Showing posts with label advanced. Show all posts
Showing posts with label advanced. Show all posts

Thursday, June 9, 2011

A Member of NHPCO’s Leadership Team Shares Thoughts on Death(ly) Panels

I spent Memorial Day Weekend with a group of Cub Scouts ranging in age from six to 11. My son, who is eleven, was excited to be “crossing the bridge” from Cub Scouts to Boy Scouts. The formal ritual, which involved his Den leader saying some nice words about his growth and older Boy Scouts welcoming him to their midst, was an important milestone in my son’s life. He isn’t a little kid any more, he’s a teenager. I have no idea when that happened.



Nor do I know the specific moment when I became the adult caregiver of my mother, who turns 80 this year and has been in good physical and mental shape for years. Yet it hasn’t been easy. The death of her two sisters within six months of one another and two knee replacements surgeries of her own during those difficult months left her exhausted as well as emotionally and physically frail. I flew to Florida to visit her in the facility where she is receiving rehab, arranged for non-medical aides to help her when she moved back home and spent a few days with her so she wouldn’t be alone. This was an important milestone for me as an adult daughter. My responsibility level has increased and there really isn’t any going back.



As adults we experience multiple milestones – planned and unplanned – that mark our progression through life. One day we are happily single and the next we’re in a committed relationship. We’re childless and then become parents in a few short months. We are healthy and the next day we’re told we have a potentially life-limiting illness. It all happens so fast and there’s little we can do to slow down this inevitable march onward, through life’s stages.



We can’t stop it, even though many people try to slow down the aging process through surgery, exercise, nutrition or just plain denial. We can save money for our kids’ education. We can put money away for retirement. But eventually we’re all going to face the fact that we’re all mortal. Even as aware as we all are that we will die some day, we do little to plan for it.



When there is a healthcare crisis, which happens to so many people, we are unprepared, as are our families. We haven’t thought about the type of care we want or don’t want. We haven’t selected someone to speak for us if we can’t talk to the doctors ourselves. We haven’t told anyone whether we would or would not want to be kept alive through medical interventions if the chance of recovery was slim. We haven’t planned properly to make sure we are in control during what might be the last phase of our life.



My son is now memorizing all the Boy Scout pledges, laws and mottos in preparation for his first meeting. To me the most important one, besides “do a good turn every day,” is the one that is best known and yet universally most ignored – “be prepared.”



You can’t avoid the last milestone in life. Hopefully you won’t face it for many years to come. But it will happen, in some shape or form, to all of us. Take a lesson from my son, be prepared. Download a free advance directive, read it through and talk about with your doctor and family members, sign it and give copies to folks who will need it during a crisis. Take control of the phase of your life before that milestone creeps up on you and catches you unprepared.

GUEST BLOGGER: Kathy Brandt, MS, the Senior Vice President, Office of Education and Engagement at the National Hospice and Palliative Care Organization, is a passionate believer in the need to plan for, talk about, and document end-of-life care wishes, and the proud mother of an amazing eleven year Boy Scout.

Monday, December 13, 2010

When is it Time for Hospice?

Hospice brings compassion, dignity and hope to people nearing life’s end

(Alexandria, Va) – There is a point when cure is no longer possible for someone with a life-limiting illness, but that does not mean a patient and family must abandon all hope. Through hospice care, there is still hope for a peaceful death; hope to spend final months, weeks or days free of pain; and hope for quality time with loved ones in the familiar surroundings of home.

“While there isn’t one specific point in an illness when a person should ask about hospice care, many hospice professionals would suggest that a person think about hospice long before he or she is in a medical crisis,” advises J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “In fact, learning about palliative care and hospice as options is something that should happen early in the course of a serious illness and not just in the final days.”

Hospices utilize a team of professionals and trained volunteers to provide expert medical care, pain-and-symptom management, and emotional and spiritual support to patients and family caregivers. All care is tailored to the patient’s needs and wishes.

Hospice helps patients and families focus on living as fully as possible.

“Hospice professionals can be important resources for patients and families, they can help a person figure out what goals are important and help them get their arms around the fact that their life may be coming to a close,” noted Schumacher.

Considered to be the model for high-quality, compassionate care for people nearing the end of life, hospice offers the services and support that Americans want when coping with life-limiting illness.

Last year, hospice cared for more than 1.56 million patients in the US. NHPCO estimates that 41.6 percent of all deaths in the US were under the care of a hospice program last year.

