions? Stop! Put the paramedic on the phone!” My father-in-law, Irving, the stoic Danish-American Navy veteran, had been on hospice for 3 months. His POST (physician order for life sustaining treatment) form was on file with the hospice agency and his custodial care facility: DNR/DNI, comfort measures only. ... “I’m Irv’s daughter-in-law. I’m a physician. He’s a DNR, he’s on hospice. Stop doing compressions.” 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 ... I listened to the ACLS algorithm unfold in the background. ...

Difficult roads often lead to beautiful destinations. ~ Zig Ziglar

The path to the future may be the un-obvious: Top news stories, July 2025 Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Cordt Kassner; 8/6/25 The future of hospice care hangs in the balance as providers navigate a perfect storm of challenges and opportunities. From financial pressures closing hospice houses to unprecedented Medicare fraud schemes, from technological disruption to changing consumer expectations – the hospice field stands at a critical inflection point that demands both reflection and action. Join hosts Chris Comeaux and Cordt Kassner as they delve into the latest trends and challenges in Hospice and Palliative Care, discussing key trends, challenges, and innovations shaping the field. This episode covers a wide range of topics, including the impact of healthcare layoffs, disruptive innovations, and the importance of disaster preparedness. 

Arkansas Hospice to rebrand as LifeTouch Health Hospice News; by Holly Vossel; 8/5/25 Arkansas Hospice Family of Care will soon rebrand as LifeTouch Health to better reflect its evolving mix of services. The nonprofit’s rebranding will take effect in October. The move marks a period of revitalization for the hospice provider, according to its recently named President and CEO Brian Bell.