Literature Review

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.

Daughter asks US Marine to honor her dying war hero dad. She broke down when she answered the door next dayScoop Up Worthy; by Abhishek Bhatia; 3/13/25 The Korean War veteran's daughter, who was seen standing beside him in the footage, wanted her dad to be remembered as a national hero in his final moments. At the daughter's request, Tim visited her dad and thanked him for his service to the country. "Marine on deck. Good afternoon, Sir. Sergeant Chambers, reporting his order. You ever run across that horse in Korea that was running artillery rounds in evacuating wounded?" he asked the veteran, referring to Sergeant Reckless, a famous horse that served with the U.S. Marine Corps during the Korean War.  ...

‘Innovative opportunities’ exist in growing need for trauma-informed bereavement care Hospice News; by Holly Vossel; 3/11/25 Hospices may be seeing a growing need for trauma-informed bereavement services on the horizon. Shaping their grief support programs with this trend in mind will be pivotal to hospices’ ability to expand the depth and reach of their services. This is according to Chloe Bishop, bereavement and social work supervisor at Maryland-based Frederick Health Hospice. The community-based nonprofit provides hospice and palliative care, as well as grief support and veterans programs.Editor's note: For expert, professional continuing education, certifications, conferences, resources, and certifications that encompass the wide scope of bereavement care (including trauma), examine ADEC - the international Association for Death Education and Counseling.

104-year-old WWII veteran honored for his service while in hospice WCCO via CNN Newsource, Cottage Grove, MN; by Reg Chapman; 3/9/25 A World War II veteran in Minnesota has the honor of being the oldest resident in his town. Even at his remarkable age, Don Tietz has not lost his wit or his humor. After he was drafted during World War II, Tietz found himself a long way from his hometown farm. Tietz served as a truck driver, hauling ammunition across America’s campaign into Europe. ... “We spearheaded across France,” he said. ... He also faced the true grim realities of war. ... “There was 212, only 12 of us came back,” he said. ... Tietz now represents a different era of grit and perseverance. Surrounded by friends and family, the Allina Health Hospice Team showed their gratitude to Tietz for his service by giving him a heartfelt ceremony, where he was awarded a pin and certificate. Most importantly, Tietz was given an opportunity to reflect on all of those years.Editor's note: Click here for the We Honor Veterans Program developed by NHPCO (now the National Alliance for Care at Home) in collaboration with the Department of Veterans Affairs (VA).

Intervention increases palliative cancer care consultations/lowers EOL care CancerNetwork.com; by Roman Fabbricatore; 3/11/25A palliative care (PC) intervention combining algorithm-based automated identification of patients eligible for PC led to an increase in PC visits and a decrease in end-of-life systemic therapy among patients with cancer, according to a randomized clinical study (NCT05590962) published in JAMA Network Open. ... "...  Prior efficacy trials in oncology have tested early PC in controlled, primarily academic settings.2To our knowledge, this is the first effectiveness randomized clinical trial of algorithm-driven default specialty PC in community oncology.”

Tumor: why not use the warrior’s metaphor anymore taketonews; 3/7/25 ... The term "warrior" is often used to describe cancer sick people, referring to their strength, determination and ability to fight the disease. Although the intention is positive, docts and psychologists believe that this metaphor can generate negative effects on people with an oncological disease. The "warrior" label is not always appropriate and can have unwanted psychological effect on cancer patients. ... Use a language that does not reduce the patient to his struggle, but that enhances his entirety, including weakness, depression and pain, can contribute to a more human and respectful experience of care. ... [Click on the title's link for this further information below.]

Assessing pain, anxiety and other symptoms of nursing home residents unable to speak for themselves Regenstrief Institute, Indianapolis, IN; by Kathleen T. Unroe, MD, MHA; 3/10/25 Revamped tool reliably addresses physical and emotional distress, well-being and end-of-life symptoms. As many as half of nursing home residents are cognitively impaired and may be unable to communicate symptoms such as pain or anxiety to the staff and clinicians caring for them. Therefore, information needed for the evaluation of symptoms and subsequent treatment decisions typically does not reliably exist in nursing home electronic health records (EHRs). A new paper reports on the novel adaptation of a commonly used symptom assessment instrument to more comprehensively acquire this difficult-to-obtain data with the ultimate goal of enabling knowledge-based expansion of palliative care services in nursing homes to address residents’ symptoms. 

