Advancing Palliative Care

Improving Palliative Care: We Can Take Better Care of People With Cancer | Institute of Medicine
http://www.iom.edu/CMS/3798/14758.aspx
This booklet summarizes the findings and recommendations of Improving Palliative Care for Cancer (2001) for the lay reader. It describes the types of palliative care (comfort care) that should be there for people dying from cancer, and the reasons why, too often, people suffer needlessly without it. The concrete steps that could be taken by society and individuals to improve access to palliative care are also in the recommendations. August 19, 2003

National Consensus Project for Quality Palliative Care
http://www.nationalconsensusproject.org
The work of the National Consensus Project began in 2002 and a NCP Task Force representing the four Coalition organizations [American Academy of Hospice and Palliative Medicine (AAHPM), Center to Advance Palliative Care (CAPC), (Hospice and Palliative Nurses Association (HPNA), National Hospice and Palliative Care Organization (NHPCO)] developed and disseminated two very successful versions of the Clinical Practice Guidelines for Quality Palliative Care (2004 and 2009). These guidelines have served as a foundation for the National Quality Forum Preferred Practices and have become a hallmark within the field guiding policy makers, providers, practitioners and consumers in understanding the principles of quality palliative care.

Navigating Palliative Care | Center to Advance Palliative Care & The National Hospice and Palliative Care Organization
http://iweb.nhpco.org/iweb/Purchase/ProductDetail.aspx?Product_code=821136
In this guide, the National Hospice and Palliative Care Organization (NHPCO) and the Center to Advance Palliative Care (CAPC) have collaborated to document the status of current hospice-based palliative care initiatives and identified the opportunities and barriers hospices face in establishing non-hospice palliative care programs across the country. The guide details the lessons hospice organizations have learned when framing and/or implementing palliative care models. It also documents the possibilities and challenges others have observed and/or experienced firsthand. This guide also includes a CD.

Palliative Care in Hospitals Surges 63 Percent in Three Years | Senior Journal
http://seniorjournal.com/NEWS/Eldercare/5-12-12-PalliativeCareSurges.htm
Palliative care programs continue to increase rapidly in U.S. hospitals. The study today in the Journal of Palliative Medicine shows 25% of U.S. hospitals offered palliative care in 2003. Researchers at the Mount Sinai Medical Center and the American Hospital Association report that the number of palliative care programs increased from 632 (15% of hospitals) in 2000 to 1,027 (25% of hospitals) in 2003 - a 63% increase in only three years. "This is a win-win for both patients and hospitals. Palliative care programs provide quality, efficient and cost-effective care focused directly on our sickest and most complex patients. Hospitals recognize that the cost of not providing this type of care is just too high," said Dr. Sean Morrison, one of the study's authors and Vice-Chair of Research, Department of Geriatrics at the Mount Sinai Medical Center. Dec. 12, 2005

President's Message on Health Care 2004 from the Robert Wood Johnson Foundation
This link downloads a PDF file.
http://www.rwjf.org/files/publications/annual/2004/RWJFAR04_PresLetter.pdf
Excerpt: The Center to Advance Palliative Care at the Mount Sinai School of Medicine in Manhattan is teaching academic, community and faith-based hospitals how to establish palliative care programs to relieve suffering and improve the quality of life for patients with advanced illness and their families. As a result, the American Hospital Association reports a 90 percent increase in palliative care programs in the past five years; today one in five hospitals has a program. U.S. News & World Report now considers palliative care as a criterion in its annual ranking of the country’s top hospitals. These are significant outcomes for Director Diane E. Meier, M.D., and the Center’s partners.

Remaking American Medicine: The North Carolina Connection | UNC-TV ONLINE
http://www.unctv.org/ncram/new_hanover.html
The [palliative care] program's acceptance within the medical community is evidenced by the rapid rate of growth since its inception. In 2002 the program was initiated and a total of 279 palliative care consultations were provided. By the close of the 2005 fiscal year, the program is projected to provide over 4,600 consultations annually. Additionally, the program has documented outcomes including a reduction in the average length of an inpatient stay of 1.6 days, a reduction in treatment costs of approximately $1500 per admission as well as increased patient, family and physician satisfaction scores. Other outcomes include an increase in the number of patients and family members who have participated in Advanced Care Planning and established directives for their future care.

