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Hospice News Nebraska, May 18, 2017
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May 31 (Wed) - Live In-Person Workshop and Webinar: Emergency Preparedness Planning.

June 15 (Thurs) - Social Workers Networking Conference Call.

June 20 (Tues) - Volunteer Coordinators Networking Conference Call.

June 22 (Thurs) - Chaplains Networking Conference Call

Nebraska News


NHPCA 2017-6 - International Cyber Threat to Health Care Organizations
The U.S. Department of Health and Human Services has issued a notice informing health care organizations of a ransomware attack currently affecting more than 150 countries. The notice includes information on the attack, tips for strengthening your cybersecurity, and instructions on how to report an attack.


An Emergency Preparedness web page is now available on the NHPCA website. This page contains several resources to help providers meet the requirements of the final rule.


Hospice and End-of-Life Notes

* A study reveals that women of color with ovarian cancer are less likely to enroll in hospice care than white women. (OncLive)

* Who makes medical decisions when the patient is not able to do so? The answer to this question varies depending on what state the patient is in. “States vary in their procedures for appointing and challenging default surrogates, the attributes they require of them, priority ranking of possible decision makers, and dispute resolution — with important implications for clinicians, patients, and public health.” (New England Journal of Medicine)

* How are hospices marketing themselves these days? According to one study, not very effectively. “Many hospice organizations do not have a dedicated marketing staff person, have a limited marketing budget, do not fully utilize all strategic planning tools, and have yet to differentiate themselves via branding.” (PubMed)

* Nurses at UC San Diego are using a clever DIY marketing campaign to get their colleagues thinking about advance directives. “Operating like a guerrilla marketing group, albeit with the approval of two key hospital bosses, they began posting signs at both UC San Diego hospitals and its seven largest clinics. The signs simply asked: ‘WGYLM?’” The acronym, which stands for What Gives Your Life Meaning, is used as a tool to attract attention and encourage discussion. “Nearly 1,300 employees in the UC San Diego Health system have taken the pledge to prepare their end-of-life documents and talk with their loved ones about these issues.” (San Diego Union-Tribune)

* The words we say just before we die can carry a special weight and meaning for those who speak them, and those who hear. “Last words might offer a warning: ‘Money can’t buy life,’ said Bob Marley. Or they may express a long-held desire, like Joe DiMaggio’s: ‘I finally get to see Marilyn.’ Others might offer an ironic dig: ‘Last words are for fools who haven’t said enough,’ said Karl Marx.” (Courier)

* What is the proper way to die? A student at Sanford Medical School writes about his thoughts on answering this question. At a certain point, we can only decide how we live, not the timing of our death. “It’s natural to want one more day with the kids or one more weekend with close friends, to celebrate one more anniversary or to able to add one more candle to the birthday cake. Yet at some point, our bodies will give in to heart failure, cancer, strokes, or any of the infinite number of ailments going against us.” (Scope)

* Is it time to rethink end-of-life care? Physician Gilbert Lawrence thinks so. Gilbert talks about the costs – physically, emotionally, and fiscally – of end-of-life care. “After decades of the health care system taking over patient management, medical, and social, from birth to death, we need to start providing incentives and disincentives to all parties to reverse that trend.” (Utica College Center of Public Affairs)

* How does post-death depression and complicated grief of family members impact the use of bereavement services? A recent study finds there is a measurable difference for those experiencing depression or complicated grief. The study says, “Follow-up screenings six to 12 months post-bereavement are recommended to identify those in need of formal psychosocial support.” (JPM)

* Four medical schools in Massachusetts are teaching doctors how to speak with patients about their goals for care, and for life, "so future doctors will know how far to go in keeping gravely ill patients alive.” (Boston Globe)

* An end-of-life survey in Massachusetts suggests there is often a gap between what we say and what we do when it comes to advance care planning. “For example, just about everyone — 96 percent of more than 300 respondents — agree it’s important to have conversations about end-of-life care well in advance. But about 35 percent still haven’t, the survey finds.” (WBUR)

