In The News

The Sacred Moment of Death

By Barbara Karnes

The sacred moment of death - that is the goal for those of us who work with end of life. Guiding, supporting and teaching those present what is normal in dying and what is not. What is fixable and what is not. What is painful and what is not. What to do and what not to do. What to say and what to be silent about.

All the work we do leads up to the moment of death. Our goal is to guide and support those present through the moment the last breath occurs.

How do we do that? How do we support and guide? We first give information. We teach the signs of approaching death. Teach what is normal and what is more challenging. We give guidance as to what families or significant others can do while labor is progressing.

Here are my thoughts:

In the hours before death, when the person is not responsive, suggest that each person present spend time alone with the person who is dying. To talk with them, tell them everything they have wanted and need to say, the good, and even the challenging. 

Sit by or on the bed, hold a hand, lay down in the bed, cuddle, whatever your heart guides you to do. This is their gift as well as a gift to the person who is dying. The opportunity to address “loose ends,” to say those things that were never said. 

The person that is dying is processing their life. By sharing innermost thoughts and feelings with them they are giving their special person more pieces to their puzzle of life.

Now is the time to talk with those present as to what is about to occur. Explain how the breathing changes, about the sounds they may hear, the words that won’t make sense, the often strange and unusual facial expressions they may see. All that is part of the labor of dying. 

By guiding them you are showing those present that nothing bad is happening, nothing pathological is happening. This is how people die. Dad or grandmother or friend or husband are expressing the effort to release them from their body.

Once death has occurred  encourage those present to say goodbye to the body again before calling the funeral home. This will be the last private time they will have with their special person, give them that opportunity.

Through this support and guidance you are creating the sacred experience for those present and that experience will become their sacred memory. They will carry that memory with them forever.

This is the work we do. This is the goal, the culmination of our time spent with families and significant others. This is the gift we can give them.
 

‘All Options are on the Table’: NAHC, NHPCO Form Joint Exploratory Committee

Home Health Care News | By Joyce Famakinwa
 
The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) announced Wednesday that the two organizations have formed a joint exploratory committee.
 
The aim of the committee is to determine how best to collaborate on some of the overlapping issues that are the focus of both organizations.
 
“The Boards of Directors of both NAHC and NHPCO believe the time is right to explore how a stronger, unified, and more intentional approach to collaboration could accelerate the impact of work around our respective missions and on behalf of our members,” the two organizations wrote in a joint press statement.
 
In the past, NAHC and NHPCO have often teamed up for projects and initiatives that fall under the common purview of both organizations, in an effort to raise greater awareness and leverage their combined firepower.
 
“These discussions follow naturally from our history of collaboration and are rooted in our shared belief that the more united our voices and actions are, the more we will serve and benefit our respective members and the patients and families they serve,” NAHC and NHPCO wrote.
 
Though both organizations have shied away from offering up more concrete details about what the committee may lead to in the end, a NAHC spokesperson relayed, in an email, that “all options are on the table.”
 
For now, NAHC and NHPCO have agreed to pause their executive recruitment and succession planning during the course of these discussions.
 
Plus, the organizations are working with the consulting firm McKinley Advisors for additional support. The firm will aid in providing an objective analysis of potential opportunities for NAHC and NHPCO.
 
“As part of this evaluation, McKinley will be conducting in-depth interviews with industry stakeholders over the next several weeks and will report findings and recommendations to the Boards of both organizations,” NAHC and NHPCO wrote. “The exploratory committee expects to issue additional communications about these findings and our collective next steps regarding the collaboration opportunities in May.”
 

What’s in Biden’s Budget

CNN | By Katie Lobosco and Tami Luhby
 
President Joe Biden released his annual budget Thursday, outlining his policy priorities for the year ahead.
 
Make no mistake, the proposed budget has no chance of making it through the Republican-controlled House. But Biden’s plan will frame upcoming political battles on Capitol Hill, where the GOP has yet to unveil its own spending plan.
 
Biden’s budget comes out after the US hit the debt ceiling, a cap set by Congress, earlier this year. The Treasury Department is now taking extraordinary measures to allow the government to keep paying its bills. But the country could start to default on its obligations over the summer if Congress doesn’t address the debt ceiling before then. Republicans are calling for some spending cuts in exchange for voting to raise the cap, while the White House does not want to negotiate on resolving the debt limit drama.
 
 Many of the provisions in the budget rehash the president’s earlier proposals to expand the social safety net and to pay for it by raising taxes on the wealthy and corporations. He wants to restore the expanded child tax credit and make permanent enhanced Obamacare subsidies, both enacted in the American Rescue Plan in 2021. And he wants to provide universal free preschool, make college more affordable and establish a national paid family and medical leave program, which did not make it into prior packages when the Democrats controlled Congress over the past two years.
 
Biden’s spending plan also calls for shoring up Medicare and capping the price of insulin for all Americans.
 
The administration says these proposed policies will result in a nearly $3 trillion reduction in the deficits – the difference between what the government spends and its revenue – over the next decade.
 
Here’s what’s in Biden’s budget proposal

Read Full Article
 

Lawmakers Introduce Bill to Expand Home-Based Care Coverage Under Medicaid

Home Health Care News | By Joyce Famakinwa 

A number of lawmakers – including Sen. Bob Casey (D-Pa.) and Rep. Debbie Dingell (D-Mich.) – introduced a bill Thursday that would expand coverage of home- and community-based services under Medicaid.
 
The HCBS Access Act was introduced by Casey, as a companion bill to the Better Care Better Jobs Act, which was originally unveiled in 2021 and reintroduced in January.
 
“The second bill establishes a permanent funding stream to keep the infrastructure strong and to make sure we’re able to continue to pay direct care professionals at a rate that ensures qualified, reliable services in a qualified reliable workforce into the future,” Casey said during a hearing announcing the bill.
 
The bill would also provide training and support for family or informal caregivers.
 
The legislation would provide grant funding for states, allowing them to expand their capacity for home-based care services.
 
So far, the bill has already received strong support from the Partnership for Medicaid Home-Based Care (PMHC).
 
“PMHC is encouraged by Senator Casey and Representative Dingell’s efforts to continue to bring ongoing focus on the need to treat home-based services as a long-term, viable alternative to facility-based care with sufficient funding to address workforce challenges,” a PMHC spokesperson told Home Health Care News in an email. “Ultimately, we hope to see bipartisan engagement to bring this to fruition to allow us to sustain and improve important long-term supports and services for the people we serve.”

Read Full Article
 

Fight for Your Agency at NAHC's March on Washington

Home health providers are facing devastating payment cuts. The hospice community is rallying behind targeted efforts to address fraud, waste and abuse in the program. Medicaid HCBS rates continue to be woefully inadequate. Despite unprecedented demand for our services, care-in-the-home providers need more robust policy supports to address these and other pressing challenges facing our community.

This event will be held in-person with a kickoff briefing at the Kaiser Permanente Center for Total Health on March 27, 2023. BUT, you can still participate virtually, and our team will set meetings up for you on March 28, 2023.

SCHEDULE:

  • March 27th (4:00-7:00 PM) – Briefing on logistics and issues with staff and Soapbox Consulting to prep you for the day.
  • March 28th (Scheduled Appointments) – Head to Capitol Hill to meet with your members of Congress and urge them to help with these vital issues

If you do decide to send someone from your agency to attend in person or if you register to participate virtually, please let HHAC know, so that we can track how Colorado is represented.

REGISTER 
 
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