Facts about hospice:

  • Most hospice care is provided in the home. Care is also provided in nursing homes, assisted living facilities, and hospice centers
  • Hospice care is fully covered by Medicare, private insurance, and by Medicaid in most states.
  • Hospice care is not just for people with cancer. Hospices serve those with advanced Alzheimer’s disease, heart disease, lung disease, HIV/AIDS – anyone who is facing a life-limiting illness.
  • The hospice benefit pays for medications and medical equipment related to the illness.
  • Hospice care is available as long as a doctor believes the patient is eligible.
  • Hospice care can include complementary therapies, such as music and art, to bring additional comfort.
  • Hospice’s offer grief support to the family following the death of a loved one.
“Ideally, a patient would receive hospice care for the final months of life – not just the final days,” stated Schumacher. “One of the most common sentiments from families who have been helped by hospice care is that they wish they had known about hospice sooner.”

A recent report from the Dartmouth Atlas Project looking at care for patients with advanced cancer at the end of life identified gaps between patient wishes and care received. This highlights the need for people to learn about all options available for care.

Additional research published in the Journal of Pain and Symptom Management found that Medicare beneficiaries who received hospice care lived on average 29 days longer than those who did not opt for hospice near the end of life.

For more information, contact your local hospice, visit NHPCO’s Caring Connections website at caringinfo.org, or call the HelpLine at 1-800-658-8898.

Tuesday, March 16, 2010

Wear a White Ribbon to Raise Awareness of Advance Care Planning

Fifth Anniversary of Terri Schiavo’s Death:
Wear a White Ribbon to Raise Awareness of Advance Care Planning

National Hospice and Palliative Care Organization Reminds People, “It’s About How You LIVE”
(Alexandria, Va) – Five years ago national attention was riveted as the husband and parents of Terri Schiavo waged a very public legal battle regarding who had authority to determine if she would have wanted artificial means to prolong her life. While many Americans learned about the importance of planning for critical healthcare decisions before a crisis, two-thirds of the public have not completed an advance directive.

As the fifth anniversary of Ms. Schiavo’s death approaches on March 31, the National Hospice and Palliative Care Organization is encouraging all Americans to wear a white ribbon to increase awareness of advance care planning. The ribbon also reminds people of the importance of both documenting wishes by completing an advance directive, and talking with their loved ones about their care decisions before a medical crisis.

An individual’s preferences for the kind of medical care they would or would not want are very personal and important decisions. Advance care planning lets you decide the kind of healthcare you want at the end of your life—and helps you make your wishes known.

“It doesn’t matter whether you want every medical intervention available up until the day you die, or whether you want to spend the final period of your life receiving what many call ‘comfort care,’—it should be your decision,” said J. Donald Schumacher, NHPCO president and CEO.

“Another critical piece of advance care planning includes talking about your decisions with your loved ones, healthcare providers, clergy, and others important to you,” Schumacher added.

People are occasionally confused by the terms associated with advance care planning. One aspect of an advance directive, called a living will, lets you explain the care you would want. An advance directive also includes a healthcare power-of-attorney which enables you to appoint someone to make medical decisions on your behalf should you not be able to speak for yourself.

The advance care planning ribbon was created by NHPCO’s consumer-engagement program, Caring Connections, to help people focus on the message: “It’s About How You LIVE.” The vision of the LIVE campaign is to motivate people to take at least one step along a continuum of learning, implementing, voicing and engaging in end-of-life issues before a crisis arises.
Advance Care Planning Ribbon Campaign materials are available online and include pledge cards, flyers, Powerpoint presentations and more. (Note: Advance Care Ribbon lapel pins are available from NHPCO's Marketplace.)

Two weeks after this anniversary, annual National Healthcare Decisions Day will be observed in communities across the country. This national day of awareness, held on April 16 every year, is promoted by national, state, and local organizations including healthcare providers, advocacy groups, attorneys, and other organizations. Learn more about this day of outreach at nationalhealthcaredecisionsday.org.
More information about advance care planning is available at caringinfo.org/planningahead or by calling the HelpLine at 1-800-658-8898.

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

Friday, March 12, 2010

What Are Living Wills? NHPCO offers free advance care planning resources

(Alexandria, Va) – Over the past weeks, Keith Olbermann has shared his personal experience regarding his father’s health crisis on his MSNBC program “Countdown.” On yesterday’s broadcast (03/11/10) Olbermann spoke about the necessity of loved ones talking about the care they would want and completing a living will and appointing a health care proxy.

“Talking with families about health care wishes and completing living wills while you are healthy is about living fully,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “Planning ahead and understanding the choices you and your loved ones might have to decide during a medical crisis has nothing to do with the infamous ‘death panels’ that have caused such confusion and distraction about an issue important to every single one of us.”

NHPCO’s Caring Connections initiative offers a range of materials and information free of charge—including state specific advance directive forms—at
caringinfo.org/planningahead.

