Christmas Tea

On Wednesday December 21st, Blue Skies held a Christmas tea at Kindred Care in Dyer, Indiana. Forty patients, both hospice and non-hospice, attended. Volunteers made goodies that they served with tea. There was also a raffle. The winners received Christmas blankets and holiday jewelry.

Moving Story of L.A.Man Highlights Hospice

The Los Angeles Times tells the story Steve Lopez, a 57-year-old family man, who was shocked to receive the sad and troubling diagnosis of cancer in his kidneys. His age and his love for his family make his resistant to die. The emotional pain and trauma with which he and his family must suffer is heartbreaking, but all too familiar to many families who elect to enroll a loved one into hospice treatment. "I'm not ready to go, but I'm prepared," Lopez said.

His story also addressed some of the misconceptions about hospice care, while demonstrating its true value:

Ramos was offered a chance to receive hospice care with a focus on palliative measures. Those are ominous-sounding words to a lot of terminally ill patients, and Ramos was no exception. The picture that popped into his head was of him dying in some kind of nursing facility with the hospice team at his side.

No, he was told. He could go home and be with his family. A doctor, nurse, social worker and chaplain would make house calls, care for Ramos and educate and support his family. If there were emergencies, he could still go to the hospital.

The fact that Ramos has rallied a bit since leaving the hospital in September does not surprise his doctor.

"All of our patients prefer to be home," said Dr. Peter Khang, chief of geriatrics and palliative medicine. He noted that in addition to familiar surroundings, home cooking and the love of family, this kind of care means fewer stressful, exhausting trips to the clinic or hospital.

Susan Enguidanos, an assistant professor of gerontology at USC, specializes in end-of-life care and has helped monitor Kaiser's in-home treatment programs. She said a study of Kaiser's in-home palliative program about 10 years ago showed a 45% reduction in patient costs due to the avoidance of emergency room and hospital visits, and more important, there was also a sharp increase in patient satisfaction. Other such studies, she said, have shown that 71% of palliative care patients die at home, as most people say they would prefer to do, as opposed to only 50% of those not in such programs.

The national implications are enormous, given that a large portion of the debt crisis in the United States is due to rising healthcare costs. Enguidanos said roughly 27% to 30% of total Medicare costs go to the 10% of patients who are dying, and she estimated that by placing greater emphasis on in-home care, Medicare could save 25% of what it spends on patients in the last year of life.

So why isn't this front and center in a presidential campaign season? Because many people don't understand that hospice and palliative care are about both living and dying with dignity, and because any civil discussion about end-of-life policy is more difficult since Sarah Palin uttered the words "death panels." Enguidanos and the medical staff at Kaiser — including Drs. Richard Brumley and Nancy Gibbs — told me they hope more research and education will convince the public and politicians that lower costs and greater patient satisfaction are both possible with greater emphasis on in-home care.

The financial benefits of moving America toward wiser and increasingly mature decisions regarding hospice and end-of-life care are clear, and measured in direct terms by many reputable organizations and medical professionals, as indicated by the Los Angeles Times.

The dignity and humanity of Lopez, his family, and many others in the same devastating trial of strength, love, and compassion, are invaluable and immeasurable. Hospice hels preserve them.

Blue Skies Bereavement Group Invitation

The following is a message from the Blue Skies staff inviting anyone in need to attend meetings of the Blue Skies Bereavement Support Group. Arlene Bakota, a Registered Nurse and Bereavement Coordinator, facilitates each meeting. Below are the details

Where: 2714 169th Street, Hammond, IN 46323

When: Saturday, January 28th, 2012
            Saturday, February 25th
            Saturday, March 31st
            Saturday, April 28th
            Saturday, May 26th
            Saturday, June 30th
            Saturday, July 28th
            Saturday, August 2th
            Saturday, September 29th
            Saturday, October 27th
            Saturday, November 17th
            Saturday, December 15h

Time: 2:30pm

We believe this meeting will be beneficial for both those who have experienced the loss of a loved one and for those who are currently a patient or friends and family of patients still within hospice. We hope that you will make plans to join Blue Skies Hospice as we seek to provide overall care for our patients and their friends and families.

