Category Archives: End-of-life issues

New Palliative Care Guidelines Released

palliative care guidelined

“New clinical practice guidelines for palliative care have been released by the National Consensus Project, with support from John A. Hartford Association (JAHF) for the evidence review. They include tools, resources and examples to give patients and their caregivers relief from the symptoms and stress of serious illness, based on need, not prognosis. The guidelines urge all health care professionals and organizations to integrate palliative care into their services across settings.

“Palliative care is the best friend of the seriously ill,” said JAHF Senior Program Officer Amy Berman.”

Click here or on the graphic to download the guidelines.

“The Ways Inequality Affects Black Americans at the End of Life” – next avenue

“Contributing factors: health inequity, discrimination and lack of cultural competency”

Racial-Disparities-in-the-End-of-Life-CareCredit: Adobe Stock

by Rochaun Meadows-Fernandez

“Jodi Savage was her grandmother’s caretaker in her last days. Like many black Americans, her grandmother’s cultural beliefs and religious background led to very little discussion around the end of life. Culturally speaking, black Americans on the whole tend to avoid discussing end-of-life topics for fear of speaking things into existence. Focus is placed on making the best of the time you’re given. A lack of cultural competency from physicians led to a misunderstanding of Savage’s grandmother’s needs and minimal support through the death-planning process. Savage endured all of this while trying to remain strong as her grandmother battled Alzheimer’s.

“Savage wasn’t prepared for the process of making such impactful decisions on her grandmother’s behalf. No one assisted her with end-of-life planning during the process of caretaking, and she didn’t discuss end-of-life care until the night before her grandmother died.”

Continue reading this article at next avenue in its entirety.


Part of the LIVING TO THE END OF LIFE SPECIAL REPORT

(Editor’s note: This content is provided by The John A. Hartford Foundation, a Next Avenue sponsor.)

American Bar Association | Advance Directives Counseling Guide for Lawyers (and healthcare professionals)

counseling guide

The American Bar Association has released this guide specifically for lawyers and health care professionals to align the practice of advance care planning in legal offices with the realities of implementation in health settings entitled, “Advance Directives: Counseling Guide for Lawyers.” 

“Climate Change May Cause 26,000 More U.S. Suicides by 2050” – The Atlantic

“Unusually hot days have profound effects on mental health and human physiology.”

A surfer pulls off a wave as the sun sets in Cardiff during what local media reported to be a record breaking heat wave in Southern Californiasurfer cools off during a heat wave in southern California in October 2017MIKE BLAKE / REUTERS”

by Robinson Meyer

“For almost two centuries now, scientists have noticed a place’s suicide rate bears troubling links to the changing of the seasons and the friendliness of its climate.

“In 1881the Italian physician Enrico Morselli noted that suicide rates peak in the summer, deeming the effect “too great for it to be attributed to chance of the human will.” Two decades later, the French sociologist Emile Durkheim noticed the same effect—though he also found the suicide rate was higher in Scandinavian countries.

“Even today, CDC data confirms that suicides peak in the United States in the early summer.”

Read this article in its entirety, click here.

“Letting Go: What should medicine do when it can’t save your life?” – The New Yorker

“People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others.”

gawande article“Modern medicine is good at staving off death with aggressive interventions—and bad at knowing when to focus, instead, on improving the days that terminal patients have left.”- Photograph by Phillip Toledano, “Birthday Balloon,” from “Days with My Father” (2008)

by Atul Gawande

“Sara Thomas Monopoli was pregnant with her first child when her doctors learned that she was going to die. It started with a cough and a pain in her back. Then a chest X-ray showed that her left lung had collapsed, and her chest was filled with fluid. A sample of the fluid was drawn off with a long needle and sent for testing. Instead of an infection, as everyone had expected, it was lung cancer, and it had already spread to the lining of her chest. Her pregnancy was thirty-nine weeks along, and the obstetrician who had ordered the test broke the news to her as she sat with her husband and her parents. The obstetrician didn’t get into the prognosis—she would bring in an oncologist for that—but Sara was stunned. Her mother, who had lost her best friend to lung cancer, began crying.”

Read this article in its entirety at The New Yorkerclick here.

“Is a suicide epidemic hiding under the drug overdose epidemic?”

