Podcast appearances and mentions of dame cicely saunders

What if our modern approach to hospice care is missing the mark on its original compassionate intent? Join us on this eye-opening journey through the rich history and transformative evolution of hospice care, from its heartfelt beginnings in the 1960s with Dame Cicely Saunders to its present-day challenges in the United States. We unover the pivotal moment when the Medicare hospice benefit of 1982 shifted the focus from non-profit, holistic care to the for-profit model, often compromising the essential values of time and empathy. As we navigate these changes, we shed light on the pressing need to restore the core principles of hospice to truly honor end-of-life experiences. Throughout this episode, we tackle the critical issue of the "hospice gap," highlighting the overwhelming burden on family caregivers and the systemic hurdles that contribute to inadequate end-of-life care. We explore how fear, delayed hospice engagement, and limited professional interaction leave families unsupported. To empower you, we share vital questions you should ask when selecting a hospice, emphasizing the importance of understanding the holistic nature of care and the role of family support. With resources from the Doula Givers Institute, we aim to equip you with the knowledge needed to revive the sacredness of life's final chapter.         We dive into: (00:02) The Evolution of Hospice Care (08:16) Closing the Hospice Care Gap (17:14) Important Questions to Ask a Hospice         We want to hear from you!!! If you found this podcast helpful, Please Rate, Review, & Follow so we can reach more people.         Links mentioned in this episode: Doulagivers Institute The NEXT Free Level 1 End of Life Doula Training Registration LINK  The NEXT Free Doulagivers Discovery Webinar    80-90% of a positive end of life depends on these two things: Knowing the basic skills on how to care for someone at the end of life and planning ahead - and BOTH Doulagivers Institute is giving you for FREE! Access them Below! Making your wishes known is one of the greatest gifts you can give to your loved ones. Download The Doulagivers 9 Choice Advance Directive now! It's FREE!     More about what we do at Doulagivers Institute - Click here!

Na god sv. Krištofa, 24. julija, so pred 57. leti odprli vrata prvega sodobnega hospica na svetu. Deset dni pred tem je poteklo 19. let od smrti njegove ustanoviteljice, Dame Cicely Saunders. Nič hudega, če njenega imena še niste slišali, saj tudi med njenimi rojaki ime ne sodi med najbolj prepoznavne. Njen biograf pravi, da je na področju paliativne oskrbe najbolj znana oseba, najmanj znana med Britanci. Omenjam jo zaradi njene zapuščine, ki je vsak dan dragocenejša. Komentar je pripravila dr. Irena Švab Kavčič, direktorica Doma sv. Jožefa v Celju.

When Samira K. Beckwith graces our mic, you're not just hearing from a healthcare visionary; you're learning from a powerhouse who transformed her battle with Hodgkin's disease into a beacon of hope for hospice and palliative care. Her journey, shaped by personal trials and the work of legends like Kubler-Ross and Dame Cicely Saunders, has redefined what compassionate care looks like at life's end. Join us as Samira unfolds the narrative of her life's work, mentoring future leaders and innovating patient care to resonate profoundly with those in their twilight chapters.There's a revolution brewing in elder care and hospice services, and it's one that Samira has been at the forefront of. The pioneering PACE program and the evolution of Hope Hospice into Hope Healthcare serve as testaments to the changing landscape of community-centric care. In this episode, we reveal how initiatives like 'Dancing with the Stars' are more than glitter and glam; they're strategic engagements that knit the community closer, fostering an ecosystem where leadership transcends tasks and becomes a symphony of hope and holistic care.As we wrap up, we cast a gaze toward the horizon where palliative care and the funeral industry intertwine in the concept of Celebration of Life Centers. Samira and I discuss the essentials of maintaining the sanctity of hospice in the midst of such transitions, embracing innovation while safeguarding the soul of whole-person care. We invite you to lean in, subscribe, and join the conversation that looks to the future without losing sight of the hospice heritage—a delicate dance of mission and business, ensuring the heart of care remains beating strong.Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

Join guest Harvey Max Chochinov, a psychiatrist, as he delves into the profound concept of "intensive caring" in palliative care. Inspired by Dame Cicely Saunders' powerful quote, "You matter because you are you," Harvey discusses how this approach reaffirms the worth and dignity of patients who may feel they've lost their significance, shedding light on the universal need to recognize and support their humanity. Harvey Max Chochinov is a psychiatrist. He discusses the KevinMD article, "Intensive caring: Reminding patients they matter." Our presenting sponsor is Nuance, a Microsoft company. Together, Microsoft and Nuance are leveraging their rich digital technology and advanced AI capabilities to tackle some of health care's biggest challenges. AI-driven technology promises to revolutionize patient and provider experiences with clinical documentation that writes itself. The Nuance Dragon Ambient eXperience, or DAX for short, is a voice-enabled solution that automatically captures patient encounters securely and accurately at the point of care. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows. Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 85 percent of patients say their physician is more personable and conversational. Discover AI-powered clinical documentation that writes itself. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo. VISIT SPONSOR → https://nuance.com/daxinaction SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://earnc.me/SZacIJ Powered by CMEfy.

