To Those Who Work In End Of Life

By Barbara KarnesNovember 17, 2021

I was asked to say a few words to a graduating class of end of life doulas.  I thought about what to say for quite a while. What could I give them that hadn’t already been given in their course? What would I have wanted someone to say to me when I started out in this end of life arena? 

After I wrote what I wanted to share I thought, “I want to share this with all those who work in end of life!” It isn’t just when we begin our journey of working with end of life that words of encouragement and direction can be of guidance. These thoughts apply to us anywhere on the path, the beginning, after years and even as we are about to end our career.  These words apply to hospice workers and volunteers, Stephens Ministers, parish nurses, all EOL workers ———

To all those who work or volunteer with end of life:

The greatest gift you have to give is time. It won’t be the words you say, even the guidance you give, although that is all very important. It will be the time you spend or don’t spend, your presence, that will be remembered.

Your presence literally takes away the “ghosts of fear” most of us bring to the bedside of someone who is dying. The “I’m not alone no matter what happens, someone who knows is with me” is what we bring. Our knowledge, our manner, our expressions, our words are important but our time is our most valuable tool.

Those who work with end of life are on a fantastic journey. It can be a scary journey. There will be times you feel insecure in your knowledge and your abilities. Times when there will be no words to say, no comfort to give but you will be there. Be there to guide all present into a sacred experience. You will be the conductor of their life’s song. By your guidance that song will become their sacred memory.

That is no small job!!

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New Cures 2.0 bill extends key telehealth flexibilities, hastens CMS approval of medical devices

Fierce Healthcare
Nov 16, 2021 12:51pm
 
New major legislation would require Medicare to cover breakthrough medical devices faster and make permanent key flexibilities to telehealth reimbursement for providers.
 
Lawmakers introduced on Tuesday Cures 2.0 bipartisan legislation that builds on the 21st Century Cures Act of 2016. The legislation includes major investments in medical research including the creation of a new agency to research difficult diseases such as Alzheimer’s, but also contains several reforms to Medicare reimbursement and coverage.
 
The legislation would permanently remove Medicare’s geographic and originating site requirements that require a patient to live in a rural area and be in a doctor’s office to qualify for telehealth services.
 
The use of telehealth has exploded since the pandemic when patients were afraid of going to the doctor’s office. The Centers for Medicare & Medicaid Services also granted greater flexibility for providers to get reimbursement from Medicare for telehealth services.
 
But those flexibilities are expected to be removed at the end of the COVID-19 public health emergency, which will now sunset early next year.
 
The legislation would make some of those flexibilities permanent.
 
Another key provision is to codify a rule that would let Medicare automatically cover products approved or cleared by the Food and Drug Administration under the breakthrough therapy pathway, which grants advanced approval to devices that treat unmet medical needs.
 
The bill would allow CMS to temporarily cover breakthrough products approved by FDA for four years. The agency will have to make a permanent coverage determination in those four years. It also calls for the Government Accountability Office to offer recommendations on how to enhance Medicare coverage and reimbursement of innovative health technologies.
 
But the decision comes a few days after CMS issued a final rule that got rid of a Trump-era regulation that requires CMS to approve breakthrough medical devices under the same type of pathway as in the Cures 2.0 bill.
 
CMS said that it was concerned the clinical data necessary for the FDA breakthrough therapy approval may not meet Medicare’s guidelines for a coverage determination.
 
The insurance industry has fought the Trump-era rule, arguing that it could lead to premature coverage of medical devices.
 
The legislation now heads to the House Energy & Commerce Committee. The lawmakers behind the legislation—Democratic Rep. Dianne Degette of Colorado and Republican Rep. Fred Upton of Michigan—spearheaded the 2016 law.
 
“The federal government has shown, time and time again, that when it’s given the resources needed to accomplish the impossible, there’s not much it cannot do,” the lawmakers said in a statement.

Hospice Quality Reporting Program (HQRP) October Forum Materials Available Now

On Tuesday, October 19, the Centers for Medicare & Medicaid Services (CMS) hosted the October 2021 HQRP Forum to provide information on the new Quality Measure (QM) Specifications User’s Manual v1.00 and the two new claims-based measures included in the Manual. Materials from this HQRP Forum, including a recording of the presentation, are now available in the Downloads section of the Provider and Stakeholder Engagement page at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-QRP-Provider-Engagement-Opportunities.

"Don't wait": WHO urges U.S. to pay attention as surging COVID cases flood Europe's hospitals again

London — The coronavirus has been resurging across Europe, including in some places where it was thought to be well under control. A top world health official tells CBS News the trend shows that success today does not necessarily mean success tomorrow, and the United States should pay close attention.

Europe has seen a jump of more than 50% in new coronavirus cases over the last month, and the World Health Organization has warned the continent could see another half of a million deaths by February. CBS News senior foreign correspondent Charlie D'Agata spoke with the top official ringing those alarm bells, who told him there's "grave concern" as Europe is once again under siege by COVID-19.

"If you look at the last four weeks, the hospitalizations have doubled," Dr. Hans Kluge, the World Health Organization's Regional Director for Europe, told CBS News.

He said vaccination uptake has plateaued in some parts of Europe and, "at the same time, there's a relaxation of the public health and social measures, which is a cocktail for what we see: a fourth wave."

Kluge called Europe "the epicenter" of a new global COVID-19 outbreak, fuelled by the highly transmissible Delta variant of the virus.

While case rates are up across the continent, European countries with higher vaccination uptake appear to be staving off a major new wave of severe COVID-19 illness, but in some Eastern European nations, the daily mortality rate is surging.

Portugal has one of the highest vaccination rates in the world, for instance, whereas Romania has one of the lowest in Europe — and one the highest death rates on the globe.

On Monday, Germany's daily infection rate hit its highest recorded level since the pandemic began.

"Vaccines are a game changer," said Kluge. But alone, they are "not enough."

"We need to keep pressure on the virus, not surrendering on masks, the hand-washing, indoor ventilation — particularly in the schools," he told D'Agata.

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