LEXINGTON, Ky. (Nov. 30, 2011) — A study led by the University of Kentucky researcher Elaine Wittenberg-Lyles found that hospice family caregivers are "second order patients" themselves and require their own unique care needs.
The study, published in a recent issue of Qualitative Health Research, assessed the individual stressors that caregivers experience. The researchers recorded discussions between hospice caregivers and the intervention team. The caregivers were asked to identify and describe the most pressing problems or concerns they faced.
The study enrolled hospice caregivers who were 18 years of age or older and who did not have functional hearing loss, had mild to no cognitive impairment, and had at least a sixth grade education. In addition, all participants had to have access to a standard phone line. In total, the team collected discussions from 81 participants. The study was funded by the National Institute for Nursing Research.
Using a theoretical framework called Assessing Caregivers for Team interventions (ACT), the researchers coded participants' responses in one of three categories: primary stressors, which included talk that related to the performance of caregiving tasks; secondary stressors, talk about the personal impact of performing caregiving tasks; and intrapsychic stressors, talk about their thoughts, feelings and awareness of the caregiving role.
The ACT framework has been proposed as a way to understand caregiver strain and develop customized caregiver interventions to positively affect the caregiving experience and improve outcomes. The goal of the study was to describe the variances among stressors, targeting specific concerns for caregivers.
Wittenberg-Lyles, who holds a joint appointment in the UK College of Communications and the UK Markey Cancer Center, says the study further proved that caregivers are like patients themselves and should be routinely assessed for these stressors so that interventionists may help them with personalized resources and coping strategies.
"It doesn't matter how well educated you are," said Wittenberg-Lyles. "When someone you love is dying and you are in a position to care for them at home, your home turns into a hospital room and key decisions need to be made hourly. Clinicians should assume that anyone going through the stress and chaos of caring for a terminally ill family member has low health literacy and high needs for education and support."
Hospice is provided to patients who have an estimated life expectancy of six months or less. About 69 percent of hospice patients in the U.S. receive care at home from a family caregiver.
In Wittenberg-Lyles' study, nearly one-third of the hospice patients had a cancer diagnosis, and 21 percent had a primary or secondary diagnosis of Alzheimer's disease or dementia. Nearly 43 percent of caregivers were adult children of the patient, and roughly one-third were spouses/partners. In addition, an overwhelming majority of caregivers were women (79 percent).
Source: University of Kentucky
Wednesday, November 30, 2011
Family Caregivers are "Second Order Patients"
Sunday, September 18, 2011
Hospice for Heroes Motorcycle Run
Go online at http://rabuncountyveterans.com to donate in honor or memory of a veteran, or sponsor by joining us on the 100 mile motorcycle ride on October 15th, 2011 at the Clayton City Hall parking lot at 10 a.m. All registered riders/passengers will get a free lunch and t-shirt and a magnificent tour of the Northeast Georgia mountains during beautiful leaf season.
Call the Rabun County Chamber of Commerce for more information at 706-782-4812
Friday, August 26, 2011
Tuesday, August 9, 2011
What's not to "Like" about a dream?
Help raise awareness of hospice services so those in need benefit earlier from great care that focuses on living.
Go to the Regency Hospice - Hiawassee Face Book page and click on "Like".
Easy, free, and helpful. You can't beat that combination!
I think after you see the pictures of the dream come true for an 84 year old lady, you can't help but "Like" this page.
Go to this page and click "LIKE"
Sunday, August 7, 2011
Do you really think I keep doing this because I want to be depressed? Give Me A Break!
Great initiative by volunteer coordinator to enhance her volunteers' experiences. I love the quote,
“Do you really think I would visit dying people week after week for years so I could be depressed? Give me a break.”
Visit the blog at: http://janshospicevolunteers.wordpress.com/
Saturday, August 6, 2011
Healing Grief | Personal and Professional Insights from Robert A. Neimeyer, PhD
Thanks to @jen_c_taylor for opening the door to this video through her website: http://www.livinglifedyingdeath.com/
Tuesday, July 26, 2011
Hospice Insight from Volunteer Trainees
There have been times when the hospice volunteer training program took a back seat to my other responsibilities. I sat down tonight to grade the final essays of some recent trainees and the most amazing thing happened.
The tiredness of the day took a turn. I was almost in tears just trying to decide on what to cook for dinner and then I read the essays.
"I wish I had know all this when my mother was dying"
"I will be a better communicator"
"I am a nurse but also a volunteer"
"I am a street preacher and want to do as much as I can to help others".
Service, Service, Service!
All around my are people doing everything they can to learn about hospice care, enthusiastically wanting to be of service....and I complain of being tired???
I developed the course with many intentions but the results have surprised me many times over. I am continually blessed to read the heart felt statements and authenticity of intention that pours from those who take the course, digest the meaning and deliver a true desire to serve.
I hope I can grow up to take the right path just as they have done. I am truly blessed.
Monday, July 18, 2011
Survey says, "I want to die in the hospital"????
Another point for using hospice. Social workers and case managers can help us as caregivers come to terms with the feelings that we can't deal with the death of a loved one at home.
A social worker once spent time with the wife of a patient who said she did not want her husband to die at home. "Please make sure it happens in a hospital".
The husband said he wanted to be at home but knew his wife could not handle it.
I wonder when we will be able to accept the death of a loved one at home? I certainly don't want to experience it but if my husband wants to be at home when he passes, that is where he will be and I hope he can do the same for me. Fortunately, we are not having to make that decision at this time of our lives so it is a perfect time to discuss it.
What's your thoughts about someone you love dying in their own home?