Please RSVP to (219) 554-0688

Re-Imagine The End of Life with Hospice

Thomas Patrick Donovan, the community liason for Rocky Mountain Hospice in Bozeman, Montana, addresses the question, "Does choosing hospice mean giving up?" in a beautifully written essay for the Helena Independent Record:

"To hold fast to the belief that choosing hospice means admitting that one has failed is, in truth, a failure of our ability to imagine the end of life being anything other than a hard, possibly painful, winter that we have to suffer through. Perhaps it is time to re-imagine the end of life: rather than giving up, hospice is the successful embrace of community, a way of being there for each other. Hospice offers the caring arms of hospitality to patient, family, and friends and, as a result, creates a way to meet the winter of life that has comfort and dignity at its foundation."

Read more: http://helenair.com/news/opinion/does-choosing-hospice-mean-giving-up/article_9107977a-0518-11e1-8069-001cc4c002e0.html#ixzz1cbjKJGMR

Blue Skies Attends Hammond Mayor's Volunteer Luncheon

Mayor Thomas M. McDermott, Jr. held the 25th annual volunteer luncheon on October 19th. Blue Skies Hospice volunteer coordinator Pearl Masciotra and chaplain Buddie Fennie attended the luncheon. Blue Skies was one of the participating organizations, providing information about their services to attendees of the event.

Blue Skies Volunteer Coordinator, Pearl Masciotra, and Blues Skies Chaplain, Buddie Fennie

Hammond Police began the ceremony

Mayor McDermott spoke about the importance of volunteerism and communal involvement.

X Factor Finalists and Simon Cowell Collaborate for Children's Hospice

All proceeds from the new single by X Factor finalists will benefit an England Children's Hospice called Claire House.

Simon Cowell, who has worked with Claire House for several years, said in the press release announcing the single, "Having worked close hand with this charity and seeing the amazing work they do for kids and their families who need help and support, I am thrilled that the X Factor charity single this year will benefit this charity."

"Wishing On a Star," the new single, will be available for download on November 20th.

The effort to assist the British hospice is a testament to the power and importance of hospice care. Please show your support by downloading the single. If you or anyone you know is in need of the kind of services Claire House provides in this area, please contact Blue Skies Hospice.

Blue Skies Fall Dessert Day

On October 5th Blue Skies Hospice held a fall dessert day and raffle at Regency Place of Dyer. Regency staff enjoyed desserts, and the raffle winners, Sue Frank, Jose Qma, Alisha Clay, and Amber Mender, took home beautiful fall mums.

Mourning Father Starts Hospice After Infant Son's Death

Hospice care, for patients, families, and workers alike, is a healing process that helps people overcome the pain that results from the death of a loved one, and work through the grief that follows that death. Typically, hospice care enters a person life at a seemingly natural period when the dying patient is in her elderly years.

Utah man, Derek Sorenson, however, made the decision, with the child's mother, to put his son in hospice care hours after he was born. Deyton, the baby boy, was born with a fatal heart condition and died after only six days. Sorenson worked for a hospice organization at the time, but the death of his son inspired him to start his own hospice organization, Dixie Hospice Care.

Sorenson says that "helping other people helps me heal." Read more of his inspiring story here: Infant's Death Inspires Hospice Care.

Blue Skies Hosts An Evening with Ol' Blue Eyes

On August 28th, Blues Skies Hospice hosted "An Evening with Ol' Blue Eyes" at Regency Place of Dyer. One of Northwest Indiana's favorite entertainers Jim Bulanda provided the entertainment for the residents and their families. Bulanda regularly performs Frank Sinatra, Dean Martin, and Tony Bennett songs throughout the area and has played with the Northwest Indiana Symphony Orchestra. He was kind and generous enough to donate his time and talent to help Blue Skies create a magical evening for the residents and families. The Blue Skies staff served refreshments, while the audience sang along and enjoyed the music.

Blue Skies plans to host more entertainment events at Regency. As you can see in the pictures, a good time was had by all.