Planning ahead is about preparing for the future today. Communicating your end-of-life wishes to your loved ones, appointing a health care power of attorney, and addressing financial issues such as wills and paying for long-term care are just a few of the issues you can address today to plan ahead.

What are Advance Directives?

An advance directive—often called a living will—allows you to document your wishes concerning medical treatments and care when facing a medical crisis or at the end of life.

A medical power of attorney—also known as a health care proxy—is part of advance care planning. This allows you to appoint a person you trust as your health care agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf. Before a medical power of attorney goes into effect a person’s physician must conclude that they are unable to make their own medical decisions.

Advance directives are legally valid throughout the United States. It is important to complete and sign advance directives that comply with your state's law. However, you do not need a lawyer to complete and execute a living will or health care power of attorney. Each Caring Connections, state-specific advance care planning packet comes with complete step-by-step instructions. The documents are free of charge.

Visit
caringinfo.org to learn more about planning for the unthinkable before a crisis. Information is also available from the HelpLine at 1-800-658-8898. Providers are encouraged to share these resources with their community.

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Caring Connections offers resources to help providers reach out and educate communities about advance care planning. Here are some of the resources that can be found on the Caring


Connections website:
·
How to Talk with Your Loved Ones
· What to do if Family Members Disagree
· How to Talk with Your Healthcare Providers
· Talking with Others about Their End-of-Life Wishes
· Are You Traveling Without a Map? A Layperson’s Guide to Advance Care Planning
· Advance Care Planning Awareness Ribbon

Contact:

Kathy Brandt
Vice President, Innovation and Access
Ph: 703-837-3125

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

Wednesday, December 9, 2009

NHPCO Releases Updated Resource Manual

NHPCO Releases New Hospice Volunteer Resource Manual to Support Volunteer Programs and the Nation's 550,000 Hospice Volunteers

(Alexandria, Va) – The National Hospice and Palliative Care Organization reports that more than 550,000 individuals across the nation are giving of their time and talents as trained hospice volunteers. These volunteers contribute more than 25 million hours of service annually and reach 1.5 million patients and their family caregivers every year.

These figures, part of the NHPCO report Facts & Figures: Hospice Care in America were shared at NHPCO’s recent 6th National Conference on Volunteerism and Family Caregiving held last weekend in Orlando, Fla.

As part of the conference events, NHPCO released the newly revised edition of The Hospice Volunteer Program Resource Manual.

Hospice organizations have a responsibility to ensure that volunteers are well trained and well cared for and this manual will contribute to those efforts.

“Hospice volunteers are individuals who have stepped forward to make a difference in the lives of other people in their communities and they are vital members of the hospice and palliative care interdisciplinary team,” said J. Donald Schumacher, NHPCO president and CEO.

“The help, kindness and support that patients and families receive from hospice volunteers often profoundly changes their experience at the end of life.”

The manual has been updated to reflect the 2008 hospice Conditions of Participation—the federal requirements that all hospices must meet—and includes fresh ideas on recruitment, retention, training, volunteer manager skills development, program development, and more.

The publication includes a CD-ROM that assists managers in personalizing a volunteer program that meets the specific needs of an organization. Materials that can be adapted include competency checklists, surveys, policies and procedures, visit logs, job descriptions, training outlines, and more.

To ensure that volunteers remain an integral part of hospice care, it is federally mandated that at least five percent of patient care hours be provided by trained volunteers. Providers must track and document this carefully.

When a hospice invests in establishing a fully-functioning volunteer support program, the five percent rule becomes a guidepost, instead of burden.

“I know it costs money to run a well-coordinated volunteer program, however, on every level the benefits exceed the costs. Volunteers and their gift of service can have a huge impact on both the quality of the care your organization provides and its bottom line. A well-trained, engaged volunteer who spends time with patients and families can pick up on changes or challenges before they become crises,” noted Schumacher.

The Hospice Volunteer Program Resource Manual (item #820114) is available from the NHPCO Marketplace and may be ordered online, nhpco.org/marketplace, by phone at 1-800-646-6460, or by downloading and returning theVolunteer Manual order form.

For more information visit, http://www.nhpco.org

Thursday, July 16, 2009

Google Health and Caring Connections

National Hospice and Palliative Care Organization’s Caring Connections and Google Health Offer New Way to Access Advance Directives Online

Alexandria, VA – Ensuring that one’s healthcare wishes are known and will be honored in the event of a healthcare crisis is what advance care planning is all about. Today, the National Hospice and Palliative Care Organization’s Caring Connections, a leading provider of advance care planning information, and Google Health™ have come together to increase the availability and accessibility of advance care planning information and resources online.

