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Louisiana Palliative Medicine Physicians: ( NAME: COMPANY LOCATION OFFICE CONTACT: Achee, Christopher LA Hospice & Pall

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Louisiana Palliative Medicine Physicians: ( NAME: COMPANY LOCATION OFFICE CONTACT: Achee, Christopher LA Hospice & Pall April 2011 in this issue The Palliative Care Journal PALLIATIVE CARE and PALLIATIVE MEDICINE Jack Mc Nulty, M.D., F.A.C.P., F.A.A.H.M. and of psychological, social, and spiritual problems is para- President, Palliative Care Institute of mount. The goal of palliative care is achievement of the best Southeast Louisiana quality of life for patients and their families. It affirms life, Medical Director and regards dying as a normal process. It neither hastens nor Hospice of St. Tammany prolongs death. Using an interdisciplinary approach, pallia- Assoc. Prof. tive care can be applied not only to those dying or in a hospice Clinical Medicine, LSUHSC program, but can also serve those patients undergoing active and aggressive treatment for cancer or other life-threatening conditions. It has been twenty-nine years since Congress passed the Medicare Hospice Benefit, and despite the increase in hospice CMS has Redefined Palliative Care: utilization over those years, still only four of every ten persons Palliative Care Improves Quality and Helps Relieve Suf- dying in the United States is benefiting from hospice. fering This is understandable, for it is very difficult for patients Palliative care means patient and family-centered care that facing death, for their families, and for their physicians to give optimizes quality of life by anticipating, preventing, and treat- up trying for a cure. Having to choose between hospice and ing suffering. continued aggressive care can be hard. Palliative care throughout the continuum of illness in- Often this disproportionate focus on continued treatment volves addressing physical, intellectual, emotional, social, and and tests results in little effort to reduce symptoms affecting spiritual needs and to facilitate patient autonomy, access to the patient and the family, whether those symptoms are physi- information, and choice. cal, emotional, socio-economic, or spiritual. This dissatisfaction with care at the end-of-life resulted 7 3 F R 3 2 2 0 4 , J u n e 5 , 2 0 0 8 in a broad consensus in the 1990s that change was necessary, Medicare Hospice Conditions of Participation – Final Rule and would require the support of the community, philanthropic Palliative Care is NOT only End-of-Life Care and is not organizations, the entire healthcare team, and eventually, the dependent on prognosis. Physicians are encouraged to think federal government. about palliative care earlier to relieve suffering and improve Since doctors control how medicine is practiced to a large quality of life rather than wait until death appears near and degree, it soon became apparent that no meaningful improve- inevitable. Why is it important to differentiate end-of-life and ment in palliative, end-of-life care would happen without their hospice from palliative care? active participation. The multicenter SUPPORT study in the 1) We really don’t know whose dying until the last few days mid-90s, designed to use trained social workers and nurses to of life, hence very late referral to hospice in the U.S. change outcomes in hospitalized dying patients, demonstrated 2) Most people with palliative care needs are chronically ill no improvement in outcomes without a change in doctor’s at- and not dying anytime soon, and people have an abiding titudes and practices. desire not to be dead! Palliative Care, as originally defined by the World Health Palliative Medicine, a new subspecialty of medical prac- Organization and the Institute of Medicine, seeks to provide tice, was begun in the mid-90s when academic and hospice the total active care of patients whose disease is not respon- physicians expanded the national hospice organization to sive to curative treatment. Control of pain, of other symptoms, embrace palliative care. This became the American Academy Not yet a Member? Get more information about LMHPCO at www.LMHPCO.org 717 Kerlerec, N.O., LA 70116 Toll Free 1-888-546-1500The Journal • 1 • April 2011 Pediatrics (504) 945-2414 Fax (504) 948-3908 www.LMHPCO.org next month: Louisiana-Mississippi Hospice & Palliative Care Organization of Hospice & Palliative Medicine, which now has over 4000 members. Board cer- tification by AAHPM in this specialty began in 1995. In 2008 with the sponsorship The Louisiana-Mississippi Hospice and Palliative Care Organization is a 501(c)3 non-profit organization governed by a board of directors representing all member of ten medical specialties, the sub specialty of Palliative Medicine and Hospice hospice programs. It is funded by membership dues, grants, tax-deductible received accreditation by the American Board of Medical Specialties. There were donations and revenues generated by educational activities. LMHPCO exists to ensure the continued development of hospice and palliative care services in over 1,200 physicians certified by ABMS in 2008.The majority of these physi- Louisiana and Mississippi. LMHPCO