On September 16th, Senator Max Baucus of the Senate Finance Committee proposed a health care reform plan. Some regarded the plan as a starting point and pointed out that it had several shortcomings. Some of these shortcomings would negatively impact the availability and effectiveness of palliative and hospice care. The Senate has been working diligently on amending the plan until all are satisfied with it. Though it has not yet reached an acceptable final draft, the Senate has made some positive changes to Baucus’s proposal.

An amendment to the proposal that significantly improves it is the “Ensuring People in Hospice Do Not Have to Give Up the Prospect of a Cure” amendment. Right now, a person who enrolls in hospice care becomes ineligible for Medicare coverage. This amendment intends to change the law so that is no longer the case. Patients in hospice care would still be able to pursue treatments and services that may extend their lives. This is a positive change, because it ensures that patients will be able to receive the benefits of hospice care without feeling that they have to give up hope. In addition, this may have a positive effect on how society views hospice care, as it will become clear that hospice is not a last resort, but rather a beneficial option.

While much work has been done to improve the plan, unfortunately, some negative aspects of the proposal have remained as originally written. A major cause for concern is the slashes proposed for Medicare and Medicaid funding. Part of the original proposal, for example, prohibits increased funding to hospices to account for rising costs of living. This is unacceptable, as it will mean a decrease in access to quality care. It is encouraging that improvements have been made to the proposal that will ensure access to end of life care in this country, but cutting funding to programs that provide such care hinders progress toward that goal.

The University of Virginia School of Nursing will use data collected from a Florida hospice, St. Augustine’s Haven Hospice, in a study on patient satisfaction. Findings from the study will support research done on hospice care in general as well as the services provided by the Haven facility. The study will make a significant impact on the services that are provided by the hospice.

The school has been awarded the Ruth Lanford Research Award for research in rural communities and will use the funds to study issues important in hospice care. The goal of the study is to determine how satisfied patients and their families are with hospice care and how various factors influence their satisfaction. Assistant professors Marianne Baernholdt and Cathy Campbell will attempt to find correlations between patient and family satisfaction and factors such as whether they live in urban or rural areas, certain demographic information, and services that the hospice offers. With their findings from this study, Baernholdt and Campbell hope to improve the effectiveness of hospice care.

This study will benefit Haven Hospice immensely. The hospice plans to use findings to improve the care it provides to its patients and their families. Baernholdt, Campbell, and their team plan to focus on minority patients who live in rural areas and live under the poverty line. The results of this study will be especially relevant to Haven, because over 30% of its patients live under the poverty line, and many of its patients come from minority backgrounds.

Haven Hospice has been operating for thirty years. It has been recognized for its leadership within Florida, as well as nationwide, and its participation in this study is an example of such leadership. Haven Hospice is an excellent example of an organization that serves under-served populations, and it is now taking steps to make its benefits even more comprehensive.

Senator Max Baucus of the Senate Finance Committee introduced a health care reform plan yesterday that will have a significant impact on the availability of hospice services and end of life care. Baucus’s plan attempts to bridge the gap between Democratic support and Republican refusal of health care reform. To gain Republican support, Baucus proposed a plan that lowers health care costs without raising the federal deficit. The plan does so by taxing insurance companies and employers that do not provide health care for employees. The problem with his proposal is that it also reduces government contributions for health care that is needed by many Americans, such as hospice and elder care.

Baucus’s proposed legislation calls for cut-backs in programs sponsored by Medicaid and Medicare. One section of Baucus’s legislation reads:

Revisions to Annual Market-Basket Adjustments for Part A Providers – The provision would reduce annual market basket updates for hospitals, home health providers, nursing homes, hospice providers, long-term care hospitals and inpatient rehabilitation facilities, including adjustments to reflect expected gains in productivity.

Annual market basket updates reflect the rising cost of living in the country. If these updates are reduced, funding for hospice care, nursing homes, and other such services will not be raised to levels that take into account increased rates, and patients will be forced to cover the differences.

Florida’s Senator Bill Nelson finds the plan insufficient as it now reads. He will attempt to make changes to protect Floridians who are covered by Medicare Advantage. Cutting funding for this program was another method of reducing health care spending so dramatically in Baucus’s proposal. Nelson said, “I don’t think we can punish seniors who signed up,” and called the plan “a starting point.”

In the process of amending and approving proposals for legislation, each side must make compromises. It will not be easy to come to a resolution that pleases all involved, but there are some compromises that should not be made. The well-being of Americans should be a top priority in this endeavor, and that means that Americans need to have affordable access to quality care. Hospice and elder care is one area of health care that cannot be marginalized.

As we age, caring for elderly and aging parents and family members becomes a greater concern. This is true of any culture, society, and generation. However, it is an especially relevant issue at the moment in this country, because the Baby Boom generation has begun to reach old age. Unfortunately, caring for the elderly inevitably includes consideration and discussion of end of life care. Although end of life planning is always difficult, terminal illness can bring additional problems to the situation. There is good news, though – hospice care is an effective method to reduce the stress and financial burdens associated with end of life care.

