Literature Review

Flu season lingering despite springlike weather in Indiana NBC WTHR 13, Indianapolis, IN; by Dustin Grove; 3/14/25 With warmer weather moving into central Indiana, you'd think flu season would be over by now, but it's still hanging on. The Centers for Disease Control and Prevention estimates at least 33 million cases of flu nationwide, with 430,000 people hospitalized. So far, 19,000 have died. "(I think) it is more severe than it has been in the past few years. I think that with those numbers ... it really tells a story and that, especially with the 19,000 deaths, we're talking about a serious illness this year," said Dr. Darlene Lawrence. "COVID is waning, folks are having vaccine wariness." ... Even with spring weather arriving and the thought that flu season is waning, it's still not too late to get vaccinated. ... Flu is particularly dangerous for the elderly, people with chronic conditions and children, she said. ... Patients can talk to their doctor or pharmacist to help find the best vaccine for them. 

[Canada] Use of feeding tubes among hospitalized older adults with dementiaJAMA Network Open; Anne-Marie Hartford, MSc; Wenshan Li, PhD; Danial Qureshi, MSc; Robert Talarico, MSc; Stephen G. Fung, MPH; Shirley H. Bush, MBBS; Genevieve Casey, MSc, MBBS; Sarina R. Isenberg, MA, PhD; Colleen Webber, PhD; Peter Tanuseputro, MHSc, MD; 2/25In this cohort study of hospitalized individuals with dementia, feeding tube insertion was not associated with improved survival or postdischarge outcomes. Being male or younger and having swallowing problems and greater functional impairments were associated with increased odds of feeding tube use, while having a do-not-resuscitate directive and living in rural settings were associated with reduced odds. Factors that were (or were not) associated with feeding tube placement were sometimes misaligned with best practice guidelines. Goals of care conversations, alternative intervention options, and improved clinical protocols are recommended. 

Healing spaces: The art of hospital architecture The Daily Utah Chronicle; by Isra Habib; 3/13/25 In the 20th century, architects designed hospitals as stark and functional structures with long hallways, sterile walls and fluorescent lighting that prioritized efficiency yet provided little comfort. These spaces, designed for practicality, often neglected the emotional and psychological needs of patients and their families. Today, however, architects are redesigning hospitals to heal both body and mind. They aim to transform the intimidating experience of being in a hospital into one that is comforting and supportive.

How Houston Methodist’s ACO reduced its end-of-life spending by nearly 20% MedCity News - Hospitals; by Katie Adams; March 10, 2025 Houston Methodist Coordinate Care is reducing costs through a partnership with Koda Health, a digital platform that guides patients through their end-of-life choices. Preliminary findings show the technology resulted in a 19% reduction in the total cost of care for patients at the end of their life, which equals nearly $9,000 in savings per patient. ... The ACO has been working with Koda Health for more than three years — and it is saving money by getting patients more involved in their end-of-life care plan.

21 large health systems growing bigger Becker's Hospital Review; by Alan Condon; 3/7/25 Merger and acquisition activity is rebounding after a drop in deal volume during the pandemic, with many large health systems growing their hospital portfolios or planning to add more hospitals in the coming quarters. Twenty-one large health systems growing bigger: 

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.”

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. 

The twofold challenge of an older population — and how systems are adapting Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 2/21/25 In less than a decade, older Americans are projected to outnumber children for the first time in U.S. history, sparking conversations about the need for age-friendly healthcare.  At the same time, declining birth rates and longer life expectancies — half of babies born in 2020 are expected to live past 100 years — pose potential workforce challenges. Becker's connected with four health system leaders to explore the challenges this demographic shift presents and how they are preparing to address it. [Click on the title's link to continue reading.]

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.

Patient put in hospice at 52 celebrates life years after admission, thanks to heart surgery KCTV-5, Kansas City, MO; by Morgan Riddell; 2/27/25 A local man with heart failure who was told numerous times he only had months to live now has a new outlook on life two years later. ... It started in 2023. Sam Edwards, who was diagnosed with ALS after serving in the military, started experiencing new pains. He went to doctors who all determined Sam was just experiencing issues related to ALS. Then, a doctor at the VA Hospital noticed some tests were off and found Sam was experiencing heart failure. What he needed was open heart surgery, but doctors determined the risk of putting Sam on the operation table was too high. Not only was he at risk of having a stroke and dying on the operating table, but his recovery would also be months long and painful. They declined to do the surgery at the VA and suggested Sam go get a second opinion. This is when he was connected with Dr. Michael Gibson.Editor's note: While we in the palliative and hospice field promote earlier admissions to care and elimination of overtreatment, another side of the coin exists. Click on the title's link to read more about this hospice patient who sought out a second opinion. Imagine: the hospice patient is you (at age 52); or a family member; or a best friend. Especially as AI becomes more prevalent in assessing palliative and hospice referrals, we must see the bigger picture and retain human element. 

Breaking bad news: Guidance on disclosing a dementia diagnosis Medscape; by Megan Brooks; 3/3/25 As biomarker testing for Alzheimer’s disease (AD) evolves, timely and compassionate disclosure of a diagnosis is more complex than ever. Yet, clinicians may struggle with how — or in some cases whether — to disclose that a patient has mild cognitive impairment (MCI) or dementia. A recent perspective offers a practical roadmap to help clinicians navigate these challenging conversations. The authors from the Perelman School of Medicine, University of Pennsylvania, Philadelphia, noted that disclosure of a dementia diagnosis “is particularly nuanced and requires a conscientious approach. Clinicians must assess patients’ understanding and appreciation of symptoms, goals for the evaluation, and desire for information.” 

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.