Wednesday, June 21, 2017

Summer Listening Tour: Notes from the Road, #2

Chicago - Austin - Kansas City...

As spring winds down and summer heats up, we find ourselves moving through Chicago, Austin and Kansas City in June. 

Red meat is definitely on the menu. As a barbecue aficionado, these listening tour stops gave me the added bonus of sharing Texas-style and Kansas City-style barbecue—and we enjoyed a barbecue-inspired Chicago pizza while in the Windy City (there’s nothing like a gastronomic theme to increase the fun of time on the road). As other barbecue fans will certainly understand, the style of barbecue from one geographic region of this great country to another reveals many differences that reflect the locale and population, while there are some traits that connect them all.  And we are finding that although there are regional differences among hospices, there are many more areas of common interest and concern. 

We enjoyed barbecue in Austin and Kansas City (and pizza in Chicago)
Above all, hospices are certainly concerned about the heart and soul of hospice—and that begins with training, recruitment and retention of professionals.  We are an industry of interdisciplinary care giving that relies quite heavily on trained and motivated personnel.  It is an important reminder in the day and age of smartphones and tablets that the heart of hospice needs to be tended to, cared for, nurtured, educated, disseminated, and never forgotten.  We will not take this for granted as we consider the future of hospice and palliative care.  

Our Chicago Session kicked off our tour in the mid and south-west.
We have also seen the importance of real patient and caregiver stories. Patients and caregivers have unique needs, but they are not necessarily unique by geography.  Each region has a mix of rural, urban, high and low- income.  We must remain united and focused on improving the hospice and palliative care benefits for all, and listening to our state partners and members has reaffirmed my belief that we have so much more in common than we realize. 

In the coming months, we will renew our focus on frontline professionals, and we will also continue to focus on the real lives and real stories of our patients.  Patients, providers and caregivers ARE the hospice benefit. United, we can make a real impact in the care that more and more Americans deserve to receive.  

L: Larry Farrow of Texas & New Mexico Hospice and Palliative Care Organization greets Edo in Austin. R: Board members of Nebraska Hospice and Palliative Care Association joined Edo in Kansas City.
Beginning in July, the listening tour moves on to the mid-Atlantic and New England areas.  The cuisine may be different, but I suspect that we’ll reinforce these messages as we go on, as well as garner more valuable insight from the field. I encourage you to join us for one of our upcoming sessions. Learn more and RSVP online

As we near July 4, I'm optimistic about our future and know that no matter what obstacles we face we will always be stronger together. No matter where we live and work it is clear we need to stay united and remain focused on what matters most -- the care of the patients and families we serve.

Monday, June 19, 2017

Call for Nominations: Circle of Life Award

Nominations are being sought for the 2018 Circle of Life Award, which shines a light on U.S. programs and organizations that serve as models or inspiration for other end-of-life care providers.

The Circle of Life Award honors innovative U.S. palliative and end-of-life care programs in hospices, hospitals, health care systems, long-term care facilities, and other direct care providers.

Make sure your program gets the national recognition it deserves. The Circle of Life Awards will give top honors in 2018 to up to three programs or organizations.
Visit the AHA YouTube page to hear from past honorees who talk about their innovations and the value of winning the award to their organizations.

"In speaking with hospice providers, I frequently hear many of them say ‘I don’t think we’re ready yet to submit a nomination'…But I can attest that many of these organizations do have programs that are worth nominating for The Circle of Life Award," said John Mastrojohn, NHPCO senior vice president and COO.

“In fact, many hospice providers have found that the thorough process of submitting a nomination has led to unexpected sense of satisfaction and accomplishment. So I encourage hospices to look into nominating their worthwhile programs.”