Listen to ASCO's Journal of Clinical Oncology essay, “Gosses and the Dalmatian Puppy” by Dr. Zvi Symon, Senior Consultant at the Sheba Medical Center in Israel. The essay is followed by an interview with Symon and host Dr. Lidia Schapira. Symon reflects on an ancient Jewish tradition while seeking to palliate a dying patient. TRANSCRIPT Narrator: Gosses and the Dalmatian Puppy, by Zvi Symon, MD  A few months ago, I was paged to see a newly diagnosed patient in the hospital with a malignant trachea-esophageal fistula to consider palliative radiotherapy. Despite the 60-minute delay that had already accumulated in my clinic, I hurried past the folks in my waiting room as they scowled their dismay, and promised to return quickly.  My new consult was a 70-year-old man who had lost 30 kg over the past few months. He was a heavy smoker with chronic bronchitis and a squamous cell carcinoma of the upper esophagus gnawing into the cartilage of the upper airway. The surgeons ruled out any hope for surgical remediation. The gastroenterologist attempted to insert a stent but could not get past the tumor's stricture, so radiation therapy became the last option. On the edge of the bed near the hospital room's window sat Vladimir, a ghost of a man, coughing intermittently with a constant drool of saliva dripping into a stainless steel bowl that he held in his lap. I introduced myself, but he hardly acknowledged my presence, consumed by his own discomfort. I turned to his pleasant, gray-haired wife sitting in the blue armchair next to his bed. Before proceeding, I asked her what he knew about his condition, and she referred the question to him in Russian. Vladimir closed his eyes, sighed heavily and said softly: “I don't feel well and… cannot eat.” His wife watched me as a sad smile played on her lips, and she struggled not to cry. I paused for a moment, remembering my full outpatient waiting room, but wanting to give his story justice. I turned to Vladimir's wife. “Tell me a bit about Vladimir, what did he do before he became ill?” I drew up a chair and sat closer and she sighed. “He worked as a builder. When the family emigrated to live here in Israel, his mother died soon after. He became deeply depressed and took to the bottle, spending most of the day sitting on the porch, drinking vodka, and chain smoking. A few years ago, I bought him a cute clumsy Dalmatian puppy who adored him, romping around happily, licking his hands, and jumping all over him. He developed a special relationship with the dog, stopped drinking and took the dog each day for a long walk—well, perhaps the dog took him for a walk.” A smile flickered across her face briefly. “Unfortunately, the dog died a few months ago and he sank back into a depression, stopped eating, and has lost weight.” I was touched and saw the tears in her eyes flowing freely. “Do you have any family, perhaps children you would like to call to perhaps join us for the discussion?” I asked. “We have two grown-up sons. One is currently ill with COVID and cannot come, and the other son also suffers from major depression: He has a hysterical paralysis and does not leave the house. I work as a cashier in the supermarket and am the only breadwinner for my sick son and husband.” I wondered if she had any idea of his prognosis and started a discussion regarding treatment options. Vladmir's wife told me that she had heard that radiation therapy could help. And while I would have loved to have played the role of knight in shining armor, saving him from the ravages of his cancer with radiotherapy, the reality is that the intervention is controversial in the treatment of trachea-esophageal fistula. Should I raise the possibility of not doing the treatment? How would it be received? What could I offer in lieu? Was this an opportunity for a being and not doing discussion, one that talks about dignity and love and communication, about having the chance to say goodbye forever and even to confess and bless and confide? Patients and family are so often focused on the battle against the disease; they are loath to any suggestion of not doing, despite the minimal odds for a helpful treatment.  I saw Vladimir's wife struggle to control her tears. She seemed so vulnerable and carried so much on her shoulders. I wondered if a hospice discussion, at that moment, would add to her huge burden. There was also a part of me that also debated, selfishly, if I should launch into a lengthy end-of life discussion with the angry waiting patients outside my clinic door? So often, we turn to our treatment armamentarium to avoid these deeply painful and complex discussions surrounding the end of life, particularly with patients we barely know. I breathed deeply, calmed myself and decided to keep it simple and avoid the dilemma. I gently explained that I could not guarantee good results, but radiation therapy may improve his pain and perhaps allow him to eat and drink. It was the answer she was looking for, though I grimaced as I wondered if it was the answer I should have provided. She seemed relieved and encouraged Vladimir to sign consent. Vladimir arrived at the computed tomography (CT) simulation suite sitting bent forward on the stretcher, drooling into the bowl between his legs. The radiation therapists, already running behind schedule, looked at each other, as if wondering if this was another futile heroic effort.  “I know what you are thinking,” I said to them. “But perhaps we can help. Let me tell you something about Vladimir, he had a Dalmatian puppy he loved, who took him out of his home for a walk every day after years of deep depression.” Vladimir was contorted in pain, and the attempt to transfer him from the stretcher to the CT couch seemed impossible. All eyes turned to me with a perhaps this is too much look. Suddenly, Ilan, a young Russian-speaking radiation technologist who had recently joined the department, had an idea. “Vladimir, rest a few minutes. You know, I too have a Dalmatian, let me show you a picture.” The deep lines on Vladimir's face faded into a broad smile as he took Ilan's cellphone to see the picture of the dog. From the look on his face, he seemed to be transported far from the simulation suite, and I imagined him romping with his Dalmatian puppy in a sun-swept meadow with gurgling streams and lush green grass and watched as Ilan then slid him effortlessly onto the couch