Posts Tagged ‘palliative

Five Ways Hospice Can Help

The vast majority of Americans say what they want at the end of life is to die in their own homes, as comfortable and pain-free as possible. The hospice philosophy is about making sure that a Patients prefer to stay at home. Grandfather and child.

patient’s experience reflects their wishes. Here are five ways that hospice helps to deliver this:

Hospice gives you comfort

Hospice professionals are experts at managing life-limiting illness. The hospice team ensures that medication, therapies and treatments all support a care plan that is centered on the patient’s goals. And hospice services can be offered wherever the patient calls home, allowing friends and family to visit freely—something they might not be able to do in a hospital ICU setting.

Hospice gives you peace

Beyond physical relief, hospice strives to help patients and families find emotional and spiritual comfort during what is often a very traumatic time. Hospice organizations are able to provide families with counselors, therapists, spiritual care advisors and bereavement professionals who can best support their struggles with death and grieving. These services are part of the hospice benefit, covered by Medicare, Medicaid or most private insurances.

Hospice gives you something extra

Hospice is not only about compassionate medical care and control of pain. Art and music therapists inspire joy; pet therapy and massages are offered at many programs as well.

Hospice gives caregivers guidance

Most families are not prepared to face the death of a loved one. In addition to caring for patients, hospice also offers services for families and loved ones that provide emotional support and advice to help family members become confident caregivers and adjust to the future with grief support for up to a year.

Hospice gives you more

Be it more joy, more love, or more quality of life in general, the goal of hospice is to offer patients the ability to enjoy the time they have remaining, and create meaningful memories for their families. Hospice offers more moments of life.

Learn more at www.MomentsofLife.org

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A Human Rights Treaty Finally Recognizes the Right to Palliative Care

First Instrument Of Its Kind To Explicitly Refer To Palliative Care

The resolution that older persons should enjoy all existing human rights and fundamental freedoms on an equal basis, couldn’t be timelier. ElderlyHumanRightsFor years, international conventions have protected the rights of children, women, and people with disabilities—groups recognized as vulnerable to marginalization and human rights violations. Yet the rights of older persons, who are susceptible to the same violations, have been woefully neglected in the human rights framework. Finally, there’s a sign that this is beginning to change.

In late June, the Organization of American States released a resolution in which member countries adopted the Inter-American Convention on the Human Rights of Older Persons. It was immediately signed by Argentina, Brazil, Chile, Costa Rica, and Uruguay, and completed in record time, with drafting efforts initiated in 2012 and final text approved in 2015.

The convention recognizes that older persons should enjoy all existing human rights and fundamental freedoms on an equal basis, and is based on general principles including dignity, independence, proactivity, autonomy, and full and productive integration into society.

The resolution couldn’t be timelier. Advances in science, technology, and medicine have helped make the older population one of the most rapidly growing age groups in the world. Yet older persons are often denied access to health, social benefits, work, food, and housing. They bear a disproportionately large burden of chronic, life-limiting, and incurable illnesses, and they often experience severe, debilitating pain.

This is the first instrument of its kind to explicitly refer to palliative care. It requires countries to provide access to palliative care without discrimination, to prevent unnecessary suffering and futile procedures, and to appropriately manage problems related to the fear of death. It also mandates that countries establish procedures to enable older persons to indicate in advance their will and instructions with regard to health care interventions.

The Convention Defines Palliative Care As:71359394

the active, comprehensive, and interdisciplinary care and treatment of patients whose illness is not responding to curative treatment or who are suffering avoidable pain, in order to improve their quality of life until the last day of their lives. Central to palliative care is control of pain, of other symptoms, and of the social, psychological, and spiritual problems of the older person. It includes the patient, their environment, and their family. It affirms life and considers death a normal process, neither hastening nor delaying it.

The Resolution Is Not Without Its Flaws

30334509The resolution is not without its flaws, however. For instance, it does not address important legal aspects of palliative care, such as concerns related to inheritance laws and the future of the patient’s property, access to social benefits, patient confidentiality, and the care of children and grandchildren. These legal concerns are closely tied to emotional distress during end-of-life care, and addressing them is part of palliative care’s holistic approach.

The Inter-American Convention established a follow-up mechanism to monitor progress in implementing its provisions. Countries must submit periodic reports to a committee of experts, and people or NGOs may submit petitions concerning any violation of the convention’s provisions.

The convention will enter into force as soon as two signatory countries ratify it, which is expected to happen soon. Once it does, human rights advocates in Latin America will finally be able to rely on a legally binding instrument to demand accountability for the failure to respect older persons’ rights.

