Palliative Care Versus Hospice Care

Insider information on accessing the underutilized gifts available to the public through the healthcare system: Palliative Care and HospiceMost people do not understand what Palliative Care and Hospice actually is, and how it could apply to them when dealing with a family health crisis.  Those who think they understand what it is, are often scared off by the presumption that these are death benefits and change the subject. Either they feel It is too unpleasant to contemplate, or they feel that it would be like giving up on their loved one. But, Palliative Care and Hospice are really quality of life benefits, and not just for the terminally ill patients, but also for the caregivers. Caregivers get access to expert partners who will join with them in providing the best possible support for their loved one.  These underutilized benefits of the health care system, many legally encoded, offer amazing support for those who are in the know. Taking advantage of these perks requires a certain mindset and proper information. By not availing ourselves of these amazing benefits, we are under serving ourselves and our loved one suffering with a serious or life-threatening illness.Palliative Care is easier to accept for most of us because it is a dual path: Using it when seeking a cure for the illness, and also for the best quality of life and symptom management, at the same time.  When To Consider Palliative CareIf you or your loved one has been diagnosed with a serious or life - limiting illness, you may want to consider Palliative Care. The focus of Palliative Care is to relieve the pain and symptoms associated with the illness, while you continue to receive curative treatment for your diagnosis. Its main goal is to provide the best possible quality of life for the patient, regardless of their age, or the stage of the disease. Palliative Care is delivered by a team that typically consists of a clinician (physician or nurse practitioner), a nurse manager, and/or a social worker.  The team may also include a nutritionist, creative arts therapist (music and art) and mental health or spiritual care providers such as a chaplain. These professionals can help lead discussions about the patient's goals of care, while providing support throughout all stages of the disease trajectory.Palliative Care services are billed the same as any specialist-level visit (e.g. cardiology), and most insurance programs cover them, possibly with a co-pay. They may be offered in addition to - and not instead of -  a primary care physician's services. Nowadays, most urban hospitals have a Palliative Care department, although it may not be widely advertised, and patients may have to specifically ask for a consultation. Patients can receive care anywhere they call home, including hospitals, nursing homes, outpatient clinics, or in your or your loved ones home.Palliative Care Information Act of 2011 In New York, the Palliative Care Information Act was passed into law in February 2011 to ensure that patients are fully informed of the options available to them when faced with a life-limiting or terminal illness. Health care practitioners are required to offer seriously ill patients information and counseling about Palliative Care and end-of-life options, including prognosis, range of options appropriate for this patient, risks and benefits of the various options, and the patient's legal right to comprehensive pain and symptom management at the end of life. If the patient is no longer competent to have these conversations, they must be held with the patient's health care agent (surrogate). Of course, not every patient wishes to hear this information from their physician, and they have the right to refuse it. And not every physician or nurse practitioner feels equipped to have these serious conversations. In the latter case, the healthcare provider must arrange for another qualified physician or Nurse Practitioner to hold them. What is Hospice? Hospice, also known as comfort care, is for patients who have made the personal decision to no longer pursue curative treatment for an illness. Instead, they have decided to focus on quality of life and time with family and friends. The decision to seek hospice care is an important one. If you or a loved one has been diagnosed with a terminal illness, there may come a time when efforts to cure or even slow the illness are no longer working and become debilitating rather than helpful. If that time comes, you might want to consider the benefits of hospice care. Patients usually transition to hospice care when they have decided to stop curative or aggressive treatments. "Hospice" focuses on comfort, not curing, respecting the fundamental principle that each of us has the right to live pain-free and die without suffering, and with dignity.   Who Qualifies For Hospice Any person, at any age, can receive hospice care if the following criteria are met: 1.  A licensed physician would not be surprised if this patient were no longer alive in six months if the disease runs its usual course, and, 2. The patient agrees to no longer pursue curative treatments.  Hospice Care is a personalized inter-disciplinary, specialist-level of care delivered by a team consisting of a board-certified physician or nurse practitioner, a registered nurse case manager, a social worker, clinical pastoral care providers (chaplains) and volunteers.  The team may also include a licensed creative arts therapist (music and art). Goals of care discussions between the clinical staff, patient and loved ones help form the plan of care and lend support to the patient and the family throughout the course of the disease. Pre- and post- bereavement support is provided and extends to 13 months following a patient's death.  Most hospice care is delivered in the home setting, wherever the patient resides. This may include an apartment, home, nursing home, assisted living facility, etc. If the hospice care is provided at a skilled nursing or assisted living facility, it does not take the place of the facilitys existing staff. The hospice team supplements the facilitys care and coordinates with its clinical teams. Hospice care can also be provided in special units of contracted hospitals and in separate hospice residences.   Who Pays For Care?Medicare, Medicaid, and all insurance programs offer hospice benefits. Many hospice agencies will also take on some patients who are unable to pay for their care through access to their internal foundation, grants or donations.If you would like to learn more about Palliative and Hospice Care, as well as  what is available to you, contact Miryam Rabner at mrabner@MJHS.org.  To good health! About the authorMiryam Rabner, M.Phil., has been a community outreach liaison for MJHS Hospice and Palliative care in the Bronx and Manhattan for the past 16 years.  MJHS is one of the largest not-for-profit health systems in the eastern seaboard region. MJHS provides home care services, hospice and palliative care for adults and children, rehabilitation and nursing care, and the research-based MJHS Institute for Innovation in Palliative Care. Miryam is a guest poster and friend of Senior Care Authority of New York and Southwest Florida. Senior Care Authority of New York and Southwest Florida offers assistance with quality-of-life preparation, planning and care. Contact us to schedule a complimentary consultation to learn more about this and our other services, by emailing info@scanyfl.com 

