Monthly Archives: April 2013

Medical Marijuana in Hospice Care

Is it time to legalize medical marijuana in Missouri? Maybe. Is it time to put the issue of legal medical marijuana up for discussion? Yes, absolutely. Is this an issue for our legislators to bring to the state’s voters in 2014? Without a doubt, yes.

Californians voted in November, 1996, to allow medical use of marijuana. Colorado voters approved medical marijuana in 2000. The Illinois state House of Representatives recently voted in favor of becoming the 19th state to allow medical use of marijuana. Is it time to seriously think about adding Missouri to the list? As an organization concerned about providing comfort to patients, we believe this is a topic for serious consideration.

The city of St. Louis Board of Aldermen recently reduced the penalty for possession of small amounts of marijuana to a minor offense, not unlike a traffic ticket. Colorado and Washington state voters sanctioned recreational use of marijuana in November, 2012. Obviously, opinions about marijuana use (medical and otherwise) are changing.

As with other drugs that treat patient symptoms and bring comfort, the distribution of medical marijuana in Missouri should be strictly regulated. But laws should not make it difficult for qualified patients to obtain medical marijuana.

Charles Monson of Long Beach, California, is a longtime medical marijuana advocate. He spoke to the California Hospice and Palliative Care Association at their annual conference in 2009. Monson points out: At its heart, hospice care is about bringing comfort to those who suffer. Whether by eliminating nausea and allowing a patient to enjoy a favorite food, or reducing consumption of [stronger drugs], thereby enabling a patient to interact in a more meaningful way with loved ones, or by merely providing peaceful sleep, marijuana delivers therapeutic efficacy and options to hospice care.

Advocates say that medical marijuana can help people with a variety of ailments, such as multiple sclerosis, premenstrual syndrome, epilepsy, migraines, anorexia, bipolar disorder and many others. At Hope Hospice, our primary concerns are patient comfort and symptom control. This is our motivation for putting this issue on the table.

Representative Mike Colona from St. Louis has introduced legislation in Jefferson City that would bring the issue of medical marijuana to state voters. He recently told the St. Louis Post-Dispatch, “My philosophy has always been, if we can trust a doctor to prescribe Vicodin, which is more dangerous, why can’t we trust a doctor to prescribe medical marijuana?” He also said, “Historically, this bill has never gotten a hearing.”

We at Hope Hospice believe it’s time to start talking seriously about medical marijuana for Missourians.


Compassion and, Yes, Love Are Vital Parts of Hospice Care

Every hospice care agency gets them and values them. We certainly receive our share here at Hope Hospice. We get letters—from family members and other survivors—offering thanks and gratitude for the care and concern provided by hospice team members.

A theme that runs through most of these letters is an appreciation for the level of personal concern shown by hospice nurses and home health aides. Also mentioned in the letters are other staffers, including chaplains, social workers, massage therapists and volunteers. The words “compassion,” “kindness,” “support” and, yes, “love” show up frequently in such letters.

The letters we receive at Hope Hospice demonstrate that the personal experience of having a family member or other loved one on hospice is often different from what had been anticipated.

A cross-section of these comments reveals many mentions of service that exceeded expectations. As more people learn what hospice is and become somewhat familiar with hospice care, there are preconceived notions of how things will proceed when a loved one is on hospice care. We are happy that many who write letters are pleasantly surprised the many elements of hospice care they were unaware of.

The letters often mention the knowledge and expertise of our team members. They also mention the attention paid to family members and other loved one after the patient’s death.

Of course, like anyone, we enjoy hearing from those who have found our services were more than satisfactory. We especially appreciate when family members acknowledge the compassion and love shown by specific individuals on our staff.

Because hospice care is a unique form of medical service, the opportunity to connect with patients, family members and other caregivers on personal basis is one that we don’t take lightly. To all who have taken the time to write us about your experience with Hope Hospice, we thank you.

Last Minute Hospice

Statistics reveal that many people are still waiting to the very end of a loved one’s life to call hospice. While awareness of hospice grows in the US, the numbers regarding time spent with hospice are cause for concern.

