Providence Senior and Community Services

News Media Clips/Blogs 

A major shift in end-of-life care is occurring in our health care system today and a national dialogue is taking place about it in the media.

To help you stay informed, the articles and videos below are a sampling of the discussion taking place in the media. Check back often, as we’ll continue to add items as they occur.

Please feel free to send us an email at hospiceinfo@providence.org.

*Information is being provided as a resource service only. Providence Hospice and Palliative Care Washington does not endorse or refute findings and opinions presented.

 

Headlines of Interest:

Hospice Care Improves Quality of Life and Lowers Costs
Steve Tokar, June 4, 2012

Half of adults over age 65 made at least one emergency department (ED) visit in the last month of life, in a study led by a physician at the San Francisco VA Medical Center (SFVAMC) and UCSF.

“For too many older Americans, the emergency department is a conduit to hospital admission and death in the hospital,” said lead author Alexander K. Smith, MD, MS, MPH, a palliative medicine doctor at SFVAMC and an assistant professor of medicine in the Division of Geriatrics at UCSF.

In addition, he noted, “the traditional focus of the ED is stabilization and triage, not end-of-life care, while hospice provides care specifically for patients with a prognosis of six months of life or less.”

To read the entire article, click here: http://www.ucsf.edu/news/2012/06/12101/ill-older-patients-who-rely-emergency-room-often-live-final-days-hospital-study

U.S. Hospitals Adding Palliative Care Teams at a Feverish Pace
Matt Sedensky, Associated Press - June 4, 2012

""Though the [palliative care] programs and their scope vary widely, a common scenario might look like this: A patient is diagnosed with lung cancer, and a palliative care team’s assistance is enlisted from the start, working alongside oncologists and other specialists. The palliative team may include doctors and nurses as well as a social worker and chaplain. Together, they coordinate care among the many medical professionals, have long consults with the patients and their families to answer questions, and may preventively prescribe medications for likely side effects of treatment, from pain to constipation to nausea.

The palliative team has a clear vision of the patients’ goals and personal philosophies and, depending on these factors, might help steer them away from treatments that are determined to be more painful than they’re worth. Though palliative doctors share some similarities with hospice doctors in this regard, their goal is still to cure, and their patients are not considered to be at the end of their lives, they are simply facing a serious illness."

To read the entire article, click here: http://healthland.time.com/2012/06/04/u-s-hospitals-adding-palliative-care-teams-at-a-feverish-pace/

 Clearing up Confusion About Palliative Health Care
Jon Hallberg, MD, Minnesota Public Radio - May 16, 2012

"Palliative care is an approved medical subspecialty that's present in 85 percent of larger hospitals. But a new survey in the Journal of Palliative Medicine shows that many patients and health care professionals are still confused about the concept. Many even confuse palliative care with euthanasia.

MPR's medical analyst Dr. Jon Hallberg discussed the concept of palliative care with Tom Crann of All Things Considered on Wednesday. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic."

To read the full transcript of this discussion, click here: http://minnesota.publicradio.org/display/web/2012/05/16/hallberg/

Cut Costs While Improving Health Care
Chris Zinn, The Charleston Gazette - May 9, 2012

"Health providers must learn to give high quality care for less. This is what hospice has always done well. Hospice provides great cost-savings at the end of life when people are cared for at home rather than having multiple hospitalizations and nursing home stays. Hospice has physician-directed, coordinated care that is patient- and family-focused.

A hospice team works together to help people remain at home as much as possible, which is what many [people] want. Having a nurse on call 24 hours a day is one vital service of hospice that is rare in our health care system. Without this, an expensive trip to the emergency room is often the only option in a crisis.

People with chronic illness do not usually have coordinated care and on-call backup until they are referred to hospice. However, this care coordination is greatly needed and can save money and improve care."

To read the entire article, click here: http://wvgazette.com/Opinion/OpEdCommentaries/201205090129

Lessons from Toronto's Jackie Smith as she dies of cancer
The Star - April 22, 2012

"Jackie read a newspaper story recently by a woman who wrote that all she could say about cancer is that she endured it. This made sense to Jackie. “I’m not interested in fighting this,” she says. “Actually I’ve never been in the battle. And because of that I’m having a better quality of life. I don’t have to fight to get appointments to get MRIs.”