A simple checklist for making sure your obituary honors and informs.When a loved one has passed away, writing an obituary that honors their life can seem overwhelming. Dont worry - your obituary will honor their life simply by the act of you writing it. You want to celebrate your loved ones life and offer happy and enjoyable memories. You are helping to ease the pain of others simply by telling a story about your loved one.We hope that this checklist will take the stress and pressure off of you and allow you to honor your loved one. Remember, your funeral arranger is an experienced professional and is a valuable resource for writing the obituary.Include basic details about the persons lifeYou dont have to include all of this information, but here are the basics that are often included in an obituary. Choose the elements that are most relevant to your loved one: Age Any familial survivors Education Vocation When the person retired, if relevant Any military affiliations Any volunteer affiliations Include funeral informationFamily and friends often rely on an obituary for information on when and where a persons life will be celebrated, so your obituary will make it very simple for them to get that information (and will save you the hassle of having to answer lots of questions at a time when you would prefer not to be bothered with small details). You can include: Date and time of the funeral Place the funeral is being held Any viewing details Request for donations in lieu of flowers

The thought of public speaking throws many people into a panic. Add to that fear the common discomfort of discussing death, and it's easy to understand why the idea of delivering a eulogy can be disconcerting. If you've been asked to write a eulogy, take heart. This article will help you put your fears in perspective so you can deliver a loving eulogy."Why me?"You were probably asked to deliver a eulogy because of your close relationship to the deceased, and because the family trusts you to honor his or her memory on behalf of family and friends. The family doesn't want to make you feel uncomfortable, foolish or as though your grief is on display. It's an honor they've bestowed upon you. Helping others say goodbye may turn out to be a rewarding experience. Don't worry about making mistakes. A eulogy comes from the heart of the deliverer. I can't see how a mistake could be made as long as it is honest and true."I can't write."Don't let the thought of writing intimidate you. You don't have to be a novelist to move people. Everyone has a story to tell and that's your job as a eulogist. Tell people your story.In the book "A Labor of Love: How to Write a Eulogy," author Garry Schaeffer says a eulogy should convey the feelings and experiences of the person giving the eulogy, and should be written in an informal, conversational tone. Schaeffer dispels the misconceptions that a eulogy should objectively summarize the person's life or speak for all present. Sit down and write from the heart.Eulogists often write about the person's attributes, memories and common times that were shared together. Sometimes they include the deceased's favorite poems, book passages, scripture verses, quotes, expressions, lines from songs or items that were written by the deceased. Whatever is selected, it generally reflects the loved one's lifestyle.These questions should get you thinking: How did you and the deceased become close? Is there a humorous or touching event that represents the essence of your passed loved one? What did you and others love and admire about the deceased? What will you miss most about him or her? Some of the simplest thoughts are deeply touching and easy for those congregated to identify with. For example, "I'll miss her smile," or "I'll never forget the way he crinkled his nose when he laughed," are just as good as "I admired her selflessness.""I can't speak in front of people."It may not be easy, but you can do it. A funeral is one time you'll surely have a kind and empathetic audience. They feel for you and are on your side. You'll only have to speak for five to ten minutes, but your gift will live in the hearts of the deceased's family and friends.If you're worried about choking up or breaking down in the middle of your eulogy, you can take a moment to compose yourself, then carry on, as Schaeffer recommends, or you can have a back up person ready to step in. Give a copy of your eulogy to the minister or funeral director so that person can finish the eulogy if you're unable to continue.Tips Be honest and focus on the person's positive qualities Humor is acceptable if it fits the personality of the deceased. "If you are inclined to be a perfectionist, lower your expectations and just do what you can given the short time-frame and your emotional state," writes Schaeffer in "Labor of Love." Keep it brief. Five to ten minutes is the norm, but it's a good idea to verify that with the minister or funeral director. Leo Saguin recommends interviewing family and friends in his book "How to Write and Deliver a Loving Eulogy." Put the eulogy on paper - at least in outline form. Eulogy or Sharing Time?If you're planning the funeral, you might want to consider "sharing time" as an alternative to a eulogy. In sharing time, the people congregated pass a microphone or take turns standing up to share their thoughts. It's like a lot of mini eulogies and is more spontaneous.Links Offering Examples Mona Simpson, sister to Steve Jobs, delivered a heart wrenching eulogy that was posted in The New York Times on October 30, 2011 - Click here to read it in its entirety. Former British Prime Minister Margaret Thatcher's eulogy for President Ronald Reagan was telecast at his services in 2005 as she remembered her friend. Click here to read it in its entirety. Books Offering Help, Examples and Inspiration Books Offering Help, Examples and Inspiration "The Book of Eulogies: A Collection of Memorial Tributes, Poetry, Essays, and Letters of Condolence" by Phyllis Theroux (editor) "How to Write and Deliver a Loving Eulogy" by Leo Seguin "Final Celebrations: A Guide for Personal and Family Funeral Planning" by Kathleen Sublette and Martin Flagg "In Memoriam: A Practical Guide to Planning a Memorial Service" by Amanda Bennett and Terence B. Foley "My Deepest Sympathies: Meaningful Sentiments for Condolence Notes and Conversations, Plus a Guide to Eulogies" by Florence Isaacs "Remembering Well: Rituals for Celebrating Life and Mourning Death" by Sarah York "Readings for Remembrance: A Collection for Funerals and Memorial Services" by Eleanor C. Munro (introduction) "Remembrances and Celebrations: A Book of Eulogies, Elegies, Letters, and Epitaphs" by Jill Werman Harris (editor)