As many of you know, the mumms® Software home office, located in the heart of New Orleans, was hit hard by the devastating hurrican Katrina, but continues to function. Thanks to excellent technical planning, mumms® software and servers continue to provide access to medical data and other services that our customers depend on, even in the wake of such a devastating storm. Be sure to read the full article below for a complete update.
Dispite the tragedy of Hurricane Katrina, there is exciting news this fall, including nine new friends from hospice organizations from all around the country! Additionally, there is a major new update to mumms® PAS, the all new Version 11, several upcoming conferences to meet the mumms® Team, and a variety of articles impacting the hospice community as a whole. We hope you enjoy this issue of grow, and we thank you for your continuing ideas, friendship, and dedication to the mission of hospice.
Be sure to stop by and say hi to us at these upcoming conferences:
We would like to welcome some new hospices that have joined the mumms® Software family in the past few months.
(NEW ORLEANS, LA, Sept. 15) A local company, mumms® Software, which has provided web-based programs from its New Orleans offices to Hospices for the last fifteen years was sorely tested when hurricane Katrina devastated a vast portion of the gulf coast and displaced hundreds of thousands of citizens from three states. Company sources confirmed that their strategically located backup equipment enabled Hospices from all over the country to continue their care for over ten thousand terminally ill patients while this hurricane roared through New Orleans. This specialized software did not falter although many other software providers have continued to be offline ever since the first tidal surges began their destruction. Ultimately many thousands of businesses lost every important electronic record to the storms destructive power and many lost every paper document, all of their patient files, and all of their accounts receivable information. These organizations continue to face an uncertain future without their data and no recovery method will ever be able to replace their lost information.
At the time of the storm, the corporate offices for this company were located in the Arts District in New Orleans, very close to Lee Circle and not far from the Superdome. Although many of its corporate staff members, living in New Orleans, were dramatically affected by this devastating storm, the technical support planning by mumms® ensured that no program was ever off-line. Even at the apex of the storm's fury, mumms® was accessible. After the storm dissipated and the floods ensued mumms® was accessible.
Department of Health and Human Services Secretary Mike Leavitt's office has long held that newly enacted HIPAA compliance regulations require that physical safeguards for protected health information must be implemented to ensure data integrity, confidentiality, and availability. Most companies may have falsely believed that intrusion would be the main threat to their protected health information. Technical support planners for mumms® correctly designed a system with the secure and redundant resources that maintained access to protected health information throughout the fury of this category five hurricane.
Although the physical facility for mumms® software development has been temporarily transferred to a new site in Wake Forest, North Carolina, company managers have vowed to return to the Big Easy as soon as circumstances improve. Mumms® Technical Support offices were already positioned in New Jersey before the storm and development staff at mumms® have relocated to California, Colorado, Texas, and North Carolina where they continue their program development and technical support.
( Alexandria , Va ) Dame Cicely Saunders, OM, DBE, FRCP, FRCN, regarded as the founder of the modern hospice movement and a pioneer in the field of palliative care, died peacefully on July 14, 2005 , at St. Christopher's Hospice in London . She was 87.
The founder of St Christopher's Hospice, she dedicated her life and professional work to alleviating the pain and suffering of the dying. St. Christopher's opened its doors in 1967 and provided a model of care that gave birth to one of the most significant grassroots movement of the late Twentieth Century in the U.S. Cicely Saunders' guiding principle was: To cure sometimes, but to comfort always.
Barbara Monroe, Chief Executive of St Christopher's Hospice, said, Dame Cicely's vision and work has transformed the care of the dying and the practice of medicine in the UK and throughout the world. She is an inspiration to us all. We had been caring for Dame Cicely at St Christopher's Hospice as a patient for some time. We will miss her very much. Her influence will carry on around the world as we work together in hospice and palliative care to support dying people and close to them.
