Literature Review

How work in the hospice field differs from hospital work Healthcare Business Today; 3/17/25 ... How work in the hospice field differs from hospital work goes beyond the obvious difference in care settings—it reflects a fundamental shift in approach, focus, and philosophy. Hospice focuses on enhancing quality of life, while hospitals often prioritize life-saving interventions. This contrast not only shapes patient care but also defines the role of the medical teams in these environments.

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.

My Stories program preserves cherished memories of patients in hospice The Alpena News, Alpena, MI; by Reagan Voetberg; 3/8/25 The Hospice of Michigan in Alpena preserves the stories of patients, not in a book or photo album, but on a flashdrive. It’s called the My Stories program. Patients in hospice are given the opportunity to video record their stories and memories for their loved ones to hear once they’ve passed. Patients do not have to pay a dime to record their life stories. Alpena’s Hospice of Michigan Volunteer Program Coordinator Kristie Lukes talked about how meaningful the My Stories project is to patients and their families. Lukes coordinates volunteers to help patients with their recordings. Lukes explained further what My Stories is. “It’s a recording of the patient’s life and the stories that they want to share with family and patients,” she said. “So it becomes kind of a legacy project.” 

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.” ... 

What do the ashes symbolize in life, death, and cultural rituals? Brain Wise Mind - Symbolism; by Jodie Lawrence; 1/26/25In this article, you’ll explore the rich symbolism behind ashes, from themes of loss and renewal to connections with the cycle of life. By understanding these meanings, you can gain a deeper appreciation for how ashes play a role in various rituals and practices. Get ready to uncover the significance that lies within these seemingly simple remnants. ... Ashes symbolize a range of profound concepts, particularly in relation to life and death. You can find their meanings in various cultures and traditions, reflecting significant themes.

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.]

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

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."

Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing studentsState Nurses Associations - Kansas State Nurses Association; by Shelby True, MSN, RN; Libby Rosen, PhD, RN, IBCLC; Ashley Seematter MSN, RN; Jeri Harvey & Karly Lauer, MSN, RN; 2/20/25Many baccalaureate nursing programs throughout the United States thread concepts of bereavement and end-of-life care throughout their curriculum. However, a standardized education program for nursing students that increases the knowledge, confidence level, and application of skills a nurse must possess when providing perinatal bereavement care is often absent from the curriculum (Sorce & Chamberlain, 2019).  Perinatal loss can have a profound impact on parents and their loved ones, leading to emotional, psychological, physical, and spiritual trauma that deeply affects the lives of those involved. The nursing care each parent receives at the time of the loss may be remembered for years to come and is crucial to determining the nature of the grieving process (Sorce & Chamberlain, 2019). ... To improve the knowledge, confidence, and skill level of nurses providing perinatal bereavement care, a role-play perinatal bereavement simulation was developed and implemented in two Midwestern universities’ baccalaureate nursing programs in the maternal/newborn courses. Editor's note: Having served our hospice's Pediatrics Team for four years, the grief of parents, grandparents, siblings affected me deeply. I remember vividly a young mom unable to physically leave her baby's body with the hospital's nurse. Gently, we held her baby together. Over the course of about 15 minutes, the mother gradually shifted the weight of holding her baby over to me, before the hardest task of her life--leaving the hospital without her child. (It was Christmas week. I bawled when I got home.) Visiting them at the funeral home and after in their home, I experienced horrible, disenfranchised comments and attitudes from others (especially a local preacher). Leaders: tune into your pediatric hospice and palliative team members. What specialized support and education do they need? And, we never know what personal stories of perinatal bereavement those around us continue to carry. 

Improving quality of life and end-of-life care: Standardizing goals of care notes in EHRs EurekAlert! - American Association for the Advancement of Science (AAAS), Indianapolis, IN; Regenstrief  Institute, peer-reviewed publication; 2/19/25 ... A new study by researchers from Regenstrief Institute, the Indiana University School of Medicine and Indiana University Health presents the standardized goals of care note they developed, deployed and evaluated as a quality improvement initiative at IU Health, a large, statewide healthcare system. ... The study authors report:

Cancer, aging, and meaning: Navigating psychosocial challenges The ASCO Post (Association for Clinical Oncology); by Ramy Sedhom, MD; 2/18/25 I’ve learned a lot about medicine over the years, but one thing I wasn’t taught was how to guide someone through the existential weight of dying. My education centered on diagnosing, curing, or at least managing disease—not on the delicate art of helping people and their loved ones cope with what cannot be cured. Now, several years into my career as an oncologist, primarily caring for older adults, I recognize that providing cancer care for the whole patient requires deep attention to their psychosocial health needs. ...

People with depression develop long-term health conditions quicker than those without, study finds McKnights Home Care; by Kristen Fischer; 2/13/25 Adults who have experienced depression develop long-term physical conditions about 30% faster than those without depression, a new study finds. Authors of the report said depression needs to be viewed as a “whole body” condition, with treatment approaches that address mental and physical health. The report was published Thursday [2/13/25] in PLOS Medicine. Investigators evaluated the association between depression and the rate at which conditions accrued in midlife and older age.