In Canada right now hospice is a major topic of discussion. A small number of Chinese protestors are opposing the construction of a hospice sight in a Chinese neighborhood out of cultural fears and folkloric beliefs about ghosts and hauntings. The majority of the Chinese, however, are in favor of the project. David Choi, national executive director of the National Congress of Chinese Canadians, said that "Compassion and respect – especially for the elderly – are entrenched Chinese cultural values and a hospice is compatible with those values."
The applicable aspect of this story is that just as in Northwest Indiana, around the world there are far too many people without adequate hospice care. According to the Worldwide Palliative Care Alliance, more than 100 million people a year need palliative care but fewer than eight million receive it. In Canada, only 16 to 30 per cent of residents have access to or receive hospice palliative care, depending on where they live. Read more at the Globe and Mail.
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"Beets and Beans: Living and Dying with Hospice" is a new documentary on hospice care. It will have its first screening in Ithaca, NY. Read more about it at the Ithaca Journal.
January 26, 2011
January 18, 2011
The Ten Biggest Myths About Grief
Kay Talbot, a certified grief therapist and noted author on grief and mourning, writes that there are ten persistent myths about grief.
1) When a loved one dies, our relationship with that person ends: When the person isn't there anymore, a new relationship begins. The bereaved takes on the role of biographer, and must work through the pain and suffering to establish a new relationship that acknowledged the reality of death, but maintains the bond of love.
2) People who experience the same loss have the same grief: Individuals grieve in individually unique ways.
3) There is one right way to grieve: Empty platitudes and cliches do not acknowledge the individually unique quality of grief. Grief is not a problem to be solved or disorder to be cured. It is a process to be lived.
4) Time heals all wounds: It is what the bereaved do with the time that counts. Healing begins as people acknowledge true feelings and share stories with empathetic listeners.
5) All losses are the same: Experiencing loss does not mean that you completely understand another individual's loss.
6) Feeling and expressing intense grief emotions is a sign of weakness and lack of control: It takes great strength to fully live and express grief. Therefore, individuals should take the time and energy necessary to resolve their grief, most especially emotional time and energy.
7) Once grief is resolved it never comes up again: Most people who find peace after grief will still experience occasional, temporary upsurges of grief.
8) Everything about grief is negative and devastating: Love and humor can result from grief. As Father Edward R. Ward points out, "Death makes love urgent." Grief can often help individuals gather insights into their lives and prioritize their relationships more meaningfully and beneficially.
9) Religion always brings comfort during times of loss: Many people find solace in their faith. Other, immediately after a loss, find it too difficult and painful to pray or attend church. People must be allowed to grieve, in all ways, even spiritually, according to their own inner-schedule.
10) We "get over" grief: No one ever "gets over" a devastating loss. It is not that simple. People absorb it, and leanr from it. Their lives are changed forever.
For those of you looking for assistance, comfort, and "empathetic listeners" during your time of grief, contact the Blue Skies Hospice office. Blue Skies sponsors a bereavment group that meets once a month.
1) When a loved one dies, our relationship with that person ends: When the person isn't there anymore, a new relationship begins. The bereaved takes on the role of biographer, and must work through the pain and suffering to establish a new relationship that acknowledged the reality of death, but maintains the bond of love.
2) People who experience the same loss have the same grief: Individuals grieve in individually unique ways.
3) There is one right way to grieve: Empty platitudes and cliches do not acknowledge the individually unique quality of grief. Grief is not a problem to be solved or disorder to be cured. It is a process to be lived.
4) Time heals all wounds: It is what the bereaved do with the time that counts. Healing begins as people acknowledge true feelings and share stories with empathetic listeners.
5) All losses are the same: Experiencing loss does not mean that you completely understand another individual's loss.
6) Feeling and expressing intense grief emotions is a sign of weakness and lack of control: It takes great strength to fully live and express grief. Therefore, individuals should take the time and energy necessary to resolve their grief, most especially emotional time and energy.
7) Once grief is resolved it never comes up again: Most people who find peace after grief will still experience occasional, temporary upsurges of grief.