There’s More Work To Do

30359571But the effects of the convention could reverberate even further, helping to interpret the human rights of older people elsewhere in the world. For example, it comes at a critical moment to influence the African Regional Human Rights System, which is currently in the process of considering a draft Protocol on the Rights of Older Persons in Africa. And it strengthens civil society’s long-standing call for a UN convention on older persons, which was repeatedly raised during this year’s sixth session of the UN Open-Ended Working Group on Ageing.

We hope that the Inter-American Convention can set an important precedent for the drafting of other human rights instruments that include the right to palliative care. From the right to decide about end-of-life care, to relief from unnecessary suffering, to the need for adequately trained health professionals, palliative care is a human right the world must come to recognize.

From: Open Society Foundations

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Is Profit Seeking Trumping Care? Nonprofit vs. For Profit Hospice

The truth is, most people don’t think about hospice at all until it becomes a necessity. The concept of hospice is relatively new in the United States. However, as the number of hospice providers grows, with varying degrees of quality, it’s important to be informed. Hospice places its emphasis on quality of life with care that’s tailored to the unique needs of each individual and their support network. When curative treatments cease to help, the relief of palliative care can bring a new form of hope for terminally ill patients and their families, as hospice services help them make the most of their time together. In 2007, research published in the Journal of Pain and Symptom Management reported that hospice patients lived an average 29 days longer than similar patients who did not have hospice care.

When it came to the United States from England in the 1970s, the hospice movement began as a grass-roots campaign to address the unmet needs of patients with terminal illnesses. The benefits of this care were quickly recognized by the medical establishment. In a 1978 report, a U.S. Department of Health, Education, and Welfare task force noted both the altruistic and practical advantages of government support for hospice care: “The hospice movement as a concept for the care of the terminally ill and their families is a viable concept and one which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs. As such, it is the proper subject of federal support.” In 1982, Congress included a provision to create a Medicare hospice benefit in the Tax Equity and Fiscal Responsibility Act.

With hospice services covered by Medicare, what started as a purely charitable movement became a probable source of revenue. As a result, the number of for-profit agencies entering into the business of hospice has grown exponentially, with

alarming results. An article published by the Washington Post on May 3, 2014 entitled “Terminal neglect: How some hospices treat dying patients” reported that the quality of care provided by 920x1240hospices varies widely. A Washington Post investigation analyzed Medicare billing records for over 2,500 hospices, obtained an internal Medicare tally of nursing care in patients near death and reviewed complaint records at hundreds of hospices. At many hospices, they discovered that little care was provided for patients most in need. The investigation ascribed this absence of care to skimping on nurses, and to the failure of these hospices to have access to a facility where continuous crisis care could be provided. The investigation found that about 18 percent of U.S. hospices did not provide a single day of crisis care.

The investigation noted that the absence of crisis care at those hospices stands in stark contrast to most others, where such care is common. Medicare payment rates and their unintended financial incentives may be responsible. Providing routine care such as semiweekly nursing visits can be very lucrative. However, symptom management that requires continuous nursing care or inpatient care can be financially draining and logistically problematic, especially for smaller agencies.

An area of great concern is the burgeoning growth of home health care businesses that offer hospice. “For-profit home care agencies are bleeding Medicare; they raise costs by $3.3 billion each year and lower the quality of care for frail seniors,” said Dr. Steffie Woolhandler, professor of public health at CUNY’s Hunter College, lecturer at Harvard Medical School. “Letting for-profit companies into Medicare was a huge mistake that Congress needs to correct.”

William Cabin, assistant professor of social work at Temple University and lead author of a nationwide study published in the August 2014 issue of the journal Health Affairs said, “While our study is the first to show that profit-making has trumped patient care in Medicare’s home health program, that’s no surprise. A large body of research on hospitals, nursing homes, dialysis facilities, and HMOs has shown that for-profits deliver inferior care at inflated prices.”

Researchers believe that most hospices are providing quality care and many nurses in the field consider palliative medicine as much a calling as a job. When the hospice movement took root in the United States, hospice practitioners were typically part of religious groups, or were community-supported like the Texas Medical Center’s Houston Hospice. However, since for-profit businesses have come to dominate the industry, early planning and investigation of hospice care options is a necessity.