Jim Bulanda

Blue Skies Volunteer Julie Hancin, Blue Skies Nurse Karen Lansdowne, RN, Blue Skies Volunteer Coordinator Pearl Masciotra

Bulanda Entertaining the Crowd

Blue Skies Bereavement Group - Overcoming Loneliness After Loss

Blue Skies Hospice hosts a bereavement support group the last Saturday of every month at the hospice house located at 2714 169th St. in Hammond, Indiana. For further information please call Arlene Bakota the Bereavement Coordinator at (219) 680-7977.

The grieving process is painful. Bereavement groups can often be a source of strength, comfort, and growth throughout the work of mourning. Grief counselors insist on the importance of reaching out to friends, commemorating the loss, and turning to God when searching for ways to move forward following the death of a loved one. They also, however, implore mourning people to get support from other mourners, and often that support can come from a bereavement group.

The Blues Skies Hospice bereavement support group is open to anyone looking for compassion, support, and friendship in their time of sadness.

Hospice Funding Up, But New Problems Arise

A recent report reveals that the amount of money Medicare spent on hospice care increased more than 53 percent between 2005 and 2009 to $12 billion, according to a government report.

The need for hospice care continues to grow, while the number of hospice patients increase. The trend of increased attention, focus, and funding for hospice care is worthy of applause. The government insistence, however, on giving most of its funding to For Profit hospice is lamentable as not only a problem in hospice care, but an illustration of larger problems in the American health care system.

The report states, "According to the Department of Health and Human Services, more than half of hospices in 2009 were for-profit. These same hospices received more money from Medicare than non-profit and government-owned hospices, even though there are far fewer of them."

As the Blue Skies Hospice blog has pointed out before, for-profit hospices are more likely to cut costs by cutting care, which means the patients and their families suffer.

A recent study published in the Journal of the American Medical Association found that for-profit hospices had more patients with illnesses linked to fewer medical needs and longer lengths of stay, resulting in higher payments.

Clearly, the focus for for-profit hospices is what its name indicates, profit. Few medical needs and longer lenghts of stay means greater profit, which translates into hyper-selectivity of patients.

Blue Skies Hospice is a not-for-profit hospice that accepts all patients, regardless of medical need, potential length of stay, and income level. Blue Skies is also taking donations that will directly go to the assistance of patient care and family support. Your donation will help secure the Blue Skies mission of providing competent and compassionate care for all patients.

New Documentary on Oprah's OWN on Hospice Care

A new documentary set to premiere on Oprah's cable network OWN tonight, which will run for the next few weeks, gives what critics are calling "a beautiful look" into hospice care at the Louisiana State Penitentiary-Angola. The prison, in many cases, uses inmates as hospice volunteers to visit dying inmates. As the film's director, Lisa Cohen said:

“Looking for humanity in the darkest of places has always been something that fascinated me. That’s why I keep going back to Angola, the worst of the worst, when you get down to it, they surprise you. It doesn’t mean you should trust them. It doesn’t mean you should let them out. I’m not someone who believes you should open the doors and let all those guys out. I think that if you give someone an opportunity to do good, under the right circumstances they will, and they will get something profound out of it. They will rise to the occasion.”

Hospice strives to affirm the humanity of patients, families, and volunteers at all times, regardless of where they are - in prison or in a mansion.

The New Orleans Times-Picayune has more information, along with a trailer, on the documentary.

Blue Skies Sponsors and Hosts Afternoon Tea For Residents of Regency-Place of Dyer

On June 22, 2011 Blue Skies Hospice sponsored and hosted an afternoon tea party for the residents and their families at Regency-Place of Dyer. Blue Skies volunteers, Julie Hancin and Sherry Nielsen, baked cookies for the residents to enjoy with their tea. There was also a free raffle at the end of the tea in which several residents won jewelry. Pictured below are Regency residents having fun at the party with Blue Skies volunteer coordinator, Pearl Masciotra, and volunteer Julie Hancin.

