“When death is imminent, end-of-life care decisions sometimes go out the window” – STATnews

Woman supporting mother with cancer

by Jay Baruch

Two medics roll Mrs. M into the emergency department. Sweat drips from her forehead. Her chest heaves in and out as she tries to suck every last oxygen molecule from inside the oxygen mask. I introduce myself and she opens her eyes but her glassy stare lands beyond me. “She has metastatic breast cancer,” says one of the medics. ‘She’s in hospice. But her son wants everything done.’

“‘Doing everything isn’t a plan that’s compatible with hospice,’ I mutter.

“‘We didn’t know what to do,’ says the medic, shaking his head. ‘She wasn’t this bad when we arrived at her home. She was working to breathe, but not like this.’”

Read this STAT article in its entirety, click here.

OPINION: “‘It’s the Grandparents Stealing From the Grandchildren'” – The Atlantic

There’s a fiction at the heart of the debate over entitlements: The carefully cultivated impression that beneficiaries are simply receiving back their ‘own’ money.”

gparents stealingby Eric Schnurer

“One day in 1984, Kurt Vonnegut called.

“I was ditching my law school classes to work on the presidential campaign of Walter Mondale, the Democratic candidate against Ronald Reagan, when one of those formerly-ubiquitous pink telephone messages was delivered to me saying that Vonnegut had called, asking to speak to one of Mondale’s speechwriters.

“All sorts of people called to talk to the speechwriters with all sorts of whacky suggestions; this certainly had to be the most interesting. I stared at the 212 phone number on the pink slip, picked up a phone, and dialed.

“A voice, so gravelly and deep that it seemed to lie at the outer edge of the human auditory range, rasped, ‘Hello.’ I introduced myself. There was a short pause, as if Vonnegut were fixing his gaze on me from the other end of the line, then he spoke.

“It’s the grandparents stealing from the grandchildren.”

Click here to continue reading this provocative and controversial opinion piece at The Atlantic.

“End-of-Life Care Legislation Clears Key Committee Vote | POLST Legislation Would Provide Consistency and Clarity for End-of-Life Care”

Harrisburg, Pa. (December 12)—The Pennsylvania hospital community is praising the State Senate Health and Human Services Committee for its unanimous passage of legislation to help patients and their families communicate their end-of-life care wishes. Senate Bill 623, legislation sponsored by State Senator Gene Yaw (R–Lycoming), would establish the Pennsylvania Orders for Life-Sustaining Treatment (POLST) program.

POLST is a voluntary program designed to work in tandem with advanced directives, helping patients and their families plan and communicate their wishes, so that they can receive the right care for them, in the right place, and at the right time.

The Hospital and Healthsystem Association of Pennsylvania (HAP) and its member hospitals and health systems, along with the Pennsylvania Medical Society, and other health care advocates, have been vocal supporters of POLST legislation.

“End-of-life health care is one of the most difficult topics to discuss with family and friends, but it is necessary in order to carry out the wishes of loved ones. I know from my own personal experience just how important a program like POLST can be in helping patients and families make sure that their medical wishes are honored,” said Andy Carter, HAP president and CEO.

Senate Bill 623 would codify POLST, providing a consistent and clear form that puts patients and families in charge of their end-of-life care. POLST provides an opportunity for patients and families to provide directions for the use of medical interventions, feeding methods, transportation, administration of medication, and resuscitation. The bill would ensure that the decision to complete a POLST form is voluntary and done at the discretion of each patient and his or her family. These orders would apply across all health care settings.

“Pennsylvania hospitals are proud to have closely worked with a diverse group of physicians, nurses, patient advocates, home health professionals, nursing homes, and faith-based community members to assist with developing this common-sense legislation,” Carter continued. “We applaud the committee’s vote on this bill and urge the Senate and House to follow suit, and Governor Wolf to sign it.”

Companion legislation, House Bill 1196, sponsored by Representative Bryan Cutler (R–Lancaster), awaits consideration by the House Health Committee.