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Aging and Palliative Care

Philanthropy and the 'Graying' of America | Philanthropy News Digest
http://foundationcenter.org/pnd/newsmakers/nwsmkr.jhtml?id=145400003
The oldest baby boomers have begun to turn 60, and over the next twenty-five years the population of older Americans will swell to historic proportions. According to the Census Bureau, by 2030 almost a fifth of all Americans — 72 million people — will be 65 or older, and those 85 and older will belong to the fastest-growing segment of the U.S. population.
Though the general public only recently has begun to pay attention to those demographic trends, many in the philanthropic sector have been thinking about the challenges posed by an aging population and looking to identify programs and initiatives that offer solutions. Since its beginnings as a pre-conference networking event at the Council on Foundations' annual conference in 1982, Grantmakers In Aging has emerged as one of the fastest-growing of the council's affinity groups and has galvanized a network of experts and funders in the field, all focused on strengthening grantmaking for an aging society. By Carol Farquhar, Executive Director, Grantmakers In Aging, May 25, 2006

Transforming Health Care: Services for Older Adults Can Drive High Quality Chronic Care for All | Grantmakers in Health
This link downloads a PDF file.
http://www.gih.org/usr_doc/Transforming_Health_Care_Hartford_June_2008.pdf
Excerpt: For too long, many foundations have thought of health and aging as a relatively small and specialized field. Retooling for an Aging America reminds us that the health care of older adults has significant ripple effects on our families and communities. We look forward to stimulating interest in the issue and engaging a broader group of partners to create a powerful coalition that seeks to develop a health care system and workforce that delivers high quality and cost-effective care to patients of all ages. By Corinne Rieder, Ed.D., Executive Director; and Christopher Langston, Ph.D., Program Director, The John A. Hartford Foundation, June 2, 2008

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Chronic Illness

Improving Chronic Illness Care | RWJF Anthology
http://www.rwjf.org/files/publications/books/2007/AnthologyX_CH03.pdf
In fact, the chronic care model calls for a structural change in the way people with illnesses are cared for, and the participation of nurses, social workers and patients themselves. This chapter highlights how difficult it is to change what goes on in physicians’ offices and to modify practices that have been entrenched for many years. The challenge is now one of moving an apparently effective way of improving quality from an experiment carried out primarily in health maintenance organizations to the mainstream of health care practice. By Irene M. Wielawski

Providing Care -- Not Cure -- for Patients with Chronic Conditions | RWJF Anthology
http://www.rwjf.org/files/publications/books/1999/chapter_08.html
The Foundation's goal of improving the way services are organized and delivered for people with chronic conditions has proven particularly elusive. The realities are daunting: a disorganized array of actors deliver services that are driven more by financing rules than by the needs of chronically ill individuals. Moreover, because acute care is often covered by insurance whereas more caring services--such as homemakers' visits--are not, the services offered to chronically ill people are skewed toward treating acute episodes of illness rather than coordinated approaches addressing a whole array of their needs. A logical approach to organizing services would be to start with the needs of people who have chronic conditions and then figure out how to meet those needs most effectively. By Lisa Lopez

Improving Chronic Health Conditions | Robert Wood Johnson Foundation
http://www.rwjf.org/files/publications/annual/2003/chronic-2.html
During the past decade, the Foundation has funded nearly $160 million in grants to educate physicians and nurses on palliative care, improve end-of-life care in hospitals and hospices, and change the way that health care professionals and the public think about and care for people at the end of life. This year, the Foundation took stock of its active end-of-life grants to determine which programs are firmly established and which may need further support to complete their work or to make the transition to other funding. 2003

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Conferences and Meetings

Meetings and Events Listing | National Palliative Care Research Center Resources
http://www.npcrc.org/resources/resources_show.htm?doc_id=376029
A listing of upcoming meetings and conferences.

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Critical Care Settings

Increased Access to Palliative Care in Critical Care Settings | The National Hospice and Palliative Care Organization
http://www.nhpco.org/i4a/pages/index.cfm?pageid=5715
The National Hospice and Palliative Care Organization has issued a position statement calling for increased access to palliative care for patients in critical care settings. More than one out of five deaths in the United States occur during or following admission to an Intensive Care Unit. At this critical time, palliative care providers can complement the knowledge and skills of critical care professionals in the areas of symptom management, assistance with decision-making, and end-of-life care. “The focus of critical care is primarily to saves lives,” commented J. Donald Schumacher, NHPCO president and CEO. “This is not always possible – not because of any lack of excellence on the part of critical care physicians, nurses, and others, but because some patients’ diseases are too advanced or their injuries are too severe. There are times when patients need additional care and support. They need palliative care.” September 4, 2008

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End-of-Life and Hospice

Circle of Life Award Winners | American Hospital Association
http://www.aha.org/aha/news-center/awards/circle-of-life/awardees.html
The Circle of Life Award honors innovation in palliative and end-of-life care. The Circle of Life Award honors programs that 1) are striving to equitably provide effective, patient-centered, timely, safe, and efficient palliative and end-of-life care, 2) are striving to implement the preferred practices for palliative and hospice care quality identified by the National Quality Forum consensus report, 3) show innovation and serve as models for the field, 4) support hospitals’ and health organizations’ efforts to improve palliative and end-of-life care, 5) build awareness of the importance of serving patients near the end of life well and supporting those close to them, 5) are actively working with other health care organizations and the community across the continuum of care. The 2008 award is supported in part by the California Healthcare Foundation, based in Oakland, California.

Describing Death in America: What We Need to Know | Institute of Medicine
http://www.iom.edu/CMS/3798/4929/5690.aspx
National expenditures for medical care in the months and days preceding death are enormous. But we do not know whether that money is buying good quality care or optimizing the quality of life of those dying, or whether the situation is getting better or worse over time. The information that exists "describing death" at a national level--though some of it is very informative--is fragmentary. This report recommends ways to fill the information gaps by better use of existing nationally-representative data, and through some new measures, in particular, a new, ongoing National Mortality Followback Survey. The aim is to allow us to benchmark where we are today as a society, and what goals we can set to minimize pain and suffering and maximize the quality of life of all of us who will die in the years to come. April 03, 2003

End of Life & Palliative Care: Summary & Strategy | Robert Wood Johnson Foundation
http://www.rwjf.org/pr/os.jsp?topicid=1194
Despite advances in medical care, Americans still often suffer from unnecessary pain, discomfort and lack of caring at the end of life. SUPPORT, a widely publicized research study funded by the Robert Wood Johnson Foundation (RWJF) between 1989 and 1994, found that hospitalized dying patients:

These findings spurred RWJF and the Open Society Institute to tackle the issue of improving care at the end of life. RWJF's most substantial programming in this area took place from 1995 through 2003.

Finding Our Way: Living with Dying in America
http://www.findingourway.net
. . . This is America’s other budding crisis in health care – while research for cures of life-threatening diseases barrels ahead, more and more Americans are also looking for better ways to die. As the end draws near, Americans are saying, give us the time, information and guidance to move to the final reprieve of palliative and hospice care. Allow us in our last days to live smart, to embrace the life we have left and to make our deaths our own.

Improving End of Life Care: Why Has It Been So Difficult? | The Hastings Center
This link downloads a PDF file.
http://www.thehastingscenter.org/pdf/improving_eol_care_why_has_it_been_so_difficult.pdf
November/December 2005 - This report contains 10 essays that present a synoptic overview of the most important developments in end of life decision-making and take stock of their successes or failures. The essays also provide ideas for a new strategy to improve care.

Last Acts: A Vision for Better Care at the End of Life | Robert Wood Johnson Foundation
http://www.rwjf.org/pr/product.jsp?id=20938
In 2005, Last Acts—a highly acclaimed Robert Wood Johnson Foundation national program—came to a close. The program's Web site, www.lastacts.org, ceased publication at the same time. Last Acts created a wealth of useful Web content—for health care consumers, health-care practitioners, policy-makers and employers. In the pages that follow, we present a selection of Last Acts editorial content. The articles appear here much as they appeared on the Last Acts Web site, occasionally with some editing or abridgement to conform to Robert Wood Johnson Foundation editorial requirements. The articles are presented primarily for their historical interest, to illustrate the depth of the Foundation's long commitment to quality end-of-life care. Many of the articles remain current, but readers are advised that some of the information could be dated.