Saturday, July 16, 2011
When the Doctors Need Doctoring | Psychology Today
My first month as a medical intern, over 20 years ago, I learned many important things: how to distinguish heartburn from a heart attack, how to treat pneumonia and alcohol withdrawal, how to perform a spinal tap. What I did not learn was how to manage the stress of carrying an enormous workload and great responsibility while getting little sleep and eating a diet consisting of greasy food from the hospital cafeteria and candy bars from vending machines. Stress management was not taught because the stress of being a physician wasn't acknowledged. When we were tired, anxious, sad, or sick, we just kept working.
Like athletes and soldiers, we physicians pride ourselves on working through injury, pain, fatigue, and assorted conditions that might sideline other professionals. For decades, doctors have sacrificed their own health and comfort for the sake of their patients, an ideal that has been reinforced by various media, from the embittered and overworked physician in the 1950s film The Last Angry Man to the scores of hard-drinking medical professionals in Scrubs, House, and Grey's Anatomy.
It would not surprise most people to learn that doctors have higher rates of suicide, alcohol and substance abuse, and job burnout than most people. In the past we might have written off these problems as a natural consequence of doctors working long hours in a highly stressful job, an occupational hazard of people caring for sick people, regrettable but unavoidable.
Doctors could learn a lot about stress reduction from caregivers. Shouldn't someone develop a meditation just for health care providers?
Thursday, July 14, 2011
The truth behind the hospice numbers | Georgia Health News
Given the ever-escalating costs of care for those in the last year of life, it’s no surprise that Congress, MedPAC and the Centers for Medicare and Medicaid Services continue to search for ways to curb those costs. What is surprising, and in fact perplexing, is the focus on the one aspect of end-of-life care that we know saves money and improves the quality of those who receive it.
In the article “Hospice problems raise concerns on oversight,” Georgia Health News reporter Andy Miller points out the significant growth in the field and raises concerns of oversight. Yes, costs and access have increased significantly. However, a deeper understanding of what lies behind the numbers must be part of the discussion.
Nationwide, the number of patients served annually by hospice has grown from 700,000 in 2000 to more than 1.5 million. This growth reflects that more Americans are opting for compassionate, comprehensive, quality care at life’s end. Hospices are meeting the needs of those in their communities.
Back in 2000, for every person who received hospice care, there were two others who would have benefited from it but did not get it. Ten years ago, the majority of those served by hospice had some form of cancer, and their illnesses followed a fairly predictable path. Today, less than 40 percent of hospice patients have cancer, and hospice providers are serving more patients with complex illnesses, such as late-stage dementia, who have uncertain trajectories, making prognosis much more difficult.
A private residence remains the primary location of most hospice care in the U.S. However, hospices have been working diligently to reach people in need of care wherever they are. Hospice is available to people in nursing homes, assisted living facilities, hospitals and residential facilities. Research out of Brown University demonstrates that having hospice care in the nursing home not only benefits hospice patients but increases quality throughout the nursing home, an important factor during these times when quality is of increasing importance.
Medicare spending on hospice has risen to $12 billion annually, or 2 percent of Medicare’s budget. These are dollars well spent. Independent research out of Duke University has shown that for every Medicare beneficiary who utilizes hospice, Medicare saves about $2,300. In an atmosphere of reimbursement cuts, with average net margins of less than 3 percent (according to MedPAC statistics), the hospice community remains a fiscally responsible provider of cost-effective, quality health care.
The past decade has seen an increase in the number of hospices nationally. With growth, we have witnessed a handful of providers that have ignored compliance standards, or even commit fraud. However, the actions or experiences of a few should not be used to paint an image of the entire industry.
As in any sector of health care, cases of fraud can be found. Expecting hospice to be immune to these challenges is unrealistic. Yet the hospice community, led by the National Hospice and Palliative Care Organization, has acted quickly and decisively to respond to these issues, providing education, mentoring and resources to help hospice providers succeed in their mission and duty to deliver high-quality care to those in the last months of life.
As was reported by Georgia Health News, hospice leadership has repeatedly called for more consistent and timely oversight of providers. NHPCO continues to lead the field in supporting legislation introduced in the Senate mandating CMS surveys of hospice programs at least as frequently as every three years.
Well before health care reform, a voluntary Quality Partners program, with self-assessments and other resources and tools to assist providers with quality measures and performance improvement, was created by NHPCO.
In addition, NHPCO has consistently supported the “aggregate financial cap” that places a limit on the amount of Medicare payment for all Medicare beneficiaries served by a hospice in a year.
Recently, concerns over the growth of for-profit providers in the field have surfaced in the media. Hospice – which began as a volunteer-led, grass-roots movement in the United States in the late 1970s – has moved beyond the all-volunteer organization. Now the hospice community reflects the broader health care industry in the nation. NHPCO research shows that patients served by both for-profit and non-profit hospices receive high-quality care.
Attention has also turned to patients who have received long lengths of service. (NHPCO research shows that in 2009, 11.8 percent of patients remained under hospice care for longer than 180 days). However, MedPAC, Congress and CMS have ignored the other end of the spectrum, offering no solutions to the problems with short lengths of stay – problems that have not changed in a decade.
More than a third of patients cared for by hospices die in seven days or less. When a patient or family receives care for such a brief period, it is incredibly difficult for hospice providers to transform the experience of the patient and family from crisis care to compassionate care.
Every aspect of health care must be reviewed to ensure that taxpayer dollars are being optimized to ensure that people receive the best possible care. But we must ensure that in our efforts to cut costs, we do not unintentionally prevent patients and families from accessing the most comprehensive, cost-effective, patient-centered care – hospice. Individuals who are facing the end of life, and their family caregivers, deserve the best humankind has to offer – and that is hospice.