New York Times Inquiry Into Hospice

On June 28, the New York Times ran a story examining the contemporary debate surrounding the issue of hospice care and the decision to increase the funding available for hospice care. Some critics of hospice have expressed concern over patients staying in hospice for what they view as too long, given that it is care intended for terminal patients. Hospice, however, is at its best when patients and their families have sufficient time to adjust to the dying process and prepare for mourning, as healt care experts point out in the original NY Times report, and the following letters to the editor:

Re “Concerns About Costs Rise With Hospices’ Use” (June 28): In 1996, suffering from inoperable cancer, my father received hospice care in the last three weeks of his life from a nonprofit agency. The physical comfort those dedicated nurses and social workers gave him — and the emotional support they offered to the whole family, strengthening our own ability to care for him — was extraordinary, incalculable, life-changing. The thought that for-profit health care chains are cynically exploiting this model of care to fill their own pockets, and might even endanger Medicare funding for hospice, is beyond appalling. They are vandalizing sacred ground.
Anne Berrill Carroll
Manhattan

To the Editor:
Studies show that health care costs are far less for those enrolled in hospice at death compared to those who are not, and that hospice patients have a better quality of life. The larger concerns that need to be addressed are that only 41 percent who die are on hospice (only about 25 percent in New York State) and that too many patients are enrolled for a very short time, less than three weeks on average. When hospice use increases, as it should, greater cost savings will result.
David C. Leven
Pelham, N.Y.
The writer is executive director, Compassion & Choices of New York.

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Blue Skies Hospice is dedicated to bring quality hospice care to the patients and families in Illinois and Indiana.

Inspiring Story of Young Man Who Learned Fine Cooking and Served Others in Hospice

Hospice care gives patients companionship, support, and assistance throughout a very difficult, painful, and sad time period. The typical hospice patient is a terminally ill person at the end of a long life. Scott Crane, a 23 year old native of Northbrook, IL, was atypical in many ways. Tragically, he died at a young age of Muscular Dystrophy. In his short life, Crane made a remarkable difference in the lives of other people, and he turned his debilitating, and ultimately fatal, condition into a tool to ease the suffering, bring comfort, and enhance the quality in the lives of others.

He learned to cook when in hospice care and fell in love with the culinary arts. He then combined his passion for cooking with his need to love and serve others by creating the charity, "In Chefs Hands--Food Therapy for the Soul."

He mentored young people with disabilities, and volunteered with Midwest Hospice Care Center.

Scott Crane's dedication to love and service, in spite of his own suffering, inspired his family and friends and should continue to inspire all who are familiar with his story to follow his example.

His experiences with hospice care, as a patient and volunteer, demonstrate the benefits of this unique service that places the physical comfort, emotional strength, and spiritual needs of patients and their families at the center of its calling.

Read Scott Crane's Obituary

Baseball Hall of Famer Harmon Kilebrew Gives Hospice Care a Golden Glove

Harmon Kilebrew is a retired baseball player who holds a record with Babe Ruth for hitting more than 40 home runs in eight seasons. While with the Minnesota Twins, he won the American League MVP award and set a wide variety of team and league records. After retirement, he became an advocate for child involvement in baseball and bringing assistance to sports programs in low income neighborhoods.

Sadly, Kilebrew recently announced that he will no longer pursue treatment for the esophageal cancer that has plagued his life in recent years.

The baseball legend, in his statement, gave powerful testimony to the value, service, and importance of hospice care: "I have spent the past decade of my life promoting hospice care and educating people on its benefits. I am very comfortable taking this next step and experiencing the compassionate care that hospice provides."

The comfort that hospice care gives is not limited to basbeball hall of famers. It is available to every human being, regardless of income level. Quality and universal care is the goal, promise, and mission of Blue Skies. Please call for more information if you or a loved one is in need: (219) 554 - 0688.

Meet Blue Skies Hospice Director, Lisa Guzman

Lisa Guzman is the director of Blue Skies Hospice. She recently answered questions about her background in and beliefs about health and hospice care.

What is your background in health care?

I have been an RN since 1986. I worked at South Chicago Community Hospital for 10 years and then worked in home health and hospice.  I then became an Advanced Practice Hospice and Oncology Nurse with a Masters degree in Nursing from Purdue in 2000.  I am currently working on my Doctorate degree in nursing with a focus on oncology.

Why did you choose to start your own hospice organization?

I founded Blue SKies Hospice to provide care to the terminaly ill patient allowing a more holistic approach and treatment plan.  I worked for other hospice companies in the past and found that holistic treatment was missing.

