Hospitals, Hospices Partner to Improve Care for Nation's Chronically and Terminally III
The National Hospice and Palliative Care Organization and the Center to Advance Palliative Care have joined together, with funding from The Robert Wood Johnson Foundation, on a project called "Hospital-Hospice Partnerships in Palliative Care: Creating a Continuum of Service."
The report features Executive Summary sections examining hospital-hospice partnerships, an overview of the Medicare hospice benefit, and legal issues in the hospital-hospice relationship, particularly the Antikickback Law.
Case studies of nine hospital-hospice partnerships ranging from Lexington, KY, where three hospitals and a hospice work together to provide care, to demonstration projects in San Francisco, CA; regional initiatives in Lebanon, NH; and providing inpatient hospice care in a leased unit in Hollywood, FL. These projects uniformly demonstrate innovative, community-based solutions that enhance palliative care.
NHPCO is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The Center to Advance Palliative Care (CAPC) was established by The Robert Wood Johnson Foundation to promote wider access to excellent palliative care in hospitals and other healthcare settings nationwide.
The full report has been posted on both the NHPCO and CAPC Web sites, http://www.nhpco.org and http://www.capcmssm.org. Printed copies are available from CAPC by calling 212-201-2671. (Release)
International Association for Hospice and Palliative Care Announces 2001 Institutional Award
The International Association for Hospice and Palliative Care (IAHPC) is pleased to announce that the Clinica Familia-Programa de Cuidados Paliativos from Chile was chosen as the winner for the 2001 IAHPC Institutional Award.
The Award is directed toward both public and private nonprofit institutions and its goals are to support the development of models of palliative care throughout the world; strengthen healthcare services for patients with incurable illness and their families to improve their quality of life; and promote the formation of alliances and work in cooperation among the health, academic, or governmental institutions.
The selection committee members for 2001 included Doctors Derek Doyle, Eduardo Bruera, Rosalie Shaw, Alan Nixon, and William Farr. Applications were received from India, South Africa, Chile, Ukraine, and Mexico. Congratulations are extended to all the programs for their great effort and hard work.
Information and pictures about Clinica Familia are available under http://www.hospicecare.com/awards.htm. An individual IAHPC award is also given each year; a profile of the 2001 winner, Anne Merriman of Liverpool, England, who has been influential in establishing hospice programs in several African nations, can be viewed at the site.
The IAHPC Web site has many other features, such as online essays on hospice and palliative care ethics including, "The Double Effect of Pain Medication: Separating Myth from Reality," by Susan Anderson Fohr, JD, MA; "On Consenting to, but Not Seeking, Death," by David Barnard, PhD; and "Justice, Biomedical Progress, and Palliative Care," by Daniel Callahane. The site also provides a basic manual discussing palliative care for informational purposes and to promote palliative and hospice care on a worldwide basis. Interested healthcare professionals also can sign up for the "Professional Forum," an online discussion group. (Release)
Last Acts Urges Better Care for Minorities at Tampa Conference; NAACP Announces it Will Join Last Acts Campaign
Nearly 200 people came together for the Last Acts regional conference in Tampa, FL, this past February to renew efforts to improve access to hospice care for minorities, and to help providers become more sensitive to how culture can affect patients' end-of-life choices.
Almost half of the top 100 cities in the United States have a non-white majority, but access to quality, end-of-life care for people of color and other diverse communities is insufficient. Religious, ethnic, and racial minorities in the United States receive inadequate pain treatment, are less likely to use hospice, and are more likely to die in the hospital than at home, compared to white patients.
The National Association for the Advancement of Colored People (NAACP), the largest African American civil rights advocacy group, announced its decision to join the Last Acts campaign at the February meeting. The NAACP national board approved the measure in February 2002, and this marks the first time end-of-life issues have appeared on NAACP's agenda.
"Health is a justice issue," Rupert Richardson, chair of NAACP's health committee, told the audience. When it comes to promoting quality end-of-life care for black people, "long-range education is the only answer for the future." Richardson invited Last Acts Partners to develop a rapport with their local NAACP affiliates, and hopes to make end-of-life care a prominent part of the discussion at NAACP's July 2002 Convention in Houston.
Cultural background can play a large role in patients' end-of-life care decisions, and it is crucial for providers to respect various deathrelated cultural rituals. Karla Holloway, dean of humanities and social sciences at Duke University, said the US hospital system does not accommodate the way that many black communities deal with death, whereby large delegations of family and friends often come to the hospital to stay with the dying. "Intensive-care rules [about] two people visiting don't translate. We need to anticipate a community space in the hospital room," she said.
