Whst's new with Hospice? ... it's time to have a Conversation

 

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 Washingotn does not endorse or refute findings and opinions presented.

Headlines of Interest:

Palliative care prolongs life, reduces sufferingUSA Today, Your Life - February 22, 2011

"Teams that provide palliative care focus on talking to patients, trying to understand people's values and tailor care to the patients' goals, Cooney says.
These teams — which often include psychologists, social workers, pharmacists, nutritionists and chaplains — also coordinate treatment, which can be especially important if people are being seen at more than one center, says Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.
The teams also support caregivers, who have a critical role in patients' health."
(http://yourlife.usatoday.com/health/medical/treatments/story/2011/02/Palliative-care-prolongs-life-reduces-suffering/44046292/1)

More People Choosing Hospice at Life's End
U.S. New's HealthDay - January 28, 2011

"Hospice has had to overcome many myths and ill-conceived notions on its way to gaining wider acceptance from the public.
But one notion that patients and their families still struggle with is the idea that choosing hospice means the person is "giving up." People who go into hospice are free to leave at any time, if their symptoms improve or they decide to pursue a new curative treatment, Pacurar said.
"It's not about giving up," she said. "It's about regaining control of your life at this time when chaos is reigning."'
(http://health.usnews.com/health-news/managing-your-healthcare/healthcare/articles/2011/01/28/more-people-choosing-hospice-at-lifes-end?PageNr=1)

Facing Death: How far would you go to sustain the life of someone you love, or your own?PBS Frontline - November 10, 2010

"There are clinical situations where the odds are so overwhelming that someone can['t] survive the hospitalization in a condition that they would find acceptable, then using this technology doesn't make sense," says Dr. Judith Nelson, an ICU doctor at Mount Sinai. "And yet, in my clinical experience, for almost everybody involved, it feels much more difficult to stop something that's already been started." But, according to Dr. Nelson: "Nobody wants to die. And at the same time, nobody wants to die badly. And that is my job. My job is to try to prevent people from dying if there's a possible way to do it that will preserve a quality of life that's acceptable to them, but if they can't go on, to try to make the death a good death."
(http://www.pbs.org/wgbh/pages/frontline/facing-death/)

Letting Go: What should medicine do when it can’t save your life?

The New Yorker - August 2, 2010
Atul Gawande M.D., Associate Professor of Surgery at Harvard Medical School and Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health and author of The Checklist Manifesto.

“Modern medicine is good at staving off death with aggressive interventions—and bad at knowing when to focus, instead, on improving the days that terminal patients have left… Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But studies suggest otherwise. In one, researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure. They found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer.”
(http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all)

Guidance on New Hospice Benefits for Terminally Ill Children Hailed by Hospice and Palliative Care Community
PRNewswire-USNewswire – Sept. 13, 2010

“The families of dying children who are covered under Medicaid or the Medicaid expansion Children's Health Insurance Program (CHIP) will no longer face the choice of stopping curative treatments in order for their terminally ill child to receive quality end-of-life care from hospice.”
(http://www.prnewswire.com/news-releases/guidance-on-new-hospice-benefits-for-terminally-ill-children-hailed-by-hospice-and-palliative-care-community-102767944.html)

Early Palliative Care for Patients with Metastatic Non Small Cell Lung Cancer

The New England Journal of Medicine - August 19, 2010
Temel, et.al

“Among patients with metastatic non–small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival.”
(http://www.nejm.org/doi/full/10.1056/NEJMoa1000678)

Editorial: Palliative Care — A Shifting Paradigm

The New England Journal of Medicine - August 19, 2010
Amy S. Kelley, M.D., M.S.H.S., and Diane E. Meier, M.D.

“The study by Temel et al. represents an important step in confirming the beneficial outcomes of a simultaneous care model that provides both palliative care and disease-specific therapies beginning at the time of diagnosis. This study is an example of research that shifts a long-held paradigm that has limited access to palliative care to patients who were predictably and clearly dying. The new approach recognizes that life-threatening illness, whether it can be cured or controlled, carries with it significant burdens of suffering for patients and their families and that this suffering can be effectively addressed by modern palliative care teams. Perhaps unsurprisingly, reducing patients' misery may help them live longer. We now have both the means and the knowledge to make palliative care an essential and routine component of evidence-based, high-quality care for the management of serious illness.”
(http://www.nejm.org/doi/full/10.1056/NEJMe1004139)

Medical Society of New York Fights Palliative Care Information Act Despite Mounting Evidence

HuffingtonPost.com – September 3, 2010
Barbara Coombs Lee, Compassionandchoices.org

“The ink of Governor Paterson's signature is barely dry on New York's Palliative Care Information Act (PCIA), drafted and sponsored by Compassion & Choices and its New York affiliate, yet evidence mounts daily for its vast and dramatic impact on end-of-life care. I predict this bill will shift decision-making authority radically from physicians to patients, and dwarf the impact of the Oregon and Washington Death with Dignity bills that, themselves, sent tremors through Medicine over the last thirteen years.”
(http://www.huffingtonpost.com/barbara-coombs-lee/medical-society-of-new-yo_b_705397.html)

‎The Power of Palliative Care

"Good Morning America" - August 26, 2010.

(http://abcnews.go.com/Health/video/power-palliative-care-well-being-overal-quality-live-response-treament-improved-care-11489699)

Panel Discusses New Studies in Palliative Care

The Diane Rehm Show – Aug. 24, 2010

(http://thedianerehmshow.org/shows/2010-08-24/new-studies-palliative-care)

New Law Could Help Hospice Patients Continue Aggressive Medical Treatments

Kaiser Health News in collaboration with the Philadelphia Inquirer – May 10, 2010
Reported by Medicaid Change

“The new health law could lead to a major change in Medicare policy that allows patients to get treatment and hospice care simultaneously...The new law instructs Medicaid, the state-federal program for the poor, to cover simultaneous hospice and curative care for children with terminal illnesses immediately. And it directs the federal Medicare program, which covers seniors and disabled people, to launch up to 15 pilot projects around the country to test the concept. If the experiment is deemed successful and doesn’t increase costs, then Medicare could make the benefit available to everyone in hospice.”
(http://www.kaiserhealthnews.org/Stories/2010/May/10/Hospice.aspx