Literature Review

Hospice of the Chesapeake leader aims to think outside the box on hospice, palliative care McKnights Home Care; podcast by Liza Berger with Rachel Jordan; 3/27/25 As the director of legislative affairs and advocacy at Hospice of the Chesapeake, the largest independent not-for-profit hospice provider in the state of Maryland, Rachel Jordan strives to treat the patient and not the disease. This helps explain why she worries less about the line between “curative” and “noncurative” care and more about whether a particular treatment helps to make a patient feel more comfortable. Jordan spoke to McKnight’s Home Care about her views of hospice and palliative care for a Newsmakers podcast. [Continue to the podcast ...]

Health care system adaptation and resilience during the wildfire crisisJAMA Network; by Attila J. Hertelendy, PhD, Jeremy Maggin, MD, MS, and Gregory Ciottone, MD; 3/19/25 ... Within a span of hours, the Palisades and Eaton fires, propelled by record-breaking Santa Ana winds reaching 150 miles per hour, consumed more than 37,000 acres, destroyed more than 16,000 structures, and claimed 29 lives. All told, greater than 186,000 residents were placed under evacuation orders. ... The experience in Los Angeles County demonstrates the value of maintaining dual-purpose resources: facilities and personnel who can transition between routine operations and emergency response functions. This approach is exemplified by Kaiser Permanente’s successful deployment of mobile health vehicles and the use of clinically trained administrative leaders in direct patient care roles during crisis events. Key elements of successful resource mobilization include:

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

Less wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."

Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies Journal of Hospice & Palliative Care; by Se-Il Go, Myoung Hee Kang, and Hoon-Gu Kim; 3/1/25 Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration.

[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care - Saif Mohammed ehospice; by Saif Mohammed; 3/10/25[Personal Story] ... "Reflecting on this experience, I realize that caregiving is deeply embedded in tradition and culture, a natural extension of communal life." Caregiving is as old as humanity itself. One of the earliest known cases of palliative care dates back 45,000 years to Shanidar 1, a Neanderthal male found in present-day Iraq. His skeletal remains indicated severe injuries, yet he had survived for decades, suggesting that his community had cared for him. This example highlights that palliative care is a deeply human and historical practice, far predating modern medicine. Cultures around the world continue to recognize the importance of caregiving, often embedding it in traditions and religious beliefs. ... In some societies, the emphasis on independence can make caregiving more complex, as patients may refuse assistance to maintain self-sufficiency. ... Palliative care workers must be equipped to understand and respect the cultural traditions of the communities they serve. This requires training in cultural competence, which involves:

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.

[Turkey] Actual roles of Occupational Therapists in palliative and hospice care: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Güleser Güney Yılmaz, PhD, OT; Hülya Yücel, PT, PhD; Milda Gintiliene, MD; 1/25 Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

US flu cases are peaking for a second time this season. Now you can test for the virus at home CNN; by Neha Mukherjee; 2/5/25 The United States is seeing a second peak in flu cases this season. After doctor’s office visits for flu dipped early this year, they jumped past the previous season peak at the end of last month, with a 30% test positivity rate — and there are still months to go. The US Centers for Disease Control and Prevention estimates that there have been at least 20 million cases and 11,000 deaths from flu so far this season. Hospitalizations are rising too, with an estimated 38,255 hospitalizations from flu last week alone. It’s not the only illness spreading, either ... But there are some new tools to help this respiratory virus season: over-the-counter tests that can identify whether an illness is Covid-19 or influenza. The tests are available for purchase at most pharmacies or online ... The tests won’t check for every respiratory virus, but they mark the first time the public can test for flu at home.  

The Handbook of LGBTQIA-inclusive Hospice and Palliative Care, 2nd edition Review in Ageing & Society, published online by Cambridge University Press; book authored by Kimberly D. Acquavia, review authored by Luis Stoisser; 1/23/25 The Handbook of LGBTQIA-inclusive Hospice and Palliative Care is a comprehensive guide to providing inclusive palliative and hospice care to everyone, regardless of their self-identification. Following the author's belief that LGBTQIA+ hospice and palliative care requires change at three levels - individual, institutional and systemic - the book extends state-of-the-art palliative and hospice practices (US focused) by including LGBTQIA+ perspectives. Such a rethinking educates hospice and palliative care practitioners on how to provide person-centered care, how to be self-reflexive on a daily basis and how to handle their own stereotypes and stigmas. [This book is available via Columbia University Press and Amazon.]

Hospice of Savannah awarded grant for safety improvements NBC WSAV Savannah News, Savannah, GA; by Eric Dorsch; 1/27/25 Hospice of Savannah Inc. (HSI) has announced it has been awarded a grant for repairs and home modifications. HSI will receive $1,999,111 in Older Adults Home Modification Program grant funding to complete safety and functional home modifications and limited repairs in the primary residences of two hundred eligible homeowners and renters over age 62 with low income. The work aims to improve general safety, increase accessibility, reduce falls, and improve residents’ functional abilities in the home for their safe and successful aging in place. 

Respiratory virus activity remains 'high' in US and will 'continue for several more weeks': CDC ABC News; by Mary Kekatos and Youri Benadjaoud; 1/20/25 Respiratory viruses are continuing to spread across the United States, sickening millions of Americans. Overall respiratory illness activity -- including flu, COVID-19 and RSV -- continues to be listed as "high" nationwide and is causing people to seek health care "at a high level," according to the Centers for Disease Control and Prevention. As of Jan. 17, two states -- Hawaii and New Hampshire -- are listed as having "very high" activity while another 15 states are listed as having "high" activity, CDC data shows. 

Norovirus positivity rate hits 28%, double 2024's peak: 6 notes Becker's Clinical Leadership; by Alexandra Murphy; 1/15/25 A surge in norovirus infections this season has resulted in a 28% positivity rate, more than double 2024's high, alarming health officials, CBS News reported Jan. 14. The unprecedented spike is a part of a broader viral surge as the U.S. grapples with four major viruses — norovirus, respiratory syncytial virus, influenza and COVID-19. Hospitals across the country are also feeling the strain, as emergency departments struggle to accommodate the rising number of patients. ... Experts predict that the "quademic" — norovirus, syncytial virus, influenza and COVID-19 — could worsen as hospitals are already overwhelmed. With more outbreaks likely, health systems are implementing stricter protocols including visitor restrictions and increased coordination between hospitals to maintain trauma care capacity.