On Our Own Terms: Moyers on Dying | Public Broadcasting System
http://www.pbs.org/wnet/onourownterms/
“What challenges emerge from balancing medical intervention with care and comfort at the end of life? How can you maintain meaning throughout your life? Learn about solutions for finding a better death and explore the options for humane care for the dying.” Veteran PBS journalist Bill Moyers blends interviews and research to describe the intimate experiences of patients, families, and caregivers as they struggle to infuse life's ultimate rite of passage with compassion, comfort, and meaning.

Project on Death In America | Open Society Institute
http://www.soros.org/resources/articles_publications/publications/pdia_20040101
The Project on Death in America (PDIA), an Open Society Institute initiative, has closed. From 1994 to 2003, PDIA worked to understand and transform the culture and experience of dying and bereavement. Over the course of nine years, PDIA created funding initiatives in professional and public education, the arts, research, clinical care, and public policy. PDIA and its grantees have helped build and shape this important and growing field, and have helped place improved care for the dying on the public agenda. You may download a pdf of “Project on Death in America Grantees, 1994-2003” on this site.

Unexpected Returns: Insights from SUPPORT | Robert Wood Johnson Foundation Anthology
http://www.rwjf.org/files/publications/books/1997/chapter_08.html
The chapter was written by Joanne Lynn, who is an Emily Davie and Joseph S. Kornfeld Foundation Scholar and the director of the Center to Improve Care of the Dying at George Washington University. Lynn co-directed SUPPORT with William Knaus, who is now chairman of the Department of Health Evaluation Sciences at the University of Virginia. The insights presented emerge from the collaborations of a national team of investigators that made the project happen. Lynn was involved in the study from the beginning, and she continues to work on research and medical innovations to improve care of the critically ill. As with many of the other chapters in this book, Lynn's chapter just scratches the surface of the many findings that have emerged from this complex study. We urge interested readers to seek out some of the many articles cited in the references. By Joanne Lynn

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For Patients and Families

GetPalliativeCare.org
www.getpalliativecare.org
GetPalliativeCare.org provides information for people coping with serious, complex illness. Key components of the site include a Palliative Care Directory of Hospitals, a definition of palliative care, and a detailed description of what palliative care is and how it is different from hospice. The site is provided by the Center to Advance Palliative Care.

Quality of Life and Palliative Care | Lance Armstrong Foundation
http://www.livestrong.org
Palliative care is any type of care that is meant to relieve the symptoms or problems caused by cancer or other diseases. Although this type of care was once more commonly associated with end of life, the goal of palliative care is to relieve physical, emotional and practical concerns at all stages of illness. Understanding what palliative care is and how you can get this type of care can help you improve your quality of life at any stage of survivorship.

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Grantmaking

The Foundation’s End-of-Life-Programs: Changing the American Way of Death | The RWJF Anthology
http://www.rwjf.org/files/publications/books/2003/chapter_04.html
At its heart, this chapter is a case study of the strategy involved in building a field by supporting thinkers, doers, and communicators who devote their professional attention to this important work. The Foundation’s grantmaking in this field is generally regarded as an example of “strategic philanthropy.” A small team of Foundation staff members selected three areas in which they felt the Foundation could make a difference: improving the education of practitioners; building model palliative care programs at hospitals; and raising awareness among the public. Although it is difficult to assess the success and failure of field-building efforts, the evidence presented by Bronner makes a strong case for initial success. By Ethan Bronner, 2003

Grantmakers In Aging
http://www.GIAging.com
Grantmakers In Aging (GIA), the only international professional organization of grantmakers active in the field of aging, classifies palliative care as one of its members’ focus areas. GIA has conducted  issue discussion calls on the subject, featuring a palliative care expert and offering the opportunity for GIA members to ask questions and exchange information with those directly engaged in advancing the field. Palliative care is also covered in GIA’s annual conference programming and is the topic of one of its Issue Briefs.