of the scanner. The scan was completed, Vladimir returned to the ward, and I retreated to my workroom to complete the contouring of the structures for the radiotherapy plan. It was a nasty 12-cm mass involving the full circumference of the upper esophagus and eroded into the trachea, almost obstructing the left lung. The dosimetrist calculated a conformal treatment plan, and as I approved it, I uttered a little prayer that this would make him more comfortable. Suddenly, Ilan rushed in, hair tousled, pale and agitated, and eyes red. We were too late. On returning to the inpatient ward, Vladimir experienced a massive aspiration and died less than half an hour after we had scanned him. Ilan was terribly upset. As a young therapist, this was perhaps his first patient who died so quickly and unexpectedly. I tried to comfort him. “I know it hurts, but nothing we could have done would have changed what happened. Did you see his face after you mentioned his puppy and showed him the photo of yours? We did our best for him.” After Ilan left my room, I reflected on the day's events. Was Vladimir what the rabbis refer to as a “Gosses?”2 (Gosses is a Hebrew word meaning a moribund patient). And if that was the case, was I wrong to even transport him from his room? When death is imminent in hours or days, Jewish religious law defines a state of Gosses in which it is forbidden to touch or move a moribund patient in case this could hasten death. The guttural rattle of a dying patient, unable to clear secretions, indicating death within hours or days, reminded the rabbis of the sound of bubbling when stirring the food in the cauldron. This onomatopoeia, in addition to a didactive narrative identifying the significance of performing an action which potentially changes the natural course of events, resulted in the analogy that moving a terminally ill patient which may hasten death is like stirring the food in the cauldron which may hasten the cooking on Sabbath, hence the term Gosses. The ancient rabbinic sages from the beginning of the first millenium drew an additional analogy between touching a Gosses and touching a dripping candle at the end of its wick which may hasten quenching of the light. Another aspect of the law of Gosses forbids performing any act which may prolong suffering and delay a merciful death. Thus, moving a patient to receive a futile treatment would also be forbidden under law of Gosses.  2000 years later, the notion that we should neither delay nor accelerate death was front of mind formeas I reflected on my treatment of Vladimir. I wondered if the ancient rabbis incorporated into their moral discussion the difficulty of stopping the roller coaster of trying to do more and more to help the patient. How about when the treatment itself fell into a gray area of effectiveness? What advice would they have given a physician with competing demands on his time and a waiting room full of outpatients who demanded his attention? In retrospect, the painful journey of Vladimir down to the simulator may have hastened his massive aspiration and would have been best avoided. In that sense, the Gosses may have been violated. But it also allowed him and Ilan to meet and share wonderful memories of a Dalmatian puppy which made him smile and forget his pain, even for a few precious moments. Dr. Lidia Schapira: Hello and welcome to JCO's Cancer Stories: The Art of Oncology, which features essays and personal reflections from authors exploring their experience in the field of oncology. I'm your host, Dr. Lidia Schapira, Associate Editor for Art of Oncology and a professor of medicine at Stanford University. Today, we are joined by Dr. Zvi Symon, until recently Chair of Radiation Oncology and currently Senior Consultant in the Department and Director of the National School of Radiotherapy at the Sheba Medical Center in Israel and Clinical professor of Oncology at Tel Aviv University Medical School. In this episode, we will be discussing his Art of Oncology article, “Gosses and the Dalmatian Puppy.” Our guest disclosures will be linked in the transcript.  Zvi, welcome to our podcast and thank you for joining us. Dr. Zvi Symon: Thank you, Lidia. I'm very happy to be here. Dr. Lidia Schapira: To start, I'd like to ask authors to tell us what they're reading or perhaps what they've enjoyed reading and would like to recommend to fellow listeners. Dr. Zvi Symon: Okay, so it's been a bit of a stressful time reading, but I may mention some books I've read in the last few months. I've been reading memoirs. One that I particularly found very touching was Paul Kalanithi's, When Breath Becomes Air. As a physician who had cancer himself and his struggle with his transition from being a consultant neurosurgeon to being a terminal lung cancer patient, I think it's an amazing and beautifully written and touching book.  Dr. Lidia Schapira: It's a beautiful book. It's evocative and fresh. And you're absolutely right - we're completely in sympathy with and empathic with his amazing desire to live life till the last moment, right? It's just beautiful.  Dr. Zvi Symon: It's really beautiful. And I think that memoirs is a very powerful genre for me. And another book that I enjoyed very much is Jan Morris' Conundrum, which is a story of a person who made a transition from male to female over 10 years. She was actually a member of the British team that climbed Everest and a journalist in The Times. It's a beautiful book describing what she actually felt inside and how she went through the medical process as well, of her sex change. And it's also beautiful. Dr. Lidia Schapira: Thank you for that. I haven't read it, but I will add it to my lovely list here.   Tell me a little bit about writing and what that means for you. Are you somebody who has been writing throughout your career, or was this a story that sort of popped for you, that just needed to be told?  Dr. Zvi Symon: Right. I think it goes back to when I was a high school student where my Math teacher told my parents, "Your son shouldn't do medicine. He should study English literature." My parents were devastated by that statement because my father was a physician and my mother's family were all physicians, and they were very angry at the time. And I was kind of a writer in high school, and then I kind of left it through my medical career. And now, as I have sort of finished my stint as the chair of the department and I have a bit more time on my hands, I've sort of tried my hand at getting back to writing. I needed to read a lot in order to do that. So I was reading genres. I think maybe some of the initial versions of this piece were written sort of more as a memoir, rather than an article for the Art of Oncology. And I think you guys helped me a lot.  Dr. Lidia Schapira: I'm so glad to hear that we helped. Sometimes editors aren't particularly helpful in the views of authors, but I'm glad you feel differently.   So let's talk a little bit about the creative process and sort of bringing in all of these themes that you did here. And back to your prior comment that this is in the memoir genre. You have a very interesting philosophical discussion of what a Gosses is and sort of the ethical moral conflict when a patient is extremely vulnerable, instead of recognizing when perhaps all that you need to do, or perhaps what you need to do is to be present instead of trying to fix or intervene. And I loved how you made us all really suffer with you, as you're debating this internally. Can you talk a little bit about that part of the story? Dr. Zvi Symon: Yes, I think just to put it into context, in my training in internal medicine, I worked in a hospital where hospice care was part of the rotation in internal medicine. I spent three months in the hospice, and at night, when we were on call, we were in charge of the ICU and the hospice. So you would be called to treat a patient in pulmonary edema and with CPAP, or intubate him or an acute MI, and then you would be called to a dying patient in the hospice. And the transition was initially very difficult for me. I actually felt my feet would not carry me to the hospice, and I didn't want to go there, and I had to kind of force myself. But after some time, I realized that it's actually much easier to treat pulmonary edema  to than be able to sit and listen and talk to a dying patient. But the fulfillment that I began to feel when I overcame that kind of fear of going to speak to a dying patient, the fulfillment was far greater than getting somebody out of pulmonary edema. And that's kind of stayed with me to this very day.  So although radiation oncology is a kind of something you have to do, and you sort of radiate, when I'm called to patients like this, and I do have time, then I kind of sit down with a patient and discuss the options and try to give other options because very often it's a kind of turf in the house of God. Somebody doesn't want to have that conversation with a patient, and they're kind of turfing the patient in a house of God sense to have some radiation. And I'm not sure that radiation in such cases– So this is something that I'm confronting quite often in my daily practice, and it becomes more and more complex culturally because when one is confronted with families who also want to be very active and are dreading having to live with the idea that maybe there's something they could have done that they never did, and they're putting a lot of pressure, then it's a very tough situation. So I'm very sensitive to these situations.  I've often had end-of-life discussions with patients like that, sometimes against the wish of families that are close by. And the patient would say- well, they'd say to me, 'No, don't talk to him." And the patient said, "No, I want you to go away. Because I think this is the first time someone's listening to me, and I want to hear what he has to say." I feel very passionately about these– Dr. Lidia Schapira: I have so many comments that we would need hours to discuss. But, of course, the first comment I wanted to make is that some of the most humane oncological specialists I know are radiation oncologists, so I don't see you guys as just treaters and physicists wearing scrubs. I see you as incredibly compassionate members of the cancer team.   And that brings to mind a lot of the current discussion about palliative radiation, this idea that we can just throw some rads at people because there's nothing to lose and maybe there'll be some improvement in function. So can you talk a little bit about that? I mean, here you are in a very busy clinic falling behind. You've got to walk through a waiting room of people who are sort of looking at you saying, “How can you be walking out when we had an appointment with you half an hour ago?” And you go and find Vladimir, who's despondent and can't have a conversation with you. And I'm pretty sure that you must have been going through this internal conflict even before you met your patient about what to do. Tell us a little bit more about the emotional impact for you. Dr. Zvi Symon: Yeah. With great trepidation, I actually go up to the department to speak to a patient like this. I think the electronic medical record, for all the problems with that, it allows us to kind of really quickly glimpse and get a true picture of what the situation is. So I had seen the imaging and I'd seen the size of this really very nasty tumor. And I sort of remembered the literature that it's a relative contraindication and it actually may make things worse. But I was getting calls from the department and the medical oncologist who consulted that I must see this patient, and they want that patient to get treated today. So with a kind of a heavy heart, I go up the stairs. I breathe deeply on the way to calm myself and take the staircase up to the 6th floor and walk very slowly up the stairs, trying to go through my mind, what am I going to do, and kind of enter the ward. And then I am confronted by this person who is terribly suffering, very terribly. And he doesn't actually want to look at me at all. His eyes can't meet and he looks kind of, his eyes are very dull. And I see his wife watching me and watching him and turn to her. They are immigrants to the country. And there's also a cultural issue and language problems and difficult socio–  Dr. Lidia Schapira: If this were fiction, you could not have made it harder. I mean, when I remember reading the manuscript thinking, this poor immigrant, he's depressed, his son is depressed, the other son has COVID, his wife is weeping and says she's the one who's tried to make ends meet. You have all of these barriers in addition to this internal clock that you have somewhere else to be. Can't begin to imagine the pressure. So how did you