Volunteer receives more than she gives

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Posted 5 hours ago

WHO:Sherry Cicchini

WHERE:Twice a week, Sherry spends her time in the St. Joseph's Hospice of Sarnia Lambton kitchen, baking and cooking for the residents of the hospice and for the caregiver and bereavement support group luncheons She prepares breakfast, lunch and dinner meals and bakes fresh treats for families, clients and residents.

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WHAT:St. Joseph's Hospice is a 10-bed residential hospice which provides support for persons who are terminally ill and at the end of their life, as well as support for their loved ones. This support begins at the time of diagnosis and continues throughout their illness. The hospice also offers caregiver support groups, grief and bereavement support groups and children's' support groups, as well as many complimentary services for ill clients and caregivers.

Volunteers offer support in a number of different capacities. They assist with office administration in the residence and the resource centre, assist the nursing and personal support staff with the personal care of the residents and, like Sherry, provide meals on a regular basis. Housekeeping is also needed throughout both the residence and resource centre. Other areas are currently being developed where volunteers can provide additional support, such as being a friendly visitor or by providing assistance in the grief and bereavement support programs.

WHY:Sherry began her experience as a hospice client, attending a grief and bereave-m ent support group after losing her mother and father. She valued the support she received and wanted to return the favour. Tapping into her love of the kitchen and her drive to help others, she was one of the first kitchen volunteers. She values her time there and firmly believes she receives more from her efforts than she gives.

GET INVOLVED:In order to maintain and support the hospice, this non-profit organization needs over 400 volunteers to assist in all areas. Much like a personal home, there are many facets to maintaining the residential home as well as the resource centre. Although there are currently over 300 hospice volunteers, both needs and demands are growing on a daily basis. With spring just around the corner, gardening enthusiasts and volunteers to assist in fundraising efforts and general building maintenance and upkeep will be required.

If you would like to volunteer at the hospice in any capacity, contact Volunteer Coordinator Bernadette Burrowes by calling 519-337-0537 or by e-mailing bburrowes@stjosephshospice.ca.

St. Joseph's Hospice is located at 475 N. Christina St. in Sarnia.

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My First Blog Post

Dear Robin,

Just wanted to let you know how much the on-line training for Hospice Volunteers has meant to our Organization.  Our Volunteers have been able to take their training at home when they have time available.

I was also so please with the way you customize the site with our Organization’s logo.  Our Volunteers say the site is very informative.

Thank you so much for offering this site for volunteer training.  It has been so helpful to us and our volunteers.  

 

Brenda G. Meeks

Volunteer Coordinator

Eternal Hope Hospice

240 O’Dell Rd., Suite C

Griffin, GA 30224

 

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HOSPICE VOLUNTEER TRAINING COURSE CONTENTS

Course Contents:

•Hospice History and Philosophy
•Ethics and Confidentiality
•Interdisciplinary Roles
•Communication
•Hospice Eligibility
•Grief and Bereavement
•Infection Control and Safety
•Advanced Directives
•Caregiving
•Death and Dying
•Beyond the Basics

This course is not intended to be all inclusive for patient care volunteers; it provides the core concepts of hospice that are initially reviewed in the first day of orientation for new hospice volunteers. Agencies should be aware that agency specific policies should be addressed along with the criminal background check and application.

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Training / course contents for hospice volunteer training online. Agencies may now submit their service agreement online at http://volunteertrainingonline.com/hospices

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Hearts of Hospice Patients Being Needlessly Shocked: MedlinePlus

Hearts of Hospice Patients Being Needlessly Shocked

Researchers say defibrillators can be turned off on admission
HealthDay

Thursday, March 4, 2010

THURSDAY, March 4 (HealthDay News) -- Hospices that care for people who are dying often forget to turn off their implanted defibrillators, causing unnecessary discomfort, new research has found.

Only 20 percent of more than 400 hospices that responded to a survey indicated that they had a question on their admitting form that would identify people with defibrillators, and just 10 percent said it was their policy to discuss deactivating the devices, according to a report by physicians at the Mount Sinai School of Medicine in New York City, published March 2 in the Annals of Internal Medicine. The survey found that 97 percent of the hospices, though, had admitted people with implanted defibrillators.