Understanding cultural attitudes toward dying is key to presenting information in ways to which various cultural groups will respond. Aging with Dignity Director Paul Malley told the audience that through efforts to market advance directives to Hispanics, he learned that many in the Latino community prefer that their physician or family make end-of-life care decisions for them. Instead of framing advance directives as a way to increase patient autonomy, his group presented them as a gift that a dying person can give to his or her family to help make treatment choices.
The conference also featured model programs that promote quality end-of-life care to minorities. The Harlem Palliative Care Network, for example, was launched recently to identify Harlem residents who need palliative care and to link them to a network of physicians, hospice programs, and a variety of social service agencies. The program also seeks to get Harlem residents to understand the benefits of palliative care. So far, according to Richard Payne, MD, program director, the project has generated 150 client referrals.
The Last Acts Campaign has recently developed resources to promote cultural diversity in end-of-life care, including a position statement, a collection of case studies on provider issues in caring for minorities, an annotated bibliography, and a new video geared toward promoting provider sensitivity to these issues. For more information on these resources, contact Anna Bauer at e-mail [email protected]. (Release)
University of Rochester Neurologist to Lead Biggest Study Ever of Parkinson's Disease
A 5-year, $6.5-million study of 3000 Parkinson's patients nationwide is due to be launched in late 2002 or early 2003, and will be the largest study ever of patients with Parkinson's disease.
Professor of Neurology Karl Kieburtz, MD, will lead the study, funded by the National Institutes of Health. It will attempt to find a way to slow the progression of the disease, in which several hundred thousand cells in a tiny region of the brain known as the substantia nigra degenerate and die. This results in symptoms that include slowness of movement, difficulty walking and swallowing, muscle stiffness, tremors, and rigidity.
Currently, doctors use a range of medications to treat the symptoms but there is no way to slow or prevent the death of brain cells, which is at the heart of the disease.
Kieburtz will coordinate doctors from 42 sites around North America who will track the health of the patients over a 5-year period. The team will test the effectiveness of various substances at slowing the progression of the disease. Possibilities include obscure compounds in development in laboratories, as well as everyday substances like caffeine and nicotine. In similar studies bringing together doctors and patients around the country, University of Rochester Medical Center physicians recently led a team that found that a skin patch under development to treat Parkinson's disease appears as effective as traditional oral medications.
The new research will be conducted through the University of Rochester Department of Neurology's Clinical Trials Coordination Center, where Kieburtz serves as director.
For more information, please visit the University's Web site at http://www.urmc.rochester.edu. (Release)
Sigma Theta Tau Announces New Web Portal for Grief Resources
Today, nurses continue to respond to tragedy with resources to promote health. Time has passed since the terrorist attacks, but the hurt is still very real. Nursing professionals on the front lines continue to help people deal with the loss of a loved one, job, or even their sense of security.
To support nurses and the people they serve, national experts collaborated with Sigma Theta Tau, the Honor Society of Nursing, to establish a portal titled "America in Grief: Nurses Respond to Tragedy" to bring together the top online resources available today.
Topics range from grief counseling and children's issues to anthrax and preparedness; the portal is available at no cost and may be found at Web site http://www.nursingsociety.org/grief.html. (Release)
TomoTherapy Inc. Gains FDA 510(k) Clearance for New Radiation Therapy System
TomoTherapy Inc. announced in February 2002 that it has received 510(k) clearance from the US Food and Drug Administration to market its helical tomotherapy system, the TomoTherapy HI*ART System. Designed to deliver radiation therapy more accurately to tumors with less damage to surrounding tissues, the concept of helical tomotherapy was first developed by researchers at the University of Wisconsin-Madison, who were exploring ways to deliver intensity modulated radiation therapy (IMRT). TomoTherapy Inc. was later founded by two members of the research group: Professor Thomas Rockwell Mackie, a leading medical physicist, and Paul J. Reckwerdt, an accomplished mathematician and software engineer.
The TomoTherapy HI*ART System combines the benefit of megavoltage computer tomography, a feature of tomotherapy that produces CT images by reconstructing scan data and allows clinicians to take a CT scan at any point in the tomotherapy process to more accurately target tumors with advanced IMRT. This patented approach can improve the precise delivery of radiation to a tumor, while reducing the delivery of radiation to vital healthy tissues.