The term Sandwich Generation has been coined to describe the many people who are responsible for the care of their parents or older family members as well as their own children. These people are sandwiched between two or more generations of people who are unable to care for themselves. It can be trying to help loved ones deal with the transition from independent adulthood into their elder years, but this time can be more stressful and burdensome when a loved one suffers from a life-threatening or terminal illness. Health care bills can pile up, and time and effort spent on care can add up. All of this is in addition to the emotional toll the situation can take.

This is where hospice care can save the day. Not only can hospice relieve the burden of caring for an ill loved one from people who are already busy and possibly overwhelmed, but it is also more cost-effective than other methods of care. Hospice care is an ideal situation because it helps the terminally ill to be more comfortable and gives them control over their their own life situations. They can remain in their own homes or in the homes of loved ones. Hospice care helps manage symptoms of their illnesses and helps them to arrange memorial services and write wills. In addition, hospice care aids their loved ones in dealing with loss. Usually, most expenses of hospice care are paid for by Medicare or Medicaid. At a time when so many people in this country are pulled in so many different directions and have so many responsibilities in their lives, hospice care is a wonderful option.

It has been said that charity begins at home, and a local group has demonstrated that statement in action. A social and philanthropic association called Parrot Heads in Natural Settings, Inc. (PHINS) has made a generous donation to a Jacksonville hospice. PHINS is a Northeast Florida group that generously contributes to local charities. This summer, PHINS raised $12,000 for Community PedsCare, which is Community Hospice of Northeast Florida’s pediatric program.

PHINS is a group of Jimmy Buffet fans who count charity among their social activities. Each year, PHINS holds the Parrot Head Open golf tournament to raise funds to donate to charitable organizations. For the past five years, PHINS has donated the proceeds from its golf tournament to Community PedsCare. Including this years donation, the group has raised a total of $49,000 to the hospice.

Most of the funds for the programs at Community PedsCare that help terminally ill children and their families come from donations such as this. In 1979, Community Hospice of Northeast Florida was established as the first hospice in the area, and each year the hospice helps almost 900 patients with terminal illnesses in Baker, Clay, Duval, Nassau, and St. Johns counties to live more satisfying and easier lives. Community Hospice comprises around 700 employees and 900 volunteers, as well as long-term care facilities, hospitals, and four inpatient care facilities

Community Hospice of Northeast Florida is a helpful and caring nonprofit organization in the area, and contributions from groups like PHINS help to keep it in business. No person needing care is ever turned away from Community Hospice because he or she is unable to pay for services. Thanks to hospice care such as this, people suffering from terminal illness in North Florida and the rest of the country can receive aid in improving their life conditions.

Volunteers from St. Johns County have worked with a hospice to improve the life of a local boy living with a life threatening condition. Helping Hands, a women’s volunteer community service organization, made over the bedroom and closet of 11-year-old Alex Fast. Working with local sponsors, Helping Hands received donations and worked to create a bedroom that Fast could enjoy.

Alex Fast suffers from complications from a liver transplant. Community PedsCare, the pediatric program at the Community Hospice of Northeast Florida, support Fast and his family. The volunteers worked hard to please Fast – they hung pictures and brought toys into the room. He was very pleased with the result.

Community PedsCare is a valuable member of the community. According to the Jacksonville Daily Record’s website,

Established in 1979 as the first hospice program in Northeast Florida, Community Hospice of Northeast Florida helps nearly 900 patients live better with advanced illness each day in Baker, Clay, Duval, Nassau and St. Johns counties through the support of approximately 700 employees and 900 volunteers. The nonprofit organization has served more than 53,000 children and adults at home, in long term care facilities, hospitals and through four inpatient care centers in Jacksonville. Community Hospice Foundation generates philanthropic and community support for patient care services, family needs and community programs such as Community PedsCare, a pediatric palliative and hospice program. No one is ever denied care due to an inability to pay.

Community Hospice of Northeast Florida plays an important role in the community by providing quality end-of-life care to the regions’ citizens. Donations and service such as that done by Helping Hands helps to call attention to the important role that hospice care plays in the region. Alex Fast’s life is only one of many that is enhanced by hospice care and volunteers who supplement such care.

Currently, health care reform is at the forefront of political discussion, and no topic has caused more debate than end of life care. A section of the health care reform bill currently in front of Congress would allow Medicare to reimburse doctors for their time spent discussing end of life options with patients. Many volatile statements have been made about such an allowance that have caused outrage among end of life care specialists. As debate continues, those who know about the true benefits of hospice care understand that the best possible outcome of such exposure to end of life care would be that it shed light on hospice care as a positive option for the terminally ill.

