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In This Issue

The Role of Advance Care Planning In Pallliative Care
More Than 100 Gather for Sixth Annual Palliative Social Work Conference
Education Programs Celebrate National Healthcare Decisions Day
Health Care Agent vs. MDPOA -- A Skill-Builder Exercise
News You Can Use
Upcoming LQI Events
Other Upcoming Events

The Role of Advance Care Planning in Palliative Care
National Healthcare Decisions Day, Wednesday, April 16

Palliative care providers always begin with working to understand their clients' and patients' goals for care and well-being and then matching treatment to those goals. National Healthcare Decisions Day was established to inspire, educate, and empower the public and healthcare providers about the importance of discerning, discussing, and documenting goals for care and preferences for medical treatment ahead of a crisis and identifying authorized substitute decision makers, or healthcare agents -- in other words, advance care planning.

Decisions about one's medical care -- especially in a crisis or when a life-limiting illness progresses -- are deeply personal and often difficult to confront or articulate. Individuals and families struggle to identify what medical interventions they would want and the type of care they might decide to forgo sometime in the future. It's tough to make these decisions -- even tougher when you don't know what decisions might need to be made! That is why we teach healthcare professionals techniques to encourage candid, values-based conversations that allow individuals and families to express their wishes and concerns as they cope with advancing or life-limiting illness.

Advance care planning constitutes a large segment of our educational programs and projects. Our website contains abundant resources on Colorado's advance directives and advance care planning options. Also, this month, we are offering a special program to introduce The Conversation Project, a "user-friendly" approach to opening discussions on these issues with families, friends, and communities. Please join us in this campaign! Other programs you are invited to attend are detailed below.

Sixth Annual Palliative Social Work Conference
Thursday, April 10, 2014

Last week, more than 100 social workers and graduate-level social work students from Wyoming to Pueblo and Wray to Evergreen gathered for our Sixth Annual Palliative Social Work Conference. Working in settings ranging from hospitals and home care agencies and long-term care communities, hospices, and dialysis centers, they were treated to a full day of:

Education

Conversation & Peer Networking

Great Food & Camaraderie!

Thank You Conference Sponsors!

We are grateful to the following organizations for their financial support of our conference and for sharing important information about the valuable products and services they offer to support the work of conference attendees:

Agape Health Care

All the Comfort of Home

Donor Alliance
Exempla Lutheran Hospice
Gentiva Healthcare

GoldLeaf CareGivers
Horan & McConaty
Institute for Life & Care
Metropolitan State University of Denver Department of Social Work
Peak View Behavioral Health
Suncrest Hospice
The Denver Hospice
Wind Crest by Erickson Living
YouCan TooCan

The Psychological Impact of Illness and the Value of Expressing Wishes

May's Third Thursday Webinar

On Thursday, May 15, LQI Community Educator Laurel Okasaki-Cardos, MSW, LCSW, will lead a webinar that takes a look at the many ways serious illness impacts individuals and families beyond a traditionally defined medical model. Laurel will examine the value of putting pen to paper to express our wishes, goals, and desires at any age. She will also provide techniques that will assist you in more effectively broaching these conversations with individuals and families you may be working with.

Webinar registration is only $25 per person or $65 per organization. Register online today or call 303-398-6326 for more information.

Making Your Wishes Known

Free Program, Wednesday, April 16

On Wednesday, April 16, Windcrest social workers in partnership with Life Quality Institute will be presenting a similar program on the value of "putting pen to paper" to express your wishes, goals, and desires as well as how to begin these important conversations with your spouse, partner, family, and/or doctor. Resources, including advance directive forms and The Conversation Project Starter kit, will be made available. Please contact Jill Homann, 303-876-8245 for more information.

Healthcare Agent vs. "MDPOA"

This Month's Skill-Builder Exercise

In keeping with the theme of this month's newsletter, here's a Skill-Builder exercise that focuses on an important advance care directive.

Question: My mother is a healthy, vibrant 80-year old still living in her own home across town from me. She says she has made me her "healthcare agent" and that she has the completed form in the safe in her bedroom closet. Is this the same thing as a medical durable power of attorney? Shouldn't I have a copy of this form?

Life Quality Institute: Advancing Palliative Care

Answer: The terms "medical durable power of attorney" and "healthcare agent" are pretty much interchangeable. The healthcare agent is the person named in a medical durable power of attorney (MDPOA) document as an authorized substitute decision maker for the person completing the form. Because you are specifically named as your mother's healthcare agent in an MDPOA document, you will have the legal authority to make healthcare decisions for her when she cannot make or express her own decisions. This might be for a short time, while she recovers from an acute illness or injury, or it could extend over months or years if she is permanently incapacitated.