SOURCE: news release

ABOUT HAP:  HAP is a statewide membership services organization that advocates for nearly 240 Pennsylvania acute and specialty care, primary care, subacute care, long-term care, home health, and hospice providers, as well as the patients and communities they serve. Additional information about HAP is available online at www.haponline.org.

This recent HAP Blog article provides additional information about POLST.

2017-18 Veterans’ Trust Fund Grant announcement

The Department of Military and Veterans Affairs (DMVA) is pleased to announce the opening of its fiscal year 2017-18 Veterans’ Trust Fund (VTF) grant cycle.

Funding

During this grant period, a combined total of up to $800,000 in VTF grant funding will be available, divided into the following categories:

  • Up to $650,000 will be awarded to 501(c)(3) non-profit organizations with a mission of serving Pennsylvania Veterans or 501(c)(19) Veterans’ service organizations.  The maximum grant request in this category is $50,000.
  • Up to $150,000 will be awarded to County Directors of Veterans Affairs or the Pennsylvania Association of County Directors of Veterans Affairs. The maximum grant request in this category is $20,000 per county.

Timeline

It is anticipated that grant awards will be announced in March 2018. The grant paperwork and approvals may take two months or longer.  Funds are released after the process is complete, with a target date in June 2018.

Project Period

Applicants should base proposals on a project period beginning on June 1, 2018, or the date that the legal agreement is signed by all parties, whichever date is later.  No expenses or services performed prior to the grant effective date may be charged to or reimbursed by the grant. 

Deadline

Applications must be received on the premises, whether submitted by hard copy or electronically, by 3:00 p.m. Eastern Standard Time on Friday, January 19, 2018.  Submissions received after that date and time will be administratively rejected without review.

Submissions

Applications are preferred via email to, although a paper copy delivered to the following address (RA-MVVetTrustFund@pa.gov) is also acceptable.  However, please note that late or misdirected submissions not physically received at the following address prior to the deadline will be rejected without review.

Department of Military and Veterans Affairs

Office of Administration, Bureau of Budget and Finance

ATTN: Division of Grants

Edward Martin Hall, Bldg. 0-47, Fort Indiantown Gap

Annville, Pennsylvania  17003-5002

Contact Information

Please direct questions to the Grants Division at 717-861-6979 or email:

RA-MVVetTrustFund@pa.gov

“How bankers and doctors can collaborate to detect ‘early warnings’ of Alzheimer’s” – STAT

Close-up woman standing and holding the wallet empty of moneyAPStock

by Jason Karlawish

Banking and medicine have little in common. One is for creating and managing wealth, the other for managing health. Yet together they could help detect and fight the growing burden of Alzheimer’s disease and related dementias. I call this partnership of banking and medicine whealthcare.

“Thanks to decades-long advances in personal and public health, the average 65-year-old American can expect to live another 19 years. This remarkable progress presents a challenge: Many people might not have enough money to live that long.

“The monthly pension check has gone the way of the electric typewriter and calculator. Retirement funds, if we have any — half of American families have saved less than $5,000 for retirement — are ours to manage, and we really need that cash to pay for our living expenses and most of our long-term care. Aging Americans are also taking on more debt, such as their children’s and grandchildren’s student loans.”

Keep reading this article at STATnews, click here.

An opioid-like botanic | “As Kratom Use Surges, Some States Enact Bans” – STATELINE

kratumRobert Roskind is the owner of the Oasis cafe in Carrboro, North Carolina, where a typical serving of kratom is a heaping teaspoon of powder in a mug of hot water, orange juice or chocolate almond milk. As consumption of the opioid-like botanic grows, some cities and states are banning its use. – Christine Vestal, The Pew Charitable Trusts

“CARRBORO, N.C. — On a sunny November afternoon in this quiet college community, a steady stream of customers walks through the doors of a local cafe called Oasis for a cup of an increasingly popular herbal beverage. The menu offers coffee, black tea, beer, wine and pastries, but nearly everyone opts for a $5 mug of kratom (pronounced KRAY-dum).

“A powder ground from the leaves of an indigenous Southeast Asian tree related to the coffee plant, kratom (Mitragyna speciosa) offers pain relief and mood enhancement, similar to prescription painkillers.