As the US continues to grapple with a deadly opioid crisis, a growing number of experts are concerned that overdose deaths are masking a larger suicide crisis.

suicide

The background is this: Suicide rates in the US rose 30% between 2000 and 2016, according to estimates. But the real numbers are undoubtedly higher, partly because of the opioid epidemic.

According to a recent study, suicide by drug overdose is “profoundly underreported” in the US. On top of that, depression, anxiety, and post-traumatic stress disorder affect more than half of people with drug use disorders.

Here’s the thing: The official numbers say that less than 4% of the 44,000 fatal opioid overdoses in 2016 were suicides. However, experts say that data from teen deaths points to a much higher suicide rate — perhaps 13.5% of all opioid deaths. One addiction expert put it like this: “We should be very concerned that many overdoses are unrecognized suicide attempts.”

The reason this matters, as a mental health and suicide expert described, is that if people were more aware of the overlap, focusing on treating some drug users for depression would offer them a better chance of getting off drugs and not dying.

SOURCE: BuzzFeedNews

Dementia Specific Advance Directive: Podcast with Barak Gaster – GeriPal

In this GeriPal podcast, the interview is with Dr. Barak Gaster, Professor of Medicine and General Internist at the University of Washington in Seattle. Dr. Gaster felt like there was hole in the advance directives landscape around future planning for people with dementia. People with dementia experience a fairly common set of complications and decisions around feeding, loss of independence, and loss of ability to make complex decisions. His dementia specific advance directive has specific sections for care preferences for persons who progress through stages of dementia, including descriptions of mild, moderate, or severe dementia.

So many key points he makes in this podcast, you’ll have to read below or listen to the audio to learn more!

Two interesting notes:

  1. The directive is free to use, does not require a notary signature, and works synergistically with the POLST, Prepare, and Video decision aids.  He makes a major point about the need to “de-legalize” advance directives.  Right on.
  2. He describes how he published on the idea in JAMA, and was disappointed with the uptake.  It wasn’t until Paula Span wrote about it in the New York Times for the New Old Age (below) that downloads and uptake of the advance directive exploded.  Attention academics: it’s not enough to publish your work, you have to get the message out to the people!

fading

One Day Your Mind May Fade. At Least You’ll Have a Plan.” The New York Times

April 28 – National Drug Take Back Day

4-28 drug take back day

DRUG TAKE-BACK LOCATIONS.Do your part and take back those prescription pills –

If you need assistance in finding a treatment provider or funding for addiction treatment, please call 1-800-662-HELP (4357) or contact your local county drug and alcohol office.

 

 

“It always seems too early, until it’s too late.” | Tomorrow is National Healthcare Decisions Day

NHDD_Dateless_LogoMonday, April 16 is National Healthcare Decisions Day – “National Healthcare Decisions Day exists to inspire, educate and empower the public and providers about the importance of advance care planning.”

“Ideally, each of us would be able to make our own health care decisions throughout our lives. But in reality, many will have at least a limited period of time when we are unable to communicate our health care choices.  Advance health care directives increase the likelihood our wishes are followed, when we are not in a position to voice them.

“Advance health care directives are written directions that appoint another individual to make heath care decisions when a patient is unable to effect such decisions, and frequently include patients’ specific directions on the care they want to receive. Advance directives include a power of attorney that appoints a health care agent, a living will that leaves instructions on end-of-life care, do-not resuscitate orders and values surveys that offer guidance on care decisions.

“To encourage advance health care planning, April 16th is National Health Care Decisions Day. Most adults put off planning and may be confused by conflicting information and myths about advance health care planning.  Let’s clear up a few common myths:

“Myth No. 1: Advance directives are only for older people.

False. It is true older people are most likely to use advance directives, but every adult needs one. You never know when an accident or injury might leave you temporarily unable to communicate. Young adults should at a minimum name someone to make health care decisions when they can’t.

Click here to see a broader list of common myths and responses from this article, “A Call to Action for National Health Care Decisions Day” at the American Bar Association Website.

Friday Wrap-Up, March 9, 2018 | a message from the Secretary of Aging

Each week the Office of the Secretary of Pennsylvania’s Department of Aging releases a Friday newsletter with information relevant to activities, issues and events for older Pennsylvanians and persons with disabilities across the Commonwealth. Click here download the newsletter as a .pdf file.