Category: End of Life

Comments on the The Nursing Home Conditions of Participation Proposal

By Anne Montgomery Centers for Medicare and Medicaid Services (CMS) has issued the long-awaited “conditions of participation” rules proposed for nursing homes. These rules signal another step in the ongoing shift in CMS toward encouraging more livable and well-supported facilities and staffing. However, since long-stay residents must consider the facility to be their home, we

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Don’t Accept Medical Errors as the Standard of Care for Frail Elders

By Joanne Lynn, MD If you are hoping for a good night’s sleep, don’t read the stories told by Marcy Cottrell Houle of her parents’ last years of life just before you go to bed. But do read The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare [http://www.thegiftofcaring.net/], which Houle wrote

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Comments on Payment for Advance Care Planning

CMS gently proposes [2015] paying for advance care planning discussions between patients and physicians under Medicare. While this is certainly a good beginning, CMS coverage should encourage comprehensive care planning, not just “brink-of-death” care and not just for eventual incompetence but also for persons now incompetent and those who retain competence to the end of

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Sixth White House Conference on Aging: Now It’s Time to Do More. A Lot More.

By Anne Montgomery Around the country, people at more than 600 “watch parties” gathered to tune into a livestream of the White House Conference on Aging (WHCOA) [http://www.whitehouseconferenceonaging.gov] on Monday, July 13, 2015. Hosted by the White House in the East Wing and the Eisenhower Executive Office Building with an invited audience of about 200

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High and Worsening Symptom Prevalence in the Last Year of Life

by Adam Singer Symptoms such as pain and confusion are very distressing for those nearing the end of life and their families. That’s why increasing attention to end-of-life care is spurring greater interest in alleviating such symptoms as a critical component of quality of life. Yet there is still a long way to go: a

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Shaping Communities that Care for Frail Elders

Despite surveys that indicate our overwhelming preference to grow old and die in our own home, those among us who grow old and frail are more likely to live in many different settings. The likelihood that we will face old age encumbered by multiple complex health conditions makes it very likely that we will, at

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A Future So Bright? Or So Old? Challenges for an Aging America

As much  as we tell ourselves and each other that 80 is the new 60, or 60 is the new 40, we are kidding ourselves, and setting up a future in which the needs of very frail elders are unseen, misunderstood, and unmet. Popular culture and its pressure to be forever young  ignores the reality

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Very Old Adults Will Need Enhanced Social Services to Balance Medical Care

Another in our series to build the MediCaring book. Judith R. Peres contributed significantly to this post. Please feel free to comment, expand, tell us what we’ve got right, and what we have missed. For decades, older adults have relied on the medical system to cure or treat what ails them; but those aging into

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The Very, Very Old: The Challenges of Increased Longevity

A new entry for our forthcoming book on the MediCaring model for care for frail elders.  Living to be very, very old–advanced old age, the oldest of the old–is not just middle age with gray hair.  It is not. And yet even though we know what is ahead,  very old age will come as a

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Resources for Advance Care Planning include Handbook for Mortals

Handbook for Mortals cover

The following post first appeared on March 27 as “New Chapters” via http://www.mydirectives.com.  Starting productive conversations with your loved ones about your life decisions is not always easy. It takes a great deal of strength and initiative to take that first step. One of the best ways to take initiative is to find inspiration, so

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