A defibrillator delivers a shock to restore a normal heartbeat in people with rhythm abnormalities. "The purpose is to save a patient's life," said study author Dr. Nathan Goldstein, an assistant professor of geriatrics and palliative medicine at Mount Sinai. "There is a little burden, but mostly benefit. But there is no sense getting a shock when it is not going to fix their underlying condition."

Some hospice patients have compared the shock given by a defibrillator to being kicked or punched in the chest, Goldstein said.

He cited the case of a man who was dying of cancer and was shocked repeatedly by an implanted defibrillator. "That is very painful for the patient and upsetting for the patient and the family," Goldstein said.

A policy statement issued by the National Hospice and Palliative Care Organization said that all people with implanted defibrillators should be identified on admission to a hospice and that the option of deactivation "should be thoroughly explored with patients and their designated caregivers as soon as possible after admission."

The discussion should include an explanation that deactivation "does not constitute euthanasia nor physician-assisted suicide nor is it likely to hasten death," the statement said. If the device also acts as a pacemaker, that function can be maintained, it said.

"We put out this statement in 2008 because we knew that it was becoming an increasingly important issue in dealing with patients at the end of life," said Jon Radulovic, vice president for communications at the National Hospice and Palliative Care Organization. "We recognize that many hospices have a way to go to put a policy in place. The research out of Mount Sinai reminds us of how important this issue is. We now know that a lot of work needs to be done out there in the provider community in meeting the recommendation."

A conversation about turning off a defibrillator because the end of life is near is not easy to begin, Goldstein said, and many hospices "do not have a systematic way of having a conversation about the possibility of turning off defibrillators."

Family members who observe hospice patients being shocked report feelings of fear, worry and helplessness and have been shown to have increased rates of anxiety and depression, he said.

Goldstein's team has developed a model policy for managing implanted defibrillators in hospice settings. It includes an informed-consent discussion with the family and information on handling the device in an emergency.

"What is remarkable about Dr. Goldsteins study is what it uncovered," said Dr. Paul S. Mueller, director of the program in professionalism at the Mayo Clinic, who has done research on defibrillators in the end-of-life setting. "Here you have patients who have been admitted to the hospice program because they have terminal illnesses or will not live six months."

"The defibrillator is a life-preserving device. Is that kind of treatment consistent with a hospice program oriented toward end-of-life care? It would seem to be inconsistent with the goal of hospices," he added.

But one relatively bright point is that hospices that ask about defibrillators on admission are more likely to take steps to deactivate the devices, Mueller said.

SOURCES: Nathan Goldstein, M.D., assistant professor, geriatrics and palliative medicine, Mount Sinai School of Medicine, New York City; Jon Radulovic, vice president, communications, National Hospice and Palliative Care Organization, Alexandria, Va.; Paul S. Mueller, M.D., associate professor, medicine, and director, program in professionalism, Mayo Clinic, Rochester, Minn.; March 2, 2010, Annals of Internal Medicine

HealthDay

Copyright (c) 2010 HealthDay. All rights reserved.

Related News:

• More News on Hospice Care
• More News on Pacemakers and Implantable Defibrillators

More News on this Date

Related MedlinePlus Pages:

• Hospice Care
• Pacemakers and Implantable Defibrillators

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Disclaimers | Copyright | Privacy | Accessibility | Quality Guidelines U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894 National Institutes of Health | Department of Health & Human Services	Date last updated: 05 March 2010

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AAHPM Assembly 3/5/2010 « Hospice Physician's Blog

AAHPM Assembly 3/5/2010

March 5, 2010 by hospicephysician

Today is officially day 2 of the conference (this is day 3 for me as I participated in some of the preconference workshops). I appreciated another great day today. In addition to the great speakers and networking with new people, I was able to catch up with old friends and colleagues. For this reason I am sad I was unable to attend the Pallimed/Geri-pal meet and greet. Maybe next year! Listed below are several take home messages I learned today.

