Article Content

International Association for Hospice and Palliative Care Clearing House Program Accepting Donations

The International Association for Hospice and Palliative Care (IAHPC) has launched a Clearing House Program designed to help programs and individuals in developing countries by matching them with donations of medical supplies, journals, publications, and helpful items.


In the past two years, the IAHPC has gratefully accepted donations from individuals, hospices, organizations, libraries, and universities and distributed them to more than 30 programs in 27 developing countries, including Argentina, Bosnia and Herzegovina, Brazil, Chile, Colombia, Congo, Costa Rica, Croatia, Ecuador, Ghana, India, Jamaica, Latvia, Malaysia, Mexico, Pakistan, Peru, Philippines, Poland, Russia, South Africa, Uganda, Ukraine, Venezuela, Vietnam, and Zimbabwe.


Some of the donations include books, such as Palliative Medicine (3rd ed), donated by the author, Roger Woodruff, MD, also a member of the IAHPC Board of Directors, and continuing donations of pain, oncology nursing, and palliative care journals by Pamela Bennett of the Purdue Fund.


If you have material that is of limited use to you, consider donating it to IAHPC. It will be sent to programs in developing countries where it is greatly appreciated.


The following are the items IAHPC accepts for donation:


* Journals and books relevant to palliative care not more than five years old


* Medical supplies, such as stethoscopes, syringes, gauze, dressings, etc.


* Shampoo, soap, toothpaste, etc.



Unfortunately, IAHPC is unable to accept donations of medications or furniture.


Please send donations to the following address:


IAHPC Clearing House Program


5535 Memorial Dr


Suite F-PMB 509


Houston, TX 77007


Telephone: 713-880-2940


Fax: 713-880-2948


IAHPC also asks for your assistance with a new page at its Web site called Symptom Assessment and Research Tools at, which is designed to assist clinicians in developing countries to locate palliative and pain assessment tools by listing them in a central place. Please visit the page, and if you know of any free universally available tools not listed there, let the IAHPC know where to upload them.


For more information and news on IAHPC programs, visit




Spending Differences Related to Race and Gender Disappear During Last Year of Life for Medicare Recipients

Although healthcare spending on minorities, poor people, and men is often lower than spending on whites, higher income people, and women, the spending gap narrows or disappears in the last year of life for Medicare patients, according to a RAND Corporation study released in March 2004 and published in the February issue of the Journal of General Internal Medicine.


This is one of the first times that researchers have identified a segment of the healthcare system where spending differences do not exist based on race or gender. Disparities in healthcare spending, quality, and access based on race are a growing national issue. The federal Agency for Healthcare Research and Quality released a widely cited report on the issue last year.


"End of life issues are very important, and rapidly attracting more attention," said Lisa Shugarman, a RAND researcher and lead author of the report. "The number of elderly people coming to the end of life is rising rapidly and will nearly double in the first quarter of this century. No one has looked before to see what happens to medical expenditures related to gender, race, income, and age for people in their last years of life. Those costs have crucial impact in areas ranging from our personal finances to our national budget."


RAND researchers examined the medical claims of 241,047 Medicare patients from throughout the nation. The youngest patients studied were 68, and the oldest were 90 and above; the team also found that "considerable disparities may yet exist in the array of services accessed or in the quality of end of life care" during the last year, although spending levels did not vary by much.


Shugarman and her colleagues suggest several possible reasons for small or nonexistent differences in spending by gender, race, and income in the last year of life. It may be that the combination of being seriously ill and having nearly universal access to healthcare through Medicare is enough to overcome the usual barriers to getting healthcare.


However, the project did not address these issues and more research will be needed to determine whether these or other factors influence the findings, researchers say.


Although spending differences disappeared during the last year of life, they were evident in the study population earlier in life. During the second and third years before death, medical expenditures were lower for African Americans than for whites and higher for women than for men.


Shugarman said that women's expenditures are higher than men's in part because women frequently have accumulated more physical disabilities than men and are more likely to see a physician. Additionally, even though men often have a spouse at home to provide care, women frequently outlive their spouses, so they must rely more on the healthcare system to meet their healthcare needs.