Unfortunately, much misinformation has been spread to the public about end of life care as a result of debate on this issue. Talk of so-called “death panels” has tainted the public view of what is in reality a very valuable service. It is important to understand that end of life planning is voluntary and aims to give a patient the best care possible, according to his or her own wishes. Advance care planning consultations in no way aim to hasten a patient’s death. Instead, they serve to help a patient to understand what his or her options are and how they coincide with personal values and priorities.

As Congress comes to an agreement on the future of health care in this country, there will be much more discussion about issues such as end of life care. The potential benefit of such discussion is to make Americans aware of options they may not already know about. The downfall is that opponents of the bill in front of Congress will continue to make false claims about end of life care. Thus, it is important for citizens to be informed about such issues. Only then can they combat lies and misconceptions as well as make informed decisions about end of life care for themselves and their loved ones.

As our country debates the future of health care, end of life care is becoming a hot topic. Reaching a resolution on issues such as health care is a difficult endeavor. One thing we can all agree upon, though, is that we want our loved ones to be comfortable and cared for in their last days. The best way to be sure that our loved ones receive the best possible care is through hospice care. According to the National Hospice and Palliative Care Association, “hospice involves a team-oriented approach to care that includes expert medical attention, pain and symptom management, and emotional and spiritual support. “ When curing a patient becomes impossible, hospice care focuses on his or her comfort.

Hospice care has three major benefits: lower costs, better care, and satisfaction of patients and their families.

An article on end of life care in the online version of the Oregonian spells out potential savings. It says, “A study by Duke University researchers found that hospice care reduced Medicare costs by about $2,300 per patient, saving more than $2 billion a year. The savings, compared with non-hospice care of patients with the same diagnoses and life expectancy, increased steadily from about $10 on the 72nd day before death to about $500 four days before death and $750 on the day of death.” Hospice care involves many more services than do hospitals, including counseling, various therapies, and assistance in memorial service arrangements. Because hospice is an approach, rather than a place, patients can remain comfortable at home.

Hospice care is receiving a lot of exposure in the press, and that is definitely a positive development. Terminal illness is a difficult situation, and hospice care can help everyone involved. It is very important to raise awareness of the availability and benefits of such services. Hospice care should be a key topic of discussion in debate over the future of health care and end of life care.

Some opponents of the health care reform bill currently in front of Congress have made false and damaging claims about the potential implications of such a bill. They allege that such a bill will necessitate the creation of “death panels” and that the country is secretly plotting to kill off the elderly. Fortunately, some well-informed and more truthful public figures are stepping forward to clear the air. One such politician is Heather Beaven, who is running for the US House of Representatives for Florida’s 7^th district, who came to the defense of end of life care providers when Congressman John Mica attacked supporters of the bill. Outspoken politicians like Beaven, who has hospice experience, are a credit to our government and our biggest allies in the endeavor to give all citizens access to comprehensive end of life care.

Mica appeared on a radio show in Orlando and called end of life specialists “death counselors.” Beaven jumped to their defense. She said that she was appalled that Mica could speak poorly of people who do good for the terminally ill. She went on to accuse him of using harsh language to scare his constituents. She said, “If he truly believes that his country is plotting to kill its elderly citizens then I would think he would be hosting town halls from one end of the district to the other warning us. This is nothing more than an attempt to scoop up some of the health insurance lobbying money being tossed around right now for his own gain without regard to truth, honor or integrity.” Sadly, Mica is not the only politician using such scare tactics in this national debate.

According to Beaven, the issue of health care reform is extremely important to the future of this country, and using scare tactics is dangerous and unfair. This point needs to be emphasized in our national debate. End of life care is a valuable service to the terminally ill and their loved ones, and it is an important issue for Floridians and all Americans. Politicians who know about the benefits of hospice and other end of life care specialists must speak openly about it, and those who do not must learn more.

When people discuss hospice care, they often focus on certain aspects or espouse misconceptions about the service. Such misconceptions include the idea that hospice services are only for the elderly and those who have given up on life. Many mistakenly believe that the terminally ill receive hospice care only to relieve symptoms in the last days of life when doctors and their families can do no more for them. end of life care encompasses a broad range of services and can involve many professionals working as teams with patients and their loved ones.

Hospice care is not only for the elderly.

Terminally ill patients can range in age from newborn to elderly, and hospice care services benefit their loved ones, as well. For a year after a patient dies, hospice care offers his or her family members help in dealing with bereavement.

Hospice care does not end with symptom management. Hospice services include psychological and financial counseling, as well as assistance with writing wills and arranging memorial services. Therapies offered may include massage, aroma, and music, making the experience about the patient as a whole person, rather than only addressing his or her symptoms. Hospice care workers also coach loved ones in caring for the patient.

Clearly, hospice is not a service that takes over care of a patient when he or she has given up on life. In fact, hospice care improves the quality of life not only of the patient, but of his or her survivors, as well. It prepares the patient and his or her loved ones for death and life after losing a loved one. As more people become aware of the positive approach of hospice care and the benefits it provides, they will begin to look at end of life care for the wonderful option that it is.