 The Hospice Cap (32:26) |
| | The "hospice cap" is the maximum average cost per patient that Medicare will reimburse. Does this cap on average treatment costs limit good patient care, or is it just a commonsense financial control? As hospices provide care for a wider range of patients, costs can be more difficult to predict. Medical journalist Larry Beresford discusses the pros and cons of cap issues with Les Morgan of Growth House in this interview that also touches on other aspects of hospice finance. |
| Using "Go Wish" Cards for Advance Care Planning (40:32) |
| | "Go Wish" cards are a simple tool to enable advance care planning conversations. This podcast gives a realistic example of their use, with tips on issues that often come up in such planning. Hospice physician Elizabeth Menkin, M.D., has Les Morgan of Growth House use the cards to discuss his own preferences for end of life care. The "Go Wish" cards are available from the Coda Alliance. |
| Online Social Networking in Health Care (22:18) |
| | Les Morgan of Growth House interviews Val Jones, M.D., on ways doctors and health care consumers are using online social networking services. Topics covered include sites like Twitter, online support groups, the micropractice movement, and benefits of medical blogs to combat misinformation on the internet.
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| Understanding Advance Directive Paperwork (32:02) |
| | In this interview by Les Morgan of Growth House, hospice physician Elizabeth Menkin, M.D., explains the paperwork needed for advance care planning. Forms may include a Durable Power of Attorney for Healthcare (DPOA), Directives to Physicians, and various types of Physician Orders (POs) such as a Physician's Order to Permit Natural Dying (POPND). Forms discussed are available from the Coda Alliance and the Center for Practical Bioethics. |
| Stanley Terman, M.D., on Voluntary Refusal of Food and Fluids (40:07) |
 | In this interview by Les Morgan of Growth House, psychiatrist Stanley Terman, M.D., discusses why some terminally-ill people stop eating and drinking when life is coming to an end. Psychiatric assessment for depression, anorexia nervosa, mental competence, and control needs should be made in these cases. Issues covered include the legality and ethics of this choice, medical effects of dehydration and ketosis, how the family may respond to the patient's decision, assisted feeding of dementia patients, and advance care planning, Dr. Terman's book The Best Way To Say Goodbye covers these issues in detail.
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| Elizabeth Menkin, M.D., On Conflict Over Removal Of Feeding Tubes (27:19) |
| | In this interview by Les Morgan of Growth House, Dr. Elizabeth Menkin explains some of the ways that disputes about removal of feeding tubes can arise, and how to deal with them. Disagreements can arise due to differences in information and assumptions. The interview covers the importance of planning ahead to document your wishes, use of ethics committees and palliative care consultations as tools for resolving conflicts, examples of decisionmaking in end-stage dementia and minimally conscious states, and how to help families sort out values using the innovative "Go Wish Cards" that are available from the Coda Allicance (www.codaalliance.org). Dr. Menkin is a hospice physician with extensive experience in the field. |
| Bill Colby On Tube Feeding (22:07) |
 | In this interview by Les Morgan of Growth House, Bill Colby discusses artificial nutrition and hydration, including feeding tubes and withdrawl of life-sustaining treatments. The segment also covers emotional attitudes about food in caregiving, eating problems in Alzheimer's Disease, effects of dehydration at end of life, voluntary stopping of eating by hospice patients, and positive ways to include food in hospice care. Attorney Bill Colby represented the family of Nancy Cruzan, the only right-to-die case ever to come before the U.S. Supreme Court. His book Long Goodbye covers the Cruzan case in detail. Visit the Center for Practical Bioethics (formerly known as the Midwest Bioethics Center) to download the advance care planning workbook Bill mentions in his interview. Read the Growth House book review.
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| Sacred Passage (Duration: 5:54)
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 | Author Margaret Coberly, a hospice nurse, reads from her book Sacred Passage, on how to provide fearless, compassionate care for the dying from a Buddhist perspective. Check the full Growth House review.
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| Kelly Lockwood: About Music Thanatology (11:30) |
| In an interview done by Les Morgan of Growth House, harpist Kelly Lockwood gives an overview of how music is used in care of the dying. Kelly explains why music has unique value in care, the types of music and chant that are used, how musicians can get involved with hospice care, and her ow? training at the Chalice of Repose project in Missoula, Montana. |
| Dancing on Quicksand: About human dignity |
 | Here's a realistic memoir of what it's like to care for someone with progressive dementia
due to Alzheimer's Disease. The book is told from the point of view of a caretaker
with no prior experience of this sort. Author Marilyn Mitchell reads us this segment
in which she talks about what human dignity really means. To hear more readings from
this book, check the full Growth House
review.