The Medical Minute: Measles cases rising in the US, what you can do PennState, Hershey, PA; 3/6/25 A case of measles in a child was confirmed in Montgomery County on March 2 ─ the first reported case in the state in 2025. Nationwide, the Centers for Disease Control and Prevention (CDC) has reported 164 measles cases in nine states. Texas alone has seen at least 140 cases since late January, including one unvaccinated child who died. Measles is a preventable, highly contagious, airborne virus that can cause serious health complications, including death, especially in children under 5, said Dr. George McSherry, division chief of pediatric infectious diseases at Penn State Health Children’s Hospital. “Measles is a very serious illness. It’s one of the most infectious of the infectious diseases,” McSherry said. “If you put a person with measles in a room with 100 unimmunized people, 90 will get it.” Click on the title's link for more important information. 

Lending a helping harp: Music therapist Sarah Ohr uses the power of music in hospice care VolumeOne - Theme Issue "Death & Taxes"; by Barbara Arnold; 3/6/25... Dubbed the "hospice harpist," Sarah is a harpist and more. Music has been part of her life since a child growing up in Green Bay, where her parents adopted Sarah and her adopted brother Steve separately from South Korea.  ... “Harp and piano are my musical loves,” Sarah noted in an interview. ... Two events, which both occurred in early April 2018, served as life-changing catalysts for Sarah: her brother, Steve, was murdered in Chicago, and Sarah received a cancer diagnosis that would require major surgery. ... [Click on the title's link to read Sarah's career journey as a performer and into music therapy.] ... [Now, Sarah serves St. Croix Hospice in Eau Claire, WI as a board certified music therapist.] According to Sarah, there is a perception that a patient can request her to entertain them. In reality, in order for Sarah to offer support to a patient, medical necessity must be present. “First, I need to be called in as part of the care team, ... Next, I meet with the patient or the patient’s family to conduct an assessment. In super simple terms: is there social isolation, depression, anxiety, pain management, or a neurological reason, by which music can fulfill a need?"Editor's note: Find professional music therapists at the Certification Board for Music Therapists.

Understanding a patient’s AI medical journey The Hastings Center; by Ian Stevens, Erin William, Jean-Christophe Bélisle-Pion, and Vardit Ravitsky; 3/5/25As artificial intelligence becomes increasingly integrated into U.S. health care, patients should know the ways in which AI is being used in their care, concludes a new paper, “Bring a ‘Patient’s Medical AI Journey’ to the Hill.” Transparency is crucial for interactions between health care providers and individual patients, as well as for systemic level uses of AI, including:

Rare flu complication rose in recent years Medscape; by Heidi Splete; 3/4/25 Reports of children in the United States with influenza-associated encephalopathy or encephalitis (IAE) increased from none during the 2020-2021 flu season to a preliminary 14% for the 2024-2025 season, based on a new analysis from the Centers for Disease Control and Prevention (CDC). IAE involves a range of neurologic syndromes triggered by flu infection of the respiratory tract, with diagnosis based on brain lesions detectable on imaging, wrote Amara Fazal, MD, and colleagues at the CDC’s National Center for Immunization and Respiratory Diseases. A series of anecdotal reports of pediatric cases with IAE in January 2025 prompted the CDC’s investigation; the findings were published in the Morbidity and Mortality Weekly Report (MMWR).

Palliative care clinicians goals-of-care notes more extensive than other providers’ documentation Hospice News; by Jim Parker; 3/5/25 A team of researchers has developed a standardized goals-of-care note to document patient wishes in the electronic medical record. Many patients do not experience goals-of-care conversations in a timely manner. But even among those who have, their wishes can get lost if they are not documented. The standardized note created by a research team from the Regenstrief Institute, the Indiana University School of Medicine and Indiana University Health can help health care providers be aware of and access patients’ goals of care, according to lead investigator Dr. Alexia Torke. ... The research on the note was published in the American Journal of Medicine.