Advance directives, also known as living wills and healthcare power of attorney forms, allow an individual to express their wishes if they are in a medical crisis and unable to communicate. These documents provide specific information to healthcare professionals and can help guide family caregivers called upon to make decisions on behalf of someone who is not able to speak for themselves.

“How can medical professionals honor your healthcare wishes and preferences if they don’t know what they are?” said J. Donald Schumacher, president and CEO of NHPCO. “Advance directives are useless unless they are available during emergency healthcare situations. Google Health will make these documents accessible online and will eliminate a huge barrier of access during times of need.”

A new feature on Google Health enables users to download a free, state-specific advance directive and store the scanned documents securely online. This will help overcome a common barrier in emergency healthcare situations, where it can be difficult to access a patient’s advance directive.

Google Health is a secure, online Personal Health Record (PHR) that allows consumers to store, organize, and share important healthcare information. Google chose to work with Caring Connections because they are the only provider that offers free, state-specific, online advance directives. In the past three years, Caring Connections has distributed more than 2.5 million advance directive forms. They also provide information to help people understand advance care planning and begin conversations with family and healthcare professionals.

The process to store an advance directive form in Google Health is easy:


  1. Go to your Google Health account at google.com/health, or create a new account if you don’t have one already.

  2. Download and print the advance directive form for your state at caringinfo.org/googlehealth

  3. Complete the form and sign it.

  4. Scan the signed document and upload it to your Google Health account.

By taking time to do these simple steps, you are making your healthcare wishes available to those who may need them in a time of crisis. Not only is this an important step to take for your own well-being but it’s a gift for your family members and loved ones who may need to act on your behalf.

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Contact:
Jon Radulovic
NHPCO
Ph: 703-837-3139
jradulovic@nhpco.org
www.caringinfo.org
Caring Connections is a program of the National Hospice and Palliative Care Organization. Learn more at CaringInfo.org.

Thursday, March 19, 2009

Costs of Care at EOL

Discussions About End-of-Life Care Reduce Healthcare Costs in Last Week of Life

NHPCO Encourages Dialog between Patients and Physicians

(Alexandria, Va) – Patients with advanced cancer who reported talking about their end-of-life wishes with their physicians had significantly lower healthcare costs in the last week of life. Researchers found that these conversations between patients and physicians led to fewer cases of aggressive care, which saved money and resulted in a far more peaceful death for patients.

The study in the March 9 issue of Archives of Internal Medicine suggests a tangible benefit to advance care planning discussions with physicians – lower costs and reduced utilization of aggressive care, including admission to the Intensive Care Unit.

Thirty percent of Medicare’s annual costs are spent on the five percent of beneficiaries who will die in a given year. Additionally, about one-third of those dollars spent in the last year of life are spent in the last month.

“Discussions about care at the end of life result in a higher quality of life for patients – and cost the healthcare system less money, that is something that hospice and palliative care providers have long known” said J. Donald Schumacher, president and CEO of National Hospice and Palliative Care Organization.

A 2007 study out of Duke University found hospice saves Medicare about $2,300 per beneficiary that receives hospice care.

Researchers in this recent survey looking at costs in the last week of life indicate that if 50 percent of people had a discussion with their physician about end-of-life care preferences, the cost difference in a year could be more than $76 million dollars.

Study participants who discussed end-of-life care preferences were more likely to be referred to hospice sooner than those who did not.

“In fact, patients who received less invasive or aggressive treatments lived as long as patients who did not, indicating that attempts to prolong life in end-stage cancer patients might be futile,” noted Schumacher.

Research published in the Journal of Pain and Symptom Management (March 2007) found that Medicare beneficiaries who opted for hospice care at the end of life lived on average 29 days longer than similar patients who did not take advantage of hospice.

NHPCO has been a longtime advocate for people having frank discussions about the care they would want – primarily to ensure that a person’s wishes are honored and that they experience the highest quality of life possible.

“An important time to talk to your doctor about the kind of care you would want at the end of your life is not when you’re days away from death but much earlier in the course of an illness,” said Schumacher.

“In fact, I cannot stress the importance of advance care planning for all people. Taking time, right now, to have these discussions with family and loved ones can be very important in making sure wishes are honored should a medical crisis come along,” added Schumacher.

Last year, more than 1.4 million Americans with life-limiting illness received the quality care from the nation’s 4,700 hospice care providers.

Information on care at the end of life, starting these important conversations with loved ones and care providers, and state specific advance directive forms, are all available free-of-charge on NHPCO’s Caring Connections Web site, www.caringinfo.org, or from the Helpline at 800-658-8898.

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For more information visit, http://www.nhpco.org