J. Donald Schumacher is the president and CEO of the National Hospice and Palliative Care Organization, the nation’s oldest and largest leadership organization representing hospice and palliative care providers and professionals.
Enrollment Keys on Hospice Volunteer Training Online
Hospice Volunteer Training Online - VC FAQ on Prezi
A quick demo for hospice volunteer coordinators.
Saturday, July 9, 2011
Discovering the Spirituality of Hospice
Recruitment ads for hospice volunteers consistently proclaim the rewards of helping others. Surprisingly, very little is said about how the volunteer and all the hospice staff are the ones whose spirituality is enhanced once given the opportunity to work with the hospice patients.
There are no fireworks and harps paying tribute to your selflessness as you sit with the dying patient or care for an overly tired caregiver. The magic of hospice lies in the moments of silence. The silence is a tool and the foundation for the act of being present; witnessing the validity of life and the tragedy of broken hearts.
What is Their Story?
Walking into the hospital room, a middle aged woman looked up from her task of feeding lunch to her mother. She seemed startled that I was there. Just a couple of hours earlier this daughter was the one requesting I come speak to her and her father about hospice services for her mother.
Doctors do a fine job of explaining the need for hospice but until the family understands and agrees, nothing will happen in the way of a hospice admission. My job as a hospice care consultant is to go to the family wherever they are - home, hospital, long term care facility - and explain the benefits of hospice.
I have always considered this initial consultation as being the most important conversation in the cycle of hospice services. It can be the end or the beginning of the end of life conversation but without appropriate understanding, the chance to participate in a benefit that increases the comfort and peace a patient and family will feel during this crises can be compromised with the initial conversation.
Walking into the room, the daughter was courteous but distracted. Feeding her mother was not the focused effort although she attempted to make it appear that way. I immediately recognized the daughter was looking at her father. She was fearful about the ensuing conversation and the affect it would have on him. The daughter didn't say it but I could hear her fears with my heart.
The father was an elderly gentleman who was busy doing small tasks like tidying the area next to the hospital bed, straightening the covers over his wife's feet, and intermittent moments of staring out the window. The view was taking his attention. It was not a tremendous landscape or sunset. The view was a memory of him and his wife during a lifetime of living.
I apologized for interrupting the meal and began to back out of the room.
My day had been hectic and started with a change of scheduled appointments. Starting in one county to make visits to doctors to talk about why they should refer to hospice and ending up in an entirely different county to provide a hospice consultation and now I would have to wait. The daughter and father had no idea that this slight change in my schedule included an hour long drive to the hospital and the longer I had to wait the longer it would be before going home. Hot weather, tired feet from following what seemed like acres of hospital hallways to find this patient, and starting to feel the emptiness of my own hunger, I knew my personal agenda could not play a part in this conversation.
All my own issues dissipated when I noticed the man sit on the bed beside his wife as his daughter fed her.
What is their story?
This seems like the magical question that comes to mind anytime I do a consultation. I really want to know who the people are and especially who they thought they once were. While it was true that I was an hour from home, it was also true that this family was an hour from home. We lived in the same county yet I had to drive 50 miles to do the consultation in the hospital. I mentioned the fact we were both quite a long way from home as I was backing out the door and all of a sudden I was invited back into the room and into their lives.
The husband spoke of meeting his bride to be at a a company picnic more than 60 years ago and courting the old fashioned way. He took her as his bride and made her his life. They lived comfortably surrounded by the love of family and friends. There were no words spoken about clinical expectations of hospice and only a few words discussing needs for personal care and nursing assistance. They were open to a chaplain visit but felt they had plenty of spiritual support from their local church and community of friends. The volunteer services would be nice should the daughter or father need to go to town to run errands. I remember wishing I could be their volunteer. There was so much life to value here and the remembrances came so easily.
I grew tremendously that day as I found a way to eliminate by own personal frustrations by asking "what is their story?". The lesson has been with me for every consultation and does not dissapoint me with the resulting answer to the question. This husband could still see his wife as a beautiful young woman who was vibrant, fun loving and his partner in all things. He saw a beauty that I thought I could physically see by the time I left the hospital room. Wrinkles and gray could not camouflage the beauty of this couple even now as the young bride of more than 60 years waited in a hospital bed for her last days in this partnership.
Later that night, I kissed my husband and told him I loved him. I made the kind of wish you make as you blow out the candles of a birthday cake. I wished for us to forever see each other's beauty.
That's what hospice does for you.
Friday, July 8, 2011
Hospice Volunteer Training Online - Choosing the Path of Service
Please note the new service agreement form on the Hospice Volunteer Training Online program. Please contact me if you have any questions.
Thursday, July 7, 2011
10 Ways to Be a Difference Maker as a Hospice Volunteer
#1 Take the hospice volunteer training program online
#2 Explain your role as a volunteer to your personal health care provider
#3 Find out a patient's most valued accomplishment
#4 Give the caregiver a hand massage
#5 Encourage laughter
#6 Learn - and share - good meditation practices
#7 Enjoy examining spiritual truths - yours and your patient's
#8 Listen intently and learn to revel in silent friendships
#9 Use healing intentions frequently in thought
#10 Share, learn, grow, love - be a hospice volunteer at heart with all your relationships
Aricia LaFrance Blog; Asking for Help
There is a general misunderstanding that you are supposed to know how to do everything on your own. This is an especially pervasive belief among helpers and healers.