The study also found that during the last year of life, spending was higher for younger patients compared with older patients. For example, the authors found that Medicare spending for recipients who were 90 or older when they died was 31% lower than expenditures for those between the ages of 68 and 74 when they died. The opposite is true for Medicare recipients in the second and third year before death, with older patients spending more in the two years before death.


Other authors of the report are Diane E. Campbell from RAND Health and Medical Outcomes Research and Evaluation Services in Vermont, Chloe E. Bird of RAND Health, Thomas A. Louis of the Johns Hopkins Bloomberg School of Public Health, Jon Gabel of Health Research and Education Trust, and Dr Joanne Lynn of RAND Health and the Washington Home Center for Palliative Care Studies.


Support for the study was provided by the Agency for Healthcare Research and Quality, the National Institute on Aging, the Fan Fox-Leslie Samuels Foundation, and The Washington Home Center for Palliative Care Studies.


The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors throughout the world. For more information on RAND, visit its Web site at




Applications Available for 2005 Circle of Life Award

Applications are now available on the Web site for the 2005 American Hospital Association Circle of Life Award: Celebrating Innovation in End-of-Life Care.


The Circle of Life Award honors programs to improve the care people receive near the end of their lives, whether in a hospital, hospice, nursing home, or home. Up to three award winners will each receive $25,000 to further their programs' work.


Information on programs receiving the Circle of Life Award or Citations of Honor in the program' s first four years is available on the Web site. The 2004 Circle of Life Awards will be presented at the American Hospital Association Health Forum Leadership Summit and International Hospital Federation meeting July 26 in San Diego, CA.


The award is cosponsored by the American Medical Association, the American Association of Homes and Services for the Aging, and the National Hospice and Palliative Care Organization and supported by a grant from The Robert Wood Johnson Foundation.


Applications may be downloaded from the Web site or obtained by calling 312-422-2700. Deadline is August 16, 2004.




National Hospice and Palliative Care Organization Creates Hospice Manager Development Program

The National Hospice and Palliative Care Organization has launched a dynamic training program designed for hospice professionals who are or wish to become managers. The Hospice Manager Development Program (Hospice MDP) expands on participants' current knowledge by providing intensive training rooted in hospice values. State-of-the-art hospice-specific tools will be used to develop additional skills for managers to meet today's challenges.


This comprehensive educational opportunity is targeted at new hospice managers, seasoned managers who have taken on new positions and added responsibilities, and managers seeking to expand their knowledge and skills. The course is the first of its kind to combine the latest innovations in audio and Web-based learning with the benefits of face-to-face classroom training.


Highlights of the program include systematic orientation and an intensive training program for management staff, comprehensive resources an agency can use to supplement existing training materials, personal access to national hospice experts, opportunities to achieve three levels of designation, centralized training locations, and the opportunity for past participants to become involved as content experts, reviewers, or trainers.


Training goals include:


1. Developing and enhancing core hospice and palliative care management skills


2. Creating an awareness of individual management style through self-assessment and feedback


3. Identifying and developing a plan for individual dynamic skill development as a manager/leader



NHPCO conducted thorough survey and focus group research in creating the Hospice MDP. The requests of hospice and palliative care professionals guided much of the program development. A comprehensive executive development program will be unveiled in future months and will complement this new training program. In addition, the NHPCO plans to update existing modules annually and to develop and add new modules as key issues in hospice and palliative care emerge.


To request a brochure about the Hospice MDP, please contact the NHPCO Professional Education Office at 703-837-1500.




Illinois Supreme Court Rules That Only Nurses Can Testify on Standards of Care for Nurses

The American Association of Nurse Attorneys (TAANA) announced in March 2004 that the Illinois Supreme Court has ruled that only nurses can offer opinion evidence regarding standards of care for nursing when it issued a decision on Sullivan v. Edward Hospital in February 2004.


The court ruled in response to an Amicus Brief filed by TAANA, which was drafted by Karen Butler after almost two years of research by the Association's Litigation Section, and another brief filed by the Illinois Trial Lawyers Association on the issue of whether a physician who is not a nurse but who (according to the ITLA brief) can do everything a nurse can do, is qualified to offer expert testimony as to the standard of care for nurses.