The Circle of Life Award is administered by the American Hospital Association. The 2017 awards, which will be presented at the AHA annual conference in July, are supported, in part, by the California Health Care Foundation, based in Oakland, California and Cambia Health Foundation, based in Portland, Oregon. Major sponsors of the 2017 awards are the American Hospital Association, the Catholic Health Association, and the National Hospice and Palliative Care Organization & National Hospice Foundation. The awards are cosponsored by The American Academy of Hospice and Palliative Medicine, the Center to Advance Palliative Care, the Hospice & Palliative Nurses Association/the Hospice & Palliative Credentialing Center/the Hospice & Palliative Nurses Foundation, and the National Association of Social Workers.

The Circle of Life Award is administered by the Health Research & Educational Trust.

Monday, June 12, 2017

NHPCO Summer Listening Tour: Notes from the Road

First stop...Las Vegas!

Las Vegas seemed like an unlikely place to be thinking and talking about hospice and palliative care. However, last week, about twenty hospice providers sat in a classroom at a Roseman University auditorium to discuss the present and future of hospice and palliative care in Nevada. Not far from the glitz of The Strip, and concurrent with the World Series of Poker, we discussed the joys and challenges of providing serious illness and end-of-life care in Nevada. Different providers—large and small, for-profit and nonprofit—shared openly. We were also honored to be joined by Sue Negreen of the California Hospice and Palliative Care Association.  
Pictured on their way to Roseman Univ auditorium are NHPCO CEO and President Edo Banach, Director of Marketing Kendra Schilling, Executive Vice President and Chief Operating Officer John Mastrojohn, and Infinity Hospice Care Vice President Brian Bertram at the wheel.
This was a vivid reminder that no matter the geography or tax-status, hospice touches lives of real people in all places. It touches folks from the right and left, the mountains, and the city. We must cherish, protect and grow the benefit to reach more folks with the unique person-centered, interdisciplinary care model that is the hallmark of hospice and palliative care.  

We spoke about the fact that we are facing more challenges today than in the past. Being a hospice provider is far more complex than it was four decades ago. Oversight, scrutiny and increasing compliance demands are only a few of these things that concern us all. We’re all facing ongoing change. That said, we should never forget that with change comes a valuable opportunity for us to innovate and continually examine what we do, how we do it, and what the needs are of those we serve.  

I want to be clear about the fact that innovation is not about recreating the wheel. We have the tools we need—that bottled passion and compassion, and four decades of experience meeting the needs of patients and families. The work that all of us are doing, ultimately, is about the people we serve, and the passion for them is what keeps us united and moving forward in our shared mission. I’m so pleased to see that passion firsthand.

The first stop on Edo’s Listening Tour – Las Vegas.

While in Las Vegas, we also had the opportunity to visit with two engaged NHPCO members. Both are providing excellent, thoughtful care to patients and their families. Little touches like a painted window at one site make all the difference in a patient’s last days.  The people providing care at both programs—clearly passionate about their difficult work—make the biggest difference of all. 

During one visit, we watched a chef at an inpatient center lovingly prepare lunch for her residents, who she looked in after earlier in the day to make sure that she was making them something they would want and enjoy. Now, that is patient-centered care. 
Edo views a memorial sidewalk at an inpatient facility in Las Vegas.
We had the opportunity to meet with one of the provider site’s senior leadership team. We learned about their robust palliative care program and their commitment to high-quality, innovative hospice care. 
The NHPCO team meets with the senior leadership team at a Las Vegas area hospice and palliative care provider.
They say that what happens in Vegas, stays in Vegas. I can assure you that what we learned in Vegas will not stay there; that we continue to learn from our friends and members, and grow as an association that is attuned to the needs of those who we serve and their patients. Thank you, Las Vegas.  On to Chicago and Austin. 

There’s still time to register to attend one of the free Summer Listen Tour sessions.

Thursday, June 8, 2017

Join Edo Banach for the Summer Listening Tour

The Summer Listening Tour is your opportunity to share your input and expertise to help shape NHPCO’s direction for the future. President and CEO, Edo Banach will be traveling across the country this summer to meet and hear from hospice and palliative care providers.

