It is critical to make volunteering as easy as possible with continued support and resources to make each volunteer feel empowered to make a true difference. Online training is long overdue and ease of independent study will create a new stream of people into the lives of hospice patients.
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Comments About Hospice Volunteer Training Online
Hospice Volunteer Training Online offers a comprehensive view of the history of hospice practice with the fundamental principals of medical, personal, and spiritual care for patients and their families.
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For those for whom a day training program is not an option, the online capability provides an ideal way to complete the training using a home computer.
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The lessons provide a firm knowledge base, and the tests are brief and pertinent. When several trainees complete the series, we bring them into main office to meet a member of each component of the Interdisciplinary Team for a wrap-up session that lasts three to four hours.
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Online training offers an ideal way to initiate hospice training not only for individuals, but for nursing homes and churches. I recommend it highly."
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I am a Volunteer Services Manager in Phoenix Arizona and I have to say that this course far exceeded my expectations! Now that I have completed the course I will submit it to the CEO for approval to use as a portion of the Volunteer Training Program replacing some of the current modules, (which will cut costs for future trainings, save time for the field staff, and hopefully keep those interested.)
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I can't wait to have my volunteers start doing this training themselves. Our organization is in a drastic transition, and I am proud to say that we are having "Growing Pains"!
Your program has been able to help me help my Organization tremendously! I can't wait to write to you later and tell you our success.
Keith Olbermann shares some of the details of his personal experience dealing with difficult medical decisions for his ill father and the importance of talking with loved ones about end-of-life care and the value to Americans of including “life panels” in any health reform solution.
Q What is “hospice”? What does it do and does it cost money?
A Hospice is a specialized form of care for individuals in the last stages of terminal illness. Rooted in the centuries-old tradition of preparing gifts for those embarking on a long journey, hospice care provides physical, emotional and spiritual support for dying individuals and their families. It’s appropriate for people of any age or religious faith and with any terminal illness.
Think of hospice as care that:
• emphasizes the quality of life in the remaining days, weeks or months of a person’s life.
• focuses on the person, not the disease, and also cares for the family.
• provides relief from the physical, emotional and spiritual pain that often accompanies a terminal illness.
Specially trained professionals and volunteers provide hospice service, often to individuals in their homes. But hospice care is also provided in assisted-living programs, nursing homes and other long-term residences. The needs of the patient and family determine the type and frequency of services.
A hospice team includes a doctor, nurse, social worker, spiritual caregiver and sometimes home health aides, therapists and volunteers. The patient’s personal physician can work with the team. However, at the core of the hospice team and the center of all decision-making, is the patient and the family.
In most cases, there is no cost to patients for hospice services. It’s paid for by insurance, Medicare, Medical Assistance and MinnesotaCare.
For more information, visit: www.hospicemn.org, or call 651-659-0423, toll-free 1-800-214-9597.
FROM MICHELE FEDDERLY, DIRECTOR, HOSPICE MINNESOTA
No pressure problem
Q We moved into a 60-year-old house and found that the water pressure is lower than we like. What can be done about it?
A The small-diameter pipes (less than 1 inch) of years ago do not meet water needs today. In addition, galvanized or lead pipes in older plumbing can build up deposits over time that further restrict flow.
The solution is to replace the piping with today’s standard 1-inch copper piping. That can be expensive, but it’s the only real solution. Acid solutions sometimes are used to clear old pipes of sediment, but this method is often unsuccessful and can result in leaks.
Also, check that the water meter hasn’t become clogged or that the city isn’t working on any water lines in your area.
For those looking at homes, remember to check the water pressure before buying. Turn on taps at the highest and lowest points in the house and see whether there’s plenty of pressure. Also, check that the house has copper pipes and are of the appropriate diameter. If not, you’ll want to figure the cost of updating the plumbing into your bid.
Minnesota potatoes
Q Where can I buy Minnesota-grown potatoes?
A Try your grocery store. Just because a bag doesn’t say “Minnesota grown” doesn’t mean the potatoes aren’t from Minnesota. Potatoes packaged as “grown in the USA” actually contain Minnesota potatoes, typically from the Red River Valley. Depending when different crops are ready, they can be a mix of Minnesota, Wisconsin or Iowa potatoes. However, if the bag says Idaho, then you’re buying Idaho potatoes.
Experts say Americans getting too many medical tests, maybe even President Obama – Too much cancer screening, too many heart tests, too many cesarean sections. A spate of recent reports suggests that many Americans are being overtreated. Maybe even President Barack Obama, champion of an overhaul and cost-cutting of the health care system. More
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ARTICLES / General / The Healing Power of Music/ Other Articles
The Healing Power of Music
by Steve Toll and Linda Bareham
What better ?medicine? than a ?treatment? that has only positive side effects and ?therapy? that is actually enjoyable? That is the ?miracle of music? when applied with intention. Music is shown to have the ability to help organize the brain; especially vital to those who are afflicted with Alzheimer?s.