The Journal of the American Medical Association reported in February research revealing that more that 28 percent of patients received hospice care for three days or less. At Hope Hospice, we often have patients who pass away within three days of the date we admit them. While we provide the best service we can to those individuals and their families, we can only speculate how much more we could have done if we had had a longer time with the patient under our care.

Recently shared research by two Notre Dame grad students reveals more cause for concern. They asked 300 residents of northern Indiana when they would call hospice. About 11 percent said they would call when death is expected within a few days, about 12 percent said within a few months of an expected passing and 22 percent said they did not know.

A hospice official in northern Indiana responded to the Notre Dame study by saying, “The most common phrase we hear from families is, ‘I wish we had contacted hospice sooner.’”

A hospice nurse from that part of Indiana said that hospice workers are able to bond with families when they have enough time. She says, “People tend to wait to the last minute.” She says that with short-term hospice patients, “You’re just putting out fires.”

When is the correct time to call hospice? That is not always easy to say. Follow the advice of doctors. Although some doctors are still hesitant to recommend hospice—doctors are trained to cure—more and more are realizing the value of hospice.

If you have a loved one who may be eligible for hospice care, feel free to call us at Hope Hospice anytime. We encourage you not to wait to the last minute. Reach Hope Hospice at 314-984-9800.


National Healthcare Decisions Day

Tuesday, April 16 is probably just another day to you. But it should be a day for you to consider important decisions involving key members of your family—including you, yourself.

National Healthcare Decisions Day, April 16, is a day to think about advance planning for the end of your life and the end of your loved ones’ lives.

But, wait, you say, everybody’s healthy and nobody is facing any sort of health crisis. That makes now an ideal time to think about all those relevant questions. Life-threatening medical conditions can occur suddenly. Accidents happen.

If you haven’t personally experienced the agony of making a decision regarding a family member’s treatment, you probably know someone who has. They can be marked by heated discussions and lead to personal anguish and family discord. Sometimes these decisions may be less difficult to make, but often they are grueling.

You can spare your family this painful experience by deciding now, when your mind is clear, the types of actions you would prefer to be taken on your behalf. You can make your wishes known before a crisis occurs. You can assign a “durable power of attorney” designation to your spouse, your partner, a child or other family member or friend.

In Missouri, our attorney general’s website has a form that we at Hope Hospice recommend for patients and family members. The form allows you to make end of life decisions. It also has guidance to help you make those decisions. Click HERE to obtain the form.

2013 will mark the 6th annual National Healthcare Decisions Day. NHDD was founded by attorney Nathan Kottkamp in Richmond, Virginia. NHDD has a website with much good information about advance directives and living wills. We encourage you to visit the site by clicking HERE.

As the video on the NHDD website asks, “Who will speak for you when you can’t speak for yourself?” Make those decisions now. You may not be able to make them later.

Fewer Americans Are Dying in Hospitals

New statistics from the Centers for Disease Control and Prevention reveal that during the decade 2000-2010, annual deaths in US hospitals decreased by nearly ten percent.

The CDC’s National Center for Health Statistics, in its March HCHS Data Brief, the decreases were even more dramatic among specific diseases. The report states that the in-hospital death rate for persons diagnosed with kidney disease decreased 65 percent. The decrease for cancer patients was 46 percent; for pneumonia, 33 percent; and for heart disease, 16 percent.

The drop in hospital deaths was primarily among women, although the HCHS Data Brief did not have a solid reason why. The author of the report, Margaret Jean Hall suggested, “That could just be that there were more older women who were able to be placed in alternative settings, because women live longer. That’s just a hypothesis.”

Because study after study (and our own experience with patients) reveals that most patients would prefer to die at home, we view this information as a positive. Others who have viewed these new stats feel that the decrease should have been greater, based on the increase in the number of hospice patients in America during the period.

A CDC report in February indicated that 33.5 percent of Medicare patients died in their own homes in 2009, compared to 23 percent in 2000. We at Hope Hospice find these trends encouraging and are optimistic that more patients and families will choose hospice for end-of-life care.

We continue to share information about hospice care in general and Hope Hospice care in particular to all who will listen. If your family, your church group or your civic organization wants to know more about hospice, please call Hope Hospice at 314-984-9800 or visit us online at