Large or small, urban or rural, member or non-member, all leaders need to come together at this critical time for the future of hospice and palliative care. Don’t miss your opportunity to be part of the conversation.

This two way dialogue will ensure your concerns regarding the community are heard and discussed. Your input will help shape our message to regulators and lawmakers.

Come to the city nearest you for this exclusive event, free of charge. The Listen Session will be held from 2:00pm to 4:00pm in the local time zone for each city on the dates listed below. Upcoming cities and dates:

•    Chicago, IL - June 13
•    Austin, TX - June 14
•    Kansas City, MO - June 19
•    New York City, NY - July 12
•    Alexandria, VA - July 13
•    Atlanta, GA - July 24
•    Denver, CO - TBD
•    Boston, MA - TBD

Your input will be critically important for determining future direction.  REGISTER TODAY!

Tuesday, June 6, 2017

Hospice Quality Reporting Program: Provider Preview Reports

30 day countdown to request corrections has begun!
The Hospice Provider Preview Reports with the quality measure results that will be used in public reporting on the Hospice Compare website are available now. The 30 day window for review of the results for accuracy and submission of a formal request to CMS for review and correction began on June 1, 2017.  

Hospice Provider Preview Reports:
The Hospice Provider Preview Report is an important last step in the hospice public reporting process prior to the release of data on Hospice Compare in the summer of 2017.  The results included in the report are limited to quality measures based on HIS data submitted for Quarter 4- 2015 to Quarter 3-2016. Results for quality measures based on Hospice CAHPS data will be available prior to inclusion in Hospice Compare in 2018.

The data used in the Provider Preview Reports are currently “frozen” but hospices may continue to submit corrections and additions to their HIS data for up to 36 months beyond the target date on a given assessment. Changes in submitted data will be reflected in subsequent quarterly Provider Preview Reports and refreshes of Hospice Compare.

Access to the Preview Reports: 
The Provider Preview Reports are available in the Certification and Survey Provider Enhanced Reports (CASPER) system. Instructions for accessing the reports are posted on the Hospice Quality Public Reporting page of the HQRP website. Scroll to the bottom of the page and select “Hospice Provider Preview Report Access Instructions” from the available downloads.  

If a hospice identifies inaccuracies in its Provider Preview report a formal request for review should be submitted to CMS.   

Thursday, June 1, 2017

Be the Voice of Your Patients and Families on Capitol Hill

The 2017 Hospice Action Network Advocacy Intensive is your best opportunity for the hospice community to speak with one voice with the policy makers who craft legislation that impacts the hospice and palliative care community. On July 17, we will prepare you with the skills and information you will need to educate new and returning Members of Congress about the priorities of the hospice community.

Here’s a sneak peek at some of the offerings we’re planning: 

State of Play on Capitol Hill
Participate in a discussion with bipartisan panel of lobbying experts on what is going on here in Washington. We’ll walk you through what Congress is working (or not working) on while you’re here, and what’s likely to be on the mind of your Member of Congress or their staff when you meet with them on July 18.

How to Speak “Congress”
Ever wonder what makes the other political party tick? In this session, learn how to tailor your message to effectively communicate to Republicans and Democrats. Whether your Members of Congress are “fiscal conservatives” or “progressive liberal,” you will come away from this session able to speak to their concerns, regardless of political party, to garner support for our asks. 

From Constituent to Influencer – Cultivating Strong, Meaningful Relationships with Elected Officials
Advocacy is not a once-a-year event. If you want to be more than a constituent in a crowd and if you want to have real influence with elected officials, you have to build a culture of advocacy that permeates your entire organization. During this session, faculty will discuss time-tested approaches to building strong, beneficial relationships with elected officials. Hear real-world examples from hospices that have built and sustained relationships with elected officials through site-visits, We Honor Veterans ceremonies, employee and volunteer engagement, social media campaigns, and more.

