Michigan 2006 Palliative Care Census Project (December 2006)
This project was conducted in support of the End-of-Life Care Strategic Plan developed by the Michigan Cancer Consortium, specifically the objective to increase access to palliative services throughout Michigan. Its purpose was to assess the availability and scope of palliative care services in Michigan hospitals, given the need to prevent and reduce avoidable suffering during the last phase of life for persons with cancer and other advanced chronic illness.
Note: The following project materials are available as Adobe Acrobat PDF files*:
Michigan 2007 Quick Palliative Care Survey Results (October 2007)
This project gathered information from hospital-based palliative care teams regarding: 1) barriers to optimal palliative care, and 2) sources of referral. Twenty of the 24 active programs that responded to the Michigan 2006 Palliative Care Census responded to a two-item follow-up survey they were sent. Results showed that barriers to optimal palliative care are commonly experienced by the majority of programs regardless of size of facility, tenure of program, number of patients served, or composition of the palliative care team. Physician resistance to palliative services and patient/family lack of awareness of prognosis were the top two barriers reported in most settings.
Michigan Department of Community Health (MDCH) — End-of-Life Resource Page www.michigan.gov/mdch/0,1607,7-132-2940_3183_
4895---,00.html
This site includes information and links for Michigan Circle of Life, which focuses on preserving the dignity and the rights of people who have a terminal or chronic illness, and the Michigan Commission on End-of-Life Care and its final reports and recommendations.
MDCH — Health Promotions Clearinghouse www.hpclearinghouse.org
The Circle of Life section of the MDCH Health Promotions Clearinghouse offers end-of-life care resource materials, including: the Michigan Hospice Directory; the Easing Cancer Pain brochure; the Guide to Hospice Care brochure; and the Completing a Life CD-ROM. Order these materials online using the links provided or call the Clearinghouse toll-free at 877-224-2727.
MDCH — Pain and Symptom Management www.michigan.gov/painmanagement
This Web site, a recommendation of the Governor's Advisory Committee on Pain and Symptom Management, was developed to increase the general public's and health professional's awareness of pain and symptom management. It provides information in the form of related Michigan statutes, professional papers, articles, and links to numerous organizations with expertise in the area of pain and symptom management. The Web site also includes information on the Governor's Advisory Committee on Pain and Symptom Management. The committee, reconvened in 2006, was originally a subcommittee of the Michigan Commission on End-of-Life Care. Its charge is to deal with issues pertaining to pain and symptom management, particularly in regard to public policy, public education, and professional education.
Michigan Office of Services to the Aging www.michigan.gov/miseniors
The Michigan Office of Services to the Aging provide leadership, innovation, advocacy, and supportive services on behalf of Michigan's 1.6 million older adults and their caregivers. Its mission is to promote independence and enhance the dignity of Michigan's older adults and their families.
Michigan Hospice and Palliative Care Organization (MHPCO) — Advance Directives www.mihospice.org/site/428/default.aspx
This page includes introductory information about advance directives and a link for downloading a Microsoft Word version of the booklet entitled Advance Directives: Planning for Medical Care in the Event of Loss of Decision-Making Ability, which was prepared by the Michigan State Long Term Care Ombudsman Program. The booklet includes advance directive information and copies of forms for durable powers of attorney for health care, living wills, do-not-resuscitate declarations, and declarations of anatomical gifts.
MHPCO — Caring Choices: A Guide to End-of-Life Decisions
and Care.
When people begin to address their needs
for end-of-life care, they find they have many important decisions to
make. These decisions are often difficult ones.
This Michigan Partnership
for the Advancement of End-of-Life Care guide (available in English,
Spanish and Arabic versions) is designed to help people to think about
what they want, ask for what they need, and understand some of the steps
to make sure they receive the care they desire. Sections of the guide
include:
Thinking about Your Decisions
No Matter Who You Are
Getting the Support You Need
Family
Healthcare Providers
Making Your Wishes Known
Phrases You Might Hear
Where to Turn for Information
To download a copy of the booklet, please visit:www.mihospice.org/site/398/default.aspx. To order Caring Choices: A Guide to End-of-Life
Decisions and Care, contact the Michigan Hospice and Palliative
Care Organization at 800-536-6300 (e-mail: mihospice@mihospice.org).
