Literature Review

Hosparus celebrates social workers' impact on healingCorydon Democrat; 3/26/25 Hosparus Health Southern Indiana offers comprehensive grief support services to help individuals heal from loss in a caring and understanding environment. While recognizing National Social Work Month, Hosparus celebrates the compassionate guidance of its social workers and grief counselors who support individuals and families during their most difficult moments. Editor's note: Today's the last day of March as Social Worker month. You still have time to thank your all-important social workers. For more, see our post Social Media Toolkit for Social Work Month 2025. And, appreciation and recognition is not limited to the month of March. It needs to be alive and well all year long. 

Palliative care clinic offers supportive care for patients with end-stage heart failure Yale School of Medicine; by Rachel Martin; 3/25/25 ... Michael Beasley, MD, [Yale] assistant professor of medicine (cardiovascular medicine), and Nora Segar, MD, [Yale] assistant clinical professor (general internal medicine) and director of palliative medicine at the Saint Raphael Campus of Yale New Haven Hospital, recently established a new outpatient clinic to provide dedicated palliative care for people with end-stage heart failure. ... “For many patients with advanced heart failure, hospice care does not meet their needs until very late in their course,” said Segar, an early champion of the clinic. “Instead, by providing early palliative care outside of the hospital, when it’s not a time of crisis, we can help patients accept and cope with their prognosis, manage their symptoms, and continue making plans for the future.” New patients receive longer appointments, which allows the team to hear their stories and start building relationships with them. [Continue reading ...]Editor's note: For all palliative and hospice leaders, we highlight this last statement: "New patients receive longer appointments, which allows the team to hear their stories and start building relationships with them."

Assisted ventilation withdrawal in motor neuron disease: updated results BMJ Supportive & Palliative Care; by Lucy Bleazard, Jonathan Palmer, David Wenzel, Thomas Jeffery, and Christina Faull; 3/24/25 Introduction: Patients with ventilator-dependent motor neuron disease (MND) may request withdrawal of their assisted ventilation. Facilitating this process as a healthcare professional (HCP) can be emotionally and practically challenging. The Association for Palliative Medicine (APM) issued guidance to support HCPs and invited anonymised accounts of the withdrawal process to provide an update on the guidance. ... Results: Younger patients tended to need higher doses to achieve adequate symptom management prior to withdrawal. Practices of weaning the ventilator varied significantly between respondents. The median time to death following withdrawal of ventilation was 30 min, with three-quarters of patients dying within 2 hours. Conclusion: This is the largest data set to date regarding the withdrawal of assisted ventilation in MND. This updated analysis reaffirms that a personalised, titrated approach remains appropriate and effective. The revised APM Guidance 2025 incorporates new sections on recommendations for managing the ventilator. [Continue reading ...]

Carolyn Hax: Does sibling love justify traveling to abusive mom’s deathbed?The Washington Post, Washington, DC; 3/24/25 Sister asks the letter writer to join her at their dying mom’s bedside — despite their PTSD-inducing childhoods. [The rest of this article may require a subscription to The Washington Post.]Editor's note: Even if you're not able to access the full article, what does this question stir in you? Be aware that many family caregivers (or simply family members) face complex, conflicted relationships with the persons they are tending--or in this case, even considering visiting or not. Be attuned to these common, everyday occurrences that your direct care interdisciplinary team members regularly navigate. What family systems' education and support do you provide for them?

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:

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

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.

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.”

Here’s to Laura Ptucha-Skoog, hospice nurse YubaNet.com; by Timothy May; 3/10/25 “I’m not sure I’d say much at all, not at first. I would just try to listen.” This in response to the question of how a hospice nurse should respond if patients or family members make demands that seem unreasonable, unwise, or downright impossible. ... Laura Ptucha-Skoog should know; she has been an R.N. for decades and a nurse at Hospice of the Foothills for the last nine years. She loves her job, including the challenge of facilitating communication. Her ability to talk frankly with terminally ill hospital patients and families drew her to a career in hospice. “Often,” Laura explains, “the human elements are as challenging as the medical ones. Things like asking the right questions and listening to responses; making sure your patient and their caregivers understand what you are doing and why; verifying that everyone understands where you are in the process; listening to their responses with patience and empathy.” ... 

Report finds those with Parkinson’s have unmet hospice needsMcKnights Long-Term Care News; by Kristen Fischer; 3/6/25 Hospice use varies depending on whether a person has Parkinson’s disease, Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds. Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their study, which was published Tuesday in JAMA Network Open. ... Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)