The Advocacy Intensive is free for NHPCO members. Registration is $350 for non-members.

But it’s not all work. We do let you have a little fun. Questions? Email us!

Tuesday, May 23, 2017

The Virtual Conference Agenda at a Glance

NHPCO invites you to review the Agenda at a Glance for this summer's Virtual Conference, Aligning Practice with Evidence, coming to your organization, conference center or even your home via the Internet on July 26 - 27, 2017.

Presented by NHPCO, AAHPM and HPNA, t
he 2017 Virtual Conference is one of the most economical and convenient ways to bring high quality education to your team without the expenses associated with a traditional "out of town" conference.

Do you incorporate the latest research into your practice? Why? And if not, why not? This year's conference will explore ways that the medical and clinical practices of our field are aligned with scientific evidence. Sometimes our “usual” approaches to patient care and symptom management become our standard because “it’s how we do things.” The urgencies of meeting patient/family needs can make it difficult to read clinical journals and attend conferences. Even when we do try to keep up with advances in the field, we may lack confidence in our abilities to analyze what we read and hear—and discern which evidence warrants change in practice and which does not.

Act now and register today to lock in the early bird rate!

Friday, May 19, 2017

2017 HAN Advocacy Intensive: Be Their Voice

Hospice Action Network and NHPCO will host the 2017 Advocacy Intensive in Washington, DC, on July 17-18, 2017.

Registration for the HAN Advocacy Intensive is now open. This event gives hospice programs nationwide an opportunity to stand as one community and speak with one voice on Capitol Hill – a voice for the patients and families we serve across the nation.

"We face constant change and uncertainty in health care and beyond. It is crucial that we seize the opportunity to educate policy makers about hospice and palliative care. And who better to tell the stories of hospice care than the nurses, social workers, chaplains, volunteers, and the many others who provide care at the bedside every day?" said NHPCO President and CEO Edo Banach.

The HAN Advocacy Intensive offers a comprehensive educational program for beginners and experienced advocates alike. Attendees will learn best practices to become effective hospice advocates, and how to build relationships with policy-makers over time. This is the best opportunity for the hospice community to learn the skills needed to influence the legislators and staff who are shaping the future of health care.

"Your patients need a voice in Washington. You can be that voice," added Banach.

This special event is offered free of charge.

Learn more and register for the 2017 Hospice Action Network Advocacy Intensive.

Tuesday, May 16, 2017

Call for Posters: 2017 Virtual Conference

NHPCO, AAHPM and HPNA are seeking posters of original research studies, systematic reviews, evidence-based clinical practice approaches and related topics for inclusion in the Virtual Poster Gallery for the 2017 Virtual Conference, "Aligning Practice with Evidence."

The Virtual Conference will be held July 26-27, 2017 with online content available for registered participants for three months following the conference. Poster proposals will be accepted through May 26, 2017.

Poster Expectations

  • All Posters displayed at the Virtual Conference must adhere to content validation value statements. Specifically, all suggestions or recommendations involving clinical medicine and practice must be based upon evidence that is accepted within the medical profession.
  • In addition, all scientific research referred to, reported or used in a conference session must conform to the generally accepted standards of experimental design, data collection and analysis.
  • Faculty is expected to refrain from overt statements, harsh language or pointed humor that disparages the rightful dignity and social equity of any individual or group.
  • All materials submitted for Posters must be reviewed by the conveners prior to the conference. As a result, deadlines for submission of Posters are scheduled well in advance of the event.
Poster Submission Guidelines
In order to allow an independent evaluation of the relevance and potential effectiveness of the Poster Presentation, submissions must include the following:

  • Area of Emphasis: Select from a menu of options
  • Title: A title for the Poster that informs the reviewer of the subject matter
  • Description: A brief description to be used to promote your Poster
  • Learning Objectives: Written from the perspective of what participants will learn
  • References/Citations: Three to five references from the past 5 years
  • Content Outline: Background, methods, results and conclusions for all research Posters; description of all major topics for non-research entries;
  • Faculty contact information, biographical sketch, disclosure.
Full details and the online poster submission portal is open now.

