N.J. hospice experts say patients referrals come too late | Families share stories of caring for terminally ill loved ones | Palliative care helps Toronto women live each day to its fullest
Web Version
April 25, 2012
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill

Top Story
Hospice mentor becomes patient for palliative care physician
Illinois hospice founder Dr. Harry Miller died as a palliative care patient of Dr. Martha Twaddle, for whom he had been a teacher. Caring for a mentor was profoundly humbling, Twaddle said. Miller's family said there was never any question where he would turn for care when the time came. In 1978, Miller helped establish what is now the Midwest Palliative & Hospice CareCenter. Chicago Tribune (tiered subscription model) (4/22)
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The CMO/Medical Director is one of the most important positions in a hospice. The new COPs and proposed reform to the hospice industry are requiring MORE physician involvement than ever before. The physician wields a tremendous amount of influence in terms of quality, service, cost, and compliance. To learn about the topics covered in this course, click here.
Palliative & Hospice Care Update
N.J. hospice experts say patients referrals come too late
New Jersey hospice officials say many residential-care beds are empty because patients are referred to hospice very late in the disease stage, when families no longer can provide care. Some patients and families may not want to accept a condition is terminal, but oncologist Dr. Charles Vialotti said many "very well-meaning, knowledgeable doctors are uncomfortable having that conversation" for fear it will seem as if they are abandoning their patients. The Record (Woodland Park, N.J.) (4/23)
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Patient & Family Perspective
Families share stories of caring for terminally ill loved ones
Wall Street Journal readers reacted to a financial reporter's first-person story about caring for his terminally ill father by sharing their own experiences, covering everything from long-term care insurance and hospice to finances. "I found myself scrambling to contend with many of the same dilemmas and difficulties that I've written about for years when it comes to managing end-of-life issues," reporter Tom Lauricella wrote. The Wall Street Journal (tiered subscription model) (4/21)
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Palliative care helps Toronto women live each day to its fullest
Toronto journalist and nurse Jackie Smith chose palliative care for her advanced breast cancer so she can enjoy living the rest of her life even while she is outspoken about her death. She has accepted palliative treatments to ease symptoms and says she is not interested in fighting the disease and "because of that I'm having a better quality of life." The Toronto Star (4/22)
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Medical Research
Frontotemporal dementia has distinct characteristics
Frontotemporal lobe degeneration accounts for about 3% of dementia in the elderly and differs from Alzheimer's and presenile dementia, according to a study from the Walton Centre for Neurology and Neurosurgery in England. The study in the Archives of Neurology said FTLD patients are more likely than those presenile disease to have memory loss and hippocampal sclerosis and less likely to have atrophy of the frontal and temporal lobes. MedPage Today (free registration) (4/23)
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Tau protein linked to cognitive decline in elderly, study says
High levels of a specific tau protein are needed for the development of dementia in older patients who have amyloid-beta deposition, researchers reported in the Archives of Neurology. In normal elderly patients, amyloid-beta deposition alone is not linked to cognitive decline, and the presence of p-tau "represents a critical link" in the process, according to the researchers. MedPage Today (free registration) (4/23)
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Weightlifting leads to cognitive gains in older women, study finds
Older women with mild cognitive problems who lifted weights performed better on memory tasks compared with a control group that worked only on balance and stretching, a University of British Columbia study found. Researchers reported in the Archives of Internal Medicine that another group of women who did aerobic training gained fitness but achieved no cognitive benefit. MedPage Today (free registration) (4/23)
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Health Policy & Practice
ACO aims to improve care for terminally ill, limit costs
Hospice of Michigan's HOMe unit has finalized a three-year contract to find patients with end-stage illness in the Michigan Pioneer ACO who have less than two years to live and enhance their care. The contract also aims to limit emergency room visits and decrease medical costs in the last year of life. Crain's Detroit Business (subscription required) (4/23), FierceHealthcare (4/24)
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CMS: Health care law will save Medicare $200B through 2016
The Affordable Care Act will save Medicare enrollees $208 billion through 2020 and the federal government $200 billion through 2016, according to data from a CMS actuary report. "In some instances, the private sector is leading to improve the way care is delivered," said Rick Gilfillan, director of the Center for Medicare and Medicaid Innovation. USA Today (4/23)
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Trends & Technology
Hospital EHRs fall short in addressing pneumonia, heart failure
Zynx Health examined data from 79 hospitals and found EHRs at these facilities to be lacking in evidence-based clinical processes. According to the review, only 62% of the hospitals' EHRs feature clinical best practices for cutting readmissions, mortality and overall expenses in congestive heart failure patients, while only 67% have such features for pneumonia care. InformationWeek (4/17)
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Health IT panel addresses clinical quality measures in stage 2 MU
A Health Information Technology Policy Committee work group met Monday to discuss how best to integrate clinical quality measures in the second stage of meaningful use criteria for electronic health records. One option would allow eligible providers to choose 12 out of 125 proposed measures, with at least one standard addressing each of six domains for care improvement. The group will meet again Friday before submitting its final thoughts to the full committee May 4. Modern Healthcare (subscription required) (4/23)
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Society & Ethics
Psychedelic drugs can reduce anxiety of dying, researchers say
Researchers including psychiatrist Charles Grob at Harbor-UCLA Medical Center are renewing efforts to study the efficacy of psychedelic drugs such as psilocybin or MDMA in easing anxieties about dying in patients with terminal illnesses. Grob says the outcome should be therapeutic so patients have "less anxiety, less depression and a greater acceptance of death." The New York Times (tiered subscription model) (4/20)
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Comment on performance measurement for hospice and palliative care
The report by the National Quality Forum Measure Application Partnership on performance measurement for hospice and palliative care is now open for public comment. The comment period will close today at 6 p.m. Eastern Time. This report gives guidance to CMS on the measures to choose when developing required quality measurement reporting for hospices.
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Looking for a new opportunity?
The AAHPM JobMart currently has about 100 postings, including palliative care medical directors, geriatrics physicians, nurse coordinators and faculty positions. Consider posting openings at your organization or search for your next position here.
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All things are difficult before they are easy.
Thomas Fuller,
British churchman and historian
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