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Home Health, Palliative Care, Hospice: What's the Difference and Who Needs Them?

PREPARED PATIENT BLOG | October 6, 2014 | Janet Bollig

I recently spoke with a gentleman with a significant illness whose main goal is to stay home. He decided to utilize our skilled home health services and home medical equipment. Over time, he transitioned into our palliative care program and currently is in our hospice program. Here is information on what these services are and who may benefit from them...

Seeing the Government's Star Ratings Is One Thing, Believing Them Is Another

PREPARED PATIENT BLOG | September 9, 2014 | Trudy Lieberman

Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare and Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. It turns out, though, that five-star nursing homes may not be delivering five-star quality...

Getting Bumped to First Class Health Care

PREPARED PATIENT BLOG | September 4, 2014 | Lawrence LeMoal

I am writing this post while seated comfortably in a motorized leather recliner with a window view and lots of other perks. What a legacy we would leave Saskatchewan citizens if we could figure out how to extend this first-class patient care to all patients and their families wrestling with chronic disease...

An Advantage for Medicare Patients or Just for Health Plans?

PREPARED PATIENT BLOG | August 20, 2014 | Trudy Lieberman

That the government overpays sellers of Medicare Advantage plans is well known in Beltway circles, even if much of the public remains unaware…

Early Palliative Care Cuts Costs for Critically Ill Patients

HBNS STORY | July 10, 2014

Palliative care delivered early during hospitalization can help cut costs for critically ill patients, finds a new study in Health Services Research.

What Would Mom Want?

PREPARED PATIENT BLOG | June 23, 2014 | Michael Wasserman

We've watched it many times on television or in a movie: The patient lies in the intensive care unit, gravely ill, with the family at the bedside. The doctor walks into the room and asks, "What do you want us to do?" and opens up a huge can of worms that is, in fact, ethically incorrect. The first priority that a physician has is to their patient...

Not So Easy to Stop Care When the Patient Is a Loved One

PREPARED PATIENT BLOG | June 16, 2014 | Margaret Polaneczky

To those of us who have had a loved one succumb to cancer, who had to negotiate the frightening choice between the rock and the hard place, always holding out hope for another round of chemo...we know that reining in health care costs will mean more than just raising co-pays and lowering drug costs and funding more effective interventions. It will also mean quashing hope. And learning to tell ourselves the truth...

Pulling the Plug on DNR Orders

PREPARED PATIENT BLOG | June 2, 2014 | Muriel Gillick

Recently, a friend commented that she was not sure whether or not to agree to a DNR order for her 90-year-old mother. Complicating her decision was the knowledge that her mother had chosen a DNR status when she was cognitively intact, but then reversed her decision at the time of acute illness, believing that DNR meant she would not receive vigorous medical treatment. This is incorrect, and physicians are confused as well...

A Better Health System for Frail and Disabled Elders

PREPARED PATIENT BLOG | December 9, 2013 | Ken Covinsky

Let's stop telling the public that exercising and eating blueberries are guarantees for avoiding frailty and disability. Let's start talking about how to maintain our quality of life as we age and inevitably encounter health problems.

How to Help a Young Caregiver

PREPARED PATIENT BLOG | November 4, 2013 | Tarah Knaresboro

I know a young woman who serves as the primary caregiver for her mother. Watching her put everything on hold to take the helm is both inspiring and heartbreaking. With her stamp of approval, here are ten tips for anyone out there trying to support a caregiver.

Expecting Great Beginnings – and Endings

PREPARED PATIENT BLOG | September 23, 2013 | Amy Berman

It tickles me to report that I live with incurable cancer and I am expecting. I am expecting that the cancer will take its toll, that I will need to make choices about my health and care, that I will need the support of my family and that I will need resources.

Survival Tips for Family Caregivers

PREPARED PATIENT ARTICLE

If a family member or friend has a serious medical illness or procedure, you may be called on to provide care after your loved one leaves the hospital, emergency room or doctor’s office. Assisting with their health care needs frequently falls on untrained family members or friends.

What Is Palliative Care?

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

Palliative care provides therapies are designed to make patients more comfortable and ease the symptoms of serious illnesses or conditions. Learn more.

Long-Term Care and Long-Term Care Insurance

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

Learn about long-term care and whether you need long-term care insurance.

