Wednesday, November 24, 2010

Things we are grateful for this year

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace [] – a movement

aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important – and believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having the conversation before it’s too late.

This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve heard stories with happy endings … and stories with endings that could’ve (and should’ve) been better. We’ve stared down political opposition. We’ve supported each other’s efforts. And we’ve helped make this a topic of national importance.

So in the spirit of the upcoming Thanksgiving weekend, we’d like to highlight some things for which we’re grateful.

Thank you to Atul Gawande for writing such a fiercely intelligent and compelling piece on “letting go” []– it is a work of art, and a must read.

Thank you to whomever perpetuated the myth of “death panels” for putting a fine point on all the things we don’t stand for, and in the process, shining a light on the right we all have to live our lives with intent – right through to the end.

Thank you to TEDMED [] for letting us share our story and our vision.

And of course, thank you to everyone who has taken this topic so seriously, and to all who have done so much to spread the word, including sharing The One Slide.

Tuesday, November 23, 2010

Don't Wait to Talk About Hospice

With Release of PBS FrontlineSeries and Dartmouth Atlas Report, NHPCO Reminds People of the Importance of Advance Care Planning

(Alexandria, Va) – An intimate journey into the edge of life is how this evening’s episode of the PBS series Frontline has been described. Frontline’s "Facing Death" will air this evening (11/23/10) at 9:00pm on most PBS stations.

In this groundbreaking film, doctors, patients and families at one of New York’s biggest hospitals speak with remarkable candor about the increasingly difficult choices people are making at the end of life: when to remove a breathing tube in the ICU; when to continue treatment for patients with aggressive blood cancers; when to perform a surgery; and when to call for hospice.

This follows the release of a report from the Dartmouth Atlas Project looking at care for patients with advanced cancer at the end of life that identified gaps between patient wishes and care received.

The National Hospice and Palliative Care Organization urges members of the public to learn about advance care planning and discuss wishes with family members.

“It’s an all too common situation. A family is at the bedside of a loved one who is seriously ill and nearing the end of life,” remarked J. Donald Schumacher, NHPCO president and CEO. “Each member of the family has a different idea of what should be done and what the patient would have wanted.”

Far too many people wait until they are in the midst of a health care crisis before thinking about what options are available or what care they or their loved ones would have wanted. Hospice professionals deal with these challenging situations every day – that’s what they are trained to do.

When a family is coping with a serious illness and a cure is no longer possible, hospice provides the type of care most people say they want at the end of life: comfort and dignity. Considered to be the model for high-quality, compassionate care for people with a life-limiting illness, hospice care includes expert medical care, pain management, and emotional and spiritual support. Care is provided by an inter-disciplinary team of professionals and trained volunteers. The wishes of the patient and family are always at the center of care.

Most hospice care is provided in the home – where the majority of Americans have said they would want to be at this time. Care is also provided in nursing homes, assisted living facilities, and hospice centers.

Care is paid for by Medicare, Medicaid, and most private insurance plans and HMOs.

The National Hospice and Palliative Care Organization reports that more than 1.56 million people received care from our nation’s hospices last year.

Hospice providers can help with information about care options and choices and ensure you live as fully as possible throughout your entire life. They will make sure your loved ones receive support as well.

One of the best ways to make sure you and your loved ones benefit fully from hospice, should you ever need this care, is to talk about it before it becomes an issue.

For more information on advance care planning and hospice, visit NHPCO’s Caring Connections at or call the HelpLine at 1-800-658-8898.

Caring Connections is one of the recommended resources included with the education tools PBS has made available online for “Facing Death.”


Jon Radulovic
NHPCO, Vice President of Communications
Ph: 703-837-3139

Tuesday, November 16, 2010

Dartmouth Atlas Report Identifies Gap between Patient Wishes and Care Received

NHPCO Commends Dartmouth Atlas Project and Calls on Hospitals to Increase Access to Hospice Care

(Alexandria, Va) – A new report released today from the Dartmouth Atlas Project showing that individuals in some areas of the country are far less likely to receive comfort care in accordance with their wishes and has drawn the attention of the nation’s hospice and palliative care community.

This first-ever report from the Dartmouth Atlas Project on cancer care at the end of life, found that across the US, about 29 percent of patients with advanced cancer died in a hospital between 2003 and 2007. And in 50 academic medical centers, fewer than half of these patients received hospice care.

Furthermore, the study authors state that many patients are aggressively treated with curative therapies they may not want, and, “for frail elderly patients, and any patient with advanced cancer, these treatments have limited or no benefit.”