Wednesday, May 10, 2017

Linda Rock Receives Leadership Award

For her professional leadership in the field and her dedication to advancing hospice and palliative care, Linda Rock was awarded the Galen Miller Leadership Award at the opening plenary of NHPCO’s 2017 Management and Leadership Conference.  

Rock was immediate past chair of the NHPCO Board of Directors. During her many years of active involvement with NHPCO, she staffed numerous committees and provided strong and steady leadership at a time of significant change and transition at NHPCO.

More than 1,200 hospice and palliative care leaders, practitioners, and senior managers were in attendance at the conference that began May 1, 2017 at the Washington Hilton in Washington, DC.

“There is no more worthy recipient than Linda, who has worked tirelessly on behalf of hospice at the local, regional and national level.  A stalwart advocate on behalf of rural hospice care, Linda has been a proponent of greater access and the development of high-quality care for her entire professional life,” said John Mastrojohn, NHPCO’s senior vice president and COO.

Created in memory of Galen Miller, NHPCO’s executive vice president who died in August 2013, this award recognizes a champion and advocate from the field who has demonstrated the highest levels of dedication and passion for the hospice and palliative care community and the patients and families that receive care.

Linda Rock (C) is surrounded by the members of NHPCO’s leadership team and Bob Ward at the award presentation. 

Thursday, May 4, 2017

NHPCO Comments on CMS Proposed FY2018 Hospice Wage Index Rule

On April 27, 2017, the Federal Register posted the FY2018 Hospice Wage Index proposed rule for public inspection.  Download the proposed rule, public inspection version (PDF). 

Overall, the Notice of Proposed Rule Making is both encouraging and discouraging for providers in the U.S. hospice community. NHPCO is pleased that CMS is recognizing the regulatory and administrative burdens facing the hospice community, and that CMS is trying to find ways to not add to that burden. We applaud the effort and recognition of the challenges of serving our nation’s patients and families.

Market Basket Increase
Unfortunately, the statutory limitation of the FY 2018 market basket to no more than a one percent increase, when the NPRM notes that it should be at least twice as much (2.2 percent) further burdens the community facing ever-increasing costs, and forces hospice providers to do more with less.

Quality Measures and Public Reporting
The hospice community is encouraged that CMS continues its efforts toward developing and implementing quality measures and public reporting, including a Star rating system.  At the same time, the hospice community is concerned about the use of claims data as the basis of new measures.  Also, it appears that CMS is intent on merely documenting the amount of continuous care and general inpatient care that is delivered, rather than assessing the actual needs of patients and how the hospice community is meeting those more intense clinical needs.

Patient Eligibility and the Physician’s Role
While CMS notes it is soliciting comments about the underlying documentation that is used, or should be used to determine patient eligibility, they seem to be ignoring the persistent problem of short hospice stays.

The thrust of their inquiry seems to be directed toward hospice physicians being required to review and reference the attending physician’s medical notes prior to the initial certification of a patient as eligible for hospice, or even requiring a face-to-face encounter with the hospice physician, prior to certification.  The hospice community already deals with patients dying during the admissions process, and with approximately 25 percent of hospice patients dying within seven days, and more than half within two weeks, waiting for patient records, or an appointment with the hospice physician, would be a cruel and inhumane process that would deny patients the very care they need.

Unless and until there is universal electronic medical records and the medical records are accessible across all care settings, this approach is very troubling indicator of a lack of understanding of what patients and families are going through and the devastating impact that it could have on hospice admissions.

CMS did note that the level of live discharges, from all causes, had remained relatively constant at 17 percent and as such, didn’t reveal any anomalies.