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| Heart-to-Heart: Caring for the Dying |
 | Originally created as three, hour-long audio documentaries for national radio broadcast, this wonderful education resource is now available on CD. It will make a great training tool for hospice volunteers, health care professionals, and anyone else who wants to learn about key issues in end-of-life care in an entertaining, easy-to-absorb format. The series draws from over 80 hours of tape and includes remarkable moments with people
who are facing death, their families and those who are helping them along the journey.
While the stories are personal, the themes are universal as we all struggle to come
to terms with the passing of friends, family members, and ultimately, ourselves. It examines the barriers to good care that arise from cultural misunderstanding, from fear over the use of morphine and other drugs, and from lack of funding to pay for good programs. It provides ideas, examples and inspiration for those who are searching for a good path on the journey to death. "Heart-to-Heart" was produced and directed by Claire Schoen, who has made it possible for us to share some segments of the series with you on Growth House radio. We are playing an excerpt on pain control that helps dispel common myths that many people -- including doctors -- have about pain medications. |
 Joanne Lynn interview by Jacqueline Marcell (15:16) |
| | In an interview done by Jacqueline Marcell for her own internet radio show Coping With Caregiving, Joanne Lynn, M.D., discusses major issues in end-of-life care in the United States, and explains why some parts of the health care system have serious problems in delivering quality care for the dying. Visit the Palliative Care Policy Center. |
| Hospice Veterans Partnership Initiative (10:22) |
| | One in four American? who die each year was a veteran. Learn about a new initiative
of the U. S. Veterans Health Administration to work more closely with community hospice
providers to improve care for veterans. This interview by Les Morgan of Growth house
with Diane Jones of Ethos Consulting
Group also covers new VA directives that require creation of palliative care consulting
teams at all VA facilities. |
|
Bill
Colby on Living Wills (12:16) |
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Is contract law really the best model for planning health care at the end of life? Probably not, as attorney Bill Colby explains in this interview by Les Morgan of Growth House. Bill explains the ups and downs of living wills and power of attorney for health care using feeding tubes as an example of a controversial type of care. Some approaches to advance planning may not get you the results you expect. How detailed should a living will be? Is it best to focus on simply naming someone you trust to make decisions for you? This interview also notes the growing interest in end of life care among persons with a strong interest in right to life issues, and suggests how important it is to discuss your preferences for care with your family, your health care providers, and your pastoral care providers to ensure everyone is on the same wavelength. Bill's book, Long Goodbye, includes a discussion guide that can help you think through these difficult topics.
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Marsha Hurst On Patient Advocates (17:08) |
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Learn how Patient Advocates can help you get the health care you need for yourself
or for someone you love. Advocates work as change agents in many different ways in
the health care industry. This interview by Les Morgan of Growth House with Marsha
Hurst, Director of the Health Advocacy Program at Sarah Lawrence College, concentrates
on how you can make use of Patient Advocates in a hospital setting. It also covers
use of private advocates and how hospitals must adhere to a "Patient Bill of Rights."
Visit www.sarahlawrence.edu/health_advocacy/ for
more information about health advocacy. |
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Jon Fuller interview: The U. S. health care system and chronic care (24:28) |
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In this interview by Les Morgan of Growth House, geriatrician Jon Fuller, M.D., discusses how our health care system, which was designed primarily to provide acute care, often fails those with chronic conditions. Jon offers ideas on how better care could be given at the end of life if we spend our money differently.
You can download this interview as a podcast.
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Jon Keyserling on proposed Bush FY2007 cuts to hospice funding (16:19) |
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In this interview by Les Morgan of Growth House, Jon Keyserling, Vice President of Public Policy and Counsel at the National Hospice and Palliative Care Organization, explains the proposed cuts to hospice funding in President Bush's FY2007 budget.
You can download this interview as a podcast.
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|
Rosemary
Gibson On Medical Errors (26:57) |
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In this
interview by Les Morgan of Growth house, author Rosemary Gibson discusses
how medical mistakes kill 100,000 Americans each year -- equivalent to a 747 plane
crash daily. Rosemary explains the most common types of mistake and gives tips on
how you can avoid becoming a statistic. Special issues for hospice and terminal care
include the importance of watching medications closely and how the hospice interdisciplinary
team may be a good model for how to prevent errors in other health care settings.
Read the Growth House book review. You can download this interview as a podcast.
