“Rehabbed to Death” in oncology: Where do we go from here?

“Rehabbed to Death” in oncology: Where do we go from here?
JCO Oncology Practice; by Daniel E. Lage, Craig D. Blinderman, Corita R. Grudzen; 9/3/24
You can go to rehab to see if you get stronger for chemo. These are words that every clinician caring for hospitalized patients with cancer has heard or said countless times. And yet, especially when it comes to older adults with advanced solid tumors, less than a third of these patients will ever receive systemic therapy again. Furthermore, their symptom profile is more similar to those discharged to hospice than to those discharged home, and they face debilitating functional decline and early mortality—leading some to coin the term “rehabbed to death” to describe this phenomenon. We suggest a few keys area of focus: (1) reframing hospital discharge conversations, including incorporating practices of disclosing prognoses using validated tools or other algorithms; (2) empowering team-based care and inclusion of palliative care clinicians in the SNF setting; and (3) identifying patients failing to make functional progress early. [Also see accompanying article: Respect for the patient-oncologist relationship may limit serious illness communication by acute and postacute care clinicians after discharge to a skilled nursing facility by Sarguni Singh, Ashley Dafoe, John Cagle, Elizabeth R. Kessler, Hillary D. Lum, Brooke Dorsey Holliman, Stacy Fischer.]