Literature Review

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.

Malpractice lawsuits are rising — here’s how physicians can protect themselves Becker's ASC Review; by Patsy Newitt; 3/11/25 Medical malpractice insurance is essential for protecting physicians from financial and legal risks, particularly amid the rise in malpractice lawsuits, according to a March 5 article on Physicians Thrive’s website.  In 2023, malpractice verdicts hit a record high. There were 57 medical malpractice verdicts of $10 million or more, with more than half of those verdicts hitting $25 million.  Here are nine things to know from the Physician’s Thrive article. 

Q&A: Nursing and the integration of technology at HIMSS25 mobihealthnews; by Anthony Vecchione; 3/10/25 Lavonia Thomas, nursing informatics officer at the University of Texas MD Anderson Cancer Center, sat down with MobiHealthNews at the HIMSS Global Health Conference & Exhibition in Las Vegas last week to discuss how nurses are implementing digital tools that help improve patient care.  ... [Thomas:] "We are having some great success in nurses' engagement and their feeling of being highly engaged. A nurse is not going to tell you, "I love the electronic health record" or certain things about technology. What is important is that they feel that they are heard, that their feedback is taken into the design and development and that their workflows are assessed." ...

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.” ... 

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. 

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.)

Central Coast VNA & Hospice expands registered nursing services in Monterey Buzz; 3/5/25 Central Coast VNA & Hospice is significantly expanding its registered nursing care services in Monterey, providing residents with increased access to high-quality, personalized healthcare delivered directly in their homes. … Key expanded services include advanced care planning, which helps patients and families make informed medical decisions, and a palliative care program focused on relieving symptoms and reducing stress for patients with serious illnesses. The organization also offers specialty programs targeting specific health conditions such as cardiac care, diabetic care, and orthopedic support. 

Nurse leaders can take the lead in promoting civility in the workplace Oncology Nurse Advisor; by Susan Rux, PhD, DNP, RN, FACHE; 2/28/25 Civility, the act of respecting others, especially in situations where disagreement or disparity may arise, occurs by intentionally displaying kindness and empathy. These behaviors help people to understand differences as well as uphold common ground across all social contexts. A stable foundation, afforded through civil actions, serves as a catalyst in achieving environments that promote diversity, equity, and inclusivity — the underpinnings of a culture of belonging. Nurse leaders can play a key role in creating this culture. Contrary to civility, in the healthcare setting, acts of incivility lead to increased levels of staff disengagement and turnover. Researchers have noted that a civil nursing workplace provides a safeguard against numerous professional issues, including but not limited to increased turnover rates, burnout, job dissatisfaction, and stress.

Can default palliative care referrals increase consults? Medscape; edited by Gargi Mukherjee; 3/4/25 A default palliative care referral intervention increased palliative care consultations by more than fivefold and decreased end-of-life systemic therapy by more than half among patients with advanced cancer being treated in the community oncology setting. ...

Charges dismissed against chef accused of trying to kill his Monterey county mother KSBW Action News-8, Monterey, CA; by Felix Cortez; 2/28/25 A popular San Francisco area chef who was arrested along with his sister and charged with trying to kill their mother more than two years ago has had attempted murder charges dismissed against him. “In over 30 years of practice, this was one of the saddest cases I have ever seen and one of the most incompetent investigations by the Monterey County Sheriff’s Department that I have ever seen,” said Juliet Peck, the attorney for James Stolich. ... The mother was terminally ill and lived on a ranch off Highway 68 outside Salinas. “James’ mother’s only wish was to die at home without pain, surrounded by her daughter, son, and pets,” Peck said. But that never happened; Tinker died about a week later in a hospice facility, never to see her children again, because an emergency protective order obtained by the sheriff’s office prevented the children from visiting their dying mother. ... According to court documents, the daughter, Whitney, was the “agent designated to make all health care decisions for her mother,” which included administering medication to help alleviate her mother’s pain. ...The original criminal complaint alleging attempted murder charges said Whitney or a co-conspirator “crushed up pills with a mallet.” A close friend of Tinker was willing to testify that Whitney had no intent to kill her mother but was simply following her mother’s “directive to provide effective and sufficient palliative care even if it hastened her death.”Editor's note: This case raises numerous issues, including but not limited to community education (including law enforcement), Advance Directives, patient and caregiver education and support, MAiD (Medical Aid in Dying) or the End Of Life Option Act (EOLOA) in California, ethics, and the dying process (note that "the mother died about a week later in a hospice facility). 

45% of end-of-life cancer patients potentially overtreated: 5 study notes Becker's Hospital Review; by Elizabeth Gregerson; 2/28/25 Almost half of all Medicare enrollees with cancer nearing end of life receive aggressive overtreatment as opposed to supportive palliative or hospice care, according to a study published Feb. 21 in JAMA Health Forum. Here are five things to know from the study:

Suspect armed with rifle shoots at hospice nurse, points weapon at deputies The Orange Leader, Orange County, CA; by Staff Reports; 2/28/25 A person was taken into custody after allegedly shooting at a fleeing hospice nurse and pointing a rifle at law enforcement Thursday. Orange County Sheriff’s Deputies responded to the 5600 block of Rebel Road after a hospice nurse reported to 911 that while attempting to provide care to one of her patients she was confronted by an occupant of the home. The occupant followed the nurse out of the home with a rifle, and shot at her as she fled the property.  A single bullet struck the nurse’s vehicle, according to information from OCSO. Upon arrival, Orange County Deputies established communication with the suspect who remained inside the residence with the rifle.  The suspect reportedly pointed the rifle toward the deputies while he remained in close proximity to the hospice patient.