Skip to main content

Support Veterans' Access to Hospice


Memorial Day/Decorations Day

In Columbia, MO the parade went off without a hitch. The Golden Eagles parachuted right onto their marks amongst the various downtown buildings at the start of the parade and of course they nailed their landing. It is a fitting time for all of us to pause and remember those servicemen who died while serving their country.

And in fact, it is an appropriate time to honor all veterans for their service.

I have always enjoyed working with the Veterans Administration (VA). My hospice is an active participant in We Honor Veterans. And I have always found the quality of care delivered locally to be superb, and I think the VA leaders that I have personally known are dedicated to their jobs and superb leaders, so I have found recent news reports of access problems quite disappointing.

But this Memorial Day, I want to bring to your attention a less publicized access issue that impacts veterans: access to hospice.

Current statute does not require the VA to cover hospice care for veterans who had not enrolled in the VA system in the past for prior care, or do not fit the family income and asset brackets identified by the VA. The current VA hospice directives are subjective to each individual VA facility and interpreted differently by different caseworkers.

Congressman Chris Collins R-NY wants to make sure that no veteran is denied access to hospice. Working with concerned veteran advocates, Collins drafted the Care for our Heroes Act to make all veterans eligible for VA hospice care. This is a bill that should pass.

Tell your Congressman/Congresswoman to support Care for our Heroes Act (HR 4725). You can find you representative here: Find your Representative

by: Paul Tatum (@doctatum)

Comments

SUZANNE G said…
Paul, I am surprised to hear this as in my local VA work, we consider hospice an entitlement for all veterans and have worked hard to expedite enrollment for veterans not previously established with the VA so that can use their benefits. We have also worked on building our HVPs. ANother thought I have had is that I have observed that there are many VA providers that do not have the professional credentials related to community prescribing controlled substances to be readily able to attend in hospice care in the home. I think sometimes this makes situations arise where vets have to meet new providers at the end of life rather than have continuity. I am going to have to read more about the bill though -- thanks for calling it to my attention! Suzanne G.

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …