End of Life, EOLPodcast, Hospice

Ep. 62 October End-of-Month Update – Halloween Edition

 

Dr. Wyatt thanks her newest Patreon.com supporter Tracy Zagata. You can become a supporter as well by going to Patreon.com/eolu and signing up!

Sign up for Death Expo which will take place Nov. 10-13, and hear 12 speakers on EOL issues. Go to DeathExpo.com to register free to tune in to these excellent presentations.

This episode is taking place on Halloween and the Day of the Dead. Dr. Wyatt includes the following updates:

  • CMS report 52% increase in Medicare spending on hospice between 2007 and 2015 due to 38% increase in the number of patients receiving hospice care, primarily patients with dementia
  • the DEA is mandating 34% decrease in opioid production due to dramatic increase in opioid-related deaths since 1999 – rate has quadrupled during that time frame
  • JAMA Oncology reports that the cost of secobarbital, the drug most frequently prescribed in assisted dying cases, has increased by $25oo; there is no explanation except that drug companies can get away with it
  • California is the first state to require that palliative care teams have a chaplain for those patients who want to receive spiritual care
  • Debra Beaulieu writes in HealthLeaders Media that all clinicians should know the following about palliative care: 1) that it’s not just for dying patients 2) that it is often underutilized and 3) all clinicians should have basic palliative care skills
  • Study in J. Palliative Med showed that home-based palliative care (as opposed to hospital-based care) meets more of patients’ needs in the last 3 months of life and costs $12,000 less per patient
  • Controversial “doll therapy” for dementia patients
  • Study shows that 11% of female caregivers over the age of 50 have to leave their employment to fulfill caregiver duties, costing $300,000 in lost wages, benefits, and Social Security over time
  • Census data reveals that currently 25% of seniors are considered “Elder Orphans,” meaning that they have no children or close family to care for them; these numbers will only grow as Baby Boomers age, reinforcing the need for more caregivers
  • Medicare Care Choice Pilot Program is currently underway; patients can receive home-hospice care while continuing curative treatments if they have a diagnosis of cancer, COPD, CHF, or HIV; there are 140 participating hospices in the program
  • Survey shows that 1/2 of MS patients would consider medically assisted dying in the case of unbearable pain, being a financial burden to others, or if unable to enjoy what makes life worth living
  • Study reveals the 69% of MOLST or POLST forms have incomplete information and 14% have conflicting choices, making them nearly impossible for care providers to follow
  • the nation’s first conference on VSED was held in October at the Seattle U. School of Law and was featured in an article in the NY Times. Phyllis Shacter was a speaker – you can hear her EOLU interview in episode 25
  • Conversation Sabbath will take place November 11-20 with >30 congregations from various faiths participating; the focus will be on EOL conversations and theconversationproject.org will provide tools and resources for the event
  • Andrew Henderson, 28 year old performance artist who is terminally ill has created an art performance called Taking it to the Grave and will tattoo the secrets of his audience on his body before he dies
  • Miss Norma, the 90 year old woman who chose to go on a cross-country RV tour with her son and daughter-in-law rather than undergo treatment for cancer, has died

Have a safe and meaningful Day of the Dead! Tune in every Monday for a new episode and support EOLU at Patreon.com/eolu. Until next week remember to:

Face Your Fears.                 BE Ready.                Love Your Life.

 

Aging, End of Life, EOLPodcast, Grief

Ep. 57 September End-of-Month Update and film Extremis

 

In today’s episode Dr. Wyatt thanks 3 new supporters on Patreon.com/eolu:

  • Joan Roellchen-Pfohl, RN
  • Martha Johnson – author of the upcoming book “Take Charge of the Rest of Your Life”; learn more at www.meetmarthajohnson.com
  • Marggie Hatala – author and teacher of a writing class related to end of life; her books are “Sally: A Memoir” and the forthcoming “Life as Prayer”; learn more at www.marggiehatala.com

Next she begins the Update for September by talking about the new documentary film currently streaming on Neflix: Extremis, which won 1st place at the Tribeca Film Festival. Please see this film which takes place in the ICU at Highland Hospital in Oakland and features Dr. Jessica Nutik Zitter. This is a must-see film that brilliantly depicts the conundrum that exists at the end of life when painful decisions must be made. By showing the real-life conversations that take place in the ICU between staff, family members and patients, a case is made for everyone to complete their advance directives and prepare their loved ones to honor their wishes at the end of life. But the painful process of decision-making becomes apparent as each individual struggles with the unknown and the unknowable in these dire situations.

The other topics covered this month include:

  • BMJ Online report that patients who receive hospice care for the last 6 months of life have better pain control, fewer hospital days, and are less likely to die in the hospital or ICU.
  • Researchers at John Hopkins found that their palliative care program led to  savings of ~ $19 million over 5 years in addition to improved quality of care and patient satisfaction.
  • Study originally published in Health Affairs and reported on Reuters online showed gaps in palliative care in the US. Read the article.
  • “What it feels like to die,” an article in The Atlantic discusses the active dying process from the patient’s perspective. Read the article.
  • Friends and Family Letter Project by Dr. VJ Periyakoil at Stanford includes 7 prompts for letter writers to leave messages for their loved ones. Read the article.
  • “7 Songs for a Long Life” documentary from Scotland that depicts how terminally ill patients use singing as therapy. Read the article.
  • The Friendly Atheist Julie Stahl reminds us not to impose our own religious or spiritual beliefs on those who are grieving and may not share your perspective. Read her blog.

Thanks for tuning in to the podcast! I hope you enjoy this information. If you feel inspired to offer a little support go to Patreon.com/eolu to join the community!

Until next week remember:

Face Your Fears.               BE Ready.               Love Your Life!!!

End of Life, EOLPodcast

Ep. 28 Action Steps for Improving End-of-Life Care in Your Community with Karen Wyatt MD

Click here to get the handout for this talk!

Today Dr. Karen Wyatt discusses several “Action Steps” you can take in your own community to help improve end-of-life care. Change begins with the individual and if you want to ensure that your own dying is handled with respect and dignity then you should start now to help implement change. This podcast offers tangible steps you can take–some are easy, some will require a lot more effort–to get your community talking about and making changes in how death and dying are managed. Some of the tips include:

  • Starting a Death Cafe
  • Creating an End-of-Life Book Club
  • Presenting a film series on the end-of-life
  • Volunteering for hospice
  • Teaching a death and dying class
  • Hosting a Death Over Dinner event
  • Facilitating a 5 Wishes workshop

Get the handout for this talk at http://tinyurl.com/eolaction

End of Life, EOLPodcast, Uncategorized

Ep. 16 Getting the Best Care Possible at the End of Life with Ira Byock MD

Dr. Karen Wyatt interviews palliative care physician Dr. Ira Byock about his vision for improving care at the end-of-life.

This interview will focus on:
-Defining the “best care possible” for you and your loved ones
-Why preparation for end-of-life care is important
-How to advocate with your healthcare providers for the quality of care you want