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Physician Assistants Pursue Larger Roles in Hospice and Palliative Care   By Larry Beresford

 

The role of physician assistants (PAs) in hospice and palliative care has been advancing over the past several years and is poised to keep growing, an encouraging step toward expanding access to palliative care for the increasing number of people living with serious illnesses.

Key to that growth has been a change in federal law that took effect in January 2019 authorizing PAs to serve as designated attending medical providers for patients in hospice care. Though some barriers remain that cloud reimbursement, advocacy groups like the National Hospice and Palliative Care Organization (NHPCO) and Physician Assistants in Hospice and Palliative Medicine (PAHPM) are actively exploring solutions.

More recently, the CSU Shiley Institute for Palliative Care launched a palliative care certificate program for PAs – the first of its kind in the country. The online Physician Assistant Certificate in Palliative and Serious Illness Care will welcome its first cohort of students on May 6.

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Crucial Need to Expand Palliative Care in Rural Communities   By Larry Beresford

Interest in palliative care as an essential healthcare service appears to have grown during the pandemic, but one sector still lags: rural communities.

Everything that’s challenging about delivering palliative care in urban communities is that much more difficult in rural areas, according to Lyn Ceronsky, DNP, a palliative care consultant and faculty at M Health Fairview in Minneapolis, Minn.

Yet palliative care is just as needed in rural communities – maybe more so, Ceronsky said during a presentation at the American Academy of Hospice and Palliative Medicine’s virtual 2021 Annual Assembly.

Many rural communities face chronic healthcare workforce challenges, Ceronsky said. Populations tend to be older, sicker, and poorer. Some rural hospitals have closed.

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Improving Advance Care Planning By Jennifer Moore Ballentine

April 16 is National Healthcare Decisions Day, so designated in 2008. The day after Tax Day was selected because – I kid you not – “’Tis impossible to be sure of any thing but Death and Taxes.”¹ In recognition of the day, healthcare organizations hold events and offer resources to encourage completion of advance directives. This year, the Institute will offer our course Working With POLST at no charge in April. It’s a great course, and the POLST is a great tool. We hope you’ll sign up! So why am I inwardly wincing?

Like many in palliative care, I have passionately championed advance care planning—conducting 72 community and professional presentations, 5 focused conferences, 4 multi-session trainings, and 10 plenaries and panels over about 10 years. And as the years have gone by, I’ve felt more and more uneasy about the through-line message: If you take the time to reflect, discuss, and document your wishes, you’ll get the care you want and you won’t get the care you don’t want. Though I could never quite bring myself to say so, it just isn’t true.

Last fall, Dr. Sean Morrison, professor and chair of the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai in New York City, co-director of the National Palliative Care Center, and director of the National Palliative Care Research Center, finally said it, in the Journal of Palliative Medicine no less.² 

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The Privilege of Palliative Care Social Work By Nicole Perry, LCSW, ACHP-SW, CHPCA

Working in palliative care social work has always been a privilege for me. I’ve been a social worker for almost 15 years and have found so much meaning in supporting patients and families experiencing serious illnesses, first through hands-on hospice and palliative care work and now by teaching current and future social workers about palliative care.

During my years as a hospice and palliative care social worker, I was welcomed into homes during life-changing – and sometimes life-ending – moments where I and my team members held sacred space shared only by the patient’s immediate family. To be there and to offer my skills and support during those critical life moments was a true gift.

As a professor of social work, I teach BSW and MSW students about palliative care and I try to encourage and inspire them to pursue this important field of practice. People living with chronic and terminal illness are at risk for significant physical, emotional, and spiritual suffering and palliative care is essential to addressing those needs.

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Palliative Care and COVID: One Year In By Larry Beresford

The COVID-19 pandemic’s impact on the U.S. healthcare system and the field of hospice and palliative care took center stage recently at the 2021 Annual Assembly of the American Academy of Hospice and Palliative Medicine.

In a session of COVID Conversations at the virtual conference and in outside interviews, clinical leaders and educators said they’re grateful that COVID cases appear to be waning after a horrifying holiday surge. Still, many remain concerned about the spread of new variants, scarce healthcare resources, and the long-term effects of moral distress and PTSD among healthcare providers.

“In California, the surge is abating, but we still have high death rates from cases contracted 4 to 6 weeks ago,” said Holly Yang, MD, a hospice and palliative medicine specialist with Scripps Health in San Diego, and President of the San Diego County Medical Society.

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