Grantmakers In Health
http://www.gih.org
Grantmakers In Health (GIH) is a nonprofit, educational organization dedicated to helping foundations and corporate giving programs improve the health of all people. Its mission is to foster communication and collaboration among grantmakers and others, and to help strengthen the grantmaking community's knowledge, skills, and effectiveness. Formally launched in 1982, GIH is known today as the professional home for health grantmakers, and a resource for grantmakers and others seeking expertise and information on the field of health philanthropy.

Ideas in Philanthropic Field Building | Foundation Center
This link downloads a PDF file.
http://foundationcenter.org/gainknowledge/research/pdf/practicematters_06_execsum.pdf
Ideas are often the currency of philanthropy. Ideas animate fields of philanthropic endeavor. Ideas can constitute “forces” in field building that determine a field’s direction. This paper examines the sources of ideas that program professionals in foundations draw from to create programs and influence fields of philanthropic interest. It also provides guidance about how foundation program staff can identify powerful and useful ideas and apply these to the work of philanthropy. March 2004

Transforming the Culture of Dying | The Foundation Center
This link downloads a 72 page PDF file.
http://foundationcenter.org
Transforming the Culture of Dying (72 pages, PDF) grew out of the Open Society Institute's Project on Death in America, a nine-year initiative ending December 2003 that was devoted to building the field of palliative medicine and placing improved care of the dying on the public agenda. To achieve these goals, the project funded programs in professional and public education, the arts and humanities, research, clinical care, and public policy with grants totaling $45 million. The report emphasizes the impact of private philanthropy on the development of palliative care, provides examples of strategic grantmaking, and offers recommendations to guide future funders. November 13, 2004

Project on Death in America's Recommendations to Grantmakers | Hospice Foundation of America
http://www.hospicefoundation.org/pages/page.asp?page_id=49428
Any foundation-large, small, private, corporate, community, or family-can help improve end-of-life care for patients and their families. Regardless of geographic focus, grant size, or funding priorities, any foundation concerned with alleviating human suffering has a role to play-and in the end, every funder has a personal stake in the quality of the end-of-life care system we create.

Innovative Models and Approaches for Palliative Care
http://www.promotingexcellence.org/
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes to improve health care for dying people and their families. Through the work of innovative demonstration projects and national workgroups we strived to address particular challenges to existing models of hospice and palliative care. The Promoting Excellence project was a time-limited project and no longer operates. The results of our work are archived by Growth House, Inc. for the ongoing benefit of the field.

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Healthcare Workforce, Medicine, and Nursing

End of Life/Palliative Care Education Resource Center | Medical College of Wisconsin
http://www.mcw.edu/EPERC/WhatsNew/Articles
Articles on various topics in Palliative Care education.

Palliative Care Leadership Centers
http://www.capc.org/palliative-care-leadership-initiative
Palliative Care Leadership CentersTM (PCLC) is a national training and mentoring initiative supported by a consortium of funders, with direction and technical assistance provided by the Center to Advance Palliative Care (CAPC). Exemplary palliative care programs located at six different institutions, PCLC offers training and mentoring to help start and expand hospital palliative care programs in the U.S.

Retooling for an Aging America: Building the Health Care Workforce | Institute of Medicine
http://www.iom.edu/CMS/3809/40113/53452.aspx
The nation faces an impending health care crisis as the number of older patients with more complex health needs increasingly outpaces the number of health care providers with the knowledge and skills to adequately care for them. As the nation’s baby boomers turn 65 and older and are living longer lives, fundamental changes in the health care system need to take place, and greater financial resources need to be committed to ensure they can receive high-quality care. Right now, the nation is not prepared to meet the social and health care needs of elderly people. April 14, 2008

Pearls from Your Peers | Center to Advance Palliative Care
http://www.capc.org/support-from-capc/capc-videos
Videos of leaders from the field speaking about Palliative Care.

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Organizations

American Academy of Hospice and Palliative Care Medicine
http://www.aahpm.org
The Academy is the professional organization for physicians specializing in hospice and palliative medicine. Membership is also open to nurses and other healthcare providers who are committed to improving the quality of life of patients and families facing life-threatening or serious conditions.