get through that? Dr. Zvi Symon: Yeah, I think my mind was kind of ticking over and I think that sometimes we make very practical choices. And I knew that if I sat for too long and I fired a warning shot and said, “Well, this may not help and this may not do it,” but I think that culturally I had the feeling that it was the wrong thing to do and that there was an expectation and the expectation had been created by the team, and it's very difficult to turn down that expectation. And I also felt that she was so frail and that she had really no support and maybe if one of her kids would have come within half an hour, I would have said, “Well, I'll come back after my clinic in the afternoon and let's have a chat with your son.” But the situation was such that I thought, “Well, you just have to be practical and you have to get back to your clinic.” It's a hard feeling that we make value decisions just because it's more comfortable for us. We want to finish our clinic and also go – Dr. Lidia Schapira: No question about that. Yes, and I think the reader will feel for you, as I did when I read it. I mean, I could immediately sort of imagine all these things playing out. So you follow your intuition, you assess it, you say, “Okay. We'll give it a try,” right? And then you have your team to deal with and your lovely radiation therapist, the technologist who gets personally involved. And then you introduce the idea that perhaps connecting with something in Vladimir's recent past that brings him joy. Can this image of this puppy romping through the fields, is something that can maybe help you all? Like the glue, the emotional glue that keeps you together. Talk a little bit about that part, about how you tried to bring this element out in the story, to give another dimension for the reader, a view not only as the physician giving Vladimir care, but also leading your team. Dr. Zvi Symon: So I think that an open question to a patient about their– “Just tell me a little bit about yourself,” is an invitation for a person to tell you about the things that they care most about, about the people they love most, that the things were of the most importance in their lives. And I think that kind of human connection, if we can kind of latch onto that and harness that to improve the way we communicate with the patient and the way we get the rest of the team to communicate with the patient, I think that can be very powerful. I mean, I myself love dogs, and I was like, really, my Border Collie just died a few months ago, and we buried her after 12 years, and she was a wonderful animal and part of the family. And in the two minutes that I had to listen to- that's what she told me about, she told me about the dog. And when I tried to motivate the team to add him as an urgent sim and he wasn't cooperating, then it just occurred to me to tell them about it. Dr. Lidia Schapira: It worked. It was amazing. Dr. Zvi Symon: And it worked. Yeah. Dr. Lidia Schapira: It was a beautiful story. I too, am a lover of dogs. I have a wonderful puppy now, and he brings tremendous joy. But your message is so full of compassion and humanity. It's basically back to Dame Cicely Saunders' idea that you want to know who the person is that you're treating and you want to know what matters to them. And so here you caught this moment of connection with the family and with the patient and with your young radiation therapist who needed to feel that he was actually helping this person. So it's a beautiful story. I want to just give you a chance to finish the interview by telling us something perhaps that you want the readers or the listeners to take away from your piece. Dr. Zvi Symon: Well, I think that the situation of, I think as physicians, we don't really ever know when the patient precisely is going to die. And the whole idea, I think, of a Gosses and my thoughts about the Gosses were, because it's sort of defined within Jewish religious law, someone that is going to die within 72 hours. Now, it's very difficult to define. We don't know that. We never do know that. But I think that that sensitivity to the comfort of a suffering patient and offering a treatment that may be futile or that is highly likely to be futile and that may be involved in an enormous amount of discomfort, I think that we have to be able to sit down with these patients and with their families and discuss other options as just very good sedation and not necessarily, I think, doing, but rather just being there, as you mentioned, for the patient. Dr. Lidia Schapira: It's a beautiful thought, and I think we all agree with you. And I think what made this story so poignant is that here you are, that time is compressed and you're introduced to the family as somebody who potentially could help fix something or provide something. So it's very difficult to step back, as you say, and do the deep work of sitting and talking and counseling and accompanying. But I think your humanity comes through and your desire to help comes through beautifully in the story. And I really thank you for bringing this concept to our attention. I think that it may be an old idea, but one that is still very relevant. And thank you for sending your work to JCO. Dr. Zvi Symon: Thank you very much. Dr. Lidia Schapira: Until next time, thank you for listening to JCO's Cancer Stories: The Art of Oncology. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all of the ASCO shows at asco.org/podcast.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Show Notes Like, share and subscribe so you never miss an episode and leave a rating or review.  Guest Bio:  Dr. Zvi Symon is a Senior Consultant in the Department and Director of the National School of Radiotherapy at the Sheba Medical Center in Israel and Clinical professor of Oncology at Tel Aviv University Medical School.  

Die Begründerin der modernen Hospiz- und Palliative Care Bewegung war die Interprofessionalität in Person. Dame Cicely Saunders war Sozialarbeiterin, Krankenpflegerin und Ärztin. Mit ihrem Handeln hat sie die Welt verändert und die Versorgung schwer kranker und sterbender Menschen revolutioniert. Das ausschließlich durch Spenden finanzierte St. Christophers Hospice gründete sie im Jahr 1967. Was es mit den drei polnischen Männern auf sich hat und wie uns ihre Worte und Sprüche auch heute noch im Palliativ-Alltag begleiten, erfahrt ihr in Folge 13.