Helpers and healers are notoriously bad about being able to receive. Giving – they’re all over that. Nurturing – no one better. But being able to ask for help, let alone accept a kindness – that’s a challenge.
Maybe it would help to know that by asking for help you are almost certain to learn a something new and that will help your clients. You expand your knowledge base when you ask for help. You build community. You allow yourself to feel uplifted and energized – and that’s good for everyone in your life.
A strong sense of community emerges and we’re starting to see how collaborative friendships (doesn’t this sound better than strategic alliances?) help everyone.
When you’re uncertain of your next step, consider reaching out to your community to ask for feedback, advice, ideas and suggestions. Consider asking for help. If you’re a helper or healer you may be shocked at the overwhelming response you get after years of uplifting others.
Let me know how it works out!
This post is a great reminder to seek the balance of receiving and giving.
Letter To The Editor: Hospices Are Serving A Critical Need - Kaiser Health News
Letter To The Editor: Hospices Are Serving A Critical Need - Kaiser Health News
Sunday, May 8, 2011
Friday, April 29, 2011
Dr. Danny Sands: Knowledge is Power
Learn how to reach and engage today's digital health consumers with innovative technologies.
Sample Newsletter. We respect your privacy and never sell or rent our subscriber lists.
Wednesday, March 23, 2011
A New Response to "How Long Do I Have?"
Anyone in hospice service will tell you they have been asked by a family or a patient the question "how long?" and we all have our own personalized responses which most often include?
No one knows without a doubt how long they will live. I could leave this room and be in an accident and lose my life long before you lose yours.
Once familiar with their nurse, a family may here that the time is drawing near. "Better call in the family".
I am completely filled with gratitude and awe for the words spoken by a physician's assistant recently to a patient and his family when confronted with the "how long?" question.
The patient, male, middle aged, and not ready to hear the harsh answer asked the P.A. after a lengthy discussion about his cancer how long it would be (before he dies). The family sat still and the patient waited knowingly and yet also displayed reserve and lack of knowing.
"When you were born, your mother carried you for 9 months before you came into this world. It's time now, son, for you to begin the journey back to the source. It is what it is and you need to prepare to go back there."
While the trajectory of the illness gives the doctor a great clue to how long someone will live, it does not address the appropriate communication to family and the patient at different intervals of the intial news.
Whatever your opinion of this response, I believe there will come a time when a family and patients would find great comfort in such sentiments.
After all, we are all returning to the source; plant, animal, or human we are in that wonderful cycle of life and I am grateful for those who hold our hands on this journey.
Wednesday, March 9, 2011
The Franklin Press Online Macon County, North Carolina
Contest for Subscribers | Carebuzz
Contest for Subscribers -->THANK YOU FOR YOUR INTEREST IN THE CAREGIVER OF THE MONTH CONTEST!
You may have already entered the contest– in which case, please rest assured that once you have entered the contest, your name will be “in the hat” indefinitely: you are eligible to win the award each month, and you are automatically entered to win the Kindle. If you’d like to enter a new caregiver to be considered for the contest, please do so by following the instructions below!
Carebuzz knows that being a family caregiver is a thankless role! That’s why we’re celebrating caregivers on our site and providing you the opportunity to nominate someone in your community, family or yourself who exemplifies the definition of a ‘family caregiver’ and to win the honored Caregiver of the Month Award! Each month, we will select a caregiver to be featured on the Carebuzz site, and the winner will receive a special gift to honor the work they do. Each quarter, all names submitted will have a chance to win a free Kindle! That’s right, a Kindle! As we have learned from an AARP report on caregiving, there are over 65 million potential nominations out there in the United States. So, who do you think deserves to be honored?
How it works:
1. Submit a Nominee for the Family Caregiver of the Month Award by sending an email to carol @ carebuzz.com
2. In your email, use the subject line “Caregiver Contest Entry”
3. In 25 words or less tell us why this family caregiver deserves recognition and be sure to include the nominee’s name and email address
4. We will draw a name out of the “hat” to select the featured caregiver on the 1st of each month
5. Enter one time and we will keep your name in the “hat” for each monthly drawing, as well as the quarterly Kindle drawing!Winner Notification:
We will contact each month’s winner by email to ask for a photo and mailing address so that we can send you your special gift!
Tuesday, March 8, 2011
LakeNormanMagazine.com
Slideshow
Robert Lahser
Deb Getz sings "Amazing Grace" to hospice patient Annie Brown, 77, at Levine & Dickson Hospice House in Huntersville.
ROBERT LAHSER - rlahser@charlotteobserver.com
Deb Getz with hospice patient Annie Brown, 77, at Levine & Dickson Hospice House in Huntersville.
ROBERT LAHSER - rlahser@charlotteobserver.com
Deb Getz sings "Amazing Grace" to hospice patient Annie Brown, 77, at Levine & Dickson Hospice House in Huntersville. Deb Getz is a volunteer who sings to hospice patients as a form of music therapy.
How sweet the sound
By Ladianne Mandel
Posted: Tuesday, Mar. 08, 2011
Loss, we all discover, is an inevitable part of being. Birthdays, graduations, weddings, the welcoming of new family members. And the passing of friends and loved ones. The events that take place between the point of our advent and the point of our departure construct for us the fabric of life. Not all of life’s moments are steeped in joy. Even so, some of the most challenging times can be eased with the gentle application of an art form with us almost since the beginning of our kind.
Deb Getz started singing in her church choir when she was just 5 years old. Musical theatre in high school and exploration of music at the college level followed. But after venturing on to sing with Carolina Voices, jazz ensemble Impromptu, and delivering her rendition of the American National Anthem at various sporting events, Getz allowed her voice to grow silent – until she began volunteering at the Levine & Dickson Hospice House in June of 2010.
