Pub Date : 1989-03-01DOI: 10.1177/104990918900600206
F Eldredge
{"title":"Fundraising: a planning model for a capital campaign.","authors":"F Eldredge","doi":"10.1177/104990918900600206","DOIUrl":"https://doi.org/10.1177/104990918900600206","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13854272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600202
R E Enck
{"title":"Adjuvant analgesic drugs.","authors":"R E Enck","doi":"10.1177/104990918900600202","DOIUrl":"https://doi.org/10.1177/104990918900600202","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13615087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600215
D MacDonald
{"title":"Non-admissions: the other side of the hospice story.","authors":"D MacDonald","doi":"10.1177/104990918900600215","DOIUrl":"https://doi.org/10.1177/104990918900600215","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"17-9, 40-2"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13796294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600222
J A Wallace
Sam was a sevenyearold child, diagnosedinMay, 1987,ashavingterminal degenerativemuscleandnervewastingdisease.Previousto this diagnosis he had beena normal, healthy boy. However, when I met him, he couldno longersee,hearor move,and hadto be fed througha gastrostomy tubeinsertedfourmonthspreviouslyat theinsistenceof hisfather.Samseized frequentlyeventhoughreceivingboth Dilantin and Phenobarbital.He cried out when startled, otherwisehe appearedto be comfortable.He had troublehandlinghissecretions, thusrequiring frequentsunctioning.Thebest estimateof lengthof life for this child was2-10months. Samhadbeenathomein anearby town in the careof hisfather,George, andhisstep-mother, Sara,with thesupportof visitingnurses. Thefamilyconsistentlyrefusedanyhelpfrom hospice volunteersandall attemptsto getthem to acceptcounselingfailed. Whenahospicepatientis admitted to this hospital,heis admittedto the palliativecareunit. The hospicestaff andvolunteersbecomeanintegralpart of thepalliativecareteam.Childrenare admittedto the pediatricunit and the teamgoesto them. Sam had beenadmitted to the pediatric unit because,in their exhaustion and emotional pain,
{"title":"The death of a child: the use of group for conflict resolution.","authors":"J A Wallace","doi":"10.1177/104990918900600222","DOIUrl":"https://doi.org/10.1177/104990918900600222","url":null,"abstract":"Sam was a sevenyearold child, diagnosedinMay, 1987,ashavingterminal degenerativemuscleandnervewastingdisease.Previousto this diagnosis he had beena normal, healthy boy. However, when I met him, he couldno longersee,hearor move,and hadto be fed througha gastrostomy tubeinsertedfourmonthspreviouslyat theinsistenceof hisfather.Samseized frequentlyeventhoughreceivingboth Dilantin and Phenobarbital.He cried out when startled, otherwisehe appearedto be comfortable.He had troublehandlinghissecretions, thusrequiring frequentsunctioning.Thebest estimateof lengthof life for this child was2-10months. Samhadbeenathomein anearby town in the careof hisfather,George, andhisstep-mother, Sara,with thesupportof visitingnurses. Thefamilyconsistentlyrefusedanyhelpfrom hospice volunteersandall attemptsto getthem to acceptcounselingfailed. Whenahospicepatientis admitted to this hospital,heis admittedto the palliativecareunit. The hospicestaff andvolunteersbecomeanintegralpart of thepalliativecareteam.Childrenare admittedto the pediatricunit and the teamgoesto them. Sam had beenadmitted to the pediatric unit because,in their exhaustion and emotional pain,","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"43-6"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13854270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sobering lessons from a sad story.","authors":"J M Richman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"20, 23"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600217
S L Olson
Adult daycareis arelativelyunderdevelopedalternativein thecontinuum of healthcaredeliverybutisbecoming increasingly important. By 2020 the CensusBureaupredicts that almost one-thirdoftheU.S.populationwill be at least55 yearsof age. Alreadydaycarecentersfor adults exist in nearly everystate. Nationwide,accordingto the National Institute on Adult Day Care,therewerea meredozencenters in 1970andmorethan1,200 now.1 The term day care is actually generic. Although the servicecomponentswhich comprise a day care programarenot new, day careis consideredto beanewwaytodelivercertain medical,healthand/orhealth-related social servicesfor older and/or disabledadults.Thepurpose, organization, kinds of