Literature Review

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

Weinstein Hospice launches innovative VR initiative: The program will allow residents to enjoy "bucket list" experiences Atlanta Jewish Times; by AJT Staff; 3/12/25 Jewish HomeLife and Weinstein Hospice are pioneering a new way to bring joy, comfort, and meaningful experiences to hospice patients through the groundbreaking Weinstein Hospice VR Initiative. This transformative program harnesses the power of virtual reality (VR) to fulfill unforgettable “bucket list” experiences, offering patients moments of joy and cognitive stimulation that transcend their physical limitations. For Vicki and Ed A., this initiative has been nothing short of miraculous. ... One of the most profound moments for Ed came when he was able to experience Scuba diving again—virtually. ...

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.

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."

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.” 

The rising importance of social workers on the home health team Home Health Care News; by Audrie Martin; 3/10/25 Addressing social determinants of health (SDoH) is becoming increasingly important due to new regulations from the Centers for Medicare & Medicaid Services (CMS) and the shift toward value-based care payment models. With ongoing staffing shortages and a growing demand for home-based care services, social workers are taking on greater responsibilities to support the health care system. ... Individuals requiring home health care often need complex support that addresses both their medical and psychosocial needs, especially if they are isolated from typical social interactions and services. Some home care teams are now integrating home health social workers (HHCSWs) to provide a comprehensive approach to care that considers these SDoHs.Ediotor's note: March is National Social Work Month. Click here for National Association of Social Worker's (NASW) Social Media Toolkit for Social Work 2025.

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.” ... 

Social Media Toolkit for Social Work Month 2025 NASW National Association of Social Workers; by NASW; for March 2025 Celebrate Social Work Month 2025! People enter the social work profession because they genuinely care about other people. However, social workers have the education, training, and expertise to empower people so they can live to their full potential. That is why this year’s theme is Social Work: Compassion + Action. Here are our suggestions to help you share information about the positive work social workers do during Social Work Month 2025 and beyond.

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.

My mother and brother have terminal cancer. I'm worried I won't feel anything when they die. Business Insider; essay by Kimanzi Constable; 3/1/25 ... My brother was diagnosed with Cutaneous T-cell lymphoma (CTCL) three years ago, and my mother found out she had stage four lung cancer a year ago. I got a call earlier this year that the cancer was spreading, and I flew to spend time with them. I knew it would be hard seeing them battling late-stage cancer, but what I walked into was my brother in the Advanced Cancer Care Center, unable to move, and my mother wanting to hold an "end of life" planning meeting. It was worse than I anticipated. It was hard to see him not moving and the nurses having to help him do everything. My mother looked like she weighed 50 pounds ... I'm worried I won't feel anything when they pass away. ... I think it might be just another day when they pass away. I've been thinking — what does that say about me? Am I a bad person for not falling on the ground and losing it for over half of my family dying? Or is this nothingness an OK feeling due to the complicated relationship we've had most of my life? ... Editor's note: Leaders, welcome to the daily world of your clinicians, especially your social workers, chaplains, and grief counselors. Read this with openness to the normalcy of this author's conflicted relationships, emotions, thoughts, and empowered actions toward "not wanting to regret how I handled this opportunity to say goodbye more healthily."

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.