I Wish I'd Known Earlier...Palliative Care Is Not a Mandate Not to Treat

PREPARED PATIENT BLOG | August 13, 2013 | Stephanie Sugars

When I signed up for palliative care in 2011, I thought I’d made my last medical decisions. In the future I’d take the least-invasive, lowest-cost approach to medical care and forego dramatic, expensive treatments. If only life with advanced cancer were so simple!

Why Everyone Deserves Palliative Care

PREPARED PATIENT BLOG | July 16, 2013 | Richard Besdine

Life is full of surprises, but statisticians tell us that most Americans who make it to age 65 can expect to live to almost 85, and about 1 in 4 will live past 90. Unfortunately, because palliative care is a relatively new specialty, it is often misunderstood by patients, families and even some physicians.

Some Caregivers Find Hiring a Professional Advocate Helps

PREPARED PATIENT BLOG | June 25, 2013 | Suzie Mitchell

Not long ago, I was chatting with a friend about my mom, whose life had revolved around work since my dad died 17 years ago. I was worried that my mother might be lonely, but worse, I didn't know how I would care for her at such a distance if she got sick.

“Go-to-Guy for All Things Medical” Tested at Mom’s End-of-Life

PREPARED PATIENT BLOG | March 4, 2013 | Charles Ornstein

My father, sister and I sat in the near-empty Chinese restaurant, picking at our plates, unable to avoid the question that we'd gathered to discuss: When was it time to let Mom die?

Palliative Care: Easier Said than Done

PREPARED PATIENT BLOG | February 1, 2013 | Conversation Continues

If we want our end-of-life wishes to be properly carried out, we have to prepare in advance and our clinicians must also be prepared to help us realize them.

Choosing a Nursing Home

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

Choosing a nursing home for a family member can be a challenging and exhausting process.

Making Plans for Your End-of-Life Health Care

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

It’s important to make your wishes known to your family and doctors regarding treatment at the end-of-life. Here are resources to help you have this conversation.

What Is Hospice?

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

Hospice care can provide extra support for people near the end-of-life and their families. Here’s what you need to know.

Organize Your Health Care

PREPARED PATIENT RESOURCE | Organize Your Health Care

Plan for Your End-of-Life Care

PREPARED PATIENT RESOURCE | Plan for Your End-of-Life Care

Document your wishes to reduce the chance of receiving care not consistent with your values.

Prepared Patient: Advance Directives: Caring for You & Your Family

PREPARED PATIENT BLOG | December 31, 2012 | Health Behavior News Service

Heather Rubesch first remembers talking with her mom, Linda, about end-of-life care as a teenager. "When I was 14, I had an aunt who passed because she did not receive a kidney transplant. As a family, we had that conversation-if something happened to one of us, organ donation was what we wanted to do," said Rubesch, 37, a business and marketing writer from Kansas City, Mo. Decades later, when Heather got the call from the hospital, informing her of her mother's terminal condition, she was shocked to discover she was expected to make immediate decisions about her mother's end-of-life care.

My Mother's End-of-Life Discussion That Changed How She Died

PREPARED PATIENT BLOG | August 21, 2012 | Leana Wen

I am a physician. The hardest thing I've ever had to do was to end my mother's life. She was diagnosed with breast cancer at the age of 47. After a seven-year battle that involved multiple surgeries and countless rounds of chemotherapy, she decided that she had fought long enough.

People with Few Assets Less Likely to Plan for End-of-Life Health Care

HBNS STORY | August 16, 2012

Socioeconomic status is a big predictor of how likely people are to have living wills, a power of attorney for health care decisions or to participate in informal discussions about treatment preferences with loved ones. People with few assets were half as likely as those of more means to plan for these end-of-life concerns, a new study in the Journal of Health and Social Behavior finds.

A Physician's Perspective on Shifting to Palliative Care: Help Us Change our Pace

PREPARED PATIENT BLOG | June 20, 2012 | Jessie Gruman

Last week's essay, Shifting to Palliative Care: Help Us Change our Pace, provoked the following commentary from my friend and colleague, James Cooper -- to which I responded.

Shifting to Palliative Care: Help Us Change our Pace

PREPARED PATIENT BLOG | June 13, 2012 | Jessie Gruman

It is easy to understand why the medical machine the clinicians, the tests and assorted medical procedures is poised to provide constant often heroic interventions to save and prolong life.

