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.
December 29, 2010
Theologian Stanley Hauerwas on Visiting and Befriending the Terminally Ill
Stanley Hauerwas has some very insightful comments on visiting the terminally ill and "becoming a friend of time."
December 23, 2010
Merry Christmas from the Blue Skies Hospice Staff
December 19, 2010
For-Profit vs. Not-For-Profit Hospice
There are many misconceptions about hospice care, not the least of which being that quality of care does not differ between for-profit and not-for-profit hospice organizations. Hospices in the United States care for over a million patients per year—That is one million people who seek comfort, care, and companionship at the end of their lives and millions more of family members who seek, and rightfully expect, the best level of care, highest level of respect, and most resolute level of dedication for their loved ones. When family members embark on the painful and uncertain search for a trustworthy hospice they should be aware of some crucial differences between for-profit and not-for-profit hospices.
As the name implies, for-profit hospices exist and function primarily as businesses. It is the mission, duty, and responsibility of a for-profit hospice to make money, and in order to make money, they utilize the same tactics of any smart business, especially cost cutting. The only way for a for-profit to cut costs is to cut care.
A study released by Medical Care in 2005 found that “terminally ill patients who receive end-of-life care from for-profit hospice providers receive a full range of services only half the time compared with patients treated by nonprofit hospice organizations.” (read more details)
The disparity in care between for-profit and not-for-profit hospices is directly attributable to the profit motivation in for-profit hospices. Medicare reimbursement for hospice care reached $8.3 billion in 2005. With their eyes fixed on dollar signs and turned away from patients and their families, for profit hospices are likely to cut pain-reducing medications, personal visits, counseling services, and radiation therapy, according to the Medical Care study.
The senior author of the study, Dr. Elizabeth Bradley of Yale Medical School, summarized the results with the following statement: “For-profit hospices might not be as strongly rooted in the traditional hospice philosophy” of “psychosocial support, spiritual care, the use of volunteers and family, and symptom management.”
Blue Skies Hospice, a service oriented not-for-profit, is rooted in and dedicated to the traditional hospice philosophy, as defined by Dr. Bradley. It is a reliable palliative caregiver in Northwest Indiana and the Chicago suburbs, and its team of nurses, social workers, faith leaders, and volunteers are committed to giving patients and families physical, social, and spiritual comfort in their time of pain, agony, and worry.
Unlike many other hospices, Blue Skies is not driven by bottom-line accounting and pecuniary gain. It is driven solely by love and service for patients and their families.
December 12, 2010
Blue Skies Hospice: Committed to Compassion and Quality Care
Blue Skies Hospice, Incorporated was founded by Lisa Guzman in 2002 to offer services that hospice does not normally offer. Blue Skies Hospice provides care to patients that have feeding tubes, intravenous therapy, and treatment of most infections. The philosophy of this agency is to provide any service within the scope of the law to allow dignity and to provide peaceful end-of-life care.
Care is managed through a team consisting of nurses, physicians, social workers, chaplains, home health aides, and volunteers. Staff members visit homes and long term care facilities, focusing on symptom and problem management. Registered nurses are on call 24 hours a day to help with all problems encountered that can't be handled by phone. If this occurs, a visit is made to the home. Blue Skies Hospice provides services for children and adults. Services are tailored to the needs of the individual.
We provide personalized services to improve the quality of life for both the patient and their family. We always strive to provide the highest quality care. Valuing patient and family requests and assisting with individualized care we strive to meet the needs regardless of race, religion, sex, sexual orientation, or economic status.
The vision of Blue Skies Hospice is to provide patients the option to remain in their homes during a terminal illness or, to be placed in our hospice house that provides 24 hour care with an emphasis on the patient and family's physical, emotional, and spiritual well-being.
We provide personalized services to improve the quality of life for both the patient and their family. We always strive to provide the highest quality care. Valuing patient and family requests and assisting with individualized care we strive to meet the needs regardless of race, religion, sex, sexual orientation, or economic status.
The vision of Blue Skies Hospice is to provide patients the option to remain in their homes during a terminal illness or, to be placed in our hospice house that provides 24 hour care with an emphasis on the patient and family's physical, emotional, and spiritual well-being.
For more information on the loving care and service options Blues Skies Hospice is dedicated to providing patients and their families, visit http://www.blueskieshospice.com/
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