Attention on Medical Overtreatment Raises Awareness on Advance Care Planning, Hospice and Palliative Care

NHPCO's Caring Connections Encourages People to Learn More

(Alexandria, Va) – Recent media coverage (Associated Press 06/29/10) on the challenges patients and families face with overtreatment of a life-limiting illness brings the issues of hospice and palliative care and advance care planning to public attention.

“It’s important to remember that quality of life and a patient’s personal wishes, beliefs and values must be a factor when making care decisions brought about by a serious or terminal illness,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization.

“Discussions helping patients and families understand the many benefits of hospice and palliative care must be more common and held long before a family faces a medical crisis,” Schumacher added.

Advance Care Planning

Advance care planning—which includes completing a living will and appointing a healthcare proxy—is somewhat like planning a road trip to an unfamiliar destination. Very few people would expect to get to a destination safely and comfortably without having a well-thought-out map in hand. Yet, it’s estimated that 70 percent of Americans have not completed a living will.

• A living will charts the course for your healthcare, letting your family and health care providers know what procedures and treatments you would want provided to you—and under what conditions.
• A healthcare proxy or healthcare power of attorney form, allows you to choose someone you trust to take charge of your healthcare decisions in case you are unable to make those decisions yourself.
• Advance directives can be changed as an individual’s situation or wishes change.

Hospice and Palliative Care

Many people mistakenly think that hospice is simply a place you go when nothing more can be done to address an illness. That misunderstanding can keep people from accessing the expert care that hospice and palliative care offers.

NHPCO reports that more than a third of hospice patients received care for seven days or less—not enough time to take full advantage of the range of available services.

Hospice and palliative care provide symptom management, pain control, and support to address emotional, psychological, and spiritual needs.

“Hospice brings patients and families compassionate care when a cure isn’t possible. Palliative care provides comfort and support earlier in the course of a serious illness and is not dependent upon prognosis,” explained Schumacher. “Together, hospice and palliative care provide solutions beyond traditional medical care. Most importantly, hospice and palliative care provide dignity at a time when it’s needed most.”

Important Facts

• Over 80 percent of hospice care takes place in the home.
• Over 1,300 hospitals have palliative care programs; many of the nation’s 4,800 hospice providers offer palliative care services as well.
• Hospice care is covered under Medicare, Medicaid, and most private insurance plans.
• Bereavement services are available to family for a year following the death of a loved one.
• Research has shown that hospice patients lived an average of 29 days longer than similar patients who did not opt for hospice care.

Learn more about advanced care planning, hospice care, and palliative care from NHPCO's Caring Connections at www.CaringInfo.org or call the HelpLine at 1-800-658-8898.

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Contact:
Jon Radulovic
NHPCO, Vice President of Communications
Ph: 703-837-3139
jradulovic@nhpco.org

A Message from Don Schumacher, June 2010

Becoming a Larger Part of the Care Continuum

My opening plenary at the Management and Leadership Conference in April touched on many issues that, as an industry, we must be keenly aware of—and address together. In the limited space I have here, I’d like to talk about one of the issues of increasing import right now. That is, finding additional ways to serve more people in our communities.

I actually raised this issue when I became NHPCO’s president/CEO in 2002. As an industry, we were far too dependent on reimbursement from the very fragile Medicare system—and we still are today. While hospice payment reform will be the ultimate catalyst for change, my hope is that all providers will begin taking steps now to assess the needs in their community and explore ways to utilize their skills to meet their broader community’s needs. This is what I mean when I speak of becoming a larger part of the ‘care continuum.’ Much of my plenary address was devoted to this issue and I truly believe it is the very crux of our future success or demise as an industry.

The diversification or expansion of our services is, of course, not a quick or easy task to undertake. It requires planning and a thoughtful business strategy. But it is doable—there are programs which are now demonstrating just how doable it is.

Some hospices are now offering adult day care and home-diversion programs, others have become PACE providers, and still others are expanding into palliative care. In some cases, these providers are partnering with other organizations and in other cases they are going it alone. So I ask that you study the work now being done; explore various reimbursement models, including community-based waiver programs; and identify and begin dialog with potential partners in your community. Our cover story this month shares the process that Pathways Hospice followed to develop its community grief center in Fort Collins, Colorado—an excellent example of how one program assessed a community need and, building on a core strength, expanded its services. Our thanks to Nancy Jakobson, director of the center, for sharing her program’s experience with us.

In the coming months, NHPCO will be providing tools and resources to help you in this process. Our specialty conference in August, “Developing the Care Continuum: Innovative Models to Meet the Unique Care Needs of Patients/Families” will also serve as a dynamic forum to help jumpstart discussions among providers.

I encourage every provide-member to find additional ways to become a larger part of the care continuum. If we don’t step up, others will—leaving our industry a very marginalized component of the nation’s new healthcare system.

Don

Note: Don’s monthly message appears in NewsLine; members can access this month’s and previous issues at www.nhpco.org/newsline.

June 2010 Palliative Care Grand Rounds

The June Palliative Care Grand Rounds, a "monthly blog carnival" highlighting blog post focusing on hospice, palliative care and grief matters, is being hosted this month by Julie Rosen at the Schwartz Center Blog. Check it out today!

The views expressed in the Palliative Care Grand Rounds are the sole responsibility of the authors of each blog highlighted and does not necessarily reflect the views of NHPCO, this blog or its editors.