participants,settings, programcontent, and structuremay differ markedly ranging from active rehabilitationto theprovisionofoneor morehealth-relatedsocialservices. When developinga day care program,emphasishouldbeplacedon meetinghigh quality of careandadequatebuilding safetystandardswhich confonnto stateandlocal codesand regulations. Although somestates haveattemptedto createguidelinesfor the operationof day care programs, there areno uniformly appliedstandards. In a studyby Issacs,thirty-four of the fifty states(plus the District of ColumbiaandPuertoRico)hadestablished state-levelstandardsfor both funding and licensure,twelve had standardsfor funding only, and only eighthadstandardsfor licensure.2
{"title":"Hospice day care standards development in Michigan.","authors":"S L Olson","doi":"10.1177/104990918900600217","DOIUrl":"https://doi.org/10.1177/104990918900600217","url":null,"abstract":"Adult daycareis arelativelyunderdevelopedalternativein thecontinuum of healthcaredeliverybutisbecoming increasingly important. By 2020 the CensusBureaupredicts that almost one-thirdoftheU.S.populationwill be at least55 yearsof age. Alreadydaycarecentersfor adults exist in nearly everystate. Nationwide,accordingto the National Institute on Adult Day Care,therewerea meredozencenters in 1970andmorethan1,200 now.1 The term day care is actually generic. Although the servicecomponentswhich comprise a day care programarenot new, day careis consideredto beanewwaytodelivercertain medical,healthand/orhealth-related social servicesfor older and/or disabledadults.Thepurpose, organization, kinds of participants,settings, programcontent, and structuremay differ markedly ranging from active rehabilitationto theprovisionofoneor morehealth-relatedsocialservices. When developinga day care program,emphasishouldbeplacedon meetinghigh quality of careandadequatebuilding safetystandardswhich confonnto stateandlocal codesand regulations. Although somestates haveattemptedto createguidelinesfor the operationof day care programs, there areno uniformly appliedstandards. In a studyby Issacs,thirty-four of the fifty states(plus the District of ColumbiaandPuertoRico)hadestablished state-levelstandardsfor both funding and licensure,twelve had standardsfor funding only, and only eighthadstandardsfor licensure.2","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"35-9"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13854268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600208
L E Forster, J Lynn
Theadventof hospiceprogramsand theirfundingunderMedicarehasmade eligibility for a substantial insurance benefit contingentupon whether a patienthas a life ex5pectancynot excèedingsix months. The implicit assumptionis thatsuchapredictionis not only possiblebut reliableandaccurate. Severalstudies designedto determine costs of hospicecare provided data on the averagelongevity of hospiceapplicantswhich wereusedin theformationofthiseligibility requirement (SeeRosen for an overview of these federally-sponsoredresearch studies.)5TheNationalHospiceStudy, conductedby Brown University and sponsoredby the Departmentof Health, Education,and Welfare, studiedthe costsatfourteen hospitalbasedand elevennon-hospitalbased hospices.Findings concerninglongevity ofhospicepatientssuggestedan averagelengthofstayof 62 daysin the hospital-based programsand72daysin home-carehospiceprograms.3 Until recently, Medicare benefits coveredup to 210 days of hospice care.6On January1, 1989,Medicare lifted the duration of hospiceservice coveragerestrictionwhile keepingthe financial cap amount constant,the maximum amount reimbursedfor hospicecare. If aggregate,annual servicecostsexceedthe capstipulated by Medicare, reimbursementwill be limited to this amount.To be cost-effective, it is important for hospice programsto accuratelyand reliably predictthe life spanof applicants.A hospicemust limit the numberof patients acceptedwho require prolongedcare,thecostsof which,will cause the hospiceto exceedthe Medicareaggregatepaymentcap. A study undertakento determine how accurateexpertswere in predicting thelife spanof applicantsto aninpatient-hospicefoundthatevenin this severely ill population,prediction of life-spanwasfoundtobeimprecisefor any specificindividual andonly moderatelyaccuratein the aggregate.1 The investigatorscollecteddataon 48 objective measuresregardingapplicantdemographicsandhealthvariables.This studyinvestigateswhether theseobjectivevariables,either alone or in combination,could distinguish betweenapplicantswho are likely to die within either threeor six months andthosewhoarelikely tolive longer.
