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National Journal Features A Discussion Today On

Well, the title may sound incomplete and that's because it is actually incomplete.

A National Journal  event today, supported by the Regence Foundation Living Well At the End of Life can be viewed here.

The event is introduced as "the first in what we think is a ground breaking series of three events and polls around  palliative care."
Initial thoughts:
  • Amazing! We all need to talk more about palliative care to ensure more people can be empowered to ask for it from the point of a diagnosis with a serious illness.
  • Wait! Why is the event titled Living Well At the End of Life?
I wrote about the important distinction between palliative care and end-of-life care in November here and thought some main points should be highlighted again.

  • Palliative Care is not limited to care at the end of life
  • It is appropriate to try for a cure while having integrative palliative care
  • The hope is to include Palliative Care Specialists to manage pain and symptoms and facilitate patient-centered decision making and care at every part of a patient's experience with serious illness
Why is this important to distinguish? 

Mostly because while hospice care specializes in care at the end of life,  is different from palliative care because to start hospice,  (under the Hospice Medicare Benefit) a patient has to stop curative treatments. 
  • Hospice specializes in, and is exclusively for end-of-life care 
While the possibility of receiving care at home is a large benefit for hospice patients receiving care at the end of life, it is absolutely critical to understand that while hospice clinicians are trained in and often specialize in palliative care, hospice has differences from palliative care. As physician and Executive Director of the Center to Advance Palliative Care, Diane Meier recently stated in the PBS Video, Care vs. Cure "People can get palliative care whether they have ten years to live, ten months to live, ten weeks to live. In that there's no requirement that you have to give anything up in order to access it."

These are all important aspects to distinguish, so why is this on the NHDD blog and why didn't we have a complete title to this blog post?

This is featured on the NHDD blog because often advance care planning is described as decisions for end of life.  Just as palliative care is helpful to patients and families receiving end of life care, it is not exclusive to when we experience serious illness. So, while advance care planning does address healthcare decisions for end-of-life care, it's important to distinguish that the decisions are best addressed initially as we enter adulthood which Nathan Kottkamp discusses  here in a post about the history of NHDD.

Lastly, the title of the post... well, I couldn't decide if this was about hospice, palliative care or advance care planning. It's really about all of it, and since I only made it to minute 1:32 on National Journal  event, I realize that all of these distinguishing factors may be discussed even though I hadn't made it that far into the video stream. So the title's incomplete because it's all about the conversation, right? Hopefully our community can watch the session from today and continue to talk about all of these important factors.

As we say on Twitter,  Have The Talk early to advocate for patient-centered care,  healthcare focused on patient and family goals.




So Medicare won't cover Advance Care Planning, now what?

CENTENNIAL, CO - DECEMBER 06:  Seniors attend ...Image by Getty Images via @daylifeAs many of you know advance care planning (ACP) has been in the news a lot lately. Last summer voluntary physician reimbursement for ACP was mis-characterized as leading towards 'death panels.' At the end of 2010 it looked as if some reimbursement for physicians would be made available on a voluntary basis to do advance care planning for people covered by Medicare. But then as soon as it was made available, whoosh! it was no longer there. Now the reasons why it was here and gone again are ripe for political pundits to debate, but what does it mean for you?

Regardless of your political affiliation, most people can agree that you should have a very strong voice in making your health care decisions. And those decisions can cover a number of areas including organ donation status, resuscitation status, and importantly what you would like to happen if you could no longer make complex medical decisions. This is where having the conversation with your loved ones is so important. And it is free! After you have the talk then make it legal with any of the free tools on this site.

And if you are feeling particularly strong about these issues, we invite you to donate and join us on National Healthcare Decisions Day to help other people prepare for the time when they need someone else to speak for them.

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