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|
Uncovering Compassion |
 |
Nina Livingstone is a hospice chaplain. She has recorded several guided meditations specifically intended to help you notice and develop your ability to provide compassionate service. Her non-denominational approach to Uncovering Compassion is well-suited for use by hospice volunteers. Nina also has a series of one-minute tips for caregivers on awareness and self-care recorded for radio use. These radio spots are not on the CD, but you can listen to them here. Nina's brief suggestions can help you take better care of yourself and improve your caregiving at the same time. Listen to Nina's tips on remembering the need for self-care,
naming what you are doing,
using waiting time to refresh you,
listening to others, and
wanting nothing from others
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|
Ethical
Issues in Hospice Care (29:03) |
| |
This interview by Les Morgan of Growth House with ethics consultant JoAnne Reifsnyder
explains how having a structured process for making ethical decisions can help hospice
staff face tough situations that have no easy answers. JoAnne covers common dilemmas
such as telling someone they are dying, tube feeding,
and requests for hastened death. JoAnne also discusses the importance of involving
the whole family in advance care planning to prevent family disputes at the end of
life. For more information about ethical decision processes in hospice care visit
the Ethos Consulting Group web site at www.ethosconsult.com. |
|
True
Ryndes On Hospice Case Management (20:11) |
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In this interview by Les Morgan of Growth house, True Ryndes explains how hospice
case managers protect patient interests across institutional boundaries, improving
continuity of care. True Ryndes is President of the National
Hospice Work Group and co-author of a major study that you can download on "Hospice
Access and Values". |
|
Bill
Colby On Advance Planning (17:26) |
|
Attorney
Bill Colby represented the family of Nancy Cruzan, the only right-to-die case ever
to come before the U.S. Supreme Court. His book Long
Goodbye covers the Cruzan case in detail. In this interview by Les Morgan of Growth
house, Bill explains legal issues in end-of-life care and gives practical advice on
living wills, power of attorney, health care proxies, and other key ideas on how you
can plan ahead for difficult decisions. Visit the Center for Practical Bioethics (formerly known as the Midwest Bioethics Center) to download the advance care planning workbook Bill mentions in his interview. Read the Growth House book
review.
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Christy
Whitney on Paying for Hospice Care (28:50) |
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How will you pay for the care you need at the end of life? Dying can be expensive,
and money worries are very common when someone is seriously sick. In this interview
Les Morgan of Growth House discusses the financial aspects of hospice care with Christy
Whitney, the President and CEO of Hospice
and Palliative Care of Western Colorado. Christy has been a hospice administrator
for over twenty years, and she's an expert on hospice finance. Christy explains that
many supportive benefits are available to you to ease the financial burden. Christy
explains the Medicare hospice benefit, Medicaid programs, sliding-scale services for
the uninsured, and special hospice services that support caregivers at the end of
life such as respite care. Listen in as Christy does a financial benefits analysis
on four sample cases that highlight different scenarios for hospice care.
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Rex Greene on Palliative Care in the Acute Hospital (18:08) |
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The acute care hospital is a bastion of curative technology. In this interview by Les Morgan of Growth House, Rex Greene, M.D., discusses how the palliative care team at Mills-Peninsula Hospital in San Mateo, California, integrates with other hospital services. Rex also explains how his palliative care team partners with local hospice and home care agencies to provide continuity of care across organizational boundaries. His innovative open approach inviting local providers to staff meetings to build strong working relationships across agencies.
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Carol
Barker on TeleHospice (18:38) |
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In this interview by Les Morgan of Growth House, Carol Barker, RN, PhD, explains how telehospice methods
can be used to increase access and improve care quality for home-based clients over
broad geographic areas in a cost-effective manner. A national study on "Hospice
Access and Values" argues that telehospice can play an important role in improving
access to palliative care. In addition to use in individual patient homes, it can
be used in long-term institutional settings such as nursing homes. Carol is Director
of Education and Research at the Hospice
of Michigan, which uses telehospice in both rural and urban settings. Les is an
expert on the use of information systems for end-of-life care. The interview covers
what TeleHospice is, costs and benefits, funding ideas, implementation strategies,
and where hospice telemedicine is going.
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| Advice for hospice workers (1:50) |
| Nancy Jaicks Alexander summarizes twenty years of hospice experience in this two-minute segment of advice for health care professionals and volunteers working with dying people. Nancy was a member of the K�bler-Ross workshop and training staff, helped found the first prison hospice, and speaks from the heart about how to give compassionate care. If you want to contact Nancy, you can write to her at the following address: Compassionate Seeing, P.O. Box 5534, Berkeley, California 94705. |
|
Dealing
With Loss |
 |
Hospice educator Dillon Woods reads
a selection from his audiobook Where Souls Meet on recognizing
change and loss as a gift of life. Also covers the importance of taking care of yourself
when you are a caregiver for others. Check the full
Growth House review.
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