“Advocates say the substance, which does not depress the respiratory system and therefore presents little to no overdose risk, could help reduce the nation’s reliance on highly addictive and often deadly prescription painkillers. Some addiction experts also argue the plant could be used as an alternative to methadone, buprenorphine and Vivitrol in medication-assisted therapy for opioid addiction.

“Used for centuries to fight fatigue, pain and anxiety in Indonesia, Malaysia, Myanmar, Papua New Guinea and Thailand, kratom was rarely taken in the United States until recently.”

Continue reading this STATELINE article, click here.

“The data are in, but debate rages: Are hospital readmission penalties a good idea?” – STAT

HOSPITAL BAR CODESEvan Vucci/AP

by Casey Ross

A closely watched experiment in health care has unfolded over the last few years: Financial incentives for hospitals to reduce readmissions. It was a feature of the Affordable Care Act, and researchers are now assessing its impacts. But even as data have arrived, an impassioned argument has broken out among experts — looking at the same numbers, they have reached different conclusions about whether the policy is making Americans healthier.

“And, underscoring that disagreement is a deeper one — about what kind of evidence is needed before a health policy is enacted on a national scale.

“The policy, known as the Hospital Readmissions Reduction Program, created financial penalties for hospitals whose readmissions exceed the national average for patients suffering from heart failure, heart attacks, and pneumonia.”

Keep reading this STAT article, click here.

“What You Can Do About Bullying in Assisted Living | Unfortunately, patterns of mistreatment don’t always end after middle school” – next avenue

Bullying-in-Long-Term-Care-Communities_175811082-750x485

by Jess Stonefield

Part of the Transforming Life as We Age Special Report

“A few years ago, a former co-worker got a call informing her that her grandmother had been in a fight. She had punched another resident at her assisted living facility and the director needed a member of her family to come and calm her. In the moment, some colleagues laughed at the thought. “Go, Grandma! Way to take matters into your own hands!” But as it turns out, the matter was serious. It was an example of the pervasive problem of bullying in assisted living communities.

“The idea that bullying would exist among older adults may surprise many, and it often goes undetected or unaddressed in assisted living communities. But an estimated 10 to 20 percent of residents in assisted living facilities, nursing homes and senior centers are mistreated by peers, according to an AARP article quoting an Arizona State University gerontologist.

“What’s the big deal about bullying?”

Click here to read this next avenue article in its entirety.

“Is That Service Dog A Fake? Under Federal Law, You Can’t Even Ask” – DisabilityScoop

ds171205_servicedogs.jpg“Josh Lewis, right, walks out of North Kansas City Hospital with his caregiver Meleana Still and service dog Bing after physical therapy. Bing has helped Josh with his walking and balancing.” (Shelly Yang/The Kansas City Star/TNS)

by Mark Davis, The Kansas City Star

“The unleashed dog lunged from the woman’s lap and right at Andy, Michaela Chase’s dog.

“‘It was going for blood,’ Chase said, thinking back to the narrow waiting room at her physical therapy gym in Lincoln, Neb. ‘It was in full attack mode.’

“Shielded by Chase’s wheelchair, Andy avoided the other dog, which had a tag on its collar that said ‘service dog.’ But though there was no fight, the damage was done.

“It really ruined Andy,’ Chase said of her service dog trained by Paws for Freedom Inc. in Tonganoxie, Kan. Andy — the victim of a fake service dog, Chase said — now distrusts other dogs. He’ll even bark at other service dogs.

“Fake service dogs are essentially untrained pets wearing vests or tags purchased online so Fido can tag along, too. They’ve become the bane of those who rely on trained service dogs to deal with disabilities.”

Read this article in its entirety at Disability Scoop.

Community Health Choices implementation timeline

The Department of Human Services (DHS) is committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. If you’re 21 or older and have both Medicare and Medicaid, or receive long-term supports through Medicaid because you need help with everyday personal tasks, you’ll be covered by Community HealthChoices.

Community HealthChoices will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.

CHC timeline

To download the above graphic as a .pdf format for sharing / printing / enlarging, click on the graphic or here.