Usually after twenty minutes of music, there are observable effects, such as singing, foot tapping, and clapping. Studies have shown that the results of a musical therapy session last for several hours afterward. Positive results include elevated mood, increased socialization and appetite and reduction in agitation. These benefits are attributed to the stimulation the brain receives during a music therapy session, a sort of ?cognitive workout? inspiring us to coin the phrase, ?What exercise is to the body, music is to the brain.? The power of music often inspires physical movement and can be used in combination to encourage gentle exercise.
As speech, writing and traditional forms of communication are compromised, music provides an alternative means of maintaining a connection, thereby helping to normalize interaction between caregiver and patient. Music used therapeutically creates an environment where the patient can be nurtured and cared for in a way that is safe, gentle and appropriate. Music is central to maintaining human bonds when those with dementia have lost the ability to initiate communication or to respond verbally.
The powers of music when focused and used therapeutically are many. Critical to maintaining quality of life for those with Alzheimer?s is management of emotions and preserving the connection with others. Music is conducive to keeping those connections strong as long as possible while helping the participant to focus, increase awareness and orient to the environment. A number of research studies have looked at music therapy as an important adjunct to medical treatment and findings suggest a possible link between the use of music and slowing the progression of dementia.
From the rhythms of the heartbeat experienced in the womb to the stirring sounds of a marching band, rhythmic patterns and music surround us. Language itself has a musical quality to it and from the beginning of mankind, as expressed through chanting and drumming, resembled music more closely than speech. Music is primal to life and expressed by each of us every day whether through dancing to a favorite tune, keeping rhythm with a pencil or remembering a special time when hearing a forgotten melody. It is central to our lives and is embedded in our culture, defining how we acknowledge milestones, rites of passage and celebrations as well as providing comfort, transformation and inspiration. Music links us to our world and provides a pathway back to our past.
You don?t need to have any special musical training to institute a therapeutic music program. You will need to select appropriate music, however. This music consists of familiar tunes from the 30s, 40s and 50s with more contemporary music included, depending on the preference or age of the participant. Before you invest in any CDs, check in your own home for possible sources of music. Your local library is a good source. Consider individual preferences and select music that is singable and upbeat.
Steve Toll, a professional musician and trainer, and his wife Linda Bareham, a writer and researcher in the area of alternative therapies for seniors with dementia, formed the company Prescription-Music. Mr. Toll is on the Speaker?s Board for the National Alzheimer?s Association and trains professional and family caregivers in the development of music therapy programs where his intent is to spread the word of the healing power of music for those afflicted with Alzheimer?s.
I am pleased and honored to host Palliative Care Grand Rounds for March 2010, highlighting the best of the end-of-life care blogs from February. Although there was an impressive volume of web activity, links and sites to sort through, and tons more great material than I could hope to include here, it has motivated me to dig deeper into this medium. I am not the most prolific of the bloggers who belong to this community, but the inspiration for bigger things now lies at my fingertips.
Good reading — and good inspiration for your own blogging. Let's start with the topic of social media themselves.
The American Academy of Hospice and Palliative Medicine launched a new group blog (www.aahpmblog.org) stirring up interest in its annual meeting in Boston, which starts March 3, 2010. I should also mention that the conference includes a workshop on social media in palliative care communities, with presenters from the Pallimed and GeriPal blog pages — stalwarts of this blogging community — March 5 at 7 am. The Pallimed blog (www.pallimed.org) in February and March offered several features for AAHPM conference novices, variously addressing conference twittering, networking, handy hints for how to "do" a national meeting, how to give a great medical presentation, and information about the Pallimed "street teams" that will be pushing "P" stickers in Boston. I wish I could be there with them.
The Growth House blogging portal has announced (http://growthhouse.typepad.com/les_morgan/2010/02/growth-house-needs-bloggers… that it is looking to add more guest bloggers to ensure that all of the disciplines in hospice and palliative care are represented. Hospice and palliative care professionals that would like to learn more about becoming guest bloggers may call Growth House at 415/863-3045. Growth House President Les Morgan just posted a blog piece about a major international study of national palliative care guidelines and end-of-life care practice statements in BMC Palliative Care. The study concludes that "an integrated model of the best palliative care practice is generally lacking" in the 56 documents analyzed, although that may reflect inevitable issues of context, such as specific cultural settings and patient variables.