Karla Goolsby

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Houston Hospice Nurses: Every Word, Every Action A Gift

I was surprised that within my first two months of working at Houston Hospice, a childhood friend contacted me to say that her grandmother was being admitted to our inpatient unit. She was 96 and very much beloved from a long life. After emergency brain surgery to remove a blood clot, she continued to have tiny, persistent strokes. Days of monitoring, setbacks, bad news, and countless decisions left the family’s nerves frayed. Then, they made the difficult decision to stop trying to save their loved one.

“Mimi” was admitted after business hours on a Tuesday. When I arrived at the room, the family was just getting settled, and we all started crying. Fortunately, I soon realized that the tears were more of relief and assurance than of sadness. The family told me that even though they had only been at Houston Hospice for a few minutes, they were already feeling at peace. Mimi seemed to be sleeping deeply and in the greatest comfort.

While I was there, the nurses and aides were remarkably gentle, professional, and accommodating. My friend and her mother were overwhelmed with the calm that these women transferred to them. Every action or word was a gift. I’ve heard great things about our inpatient unit staff, and I have been with my own mother for weeks in ICU and other recovery areas of a hospital setting to witness outstanding, attentive care — but our Houston Hospice nurses and aides take care to a whole new level. Their skill sets include wisdom and patience that I have never observed before. I cannot believe how proactive they are with questions and suggestions to anticipate patient and family needs.  A lot of wonderful people can be responsive, but when support persons are proactive in offering help, the effect is incredible.

My friend, her family, and I were amazed by Sarah, Darlene, Sophia, Ellen, and Kristin on the night shift – and all of the devoted nurses and aides at Houston Hospice.  THANK YOU for truly caring and for giving every patient and family the gentle help they so desperately need. You are shining examples for all of us.

Martha Cambell, Houston Hospice Community Outreach Coordinator

holding hands

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Celebrating Valentine’s Day as a Caretaker

Valentine’s Day is a holiday that people love to love or love to hate. Some people love the idea of having a whole day to celebrate their love for their friends, family, and that special someone. Other people believe Valentine’s Day is a made up holiday to generate card, chocolate and flower sales. Whatever your opinion is, as a caretaker acknowledging Valentine’s Day can benefit your loved one.

If you take away all of the commercialization of Valentine’s Day what is left? The answer is simple- love. Dedicating a whole day of love for the people in your life is a great way to realize how valuable they are. As a caretaker, you are already a laborer of love. Balancing work and family is stressful enough. You choose to become a primary caretaker because of your deep love for your family member or friend.

This Valentine’s Day, take some time to think about the love you have for the friend or family member you are taking care of. In the chaos of trying to create a successful balancing act, it’s easy to forget why you are a caretaker. Think about great memories shared between the two of you and talk about them with your sick loved one. You don’t have to buy flowers, chocolates, or cards to celebrate your love for each other.

Also, don’t forget to celebrate the love you have for yourself. Take a moment to think about your characteristics that make you unique and special. When you love yourself you can love others even more. Don’t let yourself forget your worth or that you are a strong, caring person. Give yourself a giant hug and compliment.

Even though Valentine’s Day can seem a little over the top and excessive, don’t forget the message of love. Let others in your life know that you love them even if it’s a simple phone call or letter. And celebrate the love you have for yourself.

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What Is Hospice Care?

Houston Hospice Staff

Houston Hospice Staff

When a patient with a severe illness decides that curative measures are no longer appropriate or effective, the option of hospice care is a compassionate, dignified and cost-effective end-of-life care option. When possible, the patient can receive treatment within his or her own home. The hospice team who visits the patient on a regular basis consists of a nurse, hospice aide, social worker, volunteer and chaplain. Staff physicians are consulted and are available when necessary.

 

The essence of Houston Hospice care is:

Following assessments in the areas of physical pain, emotional needs, spiritual issues, legal concerns and practical arrangements, the patient, family and physician approve a plan of care. Being involved in making the plan helps patients and families face the last stages of life more comfortably and confidently.

Patient care is provided by Houston Hospice in the home, in a nursing home or residential facility or in the Margaret Cullen Marshall Hospice Care Center which is located in the Texas Medical Center.

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When is Hospice an Appropriate Alternative?

Hospice care becomes an alternative when a patient has reached the last phases of a terminal illness and has been given a prognosis of six months or less.  The subject can be addressed at any time during the illness as physician and patient discuss treatment options.  When a patient chooses hospice, the decision to give up curative measures is made in favor of comfort care, focusing on pain management and symptom control, psychosocial support for both patient and family and ancillary services that lessen the burden of illness and care giving.

Please contact us or visit our web site  http://www.houstonhospice.org for more information.

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