8) Everything about grief is negative and devastating: Love and humor can result from grief. As Father Edward R. Ward points out, "Death makes love urgent." Grief can often help individuals gather insights into their lives and prioritize their relationships more meaningfully and beneficially.
9) Religion always brings comfort during times of loss: Many people find solace in their faith. Other, immediately after a loss, find it too difficult and painful to pray or attend church. People must be allowed to grieve, in all ways, even spiritually, according to their own inner-schedule.
10) We "get over" grief: No one ever "gets over" a devastating loss. It is not that simple. People absorb it, and leanr from it. Their lives are changed forever.
For those of you looking for assistance, comfort, and "empathetic listeners" during your time of grief, contact the Blue Skies Hospice office. Blue Skies sponsors a bereavment group that meets once a month.
January 9, 2011
Medicare, Hospice, and Health Care Reform
The major health care reform bill passed by Congress and signed into law by President Obama in 2010 originally contained a provision that would use Medicare funds to reimburse physicians for discussing end-of-life care options with patients during an "annual wellness visit."
Last week, the White House eliminated that provision from the reform in a move that received very little comment or attention. One hospice director, however, in Gainesville, Florida is concerned about not only this elimination, but the lack of priority given to end-of-life hospice and palliative care within the reform and in the larger context of American medicine.
He told the Gainesville Sun, "Health care reform is going to mean more regulation and less reimbursement."
The Obama administration's inexplicable decision to remove the provision is particularly disappointing because the pre-existing system that exists to give patients knowledge and options for end-of-life hospice care is failing. Medicare requires doctors and health care providers to give patients a list of available hospice providers in their area. It is a good law, but one that is rarely practiced and even more rarely enforced. Many hospice directors develop less-than-ethical relationships with health care providers, and these relationships influence the providers to direct patients to them, rather than inform them on all available options.
Similar problems arise in the relationships between hospices and nursing homes. Medicaid pays 95 percent of room and board fees to qualified residents in nursing homes. The involved hospice organization bills medicaid for the services it provides and then reimburses the nursing home. Hospices often pay the entire remaining 5 percent in turn for possible referrals.
While the health care reform provision would not have addressed the possibility of fraudulent practices in the complicated relationships that exist between health care providers and hospice providers, along with those shared between nursing homes and hospice providers, it would have given doctors and patients an opportunity to have important discussions outside those systems. It would have enhanced the intimacy of the doctor-patient relationship, and encouraged people to have painful, but important conversations.
Future discourse on medical policy and health care reform must prioritize end-of-life care and hospice.
Last week, the White House eliminated that provision from the reform in a move that received very little comment or attention. One hospice director, however, in Gainesville, Florida is concerned about not only this elimination, but the lack of priority given to end-of-life hospice and palliative care within the reform and in the larger context of American medicine.
He told the Gainesville Sun, "Health care reform is going to mean more regulation and less reimbursement."
The Obama administration's inexplicable decision to remove the provision is particularly disappointing because the pre-existing system that exists to give patients knowledge and options for end-of-life hospice care is failing. Medicare requires doctors and health care providers to give patients a list of available hospice providers in their area. It is a good law, but one that is rarely practiced and even more rarely enforced. Many hospice directors develop less-than-ethical relationships with health care providers, and these relationships influence the providers to direct patients to them, rather than inform them on all available options.
Similar problems arise in the relationships between hospices and nursing homes. Medicaid pays 95 percent of room and board fees to qualified residents in nursing homes. The involved hospice organization bills medicaid for the services it provides and then reimburses the nursing home. Hospices often pay the entire remaining 5 percent in turn for possible referrals.
While the health care reform provision would not have addressed the possibility of fraudulent practices in the complicated relationships that exist between health care providers and hospice providers, along with those shared between nursing homes and hospice providers, it would have given doctors and patients an opportunity to have important discussions outside those systems. It would have enhanced the intimacy of the doctor-patient relationship, and encouraged people to have painful, but important conversations.
Future discourse on medical policy and health care reform must prioritize end-of-life care and hospice.
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