These articles support the utilization of physical therapy in palliative care settings and emphasizes the impact of physical therapy on improving patients' physical, social, and emotional well-being.

With an increase in the elderly population needing medical care, and the economic crisis the United States is experiencing today, there is no wonder that health care services are feeling the brunt of this crisis. One of the largest groups to experience the effect of changes in health care is the geriatric population. Rather than matching the care needed by this growing population, health care services are instead putting restrictions on the care being provided. According to the article ''Prelude to death or practice failure?'' from the American Journal of Hospice and Palliative Medicine, ''Centers for Medicare and Medicaid Services (CMS) announced they would no longer pay for the cost of care for outcomes they deemed preventable. .. '' 1 Also, one of the most common needs for medical attention in the geriatric population is for pressure ulcers. 1 For patients admitted to the hospital with pressure ulcers, it is indicated that the cost of their care will be covered. What does this suggest for patients with ulcers, stage III or higher, that appeared during their stay in the hospital? Also, does the burden of this condition now lie in the hands of the patient or the hospital because of the fact that this ulcer was ''preventable''? According to the article, ''Prelude to death or practice failure,'' the financial needs for patients with these ulcers lie in the hands of the hospital. Hospitals are now declaring these ulcers, stage III and higher, a sign of impending death. 1 A study was performed, which outlined the significance of these ulcers based on evidence. Included in the study was how long a patient's stay related to time of death and how that compared to a patient having a pressure ulcer of stage III or higher. The name given specifically to these types of ulcers is called a Kennedy terminal ulcer (KTU). According to the study, ''Median length of stay (LOS) from admission to death was 11 days (interquartile range [IQR] 1/4 24.5-6.88 days) and median time from identification of TTI to death was 36 hours (IQR 1/4 66-22 hours).'' 2 This evidence reveals that in the case of KTU, the possibility of death is significant. A limitation that the article found was a discrepancy between the term KTU and the evidence to support this name. Also, a comparison between the skin alterations near death and the exact time of death is needed to prove that changes in skin are linked to death. Another limitation found in the article was that evidence of the ulcers still showed even after appropriate