Working as a nurse during World War II, she later became a social worker, and then went on to medical school to become a physician. As a physician, Dame Cicely felt she could make the greatest impact on improving the culture of care for people at the end of life. She emphasized the importance of listening to the patient.
The recipient of numerous awards and honors, she was made a Dame of the British Empire in 1980. In 1987, she was appointed to the Order of Merit by Queen Elizabeth II of the United Kingdom . Limited to only 24 persons, this order is the highest honor the monarch can bestow.
The world is a better place because of Cicely Saunders. Few people can go to their rest having done more to relieve suffering and to advance compassion in the world than Dame Saunders. She was our matriarch and our guiding light, never wavering in her quest to advance care for the dying, said Stephen Connor, Vice President, Access for End-of-Life Care, Research and International Development at the National Hospice and Palliative Care Organization. According to our colleagues at St. Christopher's she died today peacefully in the hospice she founded. No one could be more deserving.
Remarked J. Donald Schumacher, NHPCO President and CEO, Dame Cicely was a true pioneer in our field and through her work has fundamentally changed the care dying people receive throughout the world. Her work has been inspirational to those working on behalf of hospice and palliative care in this country and abroad.
Hospices in the U.S. cared for almost one million patients facing a life-limiting illness last year. Her work improved the end-of-life experience allowing people to die with dignity and compassion and for families to receive much needed support.
NHPCO, the National Hospice Foundation, and the Foundation for Hospices in Sub Saharan Africa extend their deepest sympathies to her family, friends, and colleagues the world over and honor her for her special gifts and contributions that improved the way we live and die.
You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.
- Dame Cicely Saunders
A tribute to Dame Cicely is available on the St. Christopher's Web site, http://www.stchristophers.org.uk/ .
Source: NHPCO News
By Ed Edelson, HealthDay Reporter
TUESDAY, July 12 (HealthDay News) -- Giving straightforward information to elderly people facing death in nursing homes makes them more likely to enter hospices, where they can receive better care in the last days of their life, a new study finds.
Over the last 10, 20, 30 years we have tried all sorts of high-tech and expensive interventions to improve end-of-life care, said Dr. David Casarett, director of the palliative care clinic at the Philadelphia Veterans Affairs Medical Center, who led the study. But if you just get people talking, you get more people into the hospice sooner, and people who have these conversations are more satisfied with the end-of-life care they receive.
The study started with Casarett and his colleagues interviewing nursing home residents or the people who made medical decisions for them, to help identify those who would benefit from entering hospices -- facilities specializing in end-of-life care.
Of the 205 nursing home residents who were so selected, 107 were given an informational visit describing hospice care, and 98 received usual care, according to a report in the July 13 issue of the Journal of the American Medical Association .
One of every five people who got the informational visit entered a hospice within the next 30 days, compared to only one person among those who received usual care.
Eventually, 25 percent of those getting hospice information entered hospices, compared to 6 percent of those who did not.
The people who entered hospices had fewer acute care hospital admissions and spent fewer days in the hospital, the researchers noted. Most important, family members of those who entered hospices rated the quality of end-of-life care higher -- 4.1 on a scale of five, compared to 2.5 for those remaining in nursing homes, the study found.
It's true that many people nearing the end of life may not want to have these discussions for a variety of reasons, Casarett said. On the other hand, many people want to have these discussions but don't know how, he said.
Previous studies have shown that a lot of people are thinking about hospices as something that can help them and are waiting for their physicians to start these discussions, he said.
Doctors and nurses often do have such conversations with patients, but what we are not doing is having these conversations in a systematic way, Casarett. I hope that this study will help change that.
According to background information for the article, At least one in four Americans dies in a nursing home, and considerable evidence indicates that nursing home residents do not receive optimal end-of-life care. Approximately 25 percent of residents with daily cancer pain receive no pain medications, and residents are often transferred to an acute care setting to receive aggressive treatment in the last weeks of life. Families often express dissatisfaction with the end-of-life care their relative receives in nursing homes.