“I’d lost two people very close to me – one a dear friend and the other my oldest son – within the last few years. Hospice was so helpful. Their services resonated with me. I was inspired to step up and make a call to see if I could volunteer,” says Getz.
One day, while still in volunteer training, Getz says, the topic of singing to patients arose in conversation. “There was a patient who was restless that day and one of the nurses said the patient would benefit. I pulled out a hymnal and went in. The patient was non-responsive. She was in her 90s and she had an unrepaired hip fracture. The staff were keeping her as comfortable as they could,” Getz recalls. “I hadn’t sung in a really long time and had no idea what I was going to sound like when I opened my mouth. I knew if I was going to have an accepting audience she would be it. I started singing Amazing Grace and realized I could feel my voice filling the room. The patient opened her eyes and looked at me. I kept on singing and gave her all of my energy, focused on her, and let the music do what it was supposed to do. I watched her face changed while I was there and when I finished I could tell she was asleep. There was a peacefulness about it.”
Jan Kurtz’s family experienced, first hand, the power of Getz’s gifts. “My sister, Kathryn Cloninger, who died of lung cancer in November 2010, went into the Hospice House on October 4th, 2010. She always thought she could do things on her own but eventually found out she couldn’t. Our sister, Joyce Webb from Connecticut, was the first of us to visit Kathryn at Hospice House and experience the work that Deb does,” recalls Kurtz.
Webb told Kurtz she had to hear Deb Getz singing to Kathryn. Kurtz says that the family experienced connections with Deb Getz on many levels. “I heard Deb sing…she has the voice of an angel, and this way with people I can’t describe in words. Her voice and her actions are amazing.”
During the time Cloninger was at the Levine & Dickson Hospice House, Getz sang to her once per week. “I heard her sing three different times,” said Kurtz. “And a couple of times, my sister Joyce sang with Deb. There was one point when my sister, Kathryn, was coherent and requested some songs. Deb and Joyce ended up getting a duet going. It was beautiful. Deb melted Kathryn’s heart with her voice and her actions. I have never experienced anything like that before in my life. I was so grateful to be a part of it.”
Kurtz noted that she was incredibly impressed by all of the volunteers at Levine & Dickson Hospice House. The assistance of a significant body of volunteers makes it possible for Hospice and Palliative Care Charlotte Region to provide care and services for approximately 1,000 patients per day wherever they call home, says Christine Brown, senior director of marketing for the organization. “We have 16 beds at the Hospice House, but we serve people in their own houses as well. Hospice of Lake Norman serves the needs of that area. And there is a regional office in Cabarrus County as well.”
“I don’t think people realize how important it is for patients to have a team of specialists helping them through the end of life process. People often comment that we offer ‘end of life dream teams’ – we have doctors, nurses, chaplains, grief counselors, nurse aids, and volunteers. These volunteers and specialists enable us to help people transition from this world,” says Brown.
When asked if she would recommend that people take advantage of the services offered by Hospice House, and particularly, the talents offered by Deb Getz, Kurtz says, “Absolutely. The feeling you get when you walk through the doors is genuine. The teamwork of all of the people who are a part of the organization is amazing. It’s wonderful. I would suggest anyone consider using hospice services, even if the process begins at home.”
And how does Deb Getz feel about being a part of such a team? “All of the volunteers at Hospice House are amazing. Every time I leave there, I find myself saying, ‘Wow. They are wonderful.’ And I have to say that if I could sing to dying patients every day I would.”
More information
Like Deb, many volunteers with Hospice & Palliative Care Charlotte Region share their musical talents by singing or playing musical instruments, such as the harp, guitar, saxophone, bass, flute and clarinet. More volunteers are welcome. Contact the volunteer services department at 704-335-3578 for more information.
For more information about Hospice & Palliative Care Charlotte Region, go to www.hpccr.org or call 704-375-0100.
Sunday, February 27, 2011
Caring for people is passion of new hospice executive - The Pueblo Chieftain: Local
Caring for people is passion of new hospice executive
Sangre de Cristo Hospice is a homecoming for Carmen Ermel.
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Carmen Ermel
Posted: Sunday, September 19, 2010 12:00 am
Caring for people is passion of new hospice executive By LORETTA SWORD | lorettas@chieftain.com The Pueblo Chieftain | 0 comments
Carmen Ermel has spent most of her professional life helping older people live independently and adapt to some of the losses that aging guarantees.
Her newest job involves helping people die — with dignity, and without some of the burdens that dying so often brings along on its unpredictable journey.
Ermel took over July 26 as chief executive officer of Sangre de Cristo Hospice. It was a homecoming in several ways.
The 58-year-old grew up in Beulah and graduated from South High School. She started college at the University of Northern Colorado in Greeley, then transferred to the University of California at San Bernadino, graduating with degrees in business administration and social science.
She eventually returned to Pueblo as a community relations representative for a local nursing home.
That was 20 years ago, when the concept of hospice care was just beginning to take hold nationwide. Pueblo was ahead of the national curve with Sangre de Cristo Hospice, founded primarily by longtime CEO Joni Fair, who retired in January.
Ermel said she had contact with hospice volunteers at the nursing home, and decided to get some training from Fair so she would understand how the two organizations could better serve Pueblo's most vulnerable citizens.
"That was my introduction to hospice, and I've been connected to hospice services throughout my career since then," she said. That connection continued in her next job as director of the Area Agency on Aging for Custer, Chaffee, Fremont and Lake counties.