provides public awareness, education, cians are internists, family practitioners, and oncologists, many of whom are in research, and technical assistance regarding end-of-life care, as well as advocacy for terminally ill and bereaved persons, striving to continually improve the academic and tertiary-care centers. Fellowship training programs, one or two year, quality of end-of-life care in Louisiana and Mississippi. have been established in many of the large treatment centers and medical schools. EXECUTIVE BOARD President, Stephanie Schedler After 2012 a one-year fellowship will be required for candidates to be eligible for Glendale Healthcare certification. There are approximately 4,000 palliative care physicians, many of P.O. Box 650 • Mandeville, LA 70470 Phone: 985-626-3281 whom work part-time. There is a shortage of palliative care physicians, estimated E-mail: [email protected] at between 6,000 and 18,000. Advanced practice nurses, also in short supply, will President-Elect, Belinda Patterson Hospice Ministries play a large role in the delivery of services in both hospital-based and outpatient 450 Town Center Boulevard • Ridgeland, MS 39157 palliative care and in hospice care. Phone: 601-898-1053 • 800-273-7724 Fax: 601-898-1805 End-of-life education was not part of the medical school curriculum in the E-mail: [email protected] past, and little emphasis has been given to this subject during a doctor’s gradu- Secretary, Ann Walker Magnolia Regional Health Center & Hospice ate education. This large gap in education was finally addressed in 1997 by Dr. 2034 East Shiloh Road • Corinth, MS 38834 Linda Emanuel, who developed the EPEC Project with the support of the AMA Phone: 662-293-1405 • 800-843-7553 Fax: 662-286-4242 • E-mail: [email protected] and Northwestern Medical School. By the next year she and her co-principals, Treasurer, Martha McDurmond Drs. Charles vonGunten and Frank Ferris. had produced the 12 modules which Hospice of Shreveport/Bossier 3829 Gilbert (Madison Park) comprise the series, Education of Physicians on End-of Life Care. The three day Shreveport, LA 71104-5005 training course is presented at least twice annually, with special courses targeted Phone: 318-865-7177 • 800-824-4672 Fax: 318-865-4077 • E-mail: [email protected] to oncologists and to neurologists. There are over 1500 doctors who are certified LOUISIANA AT LARGE MEMBERS EPEC trainers now teaching end-of-life care in their communities. A similar pro- Larry Durante, St. Joseph Hospice and Palliative Care, LLC 824 Elmwood Park Boulevard, Suite 155 gram, ELNEC, is training nurses in the same educational material. In 2008, 41% New Orleans, LA 70123 of medical schools had palliative care teaching programs, and there were palliative Phone: 504-734-0140 • Toll-Free: 866-734-0140 Fax: 504-734-0320 • [email protected] care services in 1027 of 4000 hospitals in this country. Kathleen Guidry Louisiana Hospice & Palliative Care Jennings Quality gaps and challenges 422 Kade Dr. Ste. 4 • Jennings, LA 70546 Phone: 337-616-3482 • Fax: 337-616-9399 WHAT PATiENTS WANT E-mail: [email protected] • Pain and symptom control Sherrill Phelps, Christus Cabrini Hospice 4801 Jackson Street Extention, Suite B • Avoidance of inappropriate prolongation of the dying process Alexandria, LA 71302 • A sense of control (318) 448-6764 • (318) 449-2568 [email protected] • To relieve burdens on family MiSSiSSiPPi AT LARGE MEMBERS • Strengthening relationships with loved ones Mike Davis Singer et al. JAMA 1999 281(2): 163-168 Odyssey Healthcare of Jackson 5 Old River Place, Suite 200 • Jackson, MS 39202-3449 Phone: 601-973-3550 • Toll Free: 866-973-3550 Fax: 601-973-3551 • [email protected] Family Satisfaction with Hospitals as the Last Place of Care Melita Miller, RN, Forrest General Hospital 2000 Mortality Followback (Survey:n= 1578 decedents) 1414 South 28th Avenue • Hattiesburg, MS 39402 1. Not enough contact with MD: 58% Tel (601) 288-2421 • Fax (601) 288-2401 (800) 844-4663 • [email protected] 2. Not enough emotional support of patient: 51% Cindy Clark Van Woeart 3. Not enough explanation what to expect during the dying process: 50% Delta Regional Medical Center Hospice 4. Not enough emotional support of family: 38% 300 South Washington Avenue / PO Box 5247 Greenville , MS 38704-5247 5. Not enough help with pain/shortness of breath: 19% Phone: 662-725-1200 • Toll-Free: 888-516-9229 Fax: 662-725-2309 • [email protected] Teno et al.JAMA 2004 291: 88-93 Executive Director, Jamey Boudreaux 717 Kerlerec • New Orleans, LA 70116 WHAT PATiENTS GET / PALLiATiVE CARE ROLES Phone: 504-945-2414 • Toll-Free: 888-546-1500 Fax: 504-948-3908 • Expert symptom management – pain, dyspnea, constipation, nausea E-mail: [email protected] • Address issues of emotional distress and existential and spiritual suffering Education Director, Nancy Dunn P.O. Box 1999 • Batesville, MS 38606 • Expert at family meetings and establishing consensus re: goals of care and a Phone: 662-934-0860 • Fax: 504-948-3908 treatment plan matched to these goals E-mail: [email protected] F F F • Improve patient-family-professional communication and decision-making The Journal is produced monthly by Noya Design, Inc.
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