Once the spread of her cancer was detected in February, Jackie started a 10-day course of palliative whole-brain radiation. The treatment halted the tumour’s invasion of the cranial nerves affecting vision and the ability to swallow. Without the radiation, she might have experienced pain and seizures.

...How do you speak to a friend who’s dying? Truthfully, deeply, unsparingly and all the time. Jackie was never much for greeting friends with hugs or pecks on the cheek. Last week we clung to each other at the door. We looked into one another’s eyes and held on tight. We say, “I love you” when we say goodbye."

To finish this emotional article, read it all here: http://www.thestar.com/news/insight/article/1165485--lessons-from-toronto-s-jackie-smith-as-she-dies-of-cancer?bn=1

Living Life In My Own Way - And Dying That Way as Well
Amy Berman, Health Affairs - April 16, 2012

"For many patients, especially in the United States, “palliative” is, alas, a vague term, a word and medical approach they’ve heard of but don’t understand. If patients knew what it entailed, I bet many more would opt for it—precisely as I did.

To be clear: It’s not hospice care, although palliative care and hospice care often occur in tandem. Rather, the focus of a palliative approach is to prevent patients from suffering. If, in the course of an illness, suffering and pain become inevitable, then a palliative approach provides relief. It can be used at the same time as cures are being put in place—going hand-in-hand, for instance, to relieve side effects, such as nausea. It can be used with chronic conditions, such as back pain.

Palliative care can also provide comfort and symptom management at the end of life, which is why it’s frequently used even during hospice. It’s about providing the best possible quality of life, whether that means offering a cure; minimizing the burden of a chronic disease; or, as in my situation, focusing on maximizing comfort."

The article continues, and can be finished here: http://content.healthaffairs.org/content/31/4/871.full

 

Hospice Care Treats Dying with Reverence, Not as Abnormality
The Journal Times - March 24, 2012

"Without hospice involvement, the scene of an in-home death is often quite disruptive and unsettling. Why? Because in our culture, dying at home is considered “unnatural” or “unusual.” Consequently, when an in-home death is reported to authorities, what might otherwise have been a time of holy reverence often mutates into an intrusive spectacle where privacy and normal grief are swept aside to accommodate a parade of professionals who make their way into the home to orchestrate an “investigation” ... kind of like a crime scene.

There are many good reasons to choose hospice for end-of-life care. But if you chose hospice for no other reason than to facilitate an uncomplicated experience of dying at home, it would be the right choice indeed."

The article in it's entirety can be read here: http://www.journaltimes.com/news/local/commentary----hospice-care-treats-dying-with-reverence/article_941b1cd4-760b-11e1-8ae0-001871e3ce6c.html

Transforming the Way We Die
The Atlantic - March 8, 2012

An authentic, consistent pro-life message could resolve cultural controversies surrounding how we die. Knowing that, in addition to alleviating symptoms and distress, we can honor and celebrate the people we love as they die opens up fresh approaches to difficult, unavoidable life-and-death decisions. The ethics of care must no longer be confined to considerations of when and under what circumstances life-prolonging treatments can be withheld or withdrawn. Ethics must elaborate when and under what circumstances we must act to enhance a person's comfort, sense of dignity, and well-being through the end of life.

...Most people already agree on the fundamentals of high-quality care. We can stand on common ground well above the scarred fields of old culture wars. We can provide excellent lifesaving treatments, while respecting people's right to determine when enough is enough, always ensuring that their pain is treated expertly, that they and their families are treated tenderly.

Sadly, the way many Americans die remains a national disgrace. Yet, this is one national crisis we can solve. To succeed we must face hard truths and act courageously. We must be willing to collaborate even when -- especially when -- our social, religious, and political beliefs and personal preferences are very different.