Ermel's most recent position was as senior vice president of operations for Spectrum Retirement Communities, an organization with 1,000 employees that operates retirement and assisted-living communities and Alzheimer's care facilities in seven states.
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"I coordinated with hospices in each market, so when our seniors needed services they could stay in the assisted-living community rather than having to move to a skilled nursing facility," Ermel said.
She had always planned to return to Southern Colorado, she said, and she heard about the opening at the Pueblo hospice right about the time she had begun pushing herself to finally make the move.
"It was always my goal to get back down here permanently. I also had reached a point where I wanted to be involved in 'total service' for seniors — something that didn't involve real estate," she said.
Ermel counts among her goals continued outreach in all of the communities the organization serves to provide education about hospice services and recruit more volunteers.
Finding new funding streams also will be imperative, with Medicare reimbursement for hospice care due to take major cuts over the next decade.
Taking the reins of an organization that has flourished for nearly 30 years under the leadership of its passionate founder is both an honor and a welcome challenge, Ermel said.
Fair plans to remain connected to hospice as a volunteer, and Ermel said she's been generous with her knowledge and experience.
"She's very graciously opened her mind and her heart to help," she said.
"I'm very excited to really get started applying my experience, my skills in collaborative efforts, and my energy to this job. Failure is not an option. This is such an important and humbling service that we provide.
"It's a position I don't think anyone should pursue as a paycheck. It's truly a calling and a mission, and it's a humbling honor to be selected."
More about Hospice
- ARTICLE: Students give their day to hospice
- ARTICLE: One last song
More about Health
- ARTICLE: JBC OKs additional staff at CMHIP
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- ARTICLE: Ritter to visit Monte Vista
Posted in Local on Sunday, September 19, 2010 12:00 am. | Tags: Hospice, Health, Assisted Living, Nursing Home, Medicine
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Thursday, February 24, 2011
Overlake gets grant to implement palliative care - Bellevue Reporter
The Overlake Hospital Foundation has received a $150,000 grant from the Regence Foundation to implement a hospital-based palliative care program at Overlake Hospital Medical Center. Palliative care is a medical specialty geared toward helping seriously ill patients find relief from the symptoms of their disease.
The Regence grant will help Overlake implement its palliative care program, planned with the help of foundation-provided training from the Palliative Care Leadership Center (PCLC) and a financial grant in 2010. PCLC is a national training and mentoring initiative to help hospitals start and expand high-quality palliative care programs.
“The Regence Foundation’s grant enables us to implement a Palliative Care Consult Service for patients and their families coping with advanced illness and in need of symptom management,” said Cathy Whitaker, vice president of patient care services at Overlake.
She estimated about 200 patients a year would benefit from the service, delivered by physicians, nurses and support staff including social workers, chaplains, pharmacists, care management and physical therapy.
Discussing cancer treatment with the terminal patient
by Bruce Campbell, MD
For everything, there is a season…
- Ecclesiastes“Are you giving up on me?” My patient looks at me severely. “There must be other treatment options! Aren’t there some experimental drugs out there? I have beaten this cancer twice before. Are you saying that I can’t beat it again?”
No one can ever know with absolute certainty whether my patient’s newly recurrent cancer might miraculously disappear with one more treatment. His recurrence, however, has developed very quickly and is growing very rapidly. New cancer nodules are developing weekly. I have never seen a patient with a cancer this aggressive have a meaningful, sustained response to further treatment. The research literature confirms my impression.
It is always difficult to know what to recommend. Although “no further treatment” is always an alternative, I routinely run through all of the options, reviewing whatever is available, and hoping that we land on the combination that offers that improbable, one-in-a-thousand cure. However unlikely, we sometimes set up appointments and hope for the best.
Today, though, my sense is that it is time to focus on new goals.
The decision not to pursue more studies and more treatment can be very, very difficult. Surgeon and journalist Atul Gawande in an essay in The New Yorker entitled “Letting Go,” writes about how difficult it can be for physicians and patients to halt cancer treatment as the end of life draws near. The dilemma, he concludes, “arises from a still unresolved argument about what the function of medicine really is — what, in other words, we should and should not be paying for doctors to do.” In Gawande’s view, the profession should equip and supply doctors and nurses “who are willing to have the hard discussions and say what they have seen …”
In most circumstances, this moment might be the first occasion that the patient hears a physician say clearly, “I do not think we should continue with the cancer treatment. It is time to stop focusing just on the cancer and spend more of our effort focusing on the rest of you.”
Those are very difficult words to say. On the other hand, I cannot begin to imagine what it must be like to hear your physician utter them.
At some point, the topic of stopping cancer treatment must be approached clearly and compassionately. An essay by Albert Lim, MD, sent to me by a patient, reminds us that physicians often avoid these difficult discussions. We push on with futile treatments and expensive tests because “it is difficult to say ‘no’ in today’s world.” Coupled with our own doubts, the patient and family sometimes want us “to do something, anything, everything.” There are situations where we need to learn to think through the choices and then choose to do nothing.
A recently published article might help me navigate these difficult discussions in the future. Dr. Jennifer Temel and other cancer physicians at Massachusetts General Hospital followed two groups of patients who were suffering from advanced, uniformly fatal lung cancer. One group received “standard” cancer care with chemotherapy and aggressive treatment. The other group was offered the “standard” care but also met very early on with the Palliative Care team. Overall, the Palliative Care group went on to have less intense treatment, less futile cancer treatment near the end of life, an overall better quality of life, and significantly less depression. They were more likely to have talked with their relatives about their end-of-life wishes.