California Coalition for Compassionate Care
http://www.finalchoices.calhealth.org
The Coalition is a statewide partnership of more than 60 regional and statewide organizations dedicated to the advancement of palliative medicine and end-of-life care in California.

Center to Advance Palliative Care
http://www.capc.org
The Center to Advance Palliative Care (CAPC) provides health care professionals with the tools, training and technical assistance necessary to start and sustain successful palliative care programs in hospitals and other health care settings. CAPC is a national organization dedicated to increasing the availability of quality palliative care services for people facing serious illness. Direction and technical assistance are provided by Mount Sinai School of Medicine.

Hospice Foundation of America
www.hospicefoundation.org
Hospice Foundation of America meets its mission by conducting programs of professional development, public education and information, research, publications and health policy issues. Its programs for health care professionals assist those who cope either personally or professionally with terminal illness, death, and the process of grief, and are offered on a national or regional basis. Its programs for the public assist individual consumers of health care who are coping with issues of caregiving, terminal illness, and grief.

Life Quality Institute
http://www.lifequalityinstitute.org
Life Quality Institute is the premiere provider of palliative care education in Colorado. Education is a key ingredient that moves theory into practice. Through education, Life Quality Institute is dedicated to: advancing palliative care; examining spiritual, emotional and physical suffering; exploring quality of life; and developing supportive networks.

National Hospice and Palliative Care Organization
www.nhpco.org
The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization “is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.”

National Hospice Foundation
www.nationalhospicefoundation.org
Established in 1992, the National Hospice Foundation is committed to leading global, philanthropic efforts advancing quality, compassionate, end-of-life care for all. We strive to empower people around the world to make end-of-life choices that are right for them and their families. We want to ensure that at the end of life, people have the opportunity to: Maintain their dignity and self-respect; Live their final days pain-free; Access the highest quality care available through hospice. Our ultimate vision is a world where individuals and families facing serious illness, death and grief will experience the best that humankind can offer.

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Pain Management

Pain & Policy Studies Group
http://www.painpolicy.wisc.edu/index.htm
Our vision is that people who suffer pain from cancer, AIDS, surgery, accidents, and chronic conditions will have relief from their pain and a better quality of life; and that caregivers will know when and how to use opioid analgesics without fear of regulatory agencies. Our 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.

Pain and Palliative Care: What the Future Holds | Kathleen M. Foley, MD | University of California Television
http://www.uctv.tv/search-details.asp?showID=13442
Nationally recognized expert, Kathleen M. Foley, MD, talks about the assessment and treatment of pain in cancer patients, as well as developing policies for pain and palliative care worldwide. Dr. Foley is an Attending Neurologist in the Pain and Palliative Care Service at Memorial Sloan Kettering Cancer Center, and the Society of Memorial Sloan-Kettering Cancer Chair. First shown June 2, 2008

Who can benefit from palliative care? | Pain and Palliative Care for Adult Patients and Families | Dana-Farber/Brigham and Women's Cancer Center
This link downloads a PDF file.
http://www.dana-farber.org/pat/adult/pain/docs/pain-and-palliative-care-brochure.pdf
Any adult patient at Dana-Farber/Brigham and Women’s Cancer Center may take advantage of the Pain and Palliative Care Service. Palliative care can be helpful through all stages of illness. Early on, it can help make medical treatments more tolerable; at later stages, it can reduce suffering, help you carry on with your daily life, assist you in planning for future medical care, and provide support for living with a life-threatening illness.

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Pediatrics

Children’s Hospice & Palliative Care Coalition
http://www.childrenshospice.org
Children’s Hospice & Palliative Care Coalition is a social movement led by children’s hospitals, hospices, home health and grassroots agencies, and individuals to improve care for children with life-threatening conditions and their families.

Partnering for Children
http://www.partneringforchildren.org
Partnering for Children is a national awareness campaign to help get the word out about compassionate, family-centered healthcare for children with life-threatening conditions. The campaign is reaching out to parents, healthcare professionals, the media, and funders about the benefits of palliative care and hospice.