What makes hospice so important and what should people understand about hospice?

Hospice is important because it offers the patient and their families choices. Many patients do not want to undergo invasive procedures or go though the side effects of treatments if there is no chance for a cure.  They would rather have the choice of quality of life and we can offer them that.

Why Blue Skies a great organization for patients and families? What is the philosophy of Blue Skies?

Blue Skies Hospice is a great organization for patients and families because our philosophy is that each patient recieves individualized holistic care regardless of race or financial status.  We also allow patients to be enrolled in hospice and stay on all of their current medications, treat infections, and have feeding tubes if they choose to.  We provide care from nurses, chaplains, social workers, volunteers and home health aides and also offer alternative treatments such as reflexology and reiki therapy should the patient be interested in that. When we admit a patient they become a part of our family.  All of our staff regard hospice work as a calling, not a job.

What do you have planned for the future of Blue Skies?

In the future, Blue Skies Hospice wants to remain small.  We think that the nurse to patient ratio is very important and we never want to lose the personal touch that we give to all of our clients and their families.  Our goals in the future do include helping our community in any way that we can, whether that is letting businesses use our facilities in times of need as we did during the flooding in Munster, donating to local causes or continuing to take on charity cases for those less fortunate and unable to afford care.

National Nurses Week

The nurses on staff at Blue Skies Hospice are an essential and wonderful part of the team. They are dedicated to using their education, expertise, and experience to provide loving care, tender support, and effective treatment to the Blue Skies Hospice patients. Families can be confident and comfortable that their loved ones are in caring and competent hands at Blue Skies.

It is for this reason, along with gratitude to nurses everywhere, that we take a moment to celebrate National Nurses Week. The current campaign, "Trusted to Care", gives the following information and insight:

National Nurses Week 2011 Nurses Trusted to Care
Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. As nurses, we work in emergency rooms, school based clinics, and homeless shelters, to name a few. We have many roles – from staff nurse to educator to nurse practitioner and nurse researcher – and serve all of them with passion for the profession and with a strong commitment to patient safety.

Background
National Nurses Week is celebrated annually from May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing.

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Thank you to the Blue Skies nurses, who the patients and their families trust to care: Lisa Guzman RN, Amy Mosoriak RN, Karen Lansdowne RN, Arlene Bakota RN, Carol Newman RN.

We Celebrate National Volunteer Week

We are not called to be great. But we are called to reach out our own hands to our brothers and sisters, and to care for the earth in the time we are given.
- Kent Nerburn

To celebrate National Volunteer Week, we say thank you to our Blue Skies volunteers who bring light and love into people's lives:

Julie Hancin
Diane Palma
Paul Reinbolt
Carolyn Kalweit

Volunteers are the backbone of the hospice team. They allow hospice to provice services it otherwise could not offer.

If you are interested in becoming a volunteer call (219) 554-0688, and ask for volunteer coordinator Pearl Masciotra.

Michigan Man Emotionally and Spiritually Revitalized from Hospice

Too often uninformed people think of hospice care as merely a waiting station for people to check into before they die. Hospice care, while it does bring care and comfort to the dying, provides a much more holistic service than that essential element. It gives people companionship, support, and affirmation at the most difficult time of their lives. It also extends those gifts to the patients families. Blue Skies Hospice has committed staff of nurses, social workers, chaplains, doctors, and volunteers dedicated to these vital tasks.

A story of one man's experience with hospice in Petoskey, Michigan beautifully illustrates the value of hospice care:

Hospice gives local man new outlook on life

Rachel Brougham

Petoskey News: April 11, 2011

Just five months ago, Russell Mikesell was ready to give up.

In February of 2010, the 64-year-old Ellsworth resident lost his right lung to cancer.

After months of chemotherapy and recuperation, Mikesell thought he was on the path to recovery. But last fall, Mikesell found himself back in the hospital after his remaining lung collapsed.

He was released from the hospital and began receiving hospice care at his home. But caring for Mikesell at home was just too much for his family to handle.

In November, he was admitted to the VitalCare Hospice of Little Traverse Bay’s Hiland Cottage in Petoskey. With a grim diagnosis, neither he nor his wife, Ellen, thought he would survive.