Guest Blog: The End of Life Horror Show: We Can Do Better

PREPARED PATIENT BLOG | June 12, 2012 | Chris Langston

Recently, New York Magazine published an agonizing first person cover story by Michael Wolff, 'A Life Worth Ending,' about the terrible choices and harsh reality of illness at the end of his mother's life. The summary slug for the piece says it all: 'The era of medical miracles has created a new phase of aging, as far from living as it is from dying. A son's plea to let his mother go.'

Advance Directives: Rarely Easy, Always Important

PREPARED PATIENT BLOG | April 10, 2012 | Inside Health Care

Three essays discuss the critical importance of advance directives'even when implementing them is tricky.

Four Perfect Questions

PREPARED PATIENT BLOG | April 9, 2012 | Elaine Waples

I remember when my father-in-law passed away nine years ago. A nervous young doctor had the uncomfortable task of telling him that nothing more could be done about his leukemia and it was perhaps time for hospice.

1st Person: Hospice, My Husband and Me

PREPARED PATIENT BLOG | December 26, 2011 | First Person

As Jerome Rafferty, diagnosed with a progressive form of dementia and an incurable, antibiotic-resistant infection, became more ill, his wife, Renata Rafferty, used hospice services at home initially to assist her in caring for him.

Prepared Patient: Hospice Care: What Is It, Anyway?

PREPARED PATIENT BLOG | December 26, 2011 | Health Behavior News Service

Three a.m. can be a lonely time for caregivers. But when Renata Rafferty's husband Jerome struggled to breathe late one night, she knew she wasn't completely alone. Though it was the middle of the night when Renata called, the on-call nurse at their hospice responded immediately: arranging medical equipment and a nurse to check on Jerome. Now, months after Jerome's death, Renata says hospice 'is not the place you go to die, it's the place you go to celebrate and finish your life, in an environment where that is the sole and only focus.'

A Visa for the Dying: Travels to Another Country

PREPARED PATIENT BLOG | November 21, 2011 | Janice Lynch Schuster

People who are dying have much living to do, whether it is measured out in days, weeks or months, and the demarcation lines between the living and the dying might as well be drawn in pencil. But the truth is that it's important to talk about dying and what it means to each of us.

The Costs of Long-Term Care

PREPARED PATIENT BLOG | November 14, 2011 | Conversation Continues

Does long-term care insurance have a future? In this roundup, Nancy Folbre, Don Taylor, and Trudy Lieberman offer their forecasts and perspectives on its costs.

Think Silver Not Pink for Breast Cancer Awareness Month

PREPARED PATIENT BLOG | November 1, 2011 | Amy Berman

Because cancer is primarily a disease of aging, we shouldn't be thinking pink for Breast Cancer Awareness month'we should be thinking silver.

Health Reform's First Casualty

PREPARED PATIENT BLOG | October 27, 2011 | Trudy Lieberman

The Obama administration has dealt a mighty blow to one part of the health reform law by effectively killing off the CLASS Act, which was to be a baby step in the development of a national program to pay for long-term care.

Benefits of End-of-Life Planning

PREPARED PATIENT BLOG | October 7, 2011 | Conversation Continues

Two new studies have found there are numerous benefits when people discuss their end-of-life preferences with their clinicians and caregivers.

Patients with Implanted Cardiac Devices Should Learn about End-of-Life Options

HBNS STORY | October 4, 2011

An implanted device meant to correct heart rhythm may generate repeated painful shocks during a patient’s final hours, at a time when the natural process of dying often affects the heart’s rhythm.

Guest Blog: Can the Blind Lead the Seeing?

PREPARED PATIENT BLOG | August 1, 2011 | Amy Berman

Many of you know that eight months ago I was diagnosed with Stage IV inflammatory breast cancer, which has spread to my spine. My incurable diagnosis means that I live with a chronic disease, just like millions of older adults.

Easing Distress in Caregivers of Dying Patients

HBNS STORY | June 14, 2011

Interventions can buffer caregivers of terminally ill patients from the significant stresses they face in providing care to a loved one, a new Cochrane review finds.