1. “Caring for the Patient with ALS: It Takes a Village.” I have taken care of ALS patients and even though I haven’t been practicing long, I’ve probably seen more ALS patients in hospice than most primary care physicians in practice. This is most likely due to the prolonged relationships that patients develop with their primary team of Neurologists and other providers much like cancer patients become very attached and involved with their oncologist and their staff. There was a nice overview of ALS and how a certain hospice program has made ALS a focal point in their care. As they have learned more about ALS, educated their staff and worked within the VA system they have seen their referrals increase. They encouraged hospices to be more involved and if possible work in partnership with the VA system to take care of this unique population. They pointed us to a great website for resources and further information. The ALS Association; http://www.alsa.org.

2. Gail Sheehy, Guest Speaker and author of “Passages in Caregiving: Turning Choas into Confidence.” She talked about her journey with her husband as he battled cancer, over a prolonged period of time, prior to his death. Her story was touching as she told it and explained the role of palliative care in the impact of care not only for her husband but also for herself. She also agreed that many people don’t know what palliative care is, and think that palliative care = hospice (I cringe every time a physician talks about palliative care in regards to End-of-Life Care).

3. Paper Session.
a. There is an increased need for Outpatient Spiritual Care as this paper shows that patients receiving Outpatient Palliative Care want Spiritual Care to be part of their medical care.
b. The significant majority of Outpatient Palliative Care programs are associated with an Inpatient Palliative Care programs. What surprised me is that most Palliative Care programs are associated with smaller hospitals and most are tied to Non-for-Profit Hospitals.

4. “Physician Compensation Models.” Very unique discussion. Still many unanswered questions about how to fairly reimburse physicians in hospice and palliative care. It mostly breaks down into two models, Salaried versus Incentive based. What was unexpected to see, and caught me by surprise, was the number of physicians being salaried by their respective hospices. Also, many more hospices are beginning to employ physicians Full-Time versus part time or as independent contractors. Both types of reimbursements have advantages and disadvantages; however, an argument could be made that a hybrid model may be able to make both parties happy and minimize the disadvantages. This model would include a lower based salary with benefits but a percentage of the physicians compensation would be incentive based. By this, they would be reimbursed a portion of their income based on the number of patients seen per week or month or however it is worked out. There will be much information to follow in the future months and years as more physicians converse about this topic.

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• Spirituality in Palliative Care and Other Topics
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Perhaps the compensation model would be more efficient with clearly defined expectations. Incentives lend themselves to "doing" to get paid not because of need. However, this is the real world and incentives enhance the productivity of the staff. I suppose the work lies in developing appropriate incentives.

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Spirituality in Palliative Care and Other Topics « Hospice Physician's Blog

Spirituality in Palliative Care and Other Topics

March 4, 2010 by hospicephysician

Today at the AAHPM Assembly I attended four educational sessions. The one that made the biggest impact on me was the presentation entitled “None of Your Darn Business! Taking a Spritual History While Preserving Your Professional Boundaries, Your Rapport, and Your Pride,” by Tim Ford, MA MS CT at VCU Massey Cancer Center, Richmond, VA. Before I talk a little bit more about this, I also wanted to list the other educational sessions and what I took from them.

1. “Is it Futile to Discuss Futility? A review of the Medical Literature and Legal Precedent.” Futility is a difficult word to define and means many things to different clinicians. Many advocate because it is so politically charged that we get rid of it. One physician suggested that Futility is the other “F” word. Basically, there is much evidence from previous cases and court rulings that physicians are hardly ever successfully sued for a wrongful death when non-beneficial life sustaining treatments are withdrawn. I contended that many physicians do not want to withdraw care when a family “wants everything done,” due to the fear of litigation. Many physicians would rather practice against their better judgement and subject patients to things they disagree with because this is “what the family wants,” and they do not want to anger the family or make them feel that they are not appropriately taking care of the patient. It’s much easier to continue to “do” things to the patient than to discuss this with the family in an open and honest way. Nadia Tremonti, MD, Wayne State University and Children’s Hospital of Michigan made a good point about this. She stated that as physicians we have a certain obligation to the patient and the profession despite the fear of litigation. We understand as physicians that we have a certain responsibility to the patient and by choosing the easy way out we compromise ourselves and the integrity of medicine. Overall, a great presentation and much discussion afterward.