SIA Impact
CMS also noted that the Service Intensity Add-on didn’t seem to have influenced the number or duration of visits by clinical specialists in the last seven days of life.  As the hospice community continues to make adjustments under the new payment system, this bears additional review.

We look forward to a very engaged and collaborative working relationship with CMS to provide insights and actual operational impact examples of their proposals.

NHPCO members will find a regulatory alert offering more detailed analysis available on the NHPCO website.

Monday, April 24, 2017

Celebrating Volunteers during National Volunteer Week!

National Volunteer Week is April 23 – 29, 2017 and those dedicated individuals offering support, companionship and hope to those facing a life-limiting illness deserve special recognition for the difference they make in America. NHPCO salutes the estimated 430,000 trained hospice volunteers providing more than 19 million hours of service to hospice programs each year.

“Hospice began as a volunteer-driven movement in this country more than 40 years ago and volunteers continue to play an indispensable role in enabling hospice and palliative care organizations to offer the best care possible for patients and their families and caregivers,” said Edo Banach, NHPCO president and CEO.

Mercedes Ibarra believes sincerely in the hospice mission of providing quality, compassionate end-of-life care to those who are dealing with a terminal diagnosis.  She became a volunteer at Silverado Hospice Los Angeles in 2013 and says that her experience working with hospice patients has been “life-changing”.

Before becoming a hospice volunteer, I never knew that I could love someone I didn’t know that whole heartedly,” shares Mercedes. “And I like knowing that families feel that there is someone there to support them and their loved one.”

Mercedes has shared her story as part of a national campaign, Moments of Life: Made Possible by Hospice, which shows that hospice is not about giving up, but rather making more meaningful moments possible.   In “The Gift of Volunteering,”  viewers are given a glimpse into the life of a hospice volunteer as the camera follows Mercedes on two separate patient visits.  Mercedes and her patients dance, smile, laugh, cry and live in the moment.   

Hospice volunteers often serve patients and families at the bedside but they also assist in the office, help raise awareness, contribute to educational programs, and provide fundraising support and more. To learn more about hospice or to contact a local hospice, visit the Moments of Life: Made Possible by Hospice website.

Gift of Volunteering video

Wednesday, April 19, 2017

Announcing Virtual Conference 2017 Opening Plenary Speaker Joan Harrold, MD

NHPCO is proud to announce that Joan Harrold, MD, MPH, FACP, FAAHPM will be the opening plenary speaker for this summer's Virtual Conference, Aligning Practice with Evidence, coming to your organization or conference center via the Internet on July 26 - 27, 2017.

How well are the medical and clinical practices of our field aligned with scientific evidence? Do you incorporate the latest research into your practice? Why? And if not, why not?

Sometimes our “usual” approaches to patient care and symptom management become our standard because “it’s how we do things.” The urgencies of meeting patient/family needs can make it difficult to read clinical journals and attend conferences. Even when we do try to keep up with advances in the field, we may lack confidence in our abilities to analyze what we read and hear—and discern which evidence warrants change in practice and which does not.

Dr. Harrold's presentation, "Building a Foundation: Aligning Practice with Evidence," will kick of the two day event that is hosted by NHPCO, AAHPM and HPNA.

Dr. Harrold is the Medical Director and CMO/Vice President of Medical Services of Hospice and Community Care in Lancaster and York, PA.  She has more than two decades of experience in hospice and palliative care.  Prior to becoming certified in Hospice and Palliative Medicine, she received her medical degree from the Medical College of Virginia; completed an internal medicine residency at Bowman Grey; and completed a Master of Public Health degree with special emphasis in epidemiology and biostatistics at The George Washington University.

Dr. Harrold serves on the Board of Directors of NHPCO and previously served as a director on the boards of the Hospice and Palliative Nurses Foundation, the American Academy of Hospice and Palliative Medicine , the American Board of Hospice and Palliative Medicine, and the Pennsylvania Hospice Network.  Dr. Harrold is the chair of the Professional Education Committee and serves on its various subcommittees. 

