The inaugural Aspen Health Strategy Group (AHSG) report on improving end-of-life care pulls few punches in calling for significant changes in care design, delivery, financing, quality measurement and care provision.
The conclusions from the year-long study, which included input from dozens of health care leaders and experts, appealed for a serious overhaul by health systems, payers, academia, and policymakers of palliative and hospice care. Continue reading
Photo: Mary IsaacsonPowwows provide a good venue for Pine Ridge elders to discuss advanced care planning and wills.
A unique outreach program is helping elders of the Lakota nation to address issues of palliative and end of life care among residents of reservations throughout South Dakota. The program incorporates culturally appropriate language and uses peer educators to promote advance care planning and wills.
When Mary Isaacson, an assistant nursing professor at South Dakota State University, began exploring the issue with older adults from the Pine Ridge reservation in 2014, she found an overwhelming need for education and materials. Within a year, Pine Ridge elders Patricia Catches The Enemy, Valaria Red Cloud and Garfield Apple collaborated with Isaacson to develop a Lakota-specific advanced directive brochure and received training to be advance directive coaches. While attending events, such as powwows and flea markets, and visiting community centers where elder meals are served, they hope to start conversations about advanced care planning and wills. Continue reading
Hospice use is a common indicator of quality end-of-life care. The timing of hospice enrollment is an important component of that care, and a recent study finds wide variations among states.
Researchers from Yale University compared 2011 hospice use data on a state-by-state basis of 660,000 Medicare patients during the last six months of their lives. They identified several key trends among states in the rates of very short or very long hospice stays (reflecting late or early enrollment) and of patients leaving hospice before their deaths. Continue reading
A provocative examination of end-of-life care brought this question into sharp focus for journalists attending Health Journalism 2015. Paul Kleyman, who moderated a panel on the topic, noted that essential end-of-life elements first reported on 30 years ago – such as affordability and death with dignity – are still relevant and have intensified.
“Lately, there has been lots of attention around the “right-to-die” movement. Just as important as that is exploring the right to quality of life until the end,” Kleyman, director of the Ethnic Elders Newsbeat at New America Media, said at the April 24 session.
V.J. Periyakoil, M.D., who is director of palliative care education and training at Stanford University School of Medicine, specializes in multicultural palliative care and in helping families and physicians understand the related cultural components. “Providing good end-of-life medical care is not enough,” she said. “Providers must become more skilled at having effective end-of-life conversations.” Continue reading
Nancy Berlinger, Ph.D., is a research scholar at The Hastings Center and co-author of a retrospective article on palliative and end-of-life care that was published in the Feb. 12 New England Journal of Medicine.
In part one of our conversation, Berlinger focused on the need to broaden the discussion among and improve training of clinicians on talking to patients about end of life issues. In part two, she discusses foreseeable scenarios, societal perspectives and how to improve media coverage of this complex topic. Continue reading