Abstract
U.K. Hospice Care for Children
The study by Leeds University and Martin House children's hospice at Boston Spa in West Yorkshire, England, examined palliative care for children and young people. Experts believe it will help health care systems plan care more effectively. Interestingly, they point to findings that children, youngsters, and their families may need care and support provided by a hospice for many years and in some cases for more than two decades.
Canadian Hospice Care for Children
Canuck Place, a hospice inpatient unit for children in Vancouver, British Columbia, announced that a $10 million Canuck Place Children's Hospice will be built in Abbotsford, British Columbia, 40 miles (70 kilometers) from the original facility in Vancouver. The Abbotsford Hospice Society and Matthew's House, a respite care place for severely disabled children, will also be built on the new campus. While it is terrific that such an effort is underway, such plans for bricks-and-mortar projects beg the question of whether to spend money on services in the home, or in paying for the high overhead associated with buildings.
Singapore Palliative Care
It is thrilling to see the political stature of advocates for palliative care increasing. The Prime Minister of Singapore, Lee Hsien Loong, advocates for more public education and discussions about death. He predicted that demand for palliative care in Singapore will grow. Hospice and home palliative care providers are serving over 5000 patients annually and, in the future, such care can be expanded to more patients.
U.S. Certification Examination
In the United States, an examination of knowledge is required for board certification in hospice and palliative medicine. While the questions themselves are developed by volunteer clinicians, the test committee is assisted by full-time experts in test development and evaluation. As with all examinations, there is always some discussion by examinees about whether the examination adequately represents the practice, rather than the theory, of a field. This anecdote should help assuage some fears. The father of one of the staff members assigned to the hospice and palliative medicine examination became terminally ill and was referred for home hospice care. The staff member moved home in order to help her mother in the care giving. She said it was like living in the middle of the examination. She also reported that the hospice nurses loved the fact that she knew what hospice care actually was.
U.S. Hospice Care Statistics
Each year, the National Hospice and Palliative Care Organization tallies facts and figures to describe the industry in the United States, where the national insurance program for those over age 65 and the disabled, Medicare, pays for home hospice care. More than 35% of patients served by hospice programs in 2008 died or were discharged in 7 days or less—a 4.6% increase from 2007, when 30.8% of patients had what is considered a short hospice experience. While the average length of service increased from 67.4 days in 2007 to 69.5 days in 2008, the increase in patients receiving care for a short time is of concern to hospice providers. Recent studies suggest a stay of approximately 30 days is needed to maximize benefit. Only 12.1% of those served died or were discharged with service of 180 days or more.
Oldest Hospice in Africa Marks Thirtieth Anniversary
2009 marked the 30th anniversary of Island Hospice located in Harare, Zimbabwe. The hospice has been a pioneer in the provision of palliative care and support to people with life-threatening illnesses, their families, and caregivers. No stranger to operating in extremely difficult circumstances, Island Hospice has become known for its creativity and efficiency in responding to challenges and developing programs to address emerging needs. The organization has recently evolved its service to provide more tailored support to child caregivers, in response to the growing numbers of children being left to care for dying parents and siblings, and facing bereavement at a very young age.
The Cost of Dying
One wonders whether it is a good thing to be on television. The investigative journalism show, 60 Minutes, on CBS broadcast a segment on the high cost of dying in the United States in November 2009. The show reported that in 2008, Medicare paid $50 billion just for doctor and hospital bills during the last 2 months of patients' lives—that is more than the budget of the Department of Homeland Security or the Department of Education. And it has been estimated that 20%–30% of these medical expenditures may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. One might think this would be good news for hospice care, however, this kind of information could easily be used by those fearing the limitation of patient choice near the end of life.