Speaking of blogging and other social media, a member of our community, Jerry Soucy, an ICU nurse and grad student who blogs at Death Club for Cuties (http://deathclubforcuties.blogspot.com/), has just completed a comprehensive and occasionally irreverent research paper on blogging as an assignment for nursing grad school, entitled "Bloggers blogging blogs: Who we are, what we're doing, and what happens next." He writes about the assignment at his death club blog and has posted the full paper at a second site. He defines blogging and how it developed in the context of advances in information technology, concluding that "everything is tied to everything else — in multiple ways"; and "blogging is all about self-discovery." The blogger, he explains, is today's equivalent of the writer, publisher, distributor, bookstore/newsstand proprietor, media producer and researcher in one.
Do Everything
In the shadow of the national health care reform imbroglio, end-of-life care, DNR (do not resuscitate) orders, advance directives, when is it appropriate to do "everything" medically possible, and all points in between are getting unprecedented attention and debate. Thaddeus Pope's Medical Futility Blog (http://medicalfutility.blogspot.com) posting, "Not so fast with that DNR order", reviews two new articles taking what seems to be an unconventional approach to DNR orders, extolling "the benefits of proceeding with CPR even against steep odds." Writes Boris Veysman in Health Affairs: "Only after you have made every effort to let me be happy and human, ask me again if my life is worth living." That would seem a reasonable threshhold for making life-and-death decisions, except when you consider the realities of the full press of battle in an ER or ICU.
Both Pope and Lyle Fettig at PalliMed cite the recent, impassioned MSNBC opinion piece by Keith Olbermann about health care reform, "death panels," advance care planning, palliative care and his own father's suffering from advanced illness. Dr. Fettig further analyzes the underlying issues — including the benefits and limitations of advance care planning and advance directives. He also highlights a new journalistic treatment of end-of-life care by Michael Vitez in the Feb. 28 Philadelphia Inquirer. Vitez won a Pulitzer prize in 1997 for a series of articles on this same topic.
Underserved Populations
Francis Shani Parker's Hospice and Nursing Homes Blog (http://hospiceandnursinghomes.blogspot.com) highlights two short films about marginalized populations at the end of life. The first is a six-minute video from an unfinished documentary, "Prison Terminal," by Edgar A. Barens, portraying the "Sail to Serenity" hospice volunteer program at Iowa State Penitentiary. Except for captions, the film is wordless, although the faces of dying patients and volunteers, many of them lifers, and visiting family members, are eloquent.
The second is "Gen Silent," a Stu Maddox film about homophobia in nursing homes, long-term care and assisted living. Vulnerable Lesbian-Gay-Bisexual-Transgender elders, quite understandably, may feel compelled to return to the closet when they need long-term care, simply to survive in LGBT-hostile environments. This results in even more alienation and isolation than other LTC residents experience. Hospice Foundation of America's Hospice and Caregiving Blog (http://hfahospice.blogspot.com/) also cites the Maddox film but offers examples of positive advances such as a Massachusetts nursing home specifically for LGBT elders and a specialized LGBT bereavement support group offered by a Connecticut hospice.
HFA's blog also pointed me to a Milwaukee Courier article by Clarene Mitchell, community liaison for VITAS Innovative Hospice Care, listing 10 prominent African Americans who received hospice care. A fascinating article in the Wichita Falls Times Record News describes how Hospice of Wichita Falls is attempting to improve its outreach to culturally diverse communities by working with Elaine Magruder of Volunteers International. Magruder spent 15 years trying to organize hospice services and a national hospice organization in Vietnam, where today palliative care is offered in every hospital. "Now we realize we can bring the lessons we learned there back to the U.S. to help hospice services reach a much more diverse community,” she says.
Other Caregiving Perspectives
Through our near neighbors at the EldercareABC Blog Carnival, I found Tom Bill's In-Law Suite (http://in-lawsuite.com), a blog about how the author's family used a residential, in-law apartment built into the garage to bring his elderly mother-in-law into their home to get the contact and attention she needed without sacrificing the family's privacy. A recent post addresses signs, symptoms and care for depression in the elderly. It offers a down-to-earth discussion of this woefully underrecognized symptom of chronic illness, its causes, how to deal with it, how to help, and when to seek professional assistance.
Debra Bradley Ruder's Goodbyes Blog at Growth House (http://growthhouse.typepad.com/goodbyes/) tells a simple story she heard from the locksmith at Dana-Farber Cancer Institute about an unforgettable encounter he had with a patient, who "taught me not to take life for granted."
Angela Morrow's Palliative Care blog (http://dying.about.com) talks about "nearing death awareness" in patients who report seeing dead loved ones or predict the time of their own death — and how to make sense of this phenomenon, which is commonly reported in hospice.
At GeriPal, nurse practitioner Patrice Villars offers a call for hospice reform, with nurse practitioners leading the way. Villars was a hospice nurse for eight years before getting her NP degree, and thinks NPs can be the "middle children" and bridge to better symptom management in hospice care, with their advanced training in medical diagnostics and treatment giving them the ability to think in terms of diferential diagnoses, like a physician, while retaining the holistic philosophy of a nurse. "Surprisingly, NPs do not play a pivotal role in most community hospice agencies," she notes. But I wonder how many HPM-specialized NPs are out there today, ready to fill that pivotal role in America's 4,000+ hospices.