“I just figured I was going to die because that’s what you think happens when you go to hospice,” Mikesell said. “But then something changed.”

Ten days after arriving at hospice, Mikesell woke up one morning and saw things differently.

“For the first 10 days I was there, everyone was just so patient and helpful. Nobody made fun of me, they just took care of me,” Mikesell recalled. “Then, somehow, I woke up on the 11th day and felt I was going to live. It was kind of like an epiphany — I just felt entirely different.”

A couple days later, Mikesell was regularly getting up, going to the kitchen and helping the nurses with small tasks.

He continued to improve, and on Dec. 31, 2010, Mikesell graduated from hospice.

He is now cancer free, and while he is no longer in the care of hospice, he refuses to leave: He now volunteers his time at Hiland Cottage.

“I would do anything for those people. They pulled me through my darkest time, that’s what made me better,” Mikesell said. “I’m changed. I guess it happens to everyone when they go through a close call.”

Karen Gauden, clinical manager at Hiland Cottage in Petoskey, said she has seen many patients over the years leave hospice and go on to live healthy lives.

“Often, people think they come to hospice to die, but we do have patients that graduate from hospice,’” she said.

Gauden added that while no one ever wants to be in hospice, those touched by its services, whether patients or family members, often leave the hospice experience singing its praises.

“Hospice becomes part of your family and you become part of theirs. I would do anything for them so I’m going to give back,” Mikesell said.

Mikesell said now, because of hospice, he views death as part of life and as an event that should not be feared.

“My experience with hospice is something that is hard for me to talk about without getting teared up, but I want to share my experience in the hopes of helping others,” Mikesell said. “I don’t plan on dying for a long time, but when I do, I think I’ll do it more gracefully and with more poise than I would without having gone through hospice.”

Copyright © 2011, Petoskey News

Overcoming Loneliness After Loss

Erin Diehl is a clinical pastoral counselor, and she offers wise words for those in the middle of grief or preparing for it. Her guidance may be important for looking to place a loved one in hospice care.

Overcoming Loneliness After Loss

1. Reach Out to Friends: "After my husband's death, I had to learn that when my loneliness seemed overwhelming I could not sit around and wait for someone to call me. I needed to initiate the encounter...If you seek support you will find it."

2. Commemorate Your Loss: "If you are grieving the death of a loved one, find a way to express the loss you feel, and also to symbolize the ongoing presence of that loved one in your life...Find a way to celebrate the gift that your loved on has been to you. Perhaps you could plant a tree or write a poem. However you choose to memoralize your loved one, draw comfort from the fact that nothing can take your cherished memories from you or erase the untold ways your loved one has touched your life and remains very much with you."

3. Trust that the Pain Will Pass: "My friend Mary was in a lot of pain after her husband abruptly left her with six children to raise. Even though the marriage had not been an ideal one, Mary felt the agony of loneliness. But her faith carried her through the most difficult times, and she is a wiser and stronger person today.

'We can pass through pain because it will not last forever,' she says. Mary believes that all of life involves gift and loss. If your pain feels overwhelming, take some comfort in knowing it will not always feel as intense as it does today."

4. Cultivate an Appreciation For Solitude: "Find activities you can do alone that bring you satisfaction and peace of mind and heart. At your time of deepest loss, try to find something special to do that brings you joy. You can never replace the person you have lost, but you can find comfort in solitude if you learn to befriend it."

5. Get the Support You Need: "After an experience of great loss, it is natural to feel a variety of emotions. If you would like some ongoing help exploring and working through some of the difficult emotions that may surface, consider getting some private counseling, attending a support group that addresses your needs, or both."

6. Turn to God for Strength: "My faith in God was and is the best coping tool I have. Prayer and meditation can be excellent paths to inner peace and balance. If you are feeling too distressed to pray or sit quietly, don't forget that there are a host of excellent spiritual books and tapes."

"Brother David Steindl-Rast, a Benedictine monk, emphasizes the value of a grateful heart. It is hard to be thankful and sad at the same time. Spend a little time pondering the many things in your life for which you are grateful. With time, you may even feel gratitude for the admittedly painful lessons you are learning as you move through your present loss."