Matthew 5:15-16 There are two words for good in Greek. One is agathos, which simply defines a thing as good in quality. The other is kalos – that refers to things that are not merely good but also beautiful and attractive. The word used here to describe the good deeds that we must do is kalos. This is a really important point. God doesn't simply want us to do correct things but things that are beautiful and which are attractive to those around us. I often see Christians doing beautiful things and I have no doubt that it brings God enormous pleasure. I think of people who care for the dying. One of the most wonderful developments over the past 50 years has been the growth of hospices. Dame Cicely Saunders was at the heart of this development. She was a strong Christian and this was her conviction: “You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.” Thank God for those who have poured out their Christian love in this way, but I think of a thousand other ways in which, day in day out, people are turning their love for Jesus into concrete action. I think of those working with disabled people, migrants, asylum seekers, the homeless and the elderly. The work is often costly and challenging, and it is beautiful because it springs from the heart of a generous God who cares. The Church is famous for speaking a lot of words. That is understandable and right because we have good news to share. But if those words are not backed up by good and beautiful deeds then the words will ring hollow, and people will fail to see the light. Jesus' vision was for followers whose beautiful deeds would shine the light of his presence for all to see. Question What are the good deeds that flow from your own church into the community? Prayer Loving God, I pray that the good things that I and my friends do today will encourage many people to praise you. Amen

An online transcript is available At the end of last year, The New Yorker and ProPublica documented fraud and mistreatment in some for-profit hospices across the country. The exposé shouted something that has been whispered for a long while in circles concerned with the care of the dying: hospice needs saving.Begun as a visionary mission run by charities, hospice care has morphed into a 22 billion dollar industry where margin trumps mission. On today's program, host Seán Collins discusses the state of hospice, its future, and ways to preserve quality of care when caring for people at the end of their lives. Guests are Drs. Ira Byock and Glen Komatsu, longtime hospice physicians and thought leaders in the field. ..Glen Komatsu, M.D.Chief Medical OfficerProvidence Hospice, Los Angeles CountyTorrance, Calif..Ira Byock, M.D., FAAHMPEmeritus Professor of MedicineGeisel School of Medicine at DartmouthAuthor, Dying Well (1997), The Four Things That Matter Most (2004), and The Best Care Possible (2012)Missoula, Mont. ..FURTHER READINGHow Hospice Became a For-Profit Hustle by Ava Kofman (New Yorker)Endgame: How the Visionary Hospice Movement Became a For-Profit Hustle by Ava Kofman (ProPublica)Joint statement from The National Association for Home Care & Hospice (NAHC) and National Hospice and Palliative Care Organization (NHPCO) responding to Ava Kofman's reporting.Dr. Tara Friedman's response to the New Yorker article (President, American Academy of Hospice and Palliative Medicine)Hospice Needs Saving by Ira Byock  (STAT First Opinion)Hospice Industry: Start with Apologies by Ira Byock (STAT First Opinion)National Hospice Locator  (Hospice Analytics)Hospice Compare (medicare.gov)A simplified description of the person from Dr. Eric Cassell's "The Nature of Suffering and the Goals of Medicine."..   

New from the Colson Center!  Interested in the What Would You Say? video project? Subscribe to be notified when new videos are released at whatwouldyousay.org/subscribe. Watch the latest release and explore the full on-demand library! ____  Following the lead of the province of Nova Scotia, New Brunswick became the second jurisdiction in Canada to adopt a policy of “presumed consent” for organ and tissue donation. Instead of willingly opting in to be an organ donor, residents 19 years and older, with limited exceptions, will be opted in by default.   While many see this as a solution to the perpetual demand for transplant organs, laws like these treat the ethics of organ donation as a settled matter while treating humans and their bodies as means to other ends. Even more, considering Canada's policy of Medical Assistance in Dying (MAID), this step will corrode the already thin ideas of “autonomy” and “consent” while incentivizing a utilitarian view of human nature.  For context, Canada has already experienced a dramatic expansion of MAID toward not only those facing a terminal medical diagnosis but also for those suffering from mental illness deemed “grievous and irremediable” (those who suffer solely from mental illness will not be eligible until 2024). In 2021, assisted deaths rose by 35%, reaching over 10,000, or 3% of all deaths in the country. Opponents of MAID, including virtually every disability rights group in Canada, continued to warn that a so-called “right” to die will inevitably devolve into a duty to die. People are seen, both by themselves and by others, as burdens using precious resources better spent on those with better prospects for a “better” life.   These warnings were, to put it mildly, ignored. As numbers climb, so do stories of pressure and coercion. Consider the Canadian veteran suffering from PTSD who was offered MAID instead of treatment last year.   The presumed consent of the New Brunswick law adds a perverse incentive: the immense value of organs for transplant. The mismatch between supply and demand, not to mention what balancing that mismatch would mean, has always dominated the ethical conversation about organ donation. Currently, over 4,300 Canadians are waiting for an organ transplant, and as a government website states, hundreds “will die waiting...”   Canada's end-of-life policies already incentivize death. If donors request death, not only is the difficulty of obtaining consent more easily settled, so is the issue of preserving organs. Law professor F.H. Buckley explained in the Wall Street Journal,   Last year … two Canadian medical researchers and a Harvard bioethicist argued that [waiting until the patient is declared dead] could reduce the quality of donated organs. A superior model, they suggest, could be to kill the patient by removing his organs. After all, the best organs come from live people, like those who donate one of their kidneys...   [B]y linking assisted suicide and organ harvesting, it ratifies the premise that euthanasia can help create a more efficient organ supply chain. …  Where euthanasia is legal, the temptation to link the time of death and the demand for organs may similarly become too strong to resist. On a slow day there's no hurry, but when a patient [who] is waiting for a heart is in the next hospital room, you'd expect greater pressure to euthanize a patient...  Medical professionals should not be given the incentive to see their patients as sacks of valuable organs rather than as human beings.  The farther the medical world moves from its founding principle of “Do no harm,” the more harm is done. Take for instance China, where one top transplant doctor admitted that “effectively 95% of all organ transplants were from prisoners.” As unthinkable as it sounds, experts warned that these prisoners were likely executed by the means of “organ removal.”    Dame Cicely Saunders, founder of the modern hospice movement and vocal opponent of euthanasia, was deeply influenced by Christianity. She once wrote, “The question of how one feels about so-called ‘rational suicide' is, I believe, ultimately governed by the question of how much faith one has in human nature.” Powerful market incentives will only worsen an already epidemic disregard for human life. For Canadians, “presumed consent” is another stage in the downward spiral of a culture of death. If it continues to spread, there will be no opting out.   This Breakpoint was co-authored by Kasey Leander. For more resources to live like a Christian in this cultural moment, go to breakpoint.org. 