Joan Harrold, MD, MPH, FACP, FAAHPM
The 2017 Virtual Conference is one of the best, most convenient ways to bring high quality education to your team without having to leave the office. Brought to you by three leading organizations in the field.  

Act now and register today to lock in the early bird rate! 

Friday, April 14, 2017

Rallying to Encourage and Empower Us All to Make Our Healthcare Decisions Now Because... It Always Seems Too Early, Until It’s Too Late

In honor of National Healthcare Decisions Day (NHDD), April 16, we share this blog as part of national efforts to raise awareness of this issue.  

College education.  Career path.  Relationships.  Starting a family.  Buying or selling a house. Vacations. Retirement. From the age that we’re old enough to understand, most of us are taught and accept that these are the markers in life that we plan for.  However, there’s one key marker that’s all-too-often missing from this list: advance care planning.  Like planning for these other life events, planning for the time (or times) that we are unable to express our healthcare wishes is of the utmost importance. It is something that should be well thought-out, documented and revisited at different points in life to reflect any change in our desires or family situation or the person we wish to advocate for us. 

Unfortunately, it is a planning point that that majority of us have missed.  In fact, only about 25% of adults have an advance care plan.  As a consequence patients’ families suffer the added burden of having to guess when a health crisis happens. That’s why National Healthcare Decisions Day (NHDD) was founded 10 years ago and why this nationwide advance care planning awareness initiative is as important as ever. So this year, I’ve joined my fellow bloggers throughout the country to spread the word about the importance of advance care planning with this special NHDD edition blog.

NHDD, which happens every April 16—and is a week-long event this year—is a collaborative effort of thousands of national, state, and community organizations as well as dedicated individual advocates committed to ensuring that adult Americans–like you and me—have the information and opportunity to communicate and document their healthcare decisions.

If you haven’t had the talk already, check out the awesome three and a half minute “Imagine” video on the NHDD homepage: It’s proof that it takes only a few minutes to start a conversation with your loved ones about advance care planning—a conversation that affects people for a lifetime.  

After the goosebumps settle down from watching the video, here are some specific things you can do for NHDD:
  • Lead by example.  Schedule time with your loved ones (on or before the week of April 16) to “Have the Talk” and complete your own advance directive. There are many tools, including free forms, you can use to walk you through the process and make your wishes known; access them through the NHDD Public Resources page or visit the NHPCO website for information. 
  • Encourage your loved ones and friends to learn more about advance directives and to complete their advance directives. You can forward this link:
  • TAKE THE DARE!  I DARE YOU to have the talk about advance care planning and dare others as well!  When you do, share it on whatever outlet you prefer and use #healthtalkdare (and #NHDD) wherever possible.  If you don’t accept my dare, you should make a donation to NHDD  And, while my dare is about inspiring action, you get bonus points if you accept the dare AND make a donation!  (Note: you don’t have to share the specific contents of your talk—that’s your business—just share the fact that you did it.) 
  • Share your advance directive with your healthcare providers and make sure it is on file in the event it is needed. 
Already had the conversation with your loved ones, but want to do more?  Here a few suggestions to rally support for NHDD and encourage even more action:
  • Like the NHDD Facebook fan page and share it with your Facebook friends.
  •  On Twitter? Follow @NHDD and share the information with your followers, i.e. ‘Just 5 days to #NHDD, when will you #havethetalk? @NHDD can help’ OR Share the Dare!  #healthtalkdare. 
  • Send an email to your friends, staff, colleagues, lodge/social club members, and/or house of worship, telling them that you are participating in NHDD and encouraging them to do the same.  
Please use and share the resources available through the NHDD website and encourage and empower us all to make our healthcare decisions now because … It Always Seems Too Early, Until It’s Too Late!