To continue reading, find the entire article here: http://www.theatlantic.com/health/archive/2012/03/transforming-the-way-we-die/253694/

The Parent Trap: Adult Children Care for Elderly Parents
Kaiser Health News - March 1, 2012

"...the sandwich generation, [is a]...growing group of people who find themselves caring simultaneously for their children and for their parents. It’s a societal matter that can be traced to two trends: longer life spans, and the decision by couples to become parents later in life, not long before their parents begin needing care, too.

By 2030, 18 percent of the population will be over age 65, up from 13 percent in 2010, according to the Pew Research Center. The toll on the sandwich generation can be substantial, draining their time, finances and emotions, experts say. Many begin to neglect their own needs and sink into depression.

Where elderly parents end up — whether in an adult child's guest room, a nearby apartment, a senior community, a group home, an assisted living facility or a nursing home—is an intensely personal decision, experts say."

Read the entire article here: http://www.kaiserhealthnews.org/Stories/2012/March/01/Parent-Trap.aspx?utm_source=khn&utm_medium=internal&utm_campaign=emailed

 

Discussions About End-of-Life Care Between Physicians and Terminally Ill Cancer Patients Often Delayed Too Long
Medical News Today - February 12, 2012

"The vast majority of patients with incurable lung or colorectal cancer talk with a physician about their options for care at the end of life, but often not until late in the course of their illness...

And the doctor who shares in the end-of-life care talk is often a hospital physician, rather than an oncologist who has treated the patient for much of his or her illness.

Together, these circumstances may deprive patients of the opportunity for extended reflection and deliberation that would have been possible months earlier, when the conversation also could have occurred under less trying and hectic conditions, the authors suggest."

The complete article is available here: http://www.medicalnewstoday.com/releases/241449.php

Opportunities and Challenges of Palliative Care in the ICU
Journal of Palliative Medicine: Vol 15, Num 2; January 31, 2012

"The importance and potential benefits of palliative care to ease suffering and improve quality of life for patients being treated in hospital intensive care units (ICUs) has received increasing recognition but is not without significant challenges, as discussed in a Roundtable discussion in Journal of Palliative Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc.

"It seems clear that palliative care in the ICU improves the quality of care for both patients and their families. I suspect this will become standard of care in all hospitals in coming years," says Charles F. von Gunten, MD, PhD, Editor-in-Chief of Journal of Palliative Medicine, and Provost, Institute for Palliative Medicine at San Diego Hospice.

Read the entire Roundtable Discussion at  http://online.liebertpub.com/doi/pdf/10.1089/jpm.2011.9599

Why the Family Meeting is Important
Jeffrey Alderman, MD - January 24, 2012

"Every day, nearly 12,000 Americans are admitted to intensive care units for any number of life threatening conditions. In the ICU, doctors and nurses work tirelessly to help patients breathe, sustain blood pressure, and eliminate infections. Through years of training, we learn to ‘fix’ many medical problems – and we derive tremendous satisfaction when previously ill patients ‘get better’ because of our efforts."

"Yet missing from training is how to handle the “what-ifs.” What if the lungs and heart do not recover? What if the infection cannot be treated? What if, despite state-of-the-art, intensive, aggressive therapies, our patients do not ‘get better?’"

Read the entire article at http://www.kevinmd.com/blog/2012/01/family-meeting-important.html

National Hospice and Palliative Care Organization releases annual report on "Facts
and Figures: Hospice Care in America"       
NHPCO, January 11, 2012

"There are no better providers more skilled at providing palliative care at the
end of life than hospice professionals and the dying deserve the best care that
our society can offer," [J. Donald Schumacher, NHPCO president and CEO] emphasized. The report reveals that "the number of patients served remains fairly constant at 1.58 million in 2010 (a slight rise from1.56 million served in 2009).
Yet a statistic of concern to hospice and palliative care professionals is the drop
in both median and average length of service".

Two new additions to the new edition of the report include sections looking at
hospice care within the Medicare population and within the nursing home.

The entire article and the report is available on NHPCO's website, at: http://www.nhpco.org/i4a/pages/index.cfm?pageid=6056