Hospice News: Good and Bad from Around the World

"Reimbursement Cuts Will Negatively Affect Hospice Care"

A recent study shows that "as a result of two recent cuts to Medicare reimbursement, the first regulatory and the second statutory, the overall median Medicare profit margin for the hospice community could decrease from 2 percent  in 2008 to -14 percent by 2019."

The study goes on to demonstrate how, like nearly everything else involving health care in the United States, poor areas--both urban and rural--will face the worst consequences of cuts to hospice care.

Blue Skies Hospice serves many low-income families at no cost. Organizations like Blue Skies play a vital, valuable, and essential role in their communities, because they attempt to fill in the gaps of social dislocation by providing suffering people with services they otherwise could not have. Small organization can only go so far, however. The larger polity of the United States needs to make quality hospice care a larger priority.

"At India's First Hospice, Every Life is Important"

"The pin drop silence gives no indication that there are 60 patients admitted at the moment in Shanti Avedna Sadan-the country's first hospice that is located on the quiet incline leading to the Mount Mary Church in Bandra. "

"There is only one guiding principle here: no life is so worthless that it can be thrown away. 'Life is a gift given by God. We cannot dictate when it should end,' said Sister Aqula Chittatil. Sisters and nurses who take care of the day-to-day running of the hospice have only goal: to ensure that the patient's end of life is as pain-free as possible and full of care."

This beautiful story is a reminder that from Egypt to Ethiopia and from India to Indiana, human beings have the same physical, emotional, and spiritual needs. Hospice care does a wonderful service for suffering people by making a valiant and qualified effort to fill those needs.

Governor Mitch Daniels Advocates New Approach to End-of-Life Care

Indiana Governor Mitch Daniels (Republican) recently made headlines and provoked heated discussion when he discussed the fiscal, medical, and moral need to reevaluate end-of-life care. Daniels supports a stronger emphasis on palliative care for the terminally ill. He is also taking the lead within his party to engender a serious, mature, and balanced conversation on very difficult, painful, and uncomfotable issues relating to death, grief, and medical treatment. Politico reports:

“We all want to live forever, we want everything done for us to live forever,” the Indiana governor told a small group of health reporters. “We cannot afford, no one can, to do absolutely everything that modern technology makes possible to absolutely the very last day of the very last resort." 

“There will be limitations” on medical care, he said. “The question is whether the government will impose them or will people make choices for themselves? There will never be enough money.”

Daniels advocated for a more patient-centered approach, where families tackle the tough decisions of limiting care. “Someone will have to be making the decisions. I prefer it not to be the government,” he said.

“Look at it this way. It’s the most human thing in the world, when a loved one is in a desperately ill state and the question is, we can try this thing that has almost no chance of working, and it’s going to cost an incredible amount? Any person of course says, ‘Try it.’….It’s the hardest of all the questions. I don’t think there’s a more humane way than the re-involvement of patients and loved ones, to a greater extent.”

Regardless of whether or not one agress Daniels' position on end-of-life-care, he deserves recognition and respect for attempting create public space for an often muted, but always important conversation.

New Report Confirms Earlier Suspicions and Findings Regarding For-Profit Hospice

A new study adds to the already convincing evidence that for-profit business motivations and hospice are incompatible. Financial incentives defeat compassionate care under such an arrangement:

CHICAGO (AP) — For-profit hospices may be cherry-picking the least costly, most lucrative patients, potentially putting the nonprofit industry at a financial disadvantage, a study suggests.
The researchers found hospice care provided by for-profit agencies averaged 20 days versus 16 days for nonprofit agencies. Care lasting more than one year was most common among for-profit hospice patients.
Also, compared with nonprofits, for-profits had about twice as many patients with dementia and fewer cancer patients. End-of-life cancer care is typically much more intensive and costly than dementia care.
Patients with more days under hospice care and lower skilled needs may be more profitable under the Medicare reimbursement system for hospices, said lead author Dr. Melissa Wachterman, a palliative care physician at the Harvard-affiliated Beth Israel Deaconess Medical Center in Boston.

Read the rest of the report at Google News.

Hospice News from New York and Canada

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.

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.

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.