HFA's E-Newsletter - September 2012

Volume 12, Issue 9

In this issue:

Dear E-News Subscriber
Focus on: Voices about ANH - Joan Teno, MD
New Grief Webinar Series
New Perspectives on ANH
What's New @ HFA's Hospice and Caregiving Blog

Dear E-News Subscriber:

Each of our major educational programs includes an extensive evaluation asking learners to rate various aspects of the content Hospice Foundation of America provides. Viewer feedback indicates that our interviews with "real people" who share their stories are audience favorites. Often, I'm asked how HFA finds those people who are willing, even eager, to share some of the most intimate, difficult or tragic moments of their lives in a nationally viewed program. The answer is that we do a lot of research. We approach each program as journalists would, looking for people who can make a significant contribution to the curriculum developed by experts. We talk to hospice and palliative professionals for recommendations, search the internet, and do a significant amount of reading and research to find people. And sometimes those people accidentally find us. On Artificial Nutrition and Hydration at the End of Life, which debuts on Oct. 3, Michele DeMeo, an ALS patient, sent me a book she had written. On one of the last pages, she wrote about her feeding tube. Deborah Foster, a teacher, another person we interviewed for the program, blogged about her mother's illness and her own opinions of artificial nutrition and hydration. And Katey Lawson, an operating room nurse, who we found six years ago and interviewed for another HFA program, welcomed us back to her home to discuss the feeding tube her family felt was forced upon her son with terminal illness. We've traveled far and wide to meet some remarkable people over the years and to bring their stories to you, and each share a common desire: for clinicians to understand what they've been through so that care can be improved for others in the future. Thanks to all of them for doing just that.

Amy Tucci, President and CEO

Focus on: Voice about ANH - Joan Teno, MD

Artificial nutrition and hydration (ANH) can be a contentious issue in hospice, palliative care, and long-term care and has been identified as one of the most common ethical dilemmas to arise in end-of-life care. One way to sift through these issues is to listen to the voices of both professionals and laypeople who have first-hand knowledge of ANH.

Joan M. Teno, MD, MS, is Professor of Health Services Policy and Practice and Associate Director of the Center for Gerontology and Health Care Research. Dr. Teno talked with HFA recently about her cutting edge research around ANH and advanced dementia.

"Any time you do informed consent, you want to know about the risk and the benefit of that procedure. Now, while a feeding tube doesn't have a high mortality rate associated with it, there's some very important risk. And only a third of family members reported that they were informed of the risk of a feeding tube. The other thing that's important to know is our new research really suggests that feeding tubes can cause harm to patients. So, always before, the research suggested there was no evidence of benefit, but this study that was published in Archives of Internal Medicine is one of the first studies to suggest that feeding tubes may be associated with harm....Now, this may seem contrary because, you know, what happens when you get sick? Your mom gives you nutrition and nutrition makes you better. Well, I think we have to remember that a feeding tube is a foreign body attached to your stomach."

In addition to Teno's research, she has also led the way in re-thinking and re-framing these issues. "I like to talk about a new order that we recommended in an article published by the Journal of the American Geriatrics Society. We call that "comfort feedings only.' And under that order, what we do is we recognize at this point in their stage, our goal is not to maintain or increase their weight, but feed them as long as the patient is comfortably able to do that...this is a different way, really, to talk about the decision to not use artificial hydration and nutrition."

"Now, typically, those decisions have been called "do not feed" and that sort of rubs against our culture. And what we are trying to do is turn that around and say, 'yes - we're not putting in a feeding tube. We're not using artificial hydration and nutrition but what we're doing is we are going to try to continue to try and feed your family member as long as it's possible to safely do.'

More of Dr. Teno's interview will be featured on HFA's upcoming program on Artificial Nutrition and Hydration. To hear these interviews in their entirety, and to find out how the expert panel reacts to them, as well as to hear the panel's discussion of other important issues such as medical considerations, ethics, religion, the law, communication, and family dynamics, register here.

New Grief Webinar Series

Anticipatory Grief & Anticipatory Mourning: What We Know, How We Can Help will take place live online on Tuesday, September 18 from noon-1:30pm ET. Panelists will be Charles A. Corr, PhD and Kenneth Doka, PhD, MDiv. The program will explore the experiences that individuals, families, and professional caregivers may face in the course of an illness or in the face of other expected losses, and will offer specific interventive strategies that can be used with patients, families, and professional caregivers.

Other program topics in the series include:

The Death of an Adult Child: Helping Families Cope with Patricia Loder
Helping Children Cope with Their Own Dying or with the Death of a Loved One with Sherry Schachter, PhD, FT
Death of a Spouse or Partner: Current Research, New Strategies with Dale Lund, PhD

HFA webinars are a convenient way to bring the knowledge and expertise of these renowned experts directly to your staff and professional community. Registration includes the live program, access online for a full year, and unlimited CEs for a wide range of professionals. Register today.

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New Perspectives on Artificial Nutrition and Hydration

ANH

The experts on the New Perspectives program will discuss the complexities of ANH, its benefits and its burdens. In addition, they will address, and take questions from, program participants about the need for good communication with families, patients, and staff who may not always grasp the clinical, ethical, legal, cultural and spiritual considerations of this medical treatment. The program will also include interviews from experts and family members.

The program will be available on DVD on October 3, but register now to take advantage of the planning and support resources that HFA offers.

ANH Panel

What’s New @ HFA’s Hospice and Caregiving Blog

HFA’s Hospice and Caregiving Blog gathers and disseminates information useful to professionals and consumers from a single destination. Our goals are to inform, offer support, and generate online comments about important end-of life issues. Read some of the blog’s most recent postings:

Subscribe to the Hospice and Caregiving blog feed and follow us on Twitter.

This newsletter is sent to over 8,000 subscribers every month to keep you informed of what is happening in the fields of hospice, grief and bereavement, and caregiving, as well as what's new at HFA. Privacy Statement: In no case will we share e-mail addresses. See the full text of HFA's Privacy Policy.

This newsletter is published by Hospice Foundation of America
Amy Tucci, President and CEO
http://www.hospicefoundation.org
© Hospice Foundation of America 2012

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