2. Paper Sessions. I attended the paper sessions covering the Palliative Care in the ICU. The take home message from all three papers is that Palliative Care can be beneficial to patients in the ICU setting. Some crossover points in all three papers are the following. Palliative Care in the ICU:
a. Showed a decreased length of stay in the ICU
b. Increased DNR’s
c. Decreased utilization of more “aggressive” measures
d. Improved relationships between the ICU staff and the Palliative Care team
e. Increased support for the ICU staff by the Palliative Care team
f. Improved physician understanding of the role of Palliative Care in the ICU and increased utilization
g. Increased cost avoidance for the hospital showing that Palliative Care programs are beneficial, self sustaining and enforce the “Mission” of most hospitals
h. Improved patient and family satisfaction scores
i. Other…(mostly stuff I forgot)

3. “Hospice and Nonhospice Models of Palliative Care Delivery.” The bit of information that stood out to me in this session, is that some SNF’s (Skilled Nursing Facilities) are beginning to implement a “Home Grown,” palliative care service on site. Advantages and disadvantages were discussed for this type of model and I had never really thought of this as an option. I heard of the other two models in which outside Palliative Care consultants are called in to do consults or a local hospice providing non-hospice palliative care to nursing home patients, but I was not aware of the “Home Grown” model. Lots of good discussion and it will be very interesting to see how this unfolds in the coming years.

4. Last but not least, “None of Your Darn Business! Taking a Spritual History While Preserving Your Professional Boundaries, Your Rapport, and Your Pride.” This session impacted me the most because as a fellowship trained Palliative Care Physician I had always advocated for spiritual care as an important piece of patient care, but never truly appreciated the spiritual care component until this presentation. I felt like my eyes were opened and I had a deeper understanding of spirituality in palliative care. How can one presentation make such an impact. Well, he presented several points that I had not considered and he also introduced the “Transdisciplinary” (TD) approach to palliative care rather than the more traditional “Interdisciplinary” (ID) approach. In the traditional ID approach each member of the team evaluates the patient within their “nich” of practice and shares that information with the team. By contrast, the TD approach has each member providing care in all 4 domains (physical, psychological, social and spiritual) as a “generalist” but provides “specialist” care in their area of expertise. For example, in the process of doing a full consultation with a patient, I may sit down and listen to their story (presence, connection) and learn what provides “meaning” in their life while obtaining the history of the patient. In fact Tim Ford advocates that much of the spiritual history can be taken from the patient just by listening to their story and in the process of doing the consultation without having go through a checklist. In this way I am a “generalist,” for the “specialist” (chaplain) to follow up after this information is shared with the chaplain. In the same manner he stated that he would not ignore soiled linens if he went to see a patient or ignore their excruciating pain. In fact he stated that he may not be able to address their spiritual pain if the physical pain is not adequately addressed. I have often seen this on my hospice team. I will get an occasional phone call from the chaplain stating a patient he was visiting was having increased pain. He has been trained in basic pain management to a level that he can relay pertinent information that I will use for appropriate follow up care. In this manner he is being the “generalist” and I followup as the “specialist.” I feel that this model engenders the true definition of holistic medicine. And lastly he reinforced the power of “presence.” The power of “just being” present can make a significant impact on a patient or family. I am thankful I attended this session and will take a new found interest and zeal back to my practice in regards to spiritual care.

Possibly related posts: (automatically generated)

• Failure
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• Why Do You Care For The Dying?
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Posted in Hospice and Palliative Care, ICU, Malpractice, Skille Nursing Facility, Spirituality | 2 Comments

2 Responses

1. on March 4, 2010 at 11:34 pm | Reply Adelaide Dupont

   Thank you for explaining and disseminating the role of Futility in medical practice.

   Also for the way you find meaning in your people’s lives.

   
   
2. on March 5, 2010 at 1:14 am | Reply Lara

   Thank you for the excellent read!

   
   

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Review of AAHPM Assembly - Excellent, Excellent, Excellent!

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Johnny Cash: The Hospice Sessions

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The writer's awareness of death in the room, the spirit that conquers without thunder, and insight into existentialism is almost hidden but like a treasure is spotted when you understand hospice care. A really good read.

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