Dr. Shannon Westin and her guest, Dr. Harvey Max Chochinov, discuss his article "Intensive Caring: Reminding Patients They Matter." TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Dr. Shannon Westin: Hello, everyone, and thank you so much for joining us for another JCO After Hours podcast. This is the podcast that gets in depth in manuscripts published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, GI oncologist by trade and honored to serve as the Social Media Editor for the JCO.  And today we're going to be discussing a really exciting paper in the Comments and Controversies section called “Intensive Caring: Reminding Patients They Matter.” This has been recently published, and I'm so excited to have the author of this paper join us today, Dr. Harvey Max Chochinov, who is a distinguished professor in the Department of Psychiatry in the University of Manitoba, senior scientist with Cancer Care Manitoba Research Institute, and the cofounder of Canadian Virtual Hospice.   Welcome. So great to have you today.  Dr. Harvey Max Chochinov: Thanks, Shannon. Dr. Shannon Westin: And please note neither of us have any conflicts of interest, so we'll just get right started. So first, I just wanted to explore the title of your paper, “Intensive Caring.” Can you describe a bit about what that means? Dr. Harvey Max Chochinov: Well, we know that in medicine there are occasions when patients find themselves in such medical dire straits that they require intensive care. They've reached the stage where they certainly can no longer help themselves, and they require this kind of intensive approach that medicine is capable of offering. But intensive caring is meant to acknowledge that there are times when patients can be in such dire emotional straits that we need a way of being able to address that degree of abject suffering. So the idea of intensive caring was to try and provide language to describe that approach and, within the paper, as we're going to discuss, also to describe the ways in which we can actually deliver that kind of caring. Dr. Shannon Westin: Can you tell me a little bit about kind of when and where your inspiration for this work arose? Dr. Harvey Max Chochinov: The inspiration actually came from Dame Cicely Saunders. Dame Saunders was the founder of the modern hospice movement. There's a famous quote or adage that she said: “You matter because you are you, and you matter to the last moment of your life.” And this has really become kind of a central philosophical tenet of palliative care. But yet it struck me that although it describes this philosophical approach, implicit is also perhaps a clinical approach which says how do we, in fact, show patients—how do we demonstrate to patients or practice medicine in a way that actually affirms that patients matter? So that's where the title came from: “Intensive Caring: Reminding Patients They Matter.” Dr. Shannon Westin: There are so many pieces to this. I was so struck by what you said about these emotional dire straits. That's the best way I've ever heard it described. I feel like one of the major areas is that loss of hope and that feeling that you don't matter anymore. So what can we do? How do we, as practitioners, act and intervene to change that feeling? Dr. Harvey Max Chochinov: That's a wonderful question. The paradigm of contemporary medicine is we examine, we diagnose, and we fix. And yet, when it comes to addressing many elements of human suffering, it doesn't lend itself well to that paradigm because, of course, we know that there are things that are beyond the realm of fixing. So what we need, then, is to understand a way of approaching patient care where fix really is beyond our reach. How do we do that? It's by understanding that by being with the patient, by things like non-abandonment, all of these things are ways of maintaining patient engagement.  There was a wonderful study a number of years ago by Kelly Trevino in which she looked at the associations between suicidality and the intensity and the quality of the connectedness with the medical oncologist. And it turns out that that was the single most predictive factor regarding suicidality over psychological interventions or over psychotropic medication. So the way in which we start to address this kind of abject suffering, maintaining hope, is to understand that and acknowledge that there are things that we may not be capable of fixing. But the provision of intensive caring—and, again, the elements of intensive caring that I described in the article—give us ways of being able to be with patients that don't require fixing but require presence, require involvement, require ongoing commitment to the well-being of that individual.  Dr. Shannon Westin: This is a perfect segue because I was struck by that tenet of non-abandonment, you know, really committing to ongoing care. I wonder about this because we do have patients that transition to hospice, and often, in our group, they'll have an entirely new care team. And that's just part of that intensive caring that the hospice group provides. But I guess, in seeing it in these terms, I'm feeling a little bit like that may not be the ideal way for that transition to happen. So any thoughts on how we kind of combat that? Or how can we work together with hospice so that the patient feels still supported but still gets that hospice care that they so desperately need? Dr. Harvey Max Chochinov: Oh, for sure. Well, I mean, listen, we know that transferring of care is a technical task that can be accomplished by a single stroke of our keyboard on our computer. We transfer care. But there's nothing technical about the issue of caring, connectedness. And so it's unrealistic, and I don't think patients expect that all expertise resides in the hands of one individual or one team. But the reality is that when we've been looking after somebody for days, weeks, months, even years and they now have to transition to other care providers, although care can be transferred, I think there is still this human expectation of ongoing caring.   