* Certain nursing protocols can help improve quality of life at the end of life for patients, as well as the experience of family members. A recent study explores ways these facility-based protocols are positively impacting patients and families. “Predeath interventions included placing a dove sign on the door, ensuring there were enough chairs in the room for visitors, determining the need to call ‘No One Dies Alone,’ and asking the family about religious or cultural needs.” (Oncology Nurse Advisor)

* A grant from the Robert Wilson Charitable Trust helps the Hastings Center set priorities for future work on aging. “With support from the Robert Wilson Charitable Trust and with additional funds from Hastings’ endowment, the Center has begun ‘The Last Stage of Life,’ a two-year planning process to determine how best the field of bioethics in general, and The Hastings Center in particular, can meet the new and complex needs of our aging society and of aging people and their caregivers. Principal investigators are Mildred Solomon and Nancy Berlinger, a Hastings research scholar.” “To our knowledge,” says Berlinger, “this is the first opportunity for people from across so many different disciplines to gather together to identify and address ethical issues faced by our aging society.” (The Hastings Center)

Palliative Care and Other Notes

* How is the palliative care (PC) system doing? Researchers put together a scorecard to help measure the state of the practice. “The scorecard was initially created using University of Florida Health data, a new PC program, and successfully applied and implemented at University of Colorado Anschutz Medical Campus, a second institution with a mature PC program.” Through creating and using the scorecard, both programs found areas for improvement. “In addition, by automating data extraction, the scorecard decreases costs associated with manual data entry and extraction, freeing clinical staff to care for patients and increasing the value of PC delivered to patients.” (Journal of Palliative Medicine)

* Music therapy can have immediate and dramatically positive benefits for palliative care patients and their families, according to a recent study. “Family member perceptions were positive, with 82 percent of responders indicating improvement for self and patient in stress, mood, and quality of life; 80 percent rating the session as extremely helpful; and 100 percent of 49 recommending further music therapy sessions for the patient. Patients reported statistically significant improvement in pain, depression, distress, and mood scores.” (Supportive Care in Cancer)

* Does trusting your doctor help reduce pain? A study published in the Journal of Pain says, “The more patients reported trusting their doctor and feeling similar to them, the less pain they reported feeling. The study also suggests that those who experience higher levels of anxiety on a day-to-day basis experienced greater reductions in pain from feeling close to their doctor.” (National Pain Report)

* Scientists have found a way to make over-the-counter pain medications last longer. “Researchers at Northwestern University were trying to find ways to reduce the time required for maximum uptake and increase the half-life of ibuprofen, one of the most common over-the-counter pain relievers on the market. The method utilizes compounds called metal-organic frameworks, or MOFs, which consist of metal ions linked to organic ligands for drug delivery.” (UPI)


Dr. Sebastian Sepulveda has had many patients die during his career. Since he is a specialist in emergency medicine and end-of-life care, it goes with the territory. Sepulveda is confident he’s a good doctor, but it can still be a challenge to admit the reality of patient death. An article in the Boston Globe mentions there are god-like expectations on doctors, and notes these expectations are extreme. Many people seem to expect that medical technology should assure immortality. Read More


Palliative care (PC) chaplains are integral parts of palliative care teams. Their work is to address patients’ spiritual care needs. Despite their great importance in hospital settings, there has not been a comprehensive description of chaplaincy in palliative care programs nationally. A recent study published in the Journal of Palliative Medicine explores “main outcomes of chaplain demographics, practice information, integration into the PC team, and visit content.” Read More

Hospice Analytics is the national sponsor of Hospice News Network for 2017. Hospice Analytics is an information-sharing research organization whose mission is to improve hospice utilization and access to quality end-of- life care. For additional information, please call Dr. Cordt Kassner, CEO, at 719-209- 1237 or see

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