Surprisingly, the Palliative Care group, despite receiving less intense cancer treatment, also lived a bit longer! For this group of incurable cancer patients, less aggressive care actually resulted in longer and higher quality survival.
As the conversation wraps up, my patient reviews all of his options. His previous therapy was difficult and he is not interested in spending any more time at the hospital than absolutely necessary. He and his family go back and forth. Finally, they all decide against any further cancer treatment. They will continue the conversation at home.
I am relieved. He has made what I consider to be a good choice and appears to be at peace with the decision. The most difficult decision he and his family have ever had to make had, in the end, been simple. The time had arrived.
Bruce Campbell is an otolaryngologist who blogs at Reflections in a Head Mirror.
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Tagged as: Cancer, Specialist
Tuesday, February 22, 2011
Palliative care prolongs life, reduces suffering
-->Palliative care prolongs life, reduces suffering
1 | 2 Next Page »There are no secret passwords in medicine, no mysterious handshakes or signals to use when seeking the best care for a serious illness.
But experts say two words come close: palliative care.
Many people have never heard of palliative care, a comprehensive service that aims to relieve suffering in people with serious illnesses, such as cancer, lung disease or kidney failure.
Some patients — and even many doctors — confuse palliative medicine with hospice, a form of palliative care for people in the last six months of life. Other patients mistakenly worry that doctors won't work as hard to cure them if they ask for palliative care, says Gail Cooney, former president of the American Academy of Hospice and Palliative Medicine.
Those notions could change in light of recent research.
A study of 151 patients published last summer in The New England Journal of Medicine showed that getting early palliative care — in addition to regular medical treatment — helpedpeople with lung cancer live three months longer, compared with those given standard care.
In comparison, chemo can give newly diagnosed lung cancer patients an extra two to three months of life, says study co-author Thomas Lynch, director of the Yale Cancer Center.
"If this was a drug, this would be on the front page of every paper in the country, talking about 'New advance in lung cancer,' " Lynch says.
But palliative care patients didn't just live longer. They also lived better, with less depression and a higher quality of life, he says.
Tailored to the patient
It's never too early to ask about the service, doctors say.
People can begin palliative care as soon as they're diagnosed with a serious illness, even if they still hope to be cured, says Thomas Smith, medical director of palliative care at Virginia Commonwealth University's Massey Cancer Center in Richmond.
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.
'People need to ask for it'
Because of her work, Cooney knew to ask for palliative care when she was diagnosed with advanced ovarian cancer nearly three years ago.
"I wanted it all," says Cooney, 58, who's also the assistant medical director of Hospice of Palm Beach County in Florida. "I received very aggressive chemo. But I used a program of palliative care to control my symptoms and allow me to tolerate the chemo."
In addition to undergoing surgery and chemo at a hospital, Cooney sought palliative care through an outpatient center, the Sari Asher Center for Integrative Cancer Care in Palm Beach.
Though about 80% of large hospitals offer some kind of palliative care, there are fewer ways for patients to get support outside the hospital, where cancer patients today receive much of their care, Cooney says.
She used both acupuncture and conventional drugs to avoid nausea and felt well enough to indulge in milkshakes to keep up her strength and weight.
Palliative care helped with many aspects of cancer therapy, which put her in remission for two years, Cooney says.
She joined an ovarian cancer support group, received one-on-one counseling with an oncology social worker and met with a nurse educator to better understand the many drugs she was taking.
After her cancer began growing again last fall, Cooney resumed intravenous chemo and hopes for a good response.
Cooney says she wishes that more patients and their caregivers knew to ask for palliative care. "People think, 'My doctor will ask if I need it,' " Cooney says. "But people need to ask for it. It can be tough to challenge a doctor. But if people begin asking and advocate for themselves, generally doctors will say OK."
Saving money
Palliative care also could help cut spiraling medical costs, Smith says. Studies show it can save hundreds of dollars a day, keeping patients out of the hospital or expensive intensive-care units.
Kaiser Permanante, an integrated system in which the same company operates hospitals and insurance plans, found that people cared for by a palliative team live just as long as or longer than others and had fewer symptoms.
Their caregivers also experience a lighter burden because the programs address their needs as well, Smith says.
"No death panels here — exactly the opposite," he says.
In spite of these benefits, palliative programs struggle to reach everyone who might need them, Smith says. That's because few health systems are as coordinated as Kaiser, he says.
The bottom line
In most cases, the cost savings from palliative care are spread throughout the system — saving money for Medicare, for example — instead of returning money to individual hospitals or programs, Smith says. So in the short term, individual hospitals may lose money, even if the country overall saves money.
"It would be terrific to have more family support, more chaplain support," he says. "Most programs don't have any way to pay for that."
The Massey Cancer Center pays for a psychologist partly by reducing physician salaries, Smith says. His team also does fundraising to pay for a chaplain, who he says "is critical to help people come to terms with their illness and often the end of life."
Without enough resources for everyone, palliative care programs often give first priority to people with advanced or fast-moving cancers, such as pancreatic tumors, Byock says.
"Even the most robust palliative care programs have limited resources," he says. "If someone has a serious diagnosis and they have only the 'ordinary' level of stress, we'd likely not see them."
But patients shouldn't give up.
"It really does take one-on-one advocacy," Byock says. "You have to be savvy enough to ask for it. Just say, 'We want the best care for our loved one.' "
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Monday, February 21, 2011
What's the Reason You Want to be a Hospice Volunteer?
When this student was asked why he wanted to take the hospice volunteer training, the reply was
I want to help others that are facing the end of life, or a loved ones life, find the peace and comfort that a hospice team helped me find.