And caring doesn't necessarily require a great deal of time. It can be accomplished in really nuanced and subtle ways that really, I think, are within our grasp. Picking up a telephone, dropping by for a visit, putting a note in the mail simply to acknowledge that “I understand you're in hospice. Just want you to know that you've been on my mind. Hope things are going as well as they can for you and your family.” That demonstrates continued caring. It doesn't raise expectation that I, your medical oncologist who know you very well, am going to now intervene and take over your care. Dr. Shannon Westin: That's perfect. And I'm actually taking notes myself to—have a couple patients that I need to call today. So moving on to some of the other tenets, the Patient Dignity Question was really, I felt like, a revelation for me. It's so simple and so straightforward, and I feel like many of us, myself definitely included, don't feel like there's enough time, right, to dig into the details of every patient, kind of where they are in their process. Do you think this is something that everybody should implement today? Dr. Harvey Max Chochinov: So maybe backing up just for listeners to understand that the Patient Dignity Question asks patients, “What do I need to know about you as a person in order to provide you the best care possible?” We have done studies of the Patient Dignity Question, or PDQ, and there have been multiple studies and multiple translations around the world, probably the largest study being one that came out—Hadler, first author—several thousand patients at Memorial Sloan Kettering who were asked the Patient Dignity Question as part of the regular kind of palliative care consultation. I think the message that I take out of the PDQ research is that personhood should always be on our radar. And the reality is that if we don't understand at least the essence of who that person is, we can give lip service to providing person-centered care and lip service to maintaining dignity and all of those wonderful things that we say in position statements, but none of it will ring true if we don't have personhood on our radar. And it simply means that we need to be mindful of personhood.  I've asked patients, “So what do I need to know about you as a person to take the best care of you possible?” I've had people tell me, “I'm afraid to die alone.” I've had people tell me, “I am the victim of childhood sexual abuse.” I've had people tell me, “I'm a survivor of the residential school system.” One man said “I'm a former department head of medicine.” In fact, he was just a lovely man. He said when he was being treated for his cancer, he wanted to hang a sign on his bedpost that said, “PIP, Previously Important Person.” But what it says to me is that if we fail to acknowledge personhood, then essentially we're operating in the dark. When you have that kind of information about personhood, it just changes the way you see and experience that person, which makes for better patient care. Families are more satisfied. There's less discordance when it comes to goals of care, less likelihood of litigation because the reason that most people litigate is not because of medical misadventure. It's because they don't feel like they were treated like a person. They somehow feel like that was not acknowledged.   The other interesting piece of data out of the PDQ research is that when clinicians acknowledge personhood, they also report greater job satisfaction. So the reality is—and we know that one of the signs of burnout is emotional disengagement. So what our research has found is that if you give clinicians a way of at least maintaining some emotional engagement by finding out who this person is, not only are patients and families happier, but healthcare providers report greater satisfaction in the work they do. So the short answer is “Yes, I think we should be putting personhood on our clinical radar and finding ways that are feasible of making that happen.”  Dr. Shannon Westin: There's so many interesting tenets in this article and so many parts to the intensive caring. Some do seem to be elements of palliative care practice as well. So how would you say this is different or complementary?  Dr. Harvey Max Chochinov: I'd say indeed you're correct. I mean, some of the elements are probably ones that people in palliative care would recognize. And I don't necessarily think that that's a criticism or necessarily a bad thing. If some elements of intensive caring are accused of being old wine in a new bottle, a new bottle is something that can be very attractive. And if this can bring people back to understanding the human side of health care, well and good. I suppose what is unique about intensive caring are the constellation of elements that are described in the article—and all of the elements, by the way, are empirically based. So the article does lay out various elements of intensive caring and points out the empirical basis of each of those elements.   I think maybe the other thing that's unique about intensive caring is it begins to provide us a language for ways of being able to approach patients who are in these circumstances. Usually, in the face of this kind of abject suffering, our temptation is to feel the need to withdraw, maybe feelings of impotence, maybe feelings of failure. So intensive caring addresses all of those head-on by saying here is a way that you can effectively be with your patients, that you can mitigate their suffering, without feeling that your mandate is to examine, diagnose, and fix. It is a different paradigm, which says you can be present with and provide comfort to. Dr. Shannon Westin: Great. Now, what about therapeutic humility? Can you speak of it like that? I think many of us come into medicine because we like fixing problems. So how does this concept turn the paradigm on its head? You kind of already talked about it a little bit, but I think it's important to mention specifically.  Dr. Harvey Max Chochinov: I think anybody who's been practicing medicine for any period of time has had the experience of confronting things that don't lend themselves well to fixing. Let's take the instance of somebody who is near end of life, or even the instance where a patient has died, you're standing outside of their room, and the family is still there. You have some choices. You can either withdraw, just say, “There's nothing I can do; I've got other things that are more pressing,” or you can go into that room. Now, when you go into that room, you need to be able to put on the shelf any idea that you have the right words that are going to fix what ails this now bereft family.  But I think wise and seasoned clinicians—and I would put to you, see, clinicians who have therapeutic humility would say you go into the room. Why? Because being there, just being present with, acknowledging the loss—and it's not about what you say. Again, if you feel like you have to wait till you have the right words, you never will go in there. But if you just go in empty-handed and allow yourself to be in the presence of that kind of suffering, what any clinician who does that will say is it's of critical importance. It matters. It makes a difference. And so that is one example of therapeutic humility. And again, there are others because there is so much that we deal with. For those of us who deal with patients with chronic illness or incurable illness, the fact is that if you're not humble, you're going to find yourself perpetually feeling like you are failing, like you are not meeting patients' expectations. What patients expect is not that you can fix what's not fixable. They expect you to be involved. They expect you to care. You will be there for them in times that are tough. Those are elements of intensive caring that are worth taking forward into practice. Dr. Shannon Westin: Well, this has been so educational. I feel