A privately held company, TomoTherapy Inc. holds exclusive license on more than 100 patents issued worldwide to the Wisconsin Alumni Research Foundation. Currently located in Middleton, WI, the company is planning to move to a new facility in Madison this summer and anticipates that the HI*ART System will be available for delivery later in 2002.
For detailed information on how the HI*ART System is designed to work, including a glossary of terms, and to see an animated demonstration of how it targets radiation to specific areas, visit TomoTherapy's Web site at http://www.tomotherapy.com. (Release)
CMS Announces New Specialty Code for Pain Management
As of January 1, 2002, the Centers for Medicare and Medicaid Services has established a new specialty code for pain management. The new code, 72, was listed as reserved, but has been added to the Unique Provider Identifier Number Registry process. According to the American Academy of Pain Management, the special code will facilitate collection of pain-management services data for more accurate reflection of treatment services. (Release)
Lifeline's Innovative "Cut the Cord" Campaign Targets Senior Living
Lifeline Senior Living Systems, provider of Personal Response Services for elders and the disabled, has unveiled an innovative "Cut the Cord" campaign aimed at helping assisted living facilities of 50 beds or more to adopt the company's technologically advanced system. As part of their campaign, which has been continued thanks to enthusiastic response, Lifeline is offering facilities with dated pull-cord emergency systems a $25 rebate for each apartment fitted with their wireless alternative.
Lifeline's automated emergency call system includes full-featured telephones tailored to elders and wearable personal help buttons that residents press to summon help. These wireless devices, worn around the wrist or neck, connect residents via the nearest Lifeline speakerphone to a staff person, enabling communication even if the resident is immobile. Because the system is fully automated through a supplied computer, a staff monitor who moves away from the response center will be summoned through a page-forwarding feature. A patented, closed-loop protocol alerts the on-site response center when help has arrived or when further assistance is required; voice communicators quickly link with staff; and call activity is archived for required reporting and service verifications.
Lifeline's wireless smoke detectors will also send an alarm to facility staff in case of a fire. Residents are warned audibly and visually. A rechargeable battery back-up power supply provides 24 hours of power in case of a power failure. A low battery warning alerts staff when the unit's back-up battery needs to be replaced. Lithium batteries for Lifeline pendant or wristwatch provide reliable service for up to 5 years before a replacement is needed.
Lifeline's Response Center, phone, and push button system offers additional benefits, such as an inactivity alarm that automatically signals staff when residents are inactive for an extended period. Large, high-contrast buttons; Voice Assist prompts; high-volume controls and enunciated dialing for the visually impaired; and a hearing-aid-compatible handset on the CarePartner Telephone are a comprehensive system for the special needs of elders. A personal reminder service allows residents or caregivers to program the Lifeline phone to keep track of medical appointments and social engagements.
The "Cut the Cord" campaign targets assisted living facilities of 50 beds or more in the United States. More than 2500 hospital systems have successfully integrated the Lifeline service into care management for elderly patients to bridge the gap between costs and care.
Lifeline has been supplying Personal Response Services for nearly 30 years. In 2001, Lifeline won the American Society on Aging's Business of the Year Award for "exemplary programs that meet the needs of older people and their families, expand public awareness of the private sector's increasing involvement with older people, and create performance models for other companies to emulate."
For more information, please visit Lifeline's Web site at http://www.lifelinesys.com. (Release)
The World's First and Only Full Service Internet Cemetery
Universalplot.com was conceived more than 2 years ago as a way of remembering deceased loved ones and as a place for the living to compile video clips, still pictures, readings, and musical recordings for future generations to experience.
Their ambitious mission is to provide a way to pay tribute to loved ones forever, and an enriching way to visit with favorite memories at any time from the comfort of home or anywhere there is Internet access.
A basic plot for a loved one is a maximum of a Welcome (one still picture), Gallery (two large or four small pictures), and Words (up to 500 words), or three Web pages total. Audio and video space is available on a per-megabyte basis. Universalplot will set up the pages, and will work to customize the Internet cemetery plot, for a base charge of $99; or users can choose to design their own plots. Optional services, such as a pre-written e-mail notice of passing and dates and times of memorial services to be held for a loved one, are available.
Living plots may be updated at any time, until the time of death, particularly if designed by the customer. If the plot is designed by the Caretaker, submitted materials will be returned if a stamped, self-addressed envelope is included. Offsite links are not allowed due to the changing nature of the Internet, as the cost of checking and updating changed links would be prohibitive.
For more information and to view sample plots, visit http://www.universalplot.com. (Release)