Scanning Google Reader led me to two articles about dementia by Frena Gray-Davidson, who tries to describe what it might be like to have dementia, based on her years as a long-term Alzheimer's caregiver. At her blog, Soul of Dementia, she teaches the realities of dementia and "the art and psychology of understanding what is not lost" in patients who have dementia. She is also a seminar presenter and author of the book, "Alzheimer's 911: Hope, Help and Healing for Caregivers."
Widows' Stories
I was really touched by two searingly honest, ongoing multi-part blog conversations by young widows with young children, both of them trying to make sense of where fate has taken them. In Fresh Widow (http://freshwidow.blogspot.com) the blogger Supa Dupa Fresh has written a "where you came from" series dedicated to her six-year-old daughter, Short Stack, entitled "Your Birth Story," although knowing that her husband Gavin will die from cancer 30 months after the birth casts a deep shadow across the whole series:
It poignantly conveys to me (who hasn't had the experience) the chaos and crazy thinking of childbirth from inside the maelstrom. After what seemed like endless labor, Supa Dupa Fresh writes, she exhaled for five counts and "Whoosh!! My daughter zoomed out like a torpedo." Later, the daughter is "a little rosy burrito, packaged in the hospital's neutral striped blanket."
At Widow Wise (http://widowwise.blogspot.com), Gretchen Olchawa talks about how she and her husband Kevin painstakingly discussed and then decided to pursue in vitro fertilization following his first round of treatment for rectal cancer and during his three-year struggle with the disease, in "The Great IVF Debate" Parts 1-4. The latest posted on Feb. 26. "Most people get that permanence thing when they have a child. I think it becomes more profound when… death is actually residing in the house."
I didn't set out to do a comprehensive survey of young widowhood, although I personally know a wonderful young woman whose vibrant husband lost his life in a climbing accident just months after their wedding in Yosemite Park. We often hear about the parallels between birthing and dying, but these blogs really bring that lofty sentiment down to earth. I also want to cite Crash Course Widow (http://crashcoursewidow.blogspot.com) who was 27 in 2005 when her husband crashed a bicycle into a pole and died instantly. Her posting on Valentine's Day for 2010 includes cute pictures of her husband and daughter from Valentine's Day 2005, shortly before something changed everything for them.
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You can be so hungry for good information that the best is often overlooked. I hope everyone involved in hospice and palliative care has time to contribute to the growth house blog – information is our most effective tool.
The Aid and Attendance (A&A) Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an assisting living facility also qualifies.
To qualify for A&A it needs to be established by your physician that you require daily assistance by others to dress, undress, bathing, cooking, eating, taking on or off of prosthetics, leave home etc. You DO NOT have to require assistance with all of these. There simply needs to be adequate medical evidence that you cannot function completely on your own.
The A&A Pension can provide up to $1,632 per month to a veteran, $1,055 per month to a surviving spouse, or $1,949 per month to a couple*.
Eligibility must be proven by filing the proper Veterans Application for Pension or Compensation. (Form 21-534 surviving spouse) (Form 21-526 Veteran.) This application will require a copy of DD-214 (see below for more information) or separation papers, Medical Evaluation from a physician, current medical issues, net worth limitations, and net income, along with out-of-pocket Medical Expenses.
A DD-214 is issued to military members upon separation from active service. DD-214s were issued to separated service members beginning in the 1950’s. The term “DD-214″ is often used generically to mean “separation papers” or “discharge papers”, no matter what form number was used to document active duty military service. If the VA has a copy of a DD-214, it is usually because the veteran attached a copy (or sometimes, the original) to his or her application for disability or education benefits. If you’ve lost your original DD-214 or a copy and you are receiving (or applied for in the past) disability or education benefits from the VA, they may have a copy (or the original, if you gave it to them) on file. At the very least, if you are currently receiving benefits (or did in the past), they should be able to provide a Statement of Service, which can be used instead of a “DD-214″.
NHF is committed to compassionate care at the end of life. We suppport the National Hospice and Palliative Care Organization’s quality and research initiatives; hospice/palliative care provider education activities; consumer engagement and caregiver services; and global hospice partnerships. Donations Go To… National Hospice Foundation A 501(c)(3) nonprofit Positions 1. Everyone should have access to quality care at the of life. 2. Hospice care helps people live life fully, even at the end of life. http://apps.facebook.com/causes/90298
Part 4 of 12. The simplification of living near the time of dying. Stan Goldberg, author of LESSONS FOR THE LIVING: STORIES OF FORGIVENESS, GRATITUDE, AND COURAGE AT THE END OF LIFE
