MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'end of life care'. Sat, 03 Sep 2011 02:13:09 +0100 http://www.medworm.com/index.php?rid=5181738&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F30%2Fwhere-to-for-hospice%2F A column by New York Times columnist David Brooks titled “Death and Budgets,” read in combination with a recent report from the Office of the Inspector General (OIG) at the U.S. Department of Health and Human Services (“Medicare Hospices that Focus on Nursing Facility Residents”), makes painfully clear how urgently America must rethink the way [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181738 Tue, 30 Aug 2011 18:02:55 +0100 5181738 http://www.medworm.com/index.php?rid=5139673&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F17%2Fnarrative-matters-eleanor-clift-on-her-husbands-death-and-end-of-life-issues%2F In the newest Health Affairs Narrative Matters essay, prominent journalist Eleanor Clift writes about her husband Tom Brazaitis and his death from metastatic cancer at age 64. Clift describes the multiple ways in which she and her husband benefited from hospice care, in which Brazaitis spent the last four months of his life. Clift uses [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139673 Wed, 17 Aug 2011 18:19:54 +0100 5139673 http://www.medworm.com/index.php?rid=5139627&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F17%2Flocal-square-table-learning-and-evaluation-report%2F Title: Local square table learning and evaluation report Scan or click to download 'Local square table learning and evaluation report' The Skinny: Reports on the findings of open and honest discussion and increased understanding between those who provide children’s palliative care, those who experience it and those that play a wider part in supporting children, young people and families in a particular community. Finds that: Awareness and language is seen as a barrier to service access Parents say they struggle with the current assessment process Partnership working is seen as key to ensuring the best outcomes for lifelimited and life-threatened children and young people Workforce training and development is considered a priority by parents and professionals Parents f... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139627 Wed, 17 Aug 2011 15:43:14 +0100 5139627 http://www.medworm.com/index.php?rid=5130661&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fevaluation-of-learning-resources-for-end-of-life-care-in-extra-care-settings-executive-summary%2F Title: Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary Scan or click to download 'Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary' The Skinny: Summarises experiences from the use of learning resources developed to support end of life care in an “extra care” setting. Publisher: The University of York, Centre for Housing Policy Published: 13/07/11 Size: 6p. Filed under: Ooops Missed Category! Tagged: Behavioural sciences, Education, End of Life Care, Grey Literature, Medical Treatment, Palliative Care, Terminal illness, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130661 Mon, 15 Aug 2011 13:43:26 +0100 5130661 http://www.medworm.com/index.php?rid=5130666&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Ftransforming-community-services-transformational-guides%2F Scan or click to download 'Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services' Title: Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services The Skinny: Guide for use by frontline clinicians, commissioners and providers a based around a framework of ambition, action and achievement: Clearly setting out your ambition Taking action to deliver the ambition using the best available evidence (high impact changes) Demonstrating and measuring achievement (using quality indicators) The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles. Publisher: DH ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130666 Mon, 15 Aug 2011 08:09:01 +0100 5130666 http://www.medworm.com/index.php?rid=4975819&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fvra3c12TJyY%2F No Hearing: The Supreme Court yesterday rejected an appeal from insurers and other payers who said they paid too much for Eli Lilly’s antipsychotic drug Zyprexa because the drug company misrepresented the benefits of the medication, the WSJ reports. A lower court had ruled that there wasn’t a sufficient link between the high prices and Lilly’s marketing practices; the Supreme Court won’t hear a challenge to that ruling. Hospice Questions: There are concerns that commercial hospices are seeking out patients with better prognoses in an attempt to boost income, Kaiser Health News and the New York Times report. The inspector general of HHS is looking at “unusual patterns of hospice stays,” while whistleblower lawsuits have alleged efforts to keep patients in... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975819 Tue, 28 Jun 2011 10:57:19 +0100 4975819 http://www.medworm.com/index.php?rid=4952743&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F06%2F17%2Fnursing-times-2011-volume-107-no-18%2F This study explores nurses’ experiences of using the Preferred Priorities for Care (PPC) document. The article concludes that district nurses found the PPC an invaluable tool and it’s use should be extended to a wider range of healthcare professionals and not solely district nurses. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: District Nurses, End of Life, End of Life Care, Preferred Priorities for Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4952743 Fri, 17 Jun 2011 14:37:58 +0100 4952743 http://www.medworm.com/index.php?rid=4775395&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-costs-does-your-doctor-know-when-youre-going-to-die%2F2011.05.01 One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea. Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775395 Sun, 01 May 2011 18:00:00 +0100 4775395 http://www.medworm.com/index.php?rid=4642566&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F28%2Fmedicares-embedded-ethics-the-challenge-of-cost-control-in-an-aging-society%2F The challenge of reining in the rising costs of the Medicare Program is particularly thorny because it confronts a recalcitrant societal tension between the necessity for cost control and the value of open-ended technology use for life extension in the later years. That tension is becoming more deeply entrenched because a growing number of older [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4642566 Mon, 28 Mar 2011 20:02:43 +0100 4642566 http://www.medworm.com/index.php?rid=4631445&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F03%2F24%2Fnursing-times-2011-vol-107-no-11%2F This article explores the experiences of carers of patients dying at home, in particular their expectations and preparedness for the dying process. Contact the Library for a copy of this article. Filed under: Ooops Missed Category! Tagged: Bereavement, Carers, Death, Dying Process, End of Life Care, Palliative Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4631445 Thu, 24 Mar 2011 12:15:42 +0100 4631445 http://www.medworm.com/index.php?rid=4605800&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F17%2Fa-challenge-to-congress-a-critical-care-blueprint%2F While Congress’ recent efforts to repeal the healthcare reform legislation signed by President Obama last year may have been ‘dead on arrival,’ efforts to dismantle the bill continue, and likely will for months to come. Rather than simply repeat the same battles again and again, legislators on both sides of the aisle might also take [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4605800 Thu, 17 Mar 2011 16:00:17 +0100 4605800 http://www.medworm.com/index.php?rid=4592344&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F15%2Fcall-for-papers-the-care-span%2F Health Affairs has launched The Care Span, a new ongoing section of the journal, in its March 2011 edition. The Care Span will examine the topics of aging and disability, not as isolated experiences but as part of the full span of life. Toward this end, the journal aims to bring together the best current [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4592344 Tue, 15 Mar 2011 19:30:54 +0100 4592344 http://www.medworm.com/index.php?rid=4592350&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fh08O6IiOtIc%2F In the push to get more Americans to prepare advance directives outlining their end-of-life wishes, more states and regions are adopting a program known as Polst, for Physician Orders for Life-Sustaining Treatment, today’s Informed Patient column reports. Studies such as one published last year by the Journal of the American Geriatrics Society show that such documents — which become part of medical orders in a patient’s record and are co-signed by doctors — can help reduce the use of costly end-of-life care that isn’t wanted by patients. Research also shows that communicating wishes about end-of-life care to loved ones in any form can help relieve the stress on families of making decisions without knowing their loved ones’ preferences. Only about a third of Americans have s... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4592350 Tue, 15 Mar 2011 14:16:42 +0100 4592350 http://www.medworm.com/index.php?rid=4565878&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F09%2Fthe-carespan-a-new-health-affairs-feature-on-long-term-care%2F Major changes lie ahead in the structure and delivery of long-term health care services and supports, accelerated by the Affordable Care Act. Among these are expanded options for people to receive services in their homes and communities; care coordination for the disabled population dually enrolled in Medicare and Medicaid; and the creation of a new [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4565878 Wed, 09 Mar 2011 18:22:18 +0100 4565878 http://www.medworm.com/index.php?rid=4560226&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F3EPAFOBr_E4%2F Last year we wrote about a study that found advanced cancer patients who received early palliative care in combination with standard care not only reported increased quality of life, but even lived a bit longer than those who didn’t. Now a study of  four hospitals in New York State finds that using well-established palliative care teams to coordinate the care of seriously ill Medicaid patients can save money, at least in the hospital; their use reduced inpatient costs by about $6,900 per admission for the average patient. The study, published in Health Affairs, looked at data from 2004-07 covering 485 Medicaid patients who received palliative care. Patients included people with metastatic cancers, HIV/AIDS with one of several secondary diagnoses and congestive-heart failure patients... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4560226 Tue, 08 Mar 2011 19:41:31 +0100 4560226 http://www.medworm.com/index.php?rid=4532184&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FKR5-0_Y65gE%2F   The point of naming a medical surrogate is to have someone around to express your preferences about care when you can’t. But not providing surrogates with enough information ahead of time can cause them emotional distress that may last for years. That, at least, is the finding of a review of existing literature on the impact on surrogates, most of them family members, of making treatment decisions. The 40 papers analyzed in the review, published in the Annals of Internal Medicine, aren’t perfect, the authors say right up front. Many of the study populations weren’t representative of the general population, for example, and there was sometimes a big time delay between when the decisions were made and when the study was conducted. That said, the authors write they w... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4532184 Mon, 28 Feb 2011 22:21:33 +0100 4532184 http://www.medworm.com/index.php?rid=4813625&cid=t_176958_136_f&fid=37856&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FThePeacefulLiberal%2F%7E3%2FJFKRJHE1Yzk%2Fhappy-valentines-day-love-s-holiday.html I know it's been a while since I last posted and to be quite honest I have been busy dealing with lots of pain in my body and an abundant amount  of nausea. Part of the love that I feel so strongly for my husband is how aware he is of what is going on with my body.  He senses things that might not be right; he gets scared as most normally would in keeping his love alive or to be enjoying just one more day with her!  I am always grateful for that one more day; yes we are doing this one day at a time; we can't compound more stress than what is completely necessary.  It's very stressful for both of us.   I can't bite more than I can chew!) It's a blessing for me if I am able to get outside and experience walking around in a grocery store or even to go shopping.  ... ShoppingKharma: What comes around goes around blogs http://www.medworm.com/rss/comments.php?id=4813625 Tue, 15 Feb 2011 17:50:00 +0100 4813625 http://www.medworm.com/index.php?rid=4459955&cid=t_176958_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1343%2F0%2Fethicist-assisted-suicide.mp3 Podcast: ____ This is the third in a series of articles on End-of-Life Care and Covert Rationing.  The first two articles can be found here and here. ____ In his previous post, DrRich attempted to satirize the lame attempts of certain payers to “inform” certain of their “covered lives” that, among all the wonderful options available to them under their truly comprehensive health plans, the medical service of physician-assisted suicide would be compassionately offered and cheerfully paid for. DrRich even offered, thoughtfully as usual, some free though invaluable advice to payers on how they ought to go about marketing assisted suicide as a cost-saving strategy, and to do so in a far more sensitive and less ham-fisted way than they have managed so far. If the mark ... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4459955 Thu, 10 Feb 2011 16:36:02 +0100 4459955 http://www.medworm.com/index.php?rid=4450292&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-when-medicine-prolongs-dying-not-living%2F2011.02.08 The recent Washington Post article entitled, Who decides when medicine prolongs dying, not living? perfectly captures my earlier blog on why we’re afraid of death. An excerpt from the Post piece: [There's a] huge gap between Americans’ wishes about end-of-life care, as expressed in numerous public opinion polls, and what actually happens in too many instances–futile, expensive, often painful procedures performed on people too sick to leave the hospital alive–much less survive with a decent quality of life. Ninety percent of Americans say they want to die at home but only 20 percent do so. Half of Americans die in hospitals and another 25 percent in nursing homes, after a long period of suffering from chronic, incurable conditions that finally become untreatable. An ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450292 Tue, 08 Feb 2011 20:00:00 +0100 4450292 http://www.medworm.com/index.php?rid=4445799&cid=t_176958_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1326%2F0%2Fselling-assisted-suicide.mp3 Podcast: ____ This is the second in a series of articles on End-of-Life Care and Covert Rationing.  The first article can be found here. ____ In the summer of 2008, the Oregon Health Plan (the Medicaid plan in Oregon) injudiciously sent a letter to lung-cancer patient Barbara Wagner denying coverage for the expensive chemotherapy her doctor had recommended, and offering instead to cover palliative care “including doctor-assisted suicide.” Despite the fact that there were plenty of distractions at the time (including a presidential election and the world’s economy on the brink of Armageddon), that letter unleashed a firestorm of public outrage. (If you have forgotten the outrage, simply Google the search terms “Barbara Wagner” and “suicide.”) Indeed, the outrage was suf... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4445799 Mon, 07 Feb 2011 14:51:03 +0100 4445799 http://www.medworm.com/index.php?rid=4433099&cid=t_176958_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1292%2F0%2Fadvance-directives.mp3 Podcast: It is easy to have missed it, because it went by so quickly. On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual “wellness visit.” Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could no longer make medical decisions for him/herself. But on January 5, the new policy was suddenly revoked. It was revoked, CMS lamely explained, because it had not been implemented using the correct process. But, as anyone would know who watched Congress make Obamacare the law of the land, this could not possibly have been the real reason... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4433099 Thu, 03 Feb 2011 12:29:44 +0100 4433099 http://www.medworm.com/index.php?rid=4405747&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F26%2Fhealth-care-and-the-state-of-the-union%2F Below, Kavita Patel, former director of policy for the White House Office of Public Engagement and Intergovernmental Affairs, discusses President Obama’s State of the Union address and House Budget Committee chairman Paul Ryan’s (R-WI) Republican response. See other posts on this topic by Len Nichols and Joseph Antos.  The Constitution mandates that the President “from time to time [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4405747 Wed, 26 Jan 2011 21:05:12 +0100 4405747 http://www.medworm.com/index.php?rid=4394415&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F-Xsvz-rGmL0%2F As few as 40% of patients with advanced cancer have a candid discussion about their prognosis with their physician soon after being diagnosed. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4394415 Mon, 24 Jan 2011 22:06:14 +0100 4394415 http://www.medworm.com/index.php?rid=4322506&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdeath-why-are-we-so-afraid-of-it%2F2011.01.07 My cousin’s mother-in-law is in her late 90s. She had horrible osteoporosis and can barely move. She has little cognitive function left. She requires nearly 24-hour care and no one would even attempt to say she has any quality of life left. She told her son years ago that she was “ready to go,” and had had enough. And yet when I asked my cousin’s husband if his mother had any do-not-resuscitate orders, or had ever completed an advanced director  outlining her wishes of what kind of end-of-life care she wanted, he said no. His sister, he said, just wasn’t ready for that yet. So what, I asked, will you do when/if your mother gets pneumonia? Will you treat it with antibiotics? Will you put her on a respirator? If she is no longer able to eat, will you feed her t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322506 Fri, 07 Jan 2011 22:00:00 +0100 4322506 http://www.medworm.com/index.php?rid=4318303&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FR5RWavCqETg%2F Some 28% of home health care patients, 65% of nursing home residents and 88% of discharged hospice patients had at least one advance directive on file. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4318303 Thu, 06 Jan 2011 19:14:55 +0100 4318303 http://www.medworm.com/index.php?rid=4318300&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F06%2Ffact-vs-fiction-in-advance-care-planning-take-two%2F For the second time, a proposal to pay health care providers to counsel Medicare beneficiaries on future care options and end-of-life planning has fallen victim to the politics of the health care debate. The House included language to pay physicians and other providers for such “advance care planning” in its version of the Affordable Care Act, last [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4318300 Thu, 06 Jan 2011 16:53:19 +0100 4318300 http://www.medworm.com/index.php?rid=4313985&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FJQel5xbQ2d4%2F Also: reversal on end-of-life planning; the menthol wars heat up; walking faster to live longer. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4313985 Wed, 05 Jan 2011 13:34:45 +0100 4313985 http://www.medworm.com/index.php?rid=4205936&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-wishes-how-to-engage-with-grace%2F2010.11.27 As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again. And again.  This weekend the “Engage With Grace” message is being broadcast virally, through a “blog rally,” at a time when many people are with family and friends over the long weekend. The point is: We all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating healthcare decisions. CNN ran a story on “Engage With Grace” yesterday. End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a r... Better Health blogs http://www.medworm.com/rss/comments.php?id=4205936 Sat, 27 Nov 2010 13:00:00 +0100 4205936 http://www.medworm.com/index.php?rid=4200622&cid=t_176958_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2FlK-qxFlKcaw%2Fthanksgiving-2010-will-you-engage-with.html Will You Engage with Grace this Thanksgiving weekend? I hope so. For the third year running I am participating in the Thanksgiving holiday Engage with Grace Blog Rally. A viral effort to communicate the importance of having a conversation with your family and loved ones around end of life care wishes. Would you prefer to die in a hospital, or at home? Can your family correctly describe how you would want to be treated in the case of a terminal illness or sudden traumatic accident? Does your family know where you keep your living will and advanced directive? At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. They’re not easy questions, but they are important. The key is having the conversation before it’s too late. Througho... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4200622 Thu, 25 Nov 2010 14:39:01 +0100 4200622 http://www.medworm.com/index.php?rid=4118863&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FTMNo1cXBBp4%2F Wall Street Journal health blogger Katherine Hobson will take questions from readers in a live chat on Monday, Nov. 1 about the TEDMED conference in San Diego.  Ask your questions now. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4118863 Fri, 29 Oct 2010 18:27:37 +0100 4118863 http://www.medworm.com/index.php?rid=4118869&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FggWExmMNL6E%2F Drane has five questions for you to answer about your own death. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4118869 Thu, 28 Oct 2010 23:27:12 +0100 4118869 http://www.medworm.com/index.php?rid=4097885&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F21%2Fnarrative-matters-refusing-mammograms-and-caring-for-elderly-parents%2F Which groups of women, if any, should get regular mammograms to screen for breast cancer? This question has been the subject of passionate debate. For example, when the United States Preventive Services Task Force recommended that women without special risk factors begin regular mammograms at age 50, rather than 40, it unleashed an uproar that threatened [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4097885 Thu, 21 Oct 2010 15:48:00 +0100 4097885 http://www.medworm.com/index.php?rid=4013101&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F09%2F29%2Fnursing-times-2010-vol-106-no-37%2F This article considers how nurses can support patients by acknowledging and validating their spiritual needs. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Death, End of Life Care, Patient Choice, Spirituality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4013101 Wed, 29 Sep 2010 12:26:50 +0100 4013101 http://www.medworm.com/index.php?rid=4013125&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F28%2Fremembering-robert-butler%2F On July 7, Robert Butler died of leukemia. Butler was the founding director of the National Institute on Aging, a Pulitzer Prize-winning author, and one of the nation’s leading authorities on aging and geriatrics. This post, by William Hazzard, Professor of Medicine at the University of Washington and Director of Geriatrics and Extended Care for the VA [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4013125 Tue, 28 Sep 2010 17:28:47 +0100 4013125 http://www.medworm.com/index.php?rid=3920784&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F08%2F31%2Fnursing-times-2010-vol-106-no-32%2F This article focuses on a framework as a coordinated plan of care for those in the last 12 months of life identifying key actions to support it’s implementation in primary care. Contact the Library for a copy of this article. Filed under: Journals Tagged: End of Life Care, Gold Standards Framework, Palliative Care, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3920784 Tue, 31 Aug 2010 09:19:51 +0100 3920784 http://www.medworm.com/index.php?rid=3914951&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F30%2Frobert-butlers-legacy%2F Editor’s note: Earlier this summer, on July 7, Robert Butler died of leukemia. Butler was the founding director of the National Institute on Aging, a Pulitzer Prize-winning author, and one of the nation’s leading authorities on aging and geriatrics. With the essay below by Christine Cassel, president and CEO of the American Board of Internal Medicine, Health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3914951 Mon, 30 Aug 2010 19:01:06 +0100 3914951 http://www.medworm.com/index.php?rid=3880818&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FzDY68DCnrsk%2F It's not totally clear what led to the increased survival among patients receiving palliative care alongside standard cancer treatment. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3880818 Wed, 18 Aug 2010 21:29:09 +0100 3880818 http://www.medworm.com/index.php?rid=3827050&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FdaClbshrCAY%2F How might palliative and emergency medicine mix in the frantic setting of the ER? (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3827050 Thu, 05 Aug 2010 13:46:29 +0100 3827050 http://www.medworm.com/index.php?rid=3812949&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FCh4Fbu6woKk%2F If patients or their representatives want a ventricular assist device turned off, should doctors comply? (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3812949 Mon, 02 Aug 2010 22:11:30 +0100 3812949 http://www.medworm.com/index.php?rid=3798522&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F28%2Fend-of-life-savings-the-fools-gold-of-reform%2F Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life.  This is nothing new–the basic proportion has not changed since it was first noted in the 1970s.  Other nations that spend much less on health care nevertheless spend a similar [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3798522 Wed, 28 Jul 2010 20:12:46 +0100 3798522 http://www.medworm.com/index.php?rid=3762902&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-beauty-of-life-and-death-too-easily-forgotten%2F2010.07.17 Yesterday I had a university student shadowing me in the emergency department. AF is a bright student, a hard worker who will make a wonderful physician. She is always curious and insightful when I ask her questions, or show her new things. Today,  she saw something that was new for her, but perhaps too common for me. I walked into the room of an infirm, frail old gentleman who was gracious and polite, as was his family. It turns out he came to us with a terminal illness. I did not know it, but his physician was meeting him. So, as AF and I walked into the room, the patient’s physician walked in after us, and continued a conversation about hospice that he had apparently begun earlier in the day. Realizing I had nothing to add, and would not be needed, I slipped away with my shadow... Better Health blogs http://www.medworm.com/rss/comments.php?id=3762902 Sat, 17 Jul 2010 15:00:09 +0100 3762902 http://www.medworm.com/index.php?rid=3753787&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FRqZbywLiMDM%2F The U.S. was 9th on the quality of death index, primarily because of the high cost of end-of-life care. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3753787 Wed, 14 Jul 2010 22:51:19 +0100 3753787 http://www.medworm.com/index.php?rid=3736995&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F08%2Fpostgraduate-medical-journal-2010-vol-86-no-1014%2F Contents page Fade Fave: Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain Fade Skinny:Examines fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over. Finds that enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Palliateive Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3736995 Thu, 08 Jul 2010 14:32:57 +0100 3736995 http://www.medworm.com/index.php?rid=3736996&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F08%2Fpostgraduate-medical-journal-2010-vol-86-no-1013%2F Contents page Fade Fave: Improving end of life care for nursing home residents: an analysis of hospital mortality and readmission rates Fade Skinny:Considers survival and readmission rates of nursing home patients admitted acutely to general medicine and finds survival rates in nursing home residents admitted to an acute medical unit are low. The article suggests measures to reduce inappropriate admissions and facilitate improved end of life care. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Hospital Admissions, Palliative Care, Residential Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3736996 Thu, 08 Jul 2010 14:28:40 +0100 3736996 http://www.medworm.com/index.php?rid=3678525&cid=t_176958_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-planning-and-care-one-family%25e2%2580%2599s-devotion-and-pain%2F2010.06.19 Esther and I went away last weekend for a much needed break from kids, the normal routine, and pets that can wake us up when daylight arrives here in the Pacific Northwest at 5am. We stayed at a quaint bed and breakfast called “The Blue Goose” in the small town of Coupeville, Washington, on Whidbey Island northwest of Seattle. It was restful and, with great sunny weather, rejuvenating. At a bed and breakfast, of course, you typically chat with other people over coffee, egg soufflé, and bran muffins. The experience can be tiresome and too chatty. But sometimes it can be riveting. It was the latter the other morning as we chatted with Diane about health matters and she shared her pain about two episodes in her life. (more…) *This blog post was originally published... Better Health blogs http://www.medworm.com/rss/comments.php?id=3678525 Sat, 19 Jun 2010 22:00:03 +0100 3678525 http://www.medworm.com/index.php?rid=3658919&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F14%2Fnursing-times-2010-vol-106-no-21%2F This article calls for all healthcare professionals to be trained in care of the dying as part of an organisations mandatory training programme. It further discusses the use of the Liverpool Care Pathway (LCP) as a tool to aid the provision of good quality care in the final days or hours of life. Please contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: End of Life Care, Liverpool Care Pathway, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3658919 Mon, 14 Jun 2010 11:05:21 +0100 3658919 http://www.medworm.com/index.php?rid=3658920&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F14%2Fnursing-times-2010-vol-106-no-22%2F This article looks at how services must adapt to meet the needs of patients at the end of life. Contact the library for a copy of this article Filed under: Current Awareness, Journals Tagged: Community Services, End of Life Care, Palliative Care, Patient Choice, Place of Care, Place of Death (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3658920 Mon, 14 Jun 2010 10:17:49 +0100 3658920 http://www.medworm.com/index.php?rid=3640984&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F07%2Fnarrative-matters-a-case-of-medical-homelessness%2F In a Narrative Matters essay in the May issue of Health Affairs, Jack Colwill, a physician, describes his brother-in-law John’s last months and eventual death.  Colwill, also a professor emeritus and former chair of the Department of Family and Community Medicine in the School of Medicine at the University of Missouri–Columbia, explains that the suffering of John and his wife, Jeanne, was needlessly magnified by John’s “medical homelessness”: None of the doctors seeing John ever accepted responsibility for providing and coordinating his overall care. … What John and Jeanne needed was a patient-centered medical home committed to meeting their needs—but they never had one. In reality, John was medically homeless, even though a primary care physician and a pulmonologist had maj... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3640984 Mon, 07 Jun 2010 16:32:29 +0100 3640984 http://www.medworm.com/index.php?rid=3415986&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F29%2Fjournal-of-medical-ethics-2009-vol-36-no-1%2F content page Fade Fave: Rights, respect for dignity and end-of-life care: time for a change in the concept of informed consent Fade Skinny: The current concepts of autonomy, surrogate autonomy and informed consent often lead to futile and expensive care at the ends of life. They may impinge on the dignity of the patient as well as subject society to unwarranted expense. In order to provide affordable healthcare for all, these concepts are in need of modification (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Informed Consent (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3415986 Mon, 29 Mar 2010 11:20:25 +0100 3415986 http://www.medworm.com/index.php?rid=3350250&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F09%2Fshock-me-tube-me-line-me-an-er-doc-reassesses-dnrs%2F In “Shock Me, Tube Me, Line Me,” a Narrative Matters essay in the February 2010 issue of Health Affairs, emergency physician Boris Veysman sets forth his own version of an advance directive and challenges common perceptions about care at the end of life. An excerpted version of Veysman’s essay appears in today’s Washington Post Health and Science section, and it has provoked a vigorous conversation among commenters—just as it did among Health Affairs readers. Veysman recounts the exhilaration he feels after successfully resuscitating an elderly patient, followed by shock when the family appears and informs him that his patient is in the end stages of cancer and has standing “Do Not Resuscitate” and “Do Not Intubate” orders. “I get the story—several failed rounds of ch... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3350250 Tue, 09 Mar 2010 23:13:26 +0100 3350250 http://www.medworm.com/index.php?rid=3231422&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F02%2Fjournal-of-the-american-medical-association-2010-vol-303-no-4%2F  Contents Fade Fave: An 86-year-old women with cardiac cachexia contemplating the end of her life: Review of hospice care Fade Skinny: An 86-year-old women with progressive congestive heart failure and multiple chronic conditions who is experiencing worsening function and quality if life despite maximum medical therapies, seeks advice regarding control over the circumstances of the end of her life by suicide or under hospice care. An NHS Athens password is required to access this article online Filed under: Athens Password, Current Awareness, Journals Tagged: Burden of Care, Chronic Conditions, End of Life Care, Hospices, Suicide (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3231422 Tue, 02 Feb 2010 08:16:47 +0100 3231422 http://www.medworm.com/index.php?rid=3153344&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F05%2Fhealth-affairs-examines-long-term-services-and-support%2F Congress is now debating whether to include in health reform a new program to help people pay for long-term care services and supports. At this propitious time, leading experts explore critical policy issues related to long-term care in a series of articles in the January 2010 edition of Health Affairs. (As of this issue, Health Affairs also moves from a bimonthly to a monthly publication in a substantially redesigned format.) The articles suggest that providing affordable, high-quality long-term care to the elderly and disabled continues to present formidable challenges to policymakers. This issue is funded by the SCAN Foundation and was released at a briefing on January 5 at the National Press Club in Washington, DC. The Community Living Assistance Services and Supports (CLASS) Act is ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3153344 Tue, 05 Jan 2010 17:25:17 +0100 3153344 http://www.medworm.com/index.php?rid=3145946&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F05%2Fhealth-affairs-examines-long-term-services-and-support%2F