For a copy of the decision, contact Patricia M. Adkison at the TAANA National Office, 7794 Grow Dr, Pensacola, FL 32514; e-mail [email protected].




JCAHO Announces Appointment of Board Member From Long-Term Care Field

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has appointed Mary K. Ousley as the representative of the long-term care field to participate in meetings of its Board of Commissioners. Ousley is executive vice president at SunBridge Healthcare Corporation in Albuquerque, NM. Her appointment is effective immediately.


The appointment of Ousley was approved by the Board of Commissioners at its March 26-27 meeting as part of a larger effort to build and strengthen relationships between long-term care organizations and the JCAHO. This new board seat is identical to the nonvoting home care seat currently held by Frances L. Baby, President, Home-Reach. This seat was established in 2002.


"Long-term care is going to be increasingly important in America as we deal with the impending demographic explosion-the only certainty in the future of healthcare," says Ousley. "The quality and safety standards set by JCAHO must be a vital component of comprehensive national efforts to get the right patients to the right providers. I am honored to represent the long-term care profession and pledge to bring the perspective of long-term care providers-from small, independent owners to large, national corporations-to the highest levels of JCAHO."


Ousley, who joined SunBridge Healthcare Corporation in 2001, is well known and respected in the long-term care field. She recently served as chair of the American Healthcare Association and last year testified before the Senate Finance Committee on the progress made in improving the quality of long-term care in America.




Kaiser Family Foundation Releases Medicare Fact Sheets

The Kaiser Family Foundation has released three fact sheets designed to summarize information about changes in Medicare in a brief easy-to-understand format. They are:


* Medicare at a Glance: This fact sheet provides a basic overview of the Medicare program, including how it is financed, who is eligible, and what benefits are covered under the program. In addition, it describes supplemental health insurance, benefits provided by the new drug law, and data on Medicare expenditures and financing.


* The Medicare Prescription Drug Law: This fact sheet, describing the new Medicare Prescription Drug, Improvement, and Modernization Act of 2003, explores the new drug benefit, as well as additional changes to the Medicare program.


* Medicare Advantage: This fact sheet provides an overview of the Medicare Advantage program (previously known as Medicare+ Choice). It includes current data on plan participation, beneficiary enrollment, benefits and premiums, and explains changes made by the 2003 law regarding Medicare payments to participating plans.



These fact sheets can be found at For additional information about Medicare, visit the Kaiser Family Foundation Web site at




Cherokee Uniforms Seeks the Best of the Best in Healthcare for the 2004 Cherokee-Inspired Comfort Award

Cherokee Uniforms, designer and manufacturer of healthcare apparel, will announce the winners of its 2004 Cherokee Inspired Comfort Award in September 2004. The awards will honor nurses and other nonphysician healthcare professionals in four categories who, through exceptional service, sacrifice, and innovation, have profoundly affected the lives of others.


Now in its second year, the Cherokee-Inspired Comfort Award was developed to acknowledge the expertise, dedication, and compassion that nurses and nonphysician healthcare professionals demonstrate through their work. This award program raises public awareness of these vocations by putting the winners' extraordinary accomplishments in the spotlight.


The 2004 winners will come from four categories: registered nurses (RNs), licensed practical nurses/licensed vocational nurses (LPNs/LVNs), student nurses, and other nonphysician healthcare professionals. Candidates may be nominated in two categories but only may win in one.


Winners of the 2004 Cherokee-Inspired Comfort Award will receive a variety of prizes. The top prizewinner in each category will receive an all-expense paid Caribbean cruise for two and a specially engraved stethoscope. Additional prizes for eight national winners in each category include all-expense paid trips to the 2005 US medical conference of the winner's choice, annual memberships to the clinical association of his or her choice, and engraved stethoscopes. All winning nurses will receive a 2004 Cherokee-Inspired Comfort Award trophy and a medical wardrobe of Cherokee scrubs and Rockers footwear and will be included in Cherokee's 2005 Inspired Comfort Award calendar. Additionally, the individual who nominates a top prizewinner will receive an engraved stethoscope and a medical wardrobe.


For more information about Cherokee Uniforms, please visit