Nursing home residents receiving hospice care are more likely to receive better pain management, have their pain assessed and have lower rates of inappropriate medications and physical restraint use than patients who do not receive hospice care. Despite its benefits, however, only one in every four nursing home residents enrolls in hospice care before death, according to the researchers.
As Americans spend more time in nursing homes near the end of life, it will become increasingly important to emphasize simple, low-cost interventions like this one [hospice care] that can help to ensure that residents and their families have access to the best possible quality of care, the study authors wrote.
Dr. Perry G. Fine is vice president for medical affairs at the National Hospice and Palliative Care Organization, in Alexandria, Va. He said, What this study confirms is that if you institute conversations with people, they will more often choose hospice care. And they will end up far more satisfied than those who don't.
Source: HealthDay
By RAY PREGEANT
WASHINGTON, July 15 (UPI) -- Researchers have determined something that might also have seemed true intuitively: The wealthy in the United States tend to die in more comfort and less pain than their less fortunate brethren.
The researchers, at the University of Michigan in Ann Arbor, write in the upcoming August issue of the Journal of Palliative Care that men and women age 70 or older whose net worth was $70,000 or higher were 30 percent less likely than poorer people to have felt pain often during the year before they died.
The results of the study, comprising 2,604 men and women who died between 1993 and 2000, remain stable across factors such as race, gender, ethnicity, education and diagnosis, the researchers said.
The results were obtained from questionnaires that were a part of the Health and Retirement Study conducted by the university's Institute of Social Research and funded by the National Institute of Aging. The researchers asked participants questions about the amount of pain and suffering they were experiencing.
Dr. Maria Silveira, lead researcher and assistant professor at the University of Michigan Medical School, said the study is the first to link wealth and dying in comfort.
Wealth is a strong predictor (of comfort level), Silveira told United Press International.
She said the results establish a need in the United States to focus more on hospice and palliative care, home care and end-of-life care -- particularly in relation to cost of treatments.
Newer medications (and treatment) are easier to obtain by patients who can pay more out of pocket, Silveira said. Society will have to demand better coverage.
That means, she said, palliative hospice care, which is granted only by Medicare to lower income individuals who have six months' life expectancy, should be made available to anyone who needs it.
Hospice has been shown to relieve suffering, Silveira said. Medicare only covers $110 to $120 a day (for hospice). Even then, hospice care will not cover costs of everything.
Val J. Halamandaris, president of the National Association of Home Care and Hospice in Washington, who also was involved in the first hearing on death and dying by the Senate Committee on Aging in 1971, said he thinks expanded Medicare coverage would create an equality among socioeconomic classes of comfort level leading to the time of death.
Nothing has changed much regarding policy on death and dying since 1983, Halamandaris told UPI, but things have changed ... people are living longer (and) disparities between the rich and poor need to be addressed.
As the average life expectancy increases for everyone in the United States -- to 77.5 years, up from 75.8 years in 1995, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention in Atlanta -- society must accommodate the effects of cutting-edge healthcare technologies and widespread comprehensive social-care programs that cater to the terminally ill and dying.
Recently, doctors at the Mayo Clinic in Jacksonville, Fla., completed the first pancreas transplant -- considered a tremendous step forward for treatment of diabetes, a leading cause of death, according to the latest data from the NCHS.
Americans, and western society in particular, have this death-defying attitude. Halamandaris said. The questions (in policy) since the beginning have been on extending life ... I believe it should be taken from a more natural standpoint.
He said he thinks future policy debates on death and on life extension will continue for many years.
Terry Schiavo was the beginning, Halamandaris said, referring to the recent case that generated national headlines about the young woman, presumed brain-dead, whose death was hastened by a court order. That case should be considered the opening gun in a war that will last a while.