Congress is now debating whether to include in health reform a new program to help people pay for long-term care services and supports. At this propitious time, leading experts explore critical policy issues related to long-term care in a series of articles in the January 2010 edition of Health Affairs. (As of this issue, Health Affairs also moves from a bimonthly to a monthly publication in a substantially redesigned format.) The articles suggest that providing affordable, high-quality long-term care to the elderly and disabled continues to present formidable challenges to policymakers. This issue is funded by the SCAN Foundation and was released at a briefing on January 5 at the National Press Club in Washington, DC. The Community Living Assistance Services and Supports (CLASS) Act is ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3145946 Tue, 05 Jan 2010 17:25:17 +0100 3145946 http://www.medworm.com/index.php?rid=3129470&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F29%2Finternational-journal-of-palliative-nursing-2009-vol-15-no-12%2F This study aimed to identify the attitudes of community nurses to the care of the dying patient and to examine the factors that influence these attitudes. The study identified that 40% of community nurses held negative attitudes to care of the dying. These attitudes improved with training and education but were not significantly influenced by experience alone. Attitudes were also influenced by levels of support, workload and time constraints. Contact the library for a copy of this article Posted in Current Awareness, Journals Tagged: Community Nursing, Education, End of Life Care, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3129470 Tue, 29 Dec 2009 16:50:52 +0100 3129470 http://www.medworm.com/index.php?rid=3124512&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F28%2Fjan-5-briefing-on-long-term-services-and-supports%2F The January 2010 edition of Health Affairs focuses on long-term services and supports and the challenges of ensuring affordable, high-quality care to people with disabilities, including many of the nation’s aged. The journal has invited key lawmakers and leading experts in aging and health policy to discuss the policies and new approaches needed to address these challenges at a January 5th Health Affairs briefing. WHEN: 8:30 a.m. – 12:30 p.m. Tuesday, January 5, 2010 WHERE: National Press Club [Metro Center] The Ballroom 529 14th St. NW, 13th Floor Washington, DC 20045 RSVP for this event online. Health Affairs will offer live updates from the event on Twitter at #HA_LTC. Among the topics to be addressed: Will Congress adopt the Community Living Assistance Services and Supports (CLASS... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3124512 Mon, 28 Dec 2009 15:38:14 +0100 3124512 http://www.medworm.com/index.php?rid=3079309&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F10%2Fis-more-care-better-the-evidence-suggests-no%2F Editor’s Note: In the post below, Jonathan Skinner and Shannon Brownlee examine the relationship between health care spending and utilization in hospitals, on the one hand, and patient outcomes on the other. In an earlier post, John Wennberg and Brownlee rebutted claims that spending and utilization variations among academic medical centers are due to differences in patient income, race, and health status.  Many Health Affairs articles and Health Affairs Blog posts have addressed the relationship between spending/utilization and quality. For a sampling, go here, here, here, here, and here. Is more care better? Three decades of research at Dartmouth suggests that on average the answer is no. Now a newer paper, published in the journal Circulation, Cadiovascular Quality and Outcom... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3079309 Thu, 10 Dec 2009 21:18:41 +0100 3079309 http://www.medworm.com/index.php?rid=3048062&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F02%2Finternational-journal-of-palliative-care-nursing-2009-vol-15-no-11%2F Fade Fave: The role of the home-care worker in palliative and end-of-life care in the community setting: a literature review. Fade Skinny: Home-care workers play a vital role in enabling people to be cared for in their own homes. However, there is a lack of research on their role, especially in the areas of palliative and end-of-life care. A broad literature search was undertaken to explore the role of the home-care worker in palliative and end-of-life care in the community. Many positive aspects to the role were found such as providing physical and social support, however some studies highlight negative aspects including limited availability of services, lack of continuity of care, time constraints, lack of flexibility and poor quality and communication with other services. Contact the Li... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3048062 Wed, 02 Dec 2009 10:16:39 +0100 3048062 http://www.medworm.com/index.php?rid=3023245&cid=t_176958_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2F2X_SQvwxqog%2F2009-engage-with-grace-thanksgiving.html Last year Paul Levy, Matthew Holt and Alexandra Drane asked me to participate in the Engage With Grace Thanksgiving Blog Rally. My post last year describes the Engage with Grace project and tells my personal story of why end of life care is important for all of us to discuss with our family and loved ones.Along with my friends and health blogging colleagues, Paul, Matthew, Alexandra, Adam Bosworth, Christian Sinclair, Drew Rosielle, e-Patient Dave deBronkart, Jessica Lipnack, Ted Eytan and many others - we ask that you to take time to talk to your loved ones over this holiday weekend about these important end of life questions and carry out your wishes by executing a living will and medical power of attorney.How else can you participate in the Engage With Grace Thanksgiving Blog Rally?If y... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3023245 Tue, 24 Nov 2009 14:31:54 +0100 3023245 http://www.medworm.com/index.php?rid=2882975&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F12%2Fbritish-journal-of-healthcare-assistants-2009-vol-3-no-10%2F This article looks at the common core competencies that have been identified by the Department of Health as a requirement for workers in delivering high-quality end of life care along with their future development. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: End of Life Care, Palliative Care, Skills Development, Strategy (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2882975 Mon, 12 Oct 2009 12:41:07 +0100 2882975 http://www.medworm.com/index.php?rid=2800327&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F16%2Fhigh-quality-low-cost-care-an-interview-with-gundersen-lutheran-ceo-jeff-thompson%2F Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in America.” The conference was organized by four nationally noted health care improvement experts: Don Berwick, Elliott Fisher, Atul Gawande, and Mark McClellan. But that is only part of what has grabbed national headlines for this community that borders on the Mississippi River in Northwest Wisconsin.  La Crosse has become embroiled in a national controversy over end-of-life planning that has swirled around the health-care reform debate.�... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2800327 Wed, 16 Sep 2009 17:42:47 +0100 2800327 http://www.medworm.com/index.php?rid=2774593&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F07%2Ffact-or-fiction-advance-care-planning-in-health-reform%2F Patients with serious or advanced illnesses would be given more control over their care by language in health reform legislation passed by three House committees that would pay physicians, nurse practitioners, and other providers for counseling Medicare beneficiaries about advance planning for future care decisions. That was the unanimous opinion expressed by three respected geriatricians at a August 20 conference intended to clarify several issues at the heart of the current health reform debate. The conference, Fact vs. Fiction: Key Issues in Health Reform, was sponsored by Health Affairs. The participants in the panel dealing with end of life issues were Christine Cassel, MD, President, American Board of Internal Medicine; Diane E. Meier, MD, Director, Center to Advance Palliative Care,... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2774593 Mon, 07 Sep 2009 20:12:05 +0100 2774593 http://www.medworm.com/index.php?rid=2765990&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FNAOpbdagkm8%2F Attention has been paid previously to La Crosse, Wis., and the work done there urging patients to focus on their end-of-life care while they are still healthy. But the Washington Post today, under the headline “The Unwitting Birthplace of the ‘Death Panel’ Myth,” takes a detailed look at what started in La Crosse resulted in controversy for health-overhaul efforts. After starting to push local attention to end-of-life issues as far back as the mid-1980s, La Crosse’s Gundersen Lutheran Health System more recently set out to change the federal rules to reward end-of-life planning, the paper notes. It continues: The hospital got its wish this spring when House Democrats inserted that provision into their health-care reform bill — only to see former Alaska governor Sarah P... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2765990 Fri, 04 Sep 2009 16:15:47 +0100 2765990 http://www.medworm.com/index.php?rid=2751893&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FUwz91YZC8uo%2F Having a physician’s help in dying will be declared a constitutional right in Montana if the state’s Supreme Court upholds a December lower court ruling, according to the New York Times. The state would be the first in the nation to declare it as a constitutional right, though Washington and Oregon also allow physician-assisted suicide. Montana’s constitution, which declares “the dignity of the human being is inviolable,” has already led the courts to decide, for instance, that anti-sodomy laws are a violation of privacy and to protect women’s right to choose abortion. At issue in the current case is the right of individuals to make their own decision about when they have suffered enough — the so-called right to die well — versus a variety of... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2751893 Tue, 01 Sep 2009 12:26:32 +0100 2751893 http://www.medworm.com/index.php?rid=2751839&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F01%2Finternational-journal-of-palliative-care-nursing-2009-vol-15-no-8%2F Fade Fave: Core attitudes of professionals in palliative care: A qualitative study Fade Skinny: ‘Core attitude’ describes the way in which a person perceives himself and the world, and forms the basis for his actions and thoughts. The aim of this article is to explore what core attitude means for palliative care professionals and whether there is a specific core attitude in palliative care. Contact the library for a copy of this article. Posted in Current Awareness, Journals Tagged: Attitudes, Core Attitude, End of Life Care, Palliative Care, Professionals, Qualitative (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2751839 Tue, 01 Sep 2009 11:29:40 +0100 2751839 http://www.medworm.com/index.php?rid=2741367&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F08%2F27%2Fhealth-affairs-briefing-fact-versus-fiction-in-health-reform%2F What exactly is the U.S. government’s role in health care and how might it change under health reform? What are the implications of slowing the rate of growth in Medicare spending and what would the impact be on beneficiaries? How do the issues involved in end-of-life care really look to the people and providers who live it? These issues were discussed at a Health Affairs briefing titled “Fact Versus Fiction: Key Issues in Health Reform,” held August 20 at the National Press Club. Video and audio of the briefing and speaker presentations are available on the Health Affairs Web site, as is a special Health Policy Brief examining the issues discussed at the briefing. Copyright © 2009 Health Affairs Blog. This Feed is for personal non-commercial use only. All material... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2741367 Thu, 27 Aug 2009 17:11:44 +0100 2741367 http://www.medworm.com/index.php?rid=2715934&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F08%2F19%2Fhealth-affairs-briefing-to-be-covered-on-twitter%2F Tomorrow’s Health Affairs briefing, “Fact Versus Fiction: Key Issues In Health Reform,” will be covered live on Twitter. Posts from Health Affairs deputy editor Sarah Dine will appear in real time on the Twitter “channel” #healthreform with important points and content from the event. You can follow the discussion on Twitter by searching on “#healthreform.” If you have a Twitter account, you can join the discussion and post to the channel by appending “#healthreform” to your messages. If you don’t have a Twitter account, you can register for one here. Copyright © 2009 Health Affairs Blog. This Feed is for personal non-commercial use only. All material published on Health Affairs blog, excluding links, is covered under a Creative Commons Attri... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2715934 Wed, 19 Aug 2009 15:34:48 +0100 2715934 http://www.medworm.com/index.php?rid=2712082&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fyamxk3mbWKw%2F There’s been lots of political talk lately about end-of-life care. But whatever your political leanings, an advance directive can be a good way to plan ahead and get the kind of medical care you want. The WSJ’s Melinda Beck this morning gives us the most recent information. Among the highlights: There are two main types of directives. A living will explains what kind of life support you’d want in various situations. And a health-care durable power of attorney or health-care proxy allows you to appoint someone to make decisions for you if you are unable to do so. Forms often include brief options about hypothetical care situations, such as being put on a ventilator. Some also allow you to state that you want life support to be started but then stopped if it’s not do... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2712082 Tue, 18 Aug 2009 14:01:25 +0100 2712082 http://www.medworm.com/index.php?rid=2705111&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F17%2Fend-of-life-care-2009-vol-3-no-3%2F Fade Fave: End of Life Care Competencies for nurses and health and social care staff working in the community, care homes and hospitals Fade Skinny: This competency document has been developed by St. Christopher’s Hospice, London, in response to and guided by, the End of Life Care Strategy (DOH 2008) It focuses on the specific competencies required to give consistent care across care settings to those at the very end of life. Contact the library for a copy of this article Posted in Current Awareness, Journals Tagged: Competencies, End of Life Care, Nurses, Social Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2705111 Mon, 17 Aug 2009 09:08:51 +0100 2705111 http://www.medworm.com/index.php?rid=2705119&cid=t_176958_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F08%2F16%2Fhealth-affairs-briefing-on-key-issues-in-health-reform-fact-versus-fiction%2F Reforming the way health care is paid for and delivered in the United States is serious business. It deserves an equally serious discussion rising above partisanship and hot air.  Join Health Affairs, the nation’s leading health policy journal, for a special conference on Key Issues in Health Reform: Fact vs. Fiction. WHEN: Thursday August 20, 2009 – 8:30 am to 12:00 pm WHERE: National Press Club, Washington DC TOPICS TO BE DISCUSSED: What exactly is the U.S. government’s role in health care and how might it change under health reform? What are the implications of slowing the rate of growth in Medicare spending and what would the impact be on beneficiaries? End of Life Health Care: How the issues really look to the people and providers who live it. SPEAKERS TO INCLUDE:  Welcomin... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2705119 Mon, 17 Aug 2009 02:47:58 +0100 2705119 http://www.medworm.com/index.php?rid=2699545&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F14%2Fbritish-journal-of-healthcare-assistants-2009-vol-3-no-8%2F Title: End of life care of a patient: a case study Skinny: This short article covers a patient’s last 48 hours of life including a case study and management of all symptoms expected during the terminal phase. Describes some of the issues faced by dying people and the challenges this presents to healthcare assistants (HCAs). The case study regards a 74-year-old man diagnosed with Lung Cancer and bone metastases being treated under the Liverpool Care Pathway (LCP). (Print subscription available in Fade Library) Posted in Cancer, Care Pathways, End of Life, Journals, Lung Cancer, Quality of Life Tagged: Bone Metastases, Cancer, Care Pathways, Case Studies, End of Life Care, Healthcare Assistants, Liverpool Care Pathway, Lung Cancer, Palliative Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2699545 Fri, 14 Aug 2009 10:21:44 +0100 2699545 http://www.medworm.com/index.php?rid=2699574&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPyn1daqpY3Q%2F Ezekiel Emanuel, an oncologist who is advising the White House on health care, has become a target for those arguing that the Democrats’ health care plans would lead to withholding care for the sick and the elderly. Emanuel has written extensively on bioethics and end-of-life care, and this morning’s WSJ notes that parts of some of his articles — particularly one from 1996, discussing which medical services should be guaranteed — have provided fuel for opponents of President Obama’s health-care agenda. One article that hasn’t come up much is a piece he wrote in 1997, for the WSJ’s op-ed page. We’ve pulled it out of the archive, and you can read it in full if you’re a WSJ.com subscriber. That piece ran just before the Supreme Court heard... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2699574 Thu, 13 Aug 2009 13:10:11 +0100 2699574 http://www.medworm.com/index.php?rid=2699575&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPpzG3UmBHOE%2F Doctors don’t get paid for discussing end-of-life care with Medicare patients. That’s true whether the patient wants heroic measures taken to extend life in the hospital, or hospice care in the home. So, this morning’s WSJ notes, many doctors supported a provision in the big House health-care bill that would have paid physicians for talking to patients who chose to have discussions with their doctors about end-of-life care. But the outcry over the provision, amid assertions that a government “death panel” would decide whether patients live or die, has prompted the all-important Senate Finance Committee to exclude such a provision from their bill, the WSJ reports. That’s a disappointment to the AMA. “We were delighted to see this in the legislation... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2699575 Thu, 13 Aug 2009 13:09:45 +0100 2699575 http://www.medworm.com/index.php?rid=2691462&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FlXOUVncW1I0%2F Sarah Palin made headlines when she used the phrase “death panel” in a statement on the national health-care debate. That was just the latest in what’s become an ongoing series of comments that may spring from a provision in one of the big health bills introduced this year. (Read it for yourself on p. 424 of the bill.) But the provision has nothing to do with “death panels” or euthanasia, Johnny Isakson, a Republican Senator from Georgia, tells the Washington Post. “How someone could take an end of life directive or a living will as that is nuts,” he said. “You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up.” As the Associated Press reports, the provision would ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2691462 Tue, 11 Aug 2009 15:42:18 +0100 2691462 http://www.medworm.com/index.php?rid=2572906&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F05%2Finternational-journal-of-palliative-care-nursing-2009-vol-15-no-6%2F This article describes specific skin changes not previously featured in the literature in four patients at end of life with malignancy, and discusses the potential use of this as a prognostic indicator. Contact the Library for a copy of this article Posted in Current Awareness, Journals Tagged: End of Life Care, Palliative Care, Palliative Treatment, Prognosis, Skin Changes (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2572906 Sun, 05 Jul 2009 20:11:51 +0100 2572906 http://www.medworm.com/index.php?rid=2570331&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F04%2Fnursing-times-2009-vol-105-no-25%2F This articles discusses the launch of 2 major end of life care documents, New core competencies and Principles for working with adults at the end of life. Contact the Library for a copy of this article Posted in Current Awareness, Journals Tagged: End of Life Care, Guidelines, Palliative Care, Patient Choice, Primary Care, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2570331 Sat, 04 Jul 2009 13:28:57 +0100 2570331 http://www.medworm.com/index.php?rid=2441191&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FoM-7RNMbwcc%2F Not only is it tough to think about what kind of care you would want at the end of your life; it can be difficult even to imagine what the circumstances might be like. Yet it’s important to consider these things while we’re healthy, so we can decide how we want to be cared for if we become too sick to speak up for ourselves. A group of researchers in Boston tested the effects of showing adults age 65 and older a video of a woman with advanced dementia — a loss of cognitive function so severe that it often leaves people unable to speak or walk. You can watch the video here and make a pretty good guess at what the researchers found. Compared with people who heard only a verbal explanation, those who watched the video were more likely to say that they wanted only comfort car... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2441191 Fri, 29 May 2009 12:41:35 +0100 2441191 http://www.medworm.com/index.php?rid=2404958&cid=t_176958_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F05%2F14%2F3499%2F House of Commons Public Accounts Committee (2009) End of life care: Nineteenth report of session 2008-09: Report together with formal minutes and written and oral evidence recommends: 60% of people die in hospital despite expressed wishes to die at home.  PCTs and SHAs should work with the Department of Health (DH) End of Life Team to meet the needs of patients with SHAs being provided with detailed plans from PCTs on meeting increased need for community care. Pain management must be improved and patients treated with dignity and respect.  PCTs commissioning services must ensure staff in service they commission have appropriate and sufficient training. Communication between health and social services staff must improve to meet the expressed desires of those receiveing end of life care... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2404958 Thu, 14 May 2009 07:22:17 +0100 2404958 http://www.medworm.com/index.php?rid=2021960&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F5k_crDhZXfg%2F Montana residents have a constitutional right to doctor-assisted suicide — at least until the state judge’s opinion is appealed. Montana’s attorney general plans to take the case to a higher court. The judge ruled late Friday that the Montana state constitution’s protections for human dignity and individual privacy permit competent, terminally-ill Montana residents to get medications causing a peaceful death. Dorothy McCarter’s decision wasn’t a surprise. “I mean, we put our pets to sleep when they’re suffering and that’s considered humane,” she said during the trial. “And yet, if we want to do it to our loved ones, it’s considered murder.” (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2021960 Tue, 09 Dec 2008 11:57:42 +0100 2021960 http://www.medworm.com/index.php?rid=1991909&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPgPLJ8cyOFg%2F Engage with Grace (Click to enlarge) We’re all going to die. The least we can do — for ourselves, and for those who may be charged with making decisions on our behalf — is be clear about how we’d like to be cared for in our final days. That’s the idea behind Engage With Grace, a project designed to get people to talk about end-of-life issues. The basic idea is to put the key stuff on a single slide (shown at right), to keep things simple and make it easier to talk about a subject that’s often taboo. As this morning’s Boston Globe reports, the project was launched by the sister-in-law of a young mother who died of a brain tumor. And it’s been picked up lately by the health-care blogosphere, led by a few New England health care execs. Paul Lev... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=1991909 Thu, 27 Nov 2008 13:25:41 +0100 1991909 http://www.medworm.com/index.php?rid=1990603&cid=t_176958_114_f&fid=34646&url=http%3A%2F%2Fengagewithgrace.org%2Fcontent%2Ftheoneslide.ppt Last month I had the opportunity to watch Alexandra Drane announce the Engage With Grace: The One Slide Project at the Health 2.0 Conference in San Francisco. The idea behind the project is to get people to share just ONE slide that helps them and their loved ones talk about having a purposeful end-of-life experience.Alexandra's talk personally touched me because my family went through a similar experience 30 years ago when I was 12 years old. My mother died at home with cancer in 1978. She had the opportunity to die at home surrounded by her 5 children because both my dad and uncle were her doctors. In the past and today, not all families are given this important choice. The memories I have of my mother's final days 30 years ago are still important to me today. As a health care lawyer who... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1990603 Wed, 26 Nov 2008 22:50:28 +0100 1990603 http://www.medworm.com/index.php?rid=1992524&cid=t_176958_118_f&fid=36984&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHealthManagementRx%2F%7E3%2F466505634%2Fthankful-for-life-talk-with-your-family.html Blogger's Note: Please. Talk with your family, friends, advocates, and caregivers about end of life choices. Do you have an advanced directive? A living will? This is *not* the kind of thing you want to leave til the last minute (literally). Live well. Engage with grace. From the Engage with Grace team: We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die... Health Management Rx blogs http://www.medworm.com/rss/comments.php?id=1992524 Wed, 26 Nov 2008 18:25:00 +0100 1992524 http://www.medworm.com/index.php?rid=1990548&cid=t_176958_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F11%2Fnhs-meltdown-insufficient-training-in.html The NHS is collapsing from top to bottom. Now, we learn that its medical personnel have insufficient training in end of life care. From the story: Many terminally ill patients who want to die at home are being needlessly admitted to hospital, a public spending watchdog said on Wednesday. It said the majority of National Health Service doctors and nurses lack training in end-of-life care.The National Audit Office (NAO) said in a report that up to three quarters of people near the end of their lives had expressed a preference to die at home. But it said a lack of support services meant that many people died in hospital when there was no clinical reason for them to be there. "Dying people are often not being treated with the dignity and respect they deserve and their wishes are often disregar... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=1990548 Wed, 26 Nov 2008 17:20:00 +0100 1990548 http://www.medworm.com/index.php?rid=1939196&cid=t_176958_87_f&fid=35052&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FWomensBioethicsBlog%2F%7E3%2F444913257%2Fobama-election-signals-change-in-stem.html A commentary by friend and colleague Art Caplan in his MSNBC column:'Change' was the horse that Barack Obama's presidential campaign rode to victory. Indeed the 2008 election will be remembered not only for Obama becoming the first African-American president, but also for its impact on core bioethical topics that have long dominated American domestic politics. Divisive issues such as abortion bans failed to gain traction on state ballot initiatives, while newer bioethical concerns that are likely to dominate American politics for years to come, including physician-assisted suicide, emerged.The past eight years of the Bush White House have seen stem cell research and the status of embryos at the center of the moral values debate. Obama's election has brought the fight over embryonic stem ce... Women's Bioethics Blog blogs http://www.medworm.com/rss/comments.php?id=1939196 Fri, 07 Nov 2008 00:26:11 +0100 1939196 http://www.medworm.com/index.php?rid=1930545&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FfJpryLnu8Po%2F Though they haven’t drawn much national attention, health-related issues are on ballots around the country today. We wrote about several last week, and the WSJ’s Melinda Beck writes about another in today’s paper. A recap: Fluoridation is on the ballot in 41 communities in Nebraska, one in New York state, one in Maine and two in Wisconsin. As Beck notes, the CDC says adding tiny quantities of fluoride to drinking water (as a way to strengthen teeth) was one of the 10 most important public health advances of the 20th century. The AMA, WHO and American Dental Association all back fluoridation, but some skeptics still argue it shouldn’t be added to the tap water — hence all those ballot measures. Medical marijuana could be legalized in Michigan, where a ballot me... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=1930545 Tue, 04 Nov 2008 15:20:01 +0100 1930545 http://www.medworm.com/index.php?rid=1924933&cid=t_176958_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F8lRNDTqIPh8%2F Voters in Washington State will decide on Tuesday whether to allow dying patients to get a prescription for medicine to commit suicide. Here’s the complete text of the initiative, known as Measure 1000. The measure would apply to patients who are mentally competent and have a life expectancy of less than six months. Patients would have to request the lethal dose once, then go through a 15-day waiting period, then make the request again both orally and in writing. Two doctors must approve the request, and the patient must be the one to take the dose (it can’t be administered by a doctor). This Seattle Times story gives a more detailed overview of the requirements. Voters support the physician-assisted suicide measure by a margin of 56% to 38%, according to a University of Washi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=1924933 Sat, 01 Nov 2008 13:24:01 +0100 1924933 http://www.medworm.com/index.php?rid=1768781&cid=t_176958_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F09%2Fnurse-seeks-to-act-above-pay-grade-at.html This commentary by a nurse Ph.D published in Nursing Center is very disturbing. Judith Schwartz suggests that hospice nurses inform patients about methods to legally end their lives where assisted suicide is illegal. Schwartz discusses the patient with intractable symptoms who seeks hastened death. From the column:In 1994 the American Nurses Association (ANA) confirmed that nurses shouldn't "[make] the means of suicide ([such as] providing pills or a weapon) available to a patient with knowledge of the patient's intention." But the ANA did not include taking appropriate palliative measures in its definition of assisted suicide. Nurses who care for terminally ill patients must be encouraged to inform patients who ask about all legally and ethically sound palliative options, including those ... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=1768781 Fri, 05 Sep 2008 16:51:00 +0100 1768781 http://www.medworm.com/index.php?rid=1376666&cid=t_176958_114_f&fid=34646&url=http%3A%2F%2Fhealthcarebloglaw.blogspot.com%2F2008%2F04%2Fnational-healthcare-decisions-day-april.html Today (April 16, 2008) is “National Healthcare Decisions Day”, a collaborative effort of national, state and community organizations committed to ensuring that all adults with decision-making capacity in the United States have the information and opportunity to properly communicate and document their healthcare decisions.My law partner, Sam Fox, who serves on the West Virginia State Bar's Law & Medicine Committee sent out an email a few weeks ago asking lawyers in West Virginia to participate in promoting this important initiative. To do my part I thought I would blog some information.Frist, check out the resources page on the NHDD website for more information on advanced directives and advanced care planning.Second, for more information on West Virginia advanced directives go to t... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1376666 Wed, 16 Apr 2008 14:40:00 +0100 1376666 http://www.medworm.com/index.php?rid=1353905&cid=t_176958_114_f&fid=34646&url=http%3A%2F%2Fhealthcarebloglaw.blogspot.com%2F2008%2F04%2Fdartmouth-atlas-health-care-stats-on.html The WSJ Health Blog posts (WSJ article, More Choices Drive Cost of Health Care) interesting statistics on end of life care costs according to the latest Dartmouth Atlas of Health Care edition (due out today).The report shows:. . . that the cost of individual medical services isn’t the big driver of Medicare spending, at least for chronically ill patients in their last two years. It’s the intensity of care, such as the number of specialist visits and days in the ICU. . .According to the map graphic West Virginia comes in low in the "below $37,500" category showing the average Medicare Spending during the last two years of life for chronically ill patients.As the costs of our health care system increase over the coming years we will likely see an increased focus on looking at the end of ... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1353905 Mon, 07 Apr 2008 14:39:00 +0100 1353905 http://www.medworm.com/index.php?rid=985816&cid=t_176958_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F28%2Fmore-sick-children-are-dying-at-home-at-that-is-a-good-thing.html by Pat SalberIt is always unbearably sad to learn about a child's death.  But for families with children living with complex chronic conditions, such as progressive neuromuscular diseases or cancer, it is something they must be prepared to deal with.   The miracles of modern medicine simply cannot cure every serious childhood illness.  Given that, what do we know about where these children die?  A recent study, led by Chris Feudtner, MD, PhD, MPH and colleagues, published in JAMA (June 27, 2007) documented that increasingly these children are dying at home instead of in the hospital - and I believe that is a good thing, allowing both the child and loved ones the comfort and privacy we all want to have at the end of life.  Advances in techno... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=985816 Sun, 28 Oct 2007 18:56:32 +0100 985816 http://www.medworm.com/index.php?rid=745536&cid=t_176958_87_f&fid=35052&url=http%3A%2F%2Fwomensbioethics.blogspot.com%2F2007%2F07%2Fbiopolitics-at-bedside-proxy-wars-and.html (Source: Women's Bioethics Blog) Women's Bioethics Blog blogs http://www.medworm.com/rss/comments.php?id=745536 Fri, 20 Jul 2007 02:00:00 +0100 745536 http://www.medworm.com/index.php?rid=536851&cid=t_176958_87_f&fid=35052&url=http%3A%2F%2Fwomensbioethics.blogspot.com%2F2007%2F04%2Ftexas-futile-care-law.html There is a case going on in Texas right now dealing with the Texas Futile Care Law. The bill, signed in 1999 by then Governor George W. Bush, allows hospitals to end life-sustaining treatment to patients whose medical treatment is declared "medically futile." Read the entire law here: Texas Statutes Health & Safety Code, Chapter 166. Advance Directives (specifically Section 166.046)From the Washington Post: Since Dec. 28, baby Emilio Gonzales has spent his days in a pediatric intensive care unit, mostly asleep from the powerful drugs he is administered, and breathing with the help of a respirator. Children's Hospital here declared his case hopeless last month and gave his mother 10 days, as legally required, to find another facility to take the baby. That deadline, extended once alread... Women's Bioethics Blog blogs http://www.medworm.com/rss/comments.php?id=536851 Wed, 11 Apr 2007 14:41:00 +0100 536851