November 17, 2006

End of Life Issues

A number of opinion polls have been conducted regarding end of life issues. These polls reveal that:

70+% of Americans prefer to die at home, free from pain and with their loved ones. 

50% of Americans die alone in hospitals.

20 - 25% die in nursing homes.

24.9% actually die at home. 

Indiana residents have < 30% chance to die at home.*

*reported by the Brown University Center for Gerontology and Health Care Research.

Proliferation of Boomers to push
end of life issues to forefront 

• Because of the growing number of aging baby boomers, there is a need for serious efforts to research how to best provide care for dying individuals and their loved ones. For a detailed report on end of life issues, including state policies and the role of palliative care, read Means to A Better End, funded by the Robert Wood Johnson Foundation. Find this report at http://www.rwjf.org/files/publications/other/meansbetterend.pdf
  
  
• A study published in the Journal of the American Medical Association, Vol. 281, No. 2. examined 126 participants' perspectives of quality end of life care. Participants included patients receiving dialysis, people with HIV and residents of a long-term care facility. The study found five domains of quality of end of life care:

1. receiving adequate pain and symptom management;
2. avoiding inappropriate prolongation of dying;
3. achieving a sense of control;
4. relieving burden, and
5. strengthening relationships with loved ones.

An abstract of the report, originally published January 13, 1999, can be found here.

• PBS Online offers you a glimpse into the film "Before I Die/Real Life Stories" which premiered on April 22, 1997. The program explores the medical, ethical, and social issues surrounding end of life care in America today. Funded by the Robert Wood Johnson Foundation, the life stories and a glossary can be found at http://www.thirteen.org

Other end of life resources
Additional resources to educate yourself or those you serve on end of life issues include these sites:

• APA Online: The American Psychological Association site offers Fact Sheets, things to consider when exploring end of life issues, terminology, definitions, glossary of terms and resources.

• International Association for Hospice and Palliative Care (IAHPC): This site provides you with hospice and palliative care resources and education. In addition, the IAHPC site connects you to an in-depth Manual of Palliative Care at http://hospicecare.com/manual/IAHPCmanual.htm

  From the IAHPC Bookshop you can order both new and used books. Two books in which aging service providers may be interested include Providing A Palliative Care Service: Towards an Evidence Base and Good End: End of Life Concerns and Conversations about Hospice and Palliative Care.

• The National Hospice and Palliative Care Organization:  This charitable organization was created in 1992 to broaden America's understanding of hospice through research and education.

• Family information and support can be found at www.familyhospice.com.

Research study recruitment
Attention retirement facilities & senior centers:  Older research volunteers are needed for a survey related to interests in participating in a mindfulness-based stress reduction program. Linda Brown, graduate student in the clinical rehabilitation psychology program at IUPUI, is conducting the study. Volunteers will complete a questionnaire that takes about 30 minutes. To be eligible, the volunteer must be age 55 or older and either residing in a retirement facility or attending a senior center.

Brown would like to hear from senior centers or retirement facilities that can provide access to this population. She will come to the facility and present the survey with two options: the questionnaire can be completed and handed back on the spot or it can be mailed back in the self-addressed stamped envelope provided. To show appreciation to volunteers, Brown provides homemade banana bread and mulled apple cider at her presentations. If you can assist with this project, please contact Brown at (317) 278-7861 or by e-mail at lfbrown@iupui.edu.

Free Indianapolis-area home safety assessments: Fengyi Kuo, assistant professor of occupational therapy at the University of Indianapolis, and a group of graduate occupational therapy students are conducting a study that includes free home safety assessments for adults age 65 and older in the Indianapolis area. Through the program, Kuo and her students will visit the home two times - an initial 90 minute visit and a 45 minute follow-up visit about one month after the first visit. They will conduct an assessment of the home and offer recommendations for improving its safety. If you know of someone who may be interested in participating in the home assessments, please encourage them to contact Kuo at (317) 788-3428 or by e-mail at fkuo@uindy.edu. Appointments are being made for January and February 2007.

Call for presentations
The Indiana Health Care Association is currently seeking presenters for its 2007 Annual Spring Conference & Awards Luncheon, to be held April 10-11, 2007 in Indianapolis. To download a presenter application form, visit http://www.ihca.org/education/ and click "2007 Call for Presenters." Presentation proposals are due Friday, December 8. For more information, contact Cara Siletto at (317) 636-6406.

Grants to go for
Check out these grant opportunities from the federal government:

Dissemination Research on Fall Prevention: "Stepping On" in a U.S. Community Setting Grant Offered by: Department of Health and Human Services, Centers for Disease Control and Prevention
Closing date for applications: February 23, 2007
http://www.grants.gov/search/search.do?mode=VIEW&oppId=11359

Research and Evaluation on the Abuse, Neglect, and  Exploitation of Elderly Individuals, Older Women, and Residents of  Residential Care Facilities Grant United States Department of Justice
Offered by: Department of Justice, Office of Justice Programs, National Institute of Justice
Closing date for applications: January 30, 2007
http://www.grants.gov/search/search.do?mode=VIEW&oppId=11360