Ray Pregeant is an intern for UPI Science News. E-mail: sciencemail@upi.com
Source: Sciencedaily
A Newsweek article entitled A Dream Before Dying shares about the power of dreams for people close to death. In Dreaming Beyond Death , Chaplain Patricia Bulkley says that many dying persons have extraordinary dreams in their last days and weeks, but all too often, caregivers dismiss them as delusional or unworthy of attention. Bulkley discussed dreams with patients at California 's Hospice of Marin and co-authored the book of her experiences along with her son, Kelly Bulkeley. Newsweek calls the book the first volume devoted to the (paradoxically) life-affirming power of pre-death dreams.
Though stories and tales of meaningful pre-death dreams have existed from ancient times in many religions and cultures, little systematic study has been done of them. The article cites obvious problems - the inability to enroll dying people in formal studies comes immediately to mind. The percentage of people experiencing such dreams is unknown, but scientists do recognize that the dreams can have deep meaning.
Certain themes recur - journeys, reunions with deceased loved ones, stopped clocks and lights. One woman dreamed of a candle in her hospital window that is snuffed out and then spontaneously relights outside her window. One man decided that somehow, we all belong to one another after finding meaning in dreams of a square dance where partners left visible traces of movements.
But some of the dreams are very frightening, such as being caught up in tornadoes or riding in a driverless car. Rosalind Cartwright, Rush University Medical Center chair of behavioral sciences, says that these are dreams of unresolved issues. Scary as they are, they may ultimately help the dreamer find peace, Cartwright asserts, by forcing the dreamer's attention to underlying problems.
These pre-death dreams are also more urgent, more vivid and more memorable than the run-of-the-mill patchwork of dreams. That's not surprising, says Alan Siegel, psychologist at the University of California . Throughout life, at acute stages of crisis and transition, the need to dream is intensified, he says. The more intense the event, the more the dreams focus on solving emotional issues. Dreams before death can be so intense that the dying person mistakes them for reality, especially when they are dreaming of dead relatives.
Still, Bulkley says, caregivers often don't explore the meaning with dying persons, which is a loss on both sides. Discussing the dreams with family is a way to bring up the topic of death. Just talking about the dream offers a simple way to articulate complex emotions - or, if the meaning of the dream is unclear, to fathom its purpose. And when the dying person is comforted by the dreams, according to Bulkley, so is the family. These are the stories that get repeated at funerals, she says. They become part of the family lore.
Bulkley and Bulkley resist the notion that pre-death dreams prove the existence of God. But dying persons often see them as affirmations of faith. One of Bulkley's patients doubted the nature of God. She dreamed, three nights in a row, of huge boulders that pulsated with an eerie blue light. For her, they represented an unidentified divine being, one that was very real to her. She told Bulkley, I don't need to know anything more than that. God is God. But in her final dream, the boulders turned into steppingstones and a golden light glowed in the distance. It's calling me now, she said, and I want to go. The next day she died, at peace. ( Newsweek , 7/25)
A study published in the current issue of the Journal of the American Medical Association indicates that simple communication efforts can improve the quality of end-of-life care and increase the use of hospice in nursing homes. The study evaluated the impact of a simple informational intervention on referrals to hospice as well as family satisfaction with the care their loved ones received at the end of life. The study sample included 205 residents with 107 randomly selected to receive intervention. Those residents receiving intervention were more likely to enroll in hospice within 30 days, had fewer acute care admissions, and spent fewer days in an acute care setting. Families of those benefiting from intervention rated the resident's care more highly than the families of those receiving the usual care.
With one in four Americans dying in a nursing home, the importance of simple, low-cost interventions to improve care at the end of life is critical. "This study shows that sometimes the best ways to improve end-of-life care are the simplest. By 'jumpstarting' conversations about hospice, we found that it was possible to give more people access to hospice, earlier in the course of their illness," commented David Casarett, M.D., from the Philadelphia Veterans Affairs Medical Center, and lead author of the study. "This seems to be a very effective and efficient way to let more patients and families benefit from hospice, which is the gold standard of end-of-life care."
An abstract of the article is available on the JAMA Web site .
Source: NHPCO News