Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2015
Medicare Care Choices Model Enables Concurrent Palliative and Curative Care.
On July 20, 2015, the federal Centers for Medicare & Medicaid Services (CMS) announced hospices that have been selected to participate in the Medicare Care Choices Model. Fewer than half of the Medicare beneficiaries use hospice care for which they are eligible. ⋯ This report describes how CMS has expanded the model from an originally anticipated 30 Medicare-certified hospices to over 140 Medicare-certified hospices and extended the duration of the model from 3 to 5 years. Medicare-certified hospice programs that will participate in the model are listed.
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J Pain Palliat Care Pharmacother · Jan 2015
How Palliative Care Helped Me Make an Important Decision in My Life.
The author writes about her father's illness and how her knowledge of palliative care and "dying with dignity" helped her make important decisions for her father in his last days. She and her family members were able to give him the kind of care he needed and desired. He could enjoy the time he had left, and the family had the satisfaction of serving him when he needed them.
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There is a lot of unrelieved pain in developing countries. Here is a story from Bali, Indonesia, about a woman with advanced malignancy, who is in unbelievable agony. Expensive chemotherapy is available to her. ⋯ The woman's pain affects the whole family, endangering the family's income and the future of her children. The intervention of palliative care during part of her life gives her some relief, only for the agony to be repeated by pointless chemotherapy and neglect of the suffering during admission to the hospital. Whatever relief could be given to her was because of the intervention of a volunteer with no schooling in medicine or palliative care.
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Understanding spirituality during palliative care training is not easy. It slowly unravels itself when one starts caring for patients and meeting their caregivers. One such experience in the hospice has been described in this narrative. ⋯ Over time, he slowly comes to terms with the situation and eventually, a question from his illiterate wife--an insightful question about any last wish--brings out his desire to have certain religious rituals that were alien to his own religion. After his death, the family members concur with his last wish and also indulge in some religious rituals of their own choice. This story reaffirms that the essence of spirituality is the coexistence of harmony and humanity.