Briefings Palliative, Hospice, and Pain Medicine & Management

Self-Care Module found useful
A Self-Care Module developed at the University of Toronto, Canada, which aimed to provide medical learners within a palliative care clinical rotation with a structured educational experience to practice self-care, was found to be effective, according to a paper published in Journal of Palliative Medicine. Thirty-five learners completed evaluations on the experience and 86 percent found the module helpful in reflecting on their clinical encounters. Close to all of the responders said they gained an appreciation for sharing clinical experiences with peers. The module was well accepted and considered operationally feasible by the postgraduate and undergraduate learners.

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June 5, 2013

Journal of Palliative Medicine
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People on the Move

People on the Move Spotlight:

Christie Williams has joined the staff of Center for Hospice Care in Norwich, Conn. He was most recently the director of Development and Communications at Glynwood, a sustainable food and farming movement.

More People on the Move...

Whitney Rogers was named development coordinator at the Hospice and Palliative Care Foundation in Drayton, S.C....Janet Dunn, a senior health care assistant with Hartlepool and District Hospice in Hartlepool, U.K., is in the running for a Best of Health award, nominated by members of the community...Alvin Robinson, chief executive officer of Primrose Hospice in Redditch, U.K., has retired...Kathy Phelan has joined Hospice of the Valley in San Jose, Calif., as vice president development and communications.

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People on the Move news.

OIG concludes Medicare could save millions with hospice care
The Department of Health and Human Services Office of Inspector General issued a report, “Medicare could save millions by implementing a hospital transfer payment policy for early discharges to hospice care.” The Inspector General estimated that Medicare could have saved $602.5 million in 2009 and 2010 if it had applied a hospital transfer payment policy for early discharges to hospice care. About one-third of the hospital discharges to hospice were for early discharges that would have received per diem payments rather than full hospital payments under a hospital transfer payment policy. The report goes on to say that such an early discharge to hospice policy would not cause hospitals significant harm. The Inspector General recommended that the Centers for Medicare & Medicaid Services “change its regulations or pursue a legislative change, if necessary, to establish a hospital transfer payment policy for early discharges to hospice care.”

Ablation therapy used as palliative treatment for bone cancer pain
A researcher from the Thomas Jefferson University and Hospital in Philadelphia told participants at the American Society of Clinical Oncology’s annual meeting in Chicago that magnetic resonance image-guided focused ultrasound ablation therapy significantly reduced pain in 67 percent of cancer patients with bone metastasis who received the treatment. The treatment may be an option when radiation cannot be used again for metastatic bone disease or as an alternative. “The response to ExAblate was as good as radiotherapy, which was notable because it is very unusual to see a second-line treatment with a response rate that is as high as first-line therapy,” said Mark Hurwitz, MD, director of Thermal Oncology for the Department of Radiation Oncology at Thomas Jefferson University and Hospital. More>>

Hospice society calls for residential facility
The Hospice Society of Greater Halifax is calling on Nova Scotians to join together to secure a residential hospice in the Halifax Regional Municipality, the largest health district in Canada without one. Fred McGinn, board chair for the Hospice Society of Greater Halifax, said, a residential facility “will provide an alternative setting to acute care that meets the needs of patients with progressive terminal illness who are unable to remain at home to die and do not require the acute care support of a hospital.” The organization reported the average per diem cost of an acute care bed is about $1000 per day, but at a residential hospice, such care would cost $450 daily, saving healthcare dollars. More>>

NHPCO offers palliative chemo webinar
The National Hospice and Palliative Care Organization will present the webinar “Palliative Chemotherapy: What Every Clinician Needs to Know” on June 13, 2013, at 2:00pm Eastern. Jason Beckrow, DO, founder and medical director of Lighthouse Oncology in South Haven, Mich., will discuss palliative chemotherapy used in hospice patients for pain and symptom management. He will share information about how to accurately assess the patient’s and family members’ expectations and hope for a cure. More>>

Residential hospice brings online video chat to patients
Through a donation from the Martin Martinos family and a local charity, the Hospice of Windsor and Essex County in Canada has introduced a new program to bring online video chat to patients via iPads and wireless Internet services. The Martin Martinos Memorial Communication Program allows patients to easily communicate with out-of-town family members. The Transition to Betterness charity, which provided funds for the project, hopes to expand the program to area hospitals. More>>

Many Aussies are unsure of loved ones’ wishes
A survey from Palliative Care Australia found that among Australians who had recently lost a loved one, half had not talked with that person about their end-of-life care, and 56 percent of the survivors were unsure the deceased person’s wishes had been carried out. Only 15 percent of the patients had written an advance care plan, and 30 percent did not receive care in their place of choice. Eighty-four percent of the patients received palliative care in their final weeks, but 17 percent of the survivors said it was difficult to access those services. More>>

A visit changes perception of hospice house
Anna Reisman, MD, associate professor of Medicine at Yale University School of Medicine in New Haven, Conn., writes in The New York Times about her experience with a patient admitted to a hospice house. She honestly shares her shame at not wanting to visit a long-time patient admitted to the facility, not wanting to see all those people dying in one place. But once inside, she found it “quiet, and cozy, and homey,” with someone playing the piano and family photos on her patient’s windowsill. The man grabbed her hand. She writes that she regrets that fears of the place had kept her from visiting other former patients. And by sharing her story, readers can learn about the reality of inpatient hospice care. More>>

Fine wine auction benefits hospice
Hawke’s Bay winegrowers have come together to raise money for Cranford Hospice in Hastings, New Zealand, holding the annual Charity Fine Wine Auction, which began with a pre-auction tasting and a meal paired with wine. This past weekend, they raised $91,600 for the hospice, up from $65,065 last year. Since 1991, the events have raised $2 million to support the work of the hospice, becoming its largest benefactor. The hospice provides day programs, a residential unit with a family flat, and 24-hour services. More>>



Read about a saint, a rose and a tradition
VJ Periyakoil, MD, senior associate editor of Journal of Palliative Medicine, writes at the JPM blog about the Feast of St. Rita, roses, and sitting with the ill and dying. When St. Rita was ill, she asked for a rose, and despite snow, people found her one. As a palliative care physician, Dr. Periyakoil reflects on St. Rita's tradition. More>>



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