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."

The roots of palliative care: Michael Kearney, Sue Britton, and Justin SandersGeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith; 3/13/25 ... As far as we’ve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? In today’s podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care.  Sue Britton was the first nurse hired on that palliative care unit. Michael Kearney on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry.  Justin Sanders wants to be sure the newer generations of palliative care clinicians understand the early principles and problems that animated the founders of hospice and palliative care, including:

Hospice Insights Podcast - Psychedelics and end of life care: Understanding the legal landscape Hospice Insight - The Law and Beyond; by Husch Blackwell LLP; 3/12/25 There has been a lot of buzz around psychedelics, and particularly their potential usefulness in treating existential suffering at the end of life. Husch Blackwell was the first law firm in the country to establish a Psychedelics & Emerging Therapies practice group devoted to helping clinicians, researchers, and investors navigate the complex and difficult legal and regulatory issues involved in developing new therapies in this space. In this episode, host Meg Pekarske is joined by the leaders of Husch Blackwell’s Psychedelics & Emerging Therapies practice group, Kimberly Chew, Karen Luong, and Natasha Sumner, who provide an overview of what psychedelics are, their legal status under federal and state laws, and liability considerations for clinicians.

Nearly $20K awarded at 100+ Harbor Women Who Care event The Daily World, Aberdeen, WA; by Jerry Knaak; 3/13/25 After listening to three impassioned speeches at the packed house at the Hoquiam Elks Lodge No. 1082 Tuesday evening, nearly 170 donors at the seventh 100+ Harbor Women Who Care giving event ... [awarded] a grand total of $19,020 in donations to Harbors Home Health & Hospice.

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. 

Happy St. Patrick's Day! May the blessings of each day be the blessing you need the most. Editor's note: For a treasure trove of more Irish blessings, click here.  Click for the the History Channel's "History of St. Patrick's Day."

U.S. House Committee on Ways and Means Hearing Health Subcommittee  “After the Hospital: Ensuring Access to Quality Post-Acute Care” U.S. House of Representatives Documents (Federal Information & News Dispatch, Inc.); by Jonathan D. Fleece, President & CEO Empath Health; 3/11/25 Chairman Buchanan, Ranking Member Doggett, and distinguished Members of the Subcommittee. Thank you for the opportunity to be here today. ... As President and CEO of Empath Health, one of the nation’s largest not-for-profit home-based care organizations, it is an honor and privilege to serve one in five Floridians who need hospice care. ... My commitment to this mission is deeply personal. After losing my first daughter at birth, I dedicated my life’s work to ensuring that no family faces serious illness or loss without the support, dignity, and compassion they deserve. That experience shaped my belief that health care must do more than treat symptoms—it must care for the whole person and those who love them. ... Today, as the leader of Empath Health, I remain committed to advancing that vision—ensuring that patients and families have access to the right care, at the right time, in the place they call home. That is the foundation to my testimony: to speak for the millions of Americans who rely on home-based care and the policies that make it possible. ...

Leverage collaboration, detailed notes to improve end-of-life care Home Helath Line; by MaryKent Wolff; 3/13/25 Educate your hospice staff on monitoring symptoms that could indicate a patient is nearing the end of life. Agencies that manage these symptoms early and take the time to prepare and comfort caregivers and families for the transition could see these successes reflected in their CAHPS Hospice survey scores. [Subscription required for more content.]

The 1 truly difficult part about being a caregiver that often gets overlooked HuffPost; by Kimberley Richards; 3/13/25 Emma Heming Willis, wife of actor Bruce Willis, recently talked about the needs of caregivers on social media. Experts share what to know about the vital role. ... Among the different ways society may overlook the various caregiving experiences, there’s one aspect of it that isn’t often talked about: Many times it’s an “invisible” job. ... Hemings Willis’ post sparked conversations online about caregivers and the many struggles that come with it. And experts say perhaps one of the most isolating is the issue of “invisibility. ... She said that caregiving is often seen as a “family duty,” which prevents it from “being recognized as a broader issue requiring systemic attention.” “This view is often compounded by gendered expectations, where women are traditionally expected to take on caregiving roles, leading to feelings of guilt and pressure when they seek assistance,” she said. “The lack of formal policies ... only deepens the invisibility of this vital role, making it even harder for caregivers to balance their responsibilities with their own well-being.”

MedPAC’s flawed recommendations would harm patients and increase costs National Alliance for Care at Home, Alexandria, DC and Washington, DC; Press Release; 3/14/25 The National Alliance for Care at Home (the Alliance) released the following statement on the Medicare Payment Advisory Commission’s (MedPAC) March 2025 Report to Congress: Medicare Payment Policy. ... “MedPAC’s recommendations are based on flawed and incomplete analyses with conclusions unsupported by all the available facts. These recommendations severely undervalue the critical role that home health and hospice providers play in ensuring the health and well-being of Medicare beneficiaries,” said Alliance CEO Dr. Steve Landers. “Recommending unthinkable cuts for home health and stagnant payment rates for hospice in the face of workforce shortages and inflation threaten access to these vital services for our aging population and undermine the dedicated providers who support them. ..."

‘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.

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.

Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trialJAMA Network Open; Ravi B. Parikh, MD, MPP; William J. Ferrell, MPH; Yang Li, MS; Jinbo Chen, PhD; Larry Bilbrey; Nicole Johnson, BSN; Jenna White, MSW; Ramy Sedhom, MD; Natalie R. Dickson, MD; Stephen Schleicher, MD; Justin E. Bekelman, MD; Sandhya Mudumbi, MD; 2/25In this randomized clinical trial conducted in a community oncology network between November 2022 and December 2023 among 562 patients with advanced cancer identified by an automated electronic health record algorithm, default orders increased palliative care consultation (44% vs 8%) and decreased end-of-life systemic therapy (6% vs 16%) compared with usual care but did not improve patient-reported or hospice outcomes. The findings suggest that default algorithm-based palliative care orders are a scalable implementation strategy to increase palliative care referrals and reduce intensive end-of-life care.