It is wonderful to have a program that can be utilized for hospice volunteer training and now, after a couple of years, I continue to be in awe of the wonderful people who participate in the training. It is obvious with every answer that we are surrounded by people who want to be of service.
CM said, "The video on caregiving was the most valuable to me. It provided much insite into the lives of actual caregivers and their needs."
Whether it's a personal goal or a professional one, each potential volunteer presents awesome reasons for volunteering and great feedback for the most important aspects of the course.
As we begin our goodbyes to winter, there are still a few cool evenings to log in and begin training so you can find your reason for volunteering. Somebody is waiting just for you.
http://volunteertrainingonline.com/courses
Thursday, February 17, 2011
Join Us in Delivering Random Acts of Kindness to Seniors #RAKsr | Seniors For Living
Get Involved16 Feb 2011 11:11 amJoin Us in Delivering Random Acts of Kindness to Seniors #RAKsr
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UPDATE: 2/11: Join us for our second annual celebration of Random Acts of Kindness Week. To commemorate the week’s festivities, we’re relaunched our #RAKsr initiative. See below for more details!
February 14-20 is Random Acts of Kindness Week — a reminder for each of us to do something nice, and unexpected, for someone else.
What random kindness can you bestow on a senior?
Whether it’s helping with manual labor around the house – spending an afternoon just chatting and catching up — cooking dinner together — or going to the movies, we want to hear about it.
SeniorsforLiving.com is on the hunt: Who will join us in delivering random acts of kindness to seniors next week? Here are just a few thoughtful ideas to help you get started.
We’re encouraging as many people as possible to participate. But, performing an act of kindness is just one step. Here are some other ways you can get involved:
- Leave us a blog comment sharing your experience.
- Are you a blogger? If so, write about about Random Act of Kindness Week, and encourage your readers to do something nice for a senior.
- Tell your Facebook friends about this project and ask them to get involved
- Share random acts on Twitter using the hashtag #RAKsr
- Post video to YouTube or photos on Flickr using the #RAKsr tag
We’ll post some of the best stories throughout the week on our Facebook page. Make sure you’re a fan so you can keep track of all the kindness.
An added bonus: SeniorsforLiving.com Facebook fans who participate in this project will be entered into a drawing for a $50 Amazon gift certificate.
To be entered into the drawing, fans simply need to email their stories to connect@seniorsforliving.com before February 20 at 10 a.m. EST. We’ll announce the winner on Tuesday 2/22/11.
Let’s see how much out-of-the-blue kindness we can deliver in one week.
The comments are yours: How will you show kindness to that special senior in your life?
*2/22/10: WINNER UPDATE: Congratulations and thank you to Mike Gamble of Aging Parents and Eldercare who is the winner of our random #RAKsr drawing for a $50 Amazon gift certificate. And a big thank-you to all of you who shared news of #RAKsr, performed amazingly generous acts of kindness, and — in short — spread love and expanded the everyday boundaries of the heart. We were touched numerous times a day all last week by your fabulously unselfish acts, thoughts, and sentiments. Let’s keep the KINDNESS going….
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11 Responses
- Kaye Swain Says:
after publication. }--> February 10th, 2010 at 11:23 amThat’s so sweet – and perfect timing with Valentine’s Day. I’ll definitely help spread the word
- Carin Arrigo-Zimmer Says:
after publication. }--> February 10th, 2010 at 1:18 pmThis is wonderful! So happy to find you guys! Definitely a fan of helping seniors… =)
- Kathy Cox Says:
after publication. }--> February 10th, 2010 at 7:41 pmThis is what the world needs more of! Kindness needs to be shared with everyone–what a difference a smile makes.
- Make a Difference in a Senior’s Life! Says:
after publication. }--> February 12th, 2010 at 5:57 pm[...] about Random Acts of Kindness Week. They’re heading up an outstanding movement to generate random acts of kindness for seniors. How beautiful is that?!?! Read their suggestions and jump in with both feet and a full [...]
- Happy Valentine’s Day to the Sandwich Generation | SandwichINK.com Says:
after publication. }--> February 14th, 2010 at 11:14 am[...] Kindness Week. Seniors for Living has made it even more specific, using it to remind us to put into practice Random Acts of Kindness for one or more of the Senior Citizens in our lives. For those of us in [...]
- Kaye Swain Says:
after publication. }--> February 14th, 2010 at 5:03 pmHey hey hey – Happy Valentine’s Day!
Have a wonderful week!
- Kaye Swain Says:
after publication. }--> February 15th, 2010 at 12:01 pmAaaaahh – sorry for the mega oops – and Happy Random ACTS of Kindness Week.
- Carissa Says:
after publication. }--> February 15th, 2010 at 1:16 pmI have a neighbor couple who are seniors and we’d love to surprise them with something unexpectedly random this week.. I’ll let you know what we come up with!
- Dale Carter Says:
after publication. }--> February 18th, 2010 at 12:36 pmYesterday I was in the grocery store, waiting in produce behind an elderly woman who was picking out yams. I got my plastic bag and just waited patiently behind her. When she finished, she turned and apologized for taking so long, and I said “no problem at all”. Then, she kind of mumbled to herself, “where do I get a bag?” I just reached out my open bag and said, “take this”. The look in her eyes was priceless; such a small gesture but it meant so much to her. I won’t forget that sweet lady anytime soon!
- Kaye Swain Says:
after publication. }--> February 19th, 2010 at 11:00 amAwesome, Dale! Great example!
- Kaye Swain Says:
after publication. }--> February 23rd, 2010 at 12:42 amMega Congrats Mike!!!
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