MHPCO —Consumer Guide to Hospice Care Online version: www.mihospice.org/Portals/_Rainbow/
Documents/Hospice%2066479_WEB.pdf (available as an Adobe Acrobat PDF file)*
Hard copies of the guide are available for $35 per 100 copies; order online using the Adobe Acrobat PDF form located at www.mihospice.org/Portals/_Rainbow/
Documents/0135a73b-27a7-4faa-a6f4-a266bd9bb0c4.pdf. For quantities of less than 100, call MHPCO at 517-886-6667. Funding for printing of this guide was provided by the Michigan Department of Community Health and administered by the Michigan Public Health Institute in support of the MCC priority objective on end-of-life care.
MHPCO —Hospice Care: A Physician's Guide Online version: www.mihospice.org/Portals/_Rainbow/
Documents/f1d81b2d-65b4-4ad7-b232-3e0f66afdbb2.pdf (available as an Adobe Acrobat PDF file)*
Hard copies of the guide are available for $50 per 100 copies; order online using the Microsoft Word document at www.mihospice.org/Portals/_Rainbow/Documents/Physician's Guides ORDER FORM.doc. For quantities of less than 100, call MHPCO at 517-886-6667. Funding for printing of this guide was provided by the Michigan Department of Community Health and administered by the Michigan Public Health Institute in support of the MCC priority objective on end-of-life care, and the Maggie Allesee Center for Quality of Life.
Michigan Cancer Pain Initiative www.mipain.org
This site, which was made possible through funding from the Lance Armstrong Foundation and the Alliance of State Pain Initiatives, offers resources for those suffering from pain, as well as for health care providers and policymakers. While it does not provide individualized health care advice, it equips patients and families to ask the right questions and advocate for relief of their pain more effectively. The Web site provides links to numerous resources, including those dealing with various palliative care options, patients’ rights, and complementary and alternative medicine. It also offers valuable information for all health care providers. The MCPI is an association of health professionals, patient advocates, and representatives of clergy, government, and higher education dedicated to addressing the problem of unrelieved pain from cancer.
State Bar of Michigan — Advance Directives: Planning for Medical Care in the Event of Loss
of Decision-Making Ability www.michbar.org/elderlaw/adpamphlet.cfm
This online version of the Advance Directives booklet from the Michigan State Long Term Care Ombudsman Program includes general information about advance directives, as well as specific information and Adobe Acrobat PDF versions of forms for durable powers of attorney for health care, living wills, do-not-resuscitate declarations, and declarations of anatomical gifts.
American Academy of Hospice and Palliative Medicine www.aahpm.org
The American Academy of Hospice and Palliative Medicine is an organization of physicians and other medical professionals dedicated to excellence in palliative medicine and the prevention and relief of suffering among patients and families by providing education and clinical practice standards; fostering research; facilitating personal and professional development of its members; and public policy advocacy.
Journal of Palliative Medicine www.liebertpub.com/publication.aspx?pub_id=41
This bimonthly interdisciplinary journal, which is the official journal of the American Academy of Hospice and Palliative Medicine, reports on the clinical, educational, legal, and ethical aspects of care for seriously ill and dying patients. It includes coverage of the latest developments in drug and non-drug treatments for patients with life-threatening diseases including cancer; AIDS; cardiac disease; and pulmonary, neurologic, and respiratory conditions.
Center for Practical Bioethics www.practicalbioethics.org/index.aspx
The Center for Practical Bioethics is a nonprofit, free-standing and independent organization nationally recognized for its work in practical bioethics. Since 1984, the center has helped patients and their families, healthcare professionals, policymakers, and corporate leaders grapple with ethically complex issues in medicine and research.
University of Wisconsin Pain & Policy Studies Group www.painpolicy.wisc.edu/
The Pain & Policy Studies Group's mission is to "balance" international, national and state policies to ensure adequate availability of pain medications for patient care while minimizing diversion and abuse, and to support a global communications program to improve access to information about pain relief, palliative care, and policy. Its Web site has information and links to U.S. and international resources.