Yes, you should ask your mother for a copy of the MDPOA document, and keep it safe but handy in your own residence. When you ask your mother for a copy of the form, you can use the time to talk with her about what she might want or not want regarding her care if she were to become seriously ill. This is also an opportunity to start a conversation about her wishes regarding end-of-life care. Your job, as healthcare agent, will be to make decisions for your mother as she would make them, based on her preferences and values, not your own. So it is very important to know what matters to her most, and it's best to start to talk about this now, while she is healthy and not in a medical crisis.

By the way, every adult needs to have a designated healthcare agent. In Colorado, your next of kin -- spouse, adult children, siblings, or others -- has no automatic authority to make your healthcare decisions if you can't! You can find a medical durable power of attorney form in this booklet, "Your Right to Make Healthcare Decisions." For more information on the MDPOA and other Colorado advance directives, visit our the Advance Directives page on our website.

News You Can Use

Cancer Survivors Say They Would Have Benefited from Palliative Care

Treating cancer takes a damaging toll on a person's body. 22 News spoke with cancer patients and survivors who say they need better access to care services. Cancer treatments, like chemotherapy, can be a traumatic experience, and they can also cause painful side effects. Patients say improving palliative care will lessen the blow brought on by cancer. Read more.

Data Shows ACO's the ROI of Palliative Care

The Visiting Nurse Service of New York's palliative care management model called SPARK, run through a managed care plan, showed net savings of $250 per member per month, which may be useful data for accountable care organizations as they structure their networks, write Dr. Richard Bernstein of the Icahn School of Medicine at Mount Sinai and registered nurse Karol DiBello, associate director of the SPARK program. ACOs will be looking to determine if palliative care is a "wise investment that can reduce preventable admissions and generate more savings than would occur otherwise," they write. Read more.

Caregiver Support Could Save Up to $1 Billion in Alzheimer's Care

A study in Health Affairs estimated that if every Minnesota caregiver were supported by the New York University Caregiver Intervention, the state could save $1 billion in Alzheimer's disease treatment costs over 10 years. The program gives caregivers help creating a care plan, access phone calls with trained staff and weekly support meetings, which data show may help delay patient admission to a nursing home by 18 months. Read more.

Majority of Older Patients Want Coordinated Care, But Few Receive It

A survey by the John A. Hartford Foundation revealed 73% of elderly patients said they would prefer coordinated care from a team of medical professionals, but only 27% reported receiving such care. Researchers also found that 48% of older patients said they would think about switching primary care doctors if coordinated team care is available elsewhere. Read more.

Nursing Home Staff Could Communicate Better Over Late-State Dementia

Virginia Commonwealth University researchers found that family members can have difficulty understanding the disease trajectory for dementia patients and that nursing home staff may be able to help by providing clear information about what to expect in late-stage patients. Researcher Mariette Klein said advance directives cover many issues but families may need help with questions such as whether to provide antibiotics to a late-stage patient with pneumonia, which can be seen both as prolonging life and providing comfort. Read more.

Upcoming LQI Events

The Conversation Project--a New Model for Personal and Community Engagement with Advance Care Planning

Tuesday, April 22, 2014

8:30 a.m. to 3:00 p.m.
The Donor Alliance, Lowry

Harriet Warshaw, Executive Director of The Conversation Project, will walk you through The Conversation Project Starter Kit and present strategies for introducing conversations about advance care planning into your community/organization.

Registration is only $25 and includes lunch.

For more information: contact@lifequalityinstitute.org or 303-398-6326.

Save the Dates!
LQI's Interdisciplinary Palliative Care Certificate Program

Coming in June to Greeley, CO (exact dates and details to come) and on Thursday-Saturday, July 24, 25, and 26, 2014, hosted at The Denver Hospice Inpatient Care Center, 8299 Lowry Blvd., Denver.

NEW! Denver program will include a live video link for individuals and organizations who cannot attend in person.

A comprehensive introduction to the principles, approaches, and skills of palliative care for healthcare professionals of all disciplines and settings. Learn how palliative care addresses the GAPS: Goals of Care, Advance Care Planning, Pain and Symptom Management, and Spiritual-Psychosocial Suffering. New this year, a session on the role of palliative care in healthcare reform and public health policy. The course confers 20 continuing education credits in nursing or social work and a Certificate of Completion.

Other Upcoming Events

Please note: Events sponsored or presented by organizations outside Life Quality Institute are listed as a service to the palliative care community. Listing does not imply endorsement or assertion of quality of the presentation.

Colorado Hospice and Palliative Care Spring Conference

Thursday, April 24, 2014

Exempla Lutheran Medical Center

Wheat Ridge, CO