Research

National Palliative Care Research Center
www.NPCRC.org
The mission of the National Palliative Care Research Center (NPCRC) is to improve care for patients with serious illness and the needs of their families by promoting palliative care research. In partnership with the Center to Advance Palliative Care, the NPCRC will rapidly translate these findings into clinical practice. Specifically, the NPCRC is providing a mechanism to: establish priorities for palliative care research; develop a new generation of researchers in palliative care; and coordinate and support studies focused on improving care for patients and families living with serious illness.

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Rural Communities

Rural Palliative Care Pilot Project
http://www.stratishealth.org/expertise/longterm/palliative.html
Rural communities are uniquely positioned to meet the challenges of providing palliative care through collaborative efforts. Rural communities with similar areas of focus can benefit from structured opportunities to connect and share tools and lessons learned in implementation. A set process and timeline, access to palliative care program development expertise, and external facilitation to help initiate and develop community-based teams are important aspects that can assist in further developing community-based palliative care efforts in rural areas.
Final report is available for download as a pdf: http://www.stratishealth.org/documents/NRHA_PC_Report_09-09.pdf

Rural Aging | Global Action on Aging
http://www.globalaging.org/ruralaging/us/index.htm
Articles and information on Rural Aging and health in the United States.

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Social Justice

Access to Hospice Care: Expanding Boundaries, Overcoming Barriers | The Hastings Center
http://www.thehastingscenter.org/Publications/SpecialReports/Detail.aspx?id=1352
This report looks at issues of social justice, access, and public policy in hospice and palliative care. As it examines the issues from the perspectives of social justice and fairness, it also recommends ways in which the definition of hospice can be expanded to include more Americans for a longer period of time than simply the days or months shortly before death. March - April 2003

One Final Gift: Humanizing the End of Life for Women in America | Alliance for Aging Research
http://www.agingresearch.org/content/article/detail/699
One Final Gift shows that women are more likely than men to be sicker, poorer, alone, and with greater care needs at the end of their lives. This report identifies the disparities in research and public policies and raises the health, social, emotional, and spiritual concerns that confront many women as they near the end of their lives. It also outlines recommendations on how to best bridge these unacceptable gaps.

Palliative Care and Pain Treatment as Human Rights | International Association for Hospice & Palliative Care
http://www.hospicecare.com/resources/pain_pallcare_hr
There have been several requests and publications calling for palliative care and pain treatment to be recognized as human rights but not an international Declaration joining palliative care, pain, cancer, AIDS and other related organizations for this same purpose. The IAHPC and the Worldwide Palliative Care Alliance (WPCA) joined efforts and worked together to develop a Joint Declaration and Statement of Commitment which unites all organizations working in this field.

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Social Work

Social Work in Hospice and Palliative Care Network
http://swhpn.org/lhp/
We are an emerging network of social work organizations and leaders who seek to further the field of end-of-life and hospice/palliative care... in other words, we are advancing the role of the social worker in caring for the seriously ill, providing relief from pain, improving quality of life, supporting family and friends, assisting with difficult decision-making, and help in dealing with trauma, grief and loss.

The Role of Social Work in Hospice and Palliative Care | National Association of Social Workers
http://www.socialworkblog.org/helpstartshere/?p=11
The social work profession helps individuals, families, groups and/or communities enhance or restore their capacity for optimal psychological, emotional, spiritual, social and physical health. Social workers are a core service on hospice and palliative care teams. Their professional values and skills are a perfect match with hospice and palliative care programs, which are designed to treat the whole person in an interdisciplinary manner to enhance quality of life during challenging times. By Mary Raymer, MSW, ACSW

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Spirituality

New Guidelines in Incorporating Spirituality in End-of-Life Carehttp://www.archstone.org/publications2292/publications_show.htm?doc_id=1128801
The article, “Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference,” has been published in the Journal of Palliative Medicine and represents the final Consensus Report of a Summit sponsored by the Archstone Foundation. November 10, 2009.

Spirituality and Health in Late Life | University of California Television
http://www.uctv.tv/search-details.asp?showID=11727
Dr. Michael Rabow is an internal medicine and palliative care specialist at UCSF Medical Center. He explores the impact of spirituality on health, particularly in later life. July 31, 2006

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