{"title":"The use of physiologic measures and demographic variables to predict longevity among inpatient hospice applicants.","authors":"L E Forster, J Lynn","doi":"10.1177/104990918900600208","DOIUrl":"https://doi.org/10.1177/104990918900600208","url":null,"abstract":"Theadventof hospiceprogramsand theirfundingunderMedicarehasmade eligibility for a substantial insurance benefit contingentupon whether a patienthas a life ex5pectancynot excèedingsix months. The implicit assumptionis thatsuchapredictionis not only possiblebut reliableandaccurate. Severalstudies designedto determine costs of hospicecare provided data on the averagelongevity of hospiceapplicantswhich wereusedin theformationofthiseligibility requirement (SeeRosen for an overview of these federally-sponsoredresearch studies.)5TheNationalHospiceStudy, conductedby Brown University and sponsoredby the Departmentof Health, Education,and Welfare, studiedthe costsatfourteen hospitalbasedand elevennon-hospitalbased hospices.Findings concerninglongevity ofhospicepatientssuggestedan averagelengthofstayof 62 daysin the hospital-based programsand72daysin home-carehospiceprograms.3 Until recently, Medicare benefits coveredup to 210 days of hospice care.6On January1, 1989,Medicare lifted the duration of hospiceservice coveragerestrictionwhile keepingthe financial cap amount constant,the maximum amount reimbursedfor hospicecare. If aggregate,annual servicecostsexceedthe capstipulated by Medicare, reimbursementwill be limited to this amount.To be cost-effective, it is important for hospice programsto accuratelyand reliably predictthe life spanof applicants.A hospicemust limit the numberof patients acceptedwho require prolongedcare,thecostsof which,will cause the hospiceto exceedthe Medicareaggregatepaymentcap. A study undertakento determine how accurateexpertswere in predicting thelife spanof applicantsto aninpatient-hospicefoundthatevenin this severely ill population,prediction of life-spanwasfoundtobeimprecisefor any specificindividual andonly moderatelyaccuratein the aggregate.1 The investigatorscollecteddataon 48 objective measuresregardingapplicantdemographicsandhealthvariables.This studyinvestigateswhether theseobjectivevariables,either alone or in combination,could distinguish betweenapplicantswho are likely to die within either threeor six months andthosewhoarelikely tolive longer.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"31-4"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13796296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600204
D Lescohier
{"title":"Marketing hospice: the untold story.","authors":"D Lescohier","doi":"10.1177/104990918900600204","DOIUrl":"https://doi.org/10.1177/104990918900600204","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13796297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600221
D Sedman
{"title":"Echoes of silence: death and denial.","authors":"D Sedman","doi":"10.1177/104990918900600221","DOIUrl":"https://doi.org/10.1177/104990918900600221","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"21, 27-30"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13854267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-03-01DOI: 10.1177/104990918900600218
R B Patt
The provisionof analgesiaof any typeis, by definition, interventional.A recommendationof epiduralor spinal opioid therapycan beregardedas occupyingapositionatthefarextremeof the spectrumof interventional analgesictreatment.Spinal opioid therapy can reasonablybe groupedtogether with analgesicmodalitiessuchasnerve blocks andsome neurosurgery.Interventional techniquesof analgesia generallyentailsomeadditionalriskto thepatient,as well assome additional effort from practitioners,the patient andtheir family. The true test of the utility of interventional analgesic therapyis whethera techniquecontiibutes further to patientand family well beingthanwould more conventional treatment. Widespreadclinical experiencewith epidural and spinal opioid therapyindicate thatthe minimal risks and investmentof time required to learnabout and maintain treatmentjustify its use in selected patients.
{"title":"Interventional analgesia: epidural and subarachnoid therapy.","authors":"R B Patt","doi":"10.1177/104990918900600218","DOIUrl":"https://doi.org/10.1177/104990918900600218","url":null,"abstract":"The provisionof analgesiaof any typeis, by definition, interventional.A recommendationof epiduralor spinal opioid therapycan beregardedas occupyingapositionatthefarextremeof the spectrumof interventional analgesictreatment.Spinal opioid therapy can reasonablybe groupedtogether with analgesicmodalitiessuchasnerve blocks andsome neurosurgery.Interventional techniquesof analgesia generallyentailsomeadditionalriskto thepatient,as well assome additional effort from practitioners,the patient andtheir family. The true test of the utility of interventional analgesic therapyis whethera techniquecontiibutes further to patientand family well beingthanwould more conventional treatment. Widespreadclinical experiencewith epidural and spinal opioid therapyindicate thatthe minimal risks and investmentof time required to learnabout and maintain treatmentjustify its use in selected patients.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"11-4"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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