“The Dartmouth Atlas Project is to be commended for undertaking this thorough examination of end-of-life care for Medicare beneficiaries with advance cancer,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “While the findings of variation in care are not necessarily a surprise, one of the key messages that I take away from this report is the critical need for hospitals and all healthcare professionals to ensure that all patients are informed earlier about the course of an illness and the range of options available – options that include hospice and palliative care.”

The likelihood that a Medicare patient with advanced cancer will die with the support of hospice care, or in the hospital without hospice, varies markedly depending on where he or she lives and receives care. The percent of cancer patients dying in a hospital varied threefold among patients receiving most of their care at academic medical centers.

“It’s important to recognize that this report is not a negative comment on care in our nation’s hospitals or among academic medical centers, rather, it’s a much needed reminder that healthcare professionals must work to help patients and families understand where the course of their illness may take them. And, when cure is not possible, it is our duty to offer the robust benefits that the hospice team can provide,” added Schumacher.

Hospice care provides coordinated care delivered by a team of interdisciplinary professionals that are trained to address the special needs a person has at the end of life. The hospice team provides pain and symptom relief as well as emotional and spiritual support for the patient and the family.

More than 1.56 million Americans received care from the nation’s hospices last year. However, 34 percent of patients died or were discharged in seven days or less – too short a time to take full advantage of all of the services available under hospice, including support for family caregivers.

“In more than 30 years of running hospice programs, the most frequent comment I would hear from patients and families was why they didn’t learn about hospice care earlier,” Schumacher noted.

For several years, NHPCO’s Caring Connections has been providing healthcare professionals and consumers with information about care options and caregiving when facing serious or life-limiting illness. Information to help patients and family caregivers understand the benefits of hospice care, speak with physicians about care, or learn about advance care planning is available free of charge from NHPCO’s Caring Connections at or by calling the HelpLine at 1-800-658-8898.


The Dartmouth Atlas Project is run by the Dartmouth Institute for Health Policy and Clinical Practice and principally funded by the Robert Wood Johnson Foundation. A link to the full study can be found at

NHPCO is the oldest and largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. NHPCO’s mission is to lead and mobilize social change for improved care at the end of life,

Jon Radulovic
NHPCO, Vice President of Communications
Ph: 703-837-3139

November 2010 Palliative Care Grand Rounds

The 2010 November Palliative Care Grand Rounds (PCGR), highlighting blog post focusing on hospice, palliative care and grief matters, is being hosted this month by Compassion & Choices 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.

Tuesday, November 9, 2010

It's never too late to say 'thank you' to our nation's Veterans: even at the end of life

A Message from J. Donald Schumacher, PsyD
National Hospice and Palliative Care Organization

Americans across the country celebrate Veterans Day on November 11, a special day to salute the men and women who have bravely served our country in the military.

These fellow Americans have made profound sacrifices in defense of freedom and they deserve our heartfelt thanks and appreciation. Honoring our nation’s Veterans includes supporting them throughout their entire lives, especially at the end.

As our nation marks Veterans Day 2010, the National Hospice and Palliative Care Organization deepens its commitment to increase Veterans’ access to the compassionate, high quality care available from the nation’s hospice and palliative care providers.

NHPCO has been a long-time supporter of the valuable work being done by the Department of Veterans Affairs to bring palliative care services to VA Medical Centers and the communities they serve.

This past month, NHPCO in collaboration with the VA, took a great step forward to help healthcare providers better serve Veterans at life’s end by launching the website, the centerpiece of the new We Honor Veterans campaign. This campaign will help those who provide care at the end of life, better understand the unique needs of our nation’s Veterans.

But there is something that every American can do to honor and serve our Veterans – and that is to say, “thank you.” Not just on November 11 but all year long.

Ask your friends, neighbors, coworkers and others in your community whether they have served in the military (you may be surprised how many have)—and thank those who have served for their sacrifice.

A generation of World War II and Korean War Veterans are facing end-of-life care decisions now, and they are quickly being followed by younger Vietnam War Veterans, many of whom are confronting serious illnesses at an even earlier age.

It surprises many Americans to learn that every day, 1,800 Veterans die. That’s more than 680,000 Veterans every year – or 25 percent of all the people who die in this country annually.

The liberty that we, as US citizens, enjoy comes at a price paid by these valiant men and women. Let each of us make sure we do our part to recognize and support them throughout their lives.

If you know a Veteran who is in need of the special care hospice and palliative care brings to people facing serious and life-limiting illness, please reach out and help them learn more about care options. Information is available from NHPCO’s Caring Connections at or by calling the HelpLine at 1-800-658-8898.

To all our nation’s Veterans, thank you.