University of Wisconsin Pain & Policy Studies Group Report: Achieving Balance in State Pain Policy: A Progress Report Card (2007) www.painpolicy.wisc.edu/Achieving_Balance/PRC2007.pdf(available as an Adobe Acrobat PDF file)*
Improving state policy is a necessary complement to the many ongoing state-level initiatives
designed to educate healthcare professionals about the appropriate use of pain medications
and to inform the general public about the availability of pain treatment options. Most
importantly, improving state policy will remove barriers and enhance appropriate access to pain
medications for people who experience severe cancer pain during the course of their illness and
beyond. This report, which is in its second year, evaluates state-level
pain management policies across the country. It was prepared by the University of Wisconsin Pain & Policy Studies Group (PPSG) and jointly funded by the American Cancer Society, the Lance Armstrong Foundation, and Susan G. Komen for the Cure. The 2007 report card shows that California and Wisconsin had the greatest grade improvement. Other states whose grades improved from last year were Arizona, Colorado, Connecticut, Kansas, Massachusetts, and New Hampshire. In addition, Kansas and Wisconsin now join Michigan and Virginia as having the most balanced pain policies in the nation.
Medscape CME/CE Activity for Medical Professionals: "End-of-Life Care in the Setting of Cancer: Withdrawing Nutrition and Hydration"(valid for credit through Jan. 29, 2009) www.medscape.com/viewprogram/8617
This
educational activity discusses approaches to determining and
implementing treatment preferences in regard to the withholding or
withdrawing of interventions. First, general principles and approaches
are covered. Next, specific issues of artificial nutrition and
hydration are covered in more detail. These issues frequently present a
challenge in routine practice, and they also provide an example of how
to discuss withholding or withdrawing treatments in general. Upon completion of this activity, participants will be able to:
discuss the principles for withholding or withdrawing therapy at the end of life;
describe the evidence base for artificial nutrition and hydration;
use a seven-step approach to discuss the withholding or withdrawing of artificial
nutrition or hydration;
assist families and professionals with their need to give care; and
discuss hospice care with patients and caregivers.
Physicians who complete the course will be eligible for a maximum of 1.5 AMA PRA Category 1 Credit(s); nurses will be eligible for 1.5 nursing contact hours; and pharmacists will be eligible for 1.5 ACPE continuing education credits (0.15 CEUs). All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Medscape CME/CE Activity for Medical Professionals: "The Last Hours of Living: Practical Advice for Clinicians"(valid for credit through Aug. 28, 2008)
www.medscape.com/viewprogram/5808
This activity is intended for physicians, physician assistants, nurse practitioners, nurses, students, and other clinicians who care for patients during their last hours of life. The goal of this activity is to provide a comprehensive overview of the last hours of life, focusing on the assessment and management of common physical symptoms and syndromes near the time of death. Upon completion of this activity, participants will be able to:
assist families to prepare for the last hours of life;
assess and manage the pathophysiologic changes of dying; and
pronounce a death and notify the family.
Physicians who complete the course will be eligible for a maximum of 1.75 AMA PRA Category 1 Credit(s)*; nurses will be eligible for 2.1 nursing contact hours (0.3 of them in pharmacology). All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Medscape CME/CE Activity for Medical Professionals: "Principles of Effective Pain Management at the End of Life" (valid for credit through Oct. 11, 2008) www.medscape.com/viewprogram/6079
This activity is intended for physicians, advanced practice and registered nurses, pharmacists, physician assistants, social workers, and other healthcare professionals who care for patients with far-advanced illness. The goal of this activity is to provide readers with a current and comprehensive overview of pain management at the end of life, offering guidance and detailed resources to practicing clinicians. Upon completion of this activity, participants will be able to:
describe the prevalence and significance of pain at the end of life;
identify techniques to assess pain in patients, including those unable to provide verbal reports;
list differential features of nociceptive and neuropathic pain states;
describe effective nonpharmacological means to relieve pain; and
recognize the therapeutic benefits and potential adverse effects associated with opioid and nonopioid pharmacotherapy for acute and chronic pain states at end of life.
Physicians who complete the course will be eligible for a maximum of 2.0 AMA PRA Category 1 Credit(s)*; nurses will be eligible for 2.4 nursing contact hours (none of these credits is in the area of pharmacology). All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation. Physicians should only claim credit commensurate with the extent of their participation in the activity.
*Please Note: You will need Adobe Acrobat Reader to open, view and print this file once it has been downloaded. If you need a free copy of Adobe Acrobat Reader, please click here.