Guest Blog: Making Hard Decisions Easier

PREPARED PATIENT BLOG | June 13, 2011 | Amy Berman

Shortly after I was diagnosed with inflammatory breast cancer a scan showed a hot spot on my lower spine. Was it the spread of cancer? My oncologist scheduled a bone biopsy at my hospital, Maimonides Medical Center, in order for us to find out.

Few Studies Delve Into Hospice Care in Nursing Homes

HBNS STORY | March 17, 2011

A new evidence review finds scant high-quality research on the best ways for nursing homes hoping to ease the suffering of older patients through hospice care. Still, the studies suggest that strategies such as teams of specialists and partnerships between nursing homes and hospice care services are essential.

Prepared Patient: Hospice Care: What Is It, Anyway?

PREPARED PATIENT BLOG | March 10, 2011 | Health Behavior News Service

Three a.m. can be a lonely time for caregivers. But when Renata Rafferty's husband Jerome struggled to breathe late one night, she knew she wasn't completely alone. Though it was the middle of the night when Renata called, the on-call nurse at their hospice responded immediately: arranging medical equipment and a nurse to check on Jerome. Now, months after Jerome's death, Renata says hospice 'is not the place you go to die, it's the place you go to celebrate and finish your life, in an environment where that is the sole and only focus.'

1st Person: Hospice, My Husband and Me

PREPARED PATIENT BLOG | March 10, 2011 | First Person

As Jerome Rafferty, diagnosed with a progressive form of dementia and an incurable, antibiotic-resistant infection, became more ill, his wife, Renata Rafferty, used hospice services at home initially to assist her in caring for him.

Hospice Care: What Is It, Anyway?

PREPARED PATIENT ARTICLE

It's often hard for patients and their loved ones to acknowledge that the time to consider hospice care has come, but through the ups and downs of emotions and physical status, hospice team members are prepared to help patients and their families with sensitivity and flexibility.

I'm Dying To Know

PREPARED PATIENT BLOG | February 24, 2011 | Amy Berman

In some ways, I consider myself lucky. I know this is a strange comment from someone diagnosed with Stage IV breast cancer. I say this, though, because the first steps on my journey with end-stage cancer were undertaken with the help of a team of health care professionals who excelled not only in medicine, but also in communication.|

Can Good Care Produce Bad Health?

PREPARED PATIENT BLOG | February 15, 2011 | Amy Berman

For those of you who haven't yet heard, I have recently been diagnosed with Stage IV inflammatory breast cancer. This rare form of breast cancer is known for its rapid spread. True to form, it has metastasized to my spine. This means my time is limited. As a nurse, I knew it from the moment I saw a reddened spot on my breast and recognized it for what it was.

Prepared Patient: Advance Directives: Caring for You & Your Family

PREPARED PATIENT BLOG | January 3, 2011 | Health Behavior News Service

Heather Rubesch first remembers talking with her mom, Linda, about end-of-life care as a teenager. "When I was 14, I had an aunt who passed because she did not receive a kidney transplant. As a family, we had that conversation-if something happened to one of us, organ donation was what we wanted to do," said Rubesch, 37, a business and marketing writer from Kansas City, Mo. Decades later, when Heather got the call from the hospital, informing her of her mother's terminal condition, she was shocked to discover she was expected to make immediate decisions about her mother's end-of-life care.

Why Ask if You Won't Help Me

PREPARED PATIENT BLOG | July 28, 2010 | Dorothy Jeffress

In a recent iHealthBeat post, Steve Findlay talks about a provision in the new meaningful use rules for health information technology issued by DHSS. Findlay noted that nothing seems to have moved the needle on people completing advance directives. He expressed hope that this can now be rectified if hospitals embrace the optional (menu set) meaningful use objective that promotes recording the existence of an advance directive in a person's EHR. It's a start.

Advance Directives Evolve to Ensure Better End-of-Life Planning

HBNS STORY | June 17, 2010

About Death and Taxes

PREPARED PATIENT BLOG | April 16, 2010 | Dorothy Jeffress

Today is National Healthcare Decisions Day (NHDD)a day devoted to recognizing the importance of expressing your choices about your health care through advance directives, by creating a living will and designating a medical power of attorney.

Advance Directives: Caring for You & Your Family

PREPARED PATIENT ARTICLE

Starting conversations about end-of-life care with family members can be uncomfortable, but are worth having. Putting your wishes about end-of-life care in writing—with documents known as advance directives—can make a big difference in serious health situations.