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A statewide resource on end-of-life issues                                                        UPDATE   
November 18, 2010Volume 4, Number 5                  

HomeCCCC In Action

CCCC Annual Conference - Mark Your Calendar!

Make plans to attend CCCC's 3rd Annual Conference, Building a Community of Caring: Working Together to Improve End-of-Life Care, on March 16 in Burbank. Keynote speakers are Joanne Lynn, MD, author of Handbook for Mortals, and David Kessler, a colleague of Elisabeth Kubler-Ross and author of Visions, Trips and Crowded Rooms.

 

Thinking Ahead - For People with Developmental Disabilities

Thinking Ahead workbooks in English will be available once again in December 2010, thanks to a grant from the Special Hope Foundation. Contact CCCC for copies. To find out more about Thinking Ahead, visit the CCCC website for the most current information.  

 

Support CCCC's Work!

For more than a decade, CCCC has brought together people from different backgrounds and disciplines to work to improve end-of-life care in California. To continue our work, we need your financial support. Renew your membership today! Make a donation to help us reach our goals!  Send a check to CCCC, 1331 Garden Highway, Suite 100, Sacramento, CA 95814

 

Federal Public Policy

Medicare and Voluntary Advance Care Planning
CMS announced that effective January 1, 2011, both the first annual wellness visit and subsequent annual wellness visits under Medicare will include voluntary advance care planning. Click here for the entire rule and see pages 766-768 and 1488-1494 for the relevant language.
 


Rule Change to Improve Nursing Home/Hospice Coordination
T
he Centers for Medicare and Medicaid Services (CMS) has released a proposed rule change to improve coordination between hospices and nursing facilities by clarifying each provider's responsibility in caring for nursing home residents. Read and comment on the proposed rule here

 

Obama Proclaims November National Hospice Month
During National Hospice Month, the nation recognizes the dignity hospice care provides to patients who need it most, and the professionals, volunteers, and family members who bring peace to individuals in their final days.

 

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State Legislation

No Changes in Law

While the California legislature considered a couple of bills related to the end of life, including one on hospice facilities and one on after-death care, these bills did not make it to the Governor's desk.


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Resources

New Organization Focuses on End-of-Life Needs of South Asians

Pallium India-USA has formed a group in the San Francisco Bay Area to address end-of-life issues in the South Asian community.  Pallium India-USA is the USA arm of Pallium India, a registered charitable trust in India working to improve access to palliative care.   Volunteers are available for presentations. Contact [email protected] for more information.

 

Atul Gawande Video on Goals of Care

Dr. Gawande, surgeon, author and frequent contributor to the New Yorker Magazine, recently discussed four points for doctors to discuss with terminally-ill patients.  Instead of asking patients to make hard decisions, he emphasized the importance of asking questions about their hopes and fears.  Watch the video here.

 

PBS Show to Explore End-of-Life Decisions

In Facing Death, FRONTLINE visits Mount Sinai Medical Center in New York to look at end-of-life decisions in action.  Watch candid conversations about when to remove a breathing tube in the ICU; when to continue treatment for patients with aggressive blood cancers; when to perform a surgery; and when to call for hospice.  This episode airs on November 23 but can be viewed online now.

 

New Book Compiles JAMA Series on Palliative Care
The JAMA series on palliative care is now available for purchase.  Care at the Close of Life: Evidence and Experience offers evidence-based and clinical expert guidance on caring for patients with life-limiting illness, while incorporating the words and perspectives of affected patients, their families, and treating clinicians.

 

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Clinical

New Trend: Orders for Comfort Feeding
The Clinical Journal of the American Geriatrics Society and the New York Times published articles about comfort feeding as an alternative to feeding tubes for dementia patients who have lost the ability to swallow.  Not only does comfort feeding provide patients with human interaction and intimate contact, it preserves a patient's dignity.  These resources, along with the CCCC Tube Feeding brochure, can help providers discuss this issue with patients and their loved ones.

 

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Research

Hospice Care Key in Lowering End-of-life Care Costs

End-of-life care expenses continue to climb, according to new research from the United States and Canada published in the Archives of Internal Medicine, but increasing hospice services could be a major factor in improving patient care while lowering costs.  Link to the UCLA research here, the Duke research here and the University of Alberta research here.  

 

Racial Impacts on End-of-Life Care

Researchers reported in the Archives of Internal Medicine that African American patients tend to receive life-prolonging measures at the end of life even when they have DNR orders or state a preference for symptom-directed care.

 

Hospice Length of Service Continues to Decrease

The National Hospice and Palliative Care Organization (NHPCO) reports that 34.4% of patients served by hospices in 2009 died or were discharged in seven days or less.  This reflects a very slight decrease from 2008, when 35.4% of patients had a short hospice experience.

 

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Education

ELNEC Train-the-Trainer

Four courses will be provided simultaneously:  ELNEC-Core, Pediatric Palliative Care, Geriatric, and Critical Care.

Sponsors: National ELNEC Project, Palomar Pomerado Health, University of San Diego
Date:        January 13 -14
Location:  San Diego

Visit the ELNEC web site for more information.

 

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Newsletters are available on the CCCC Website (www.CoalitionCCC.org) in PDF format for anyone who is having trouble reading this email version.
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CCCC in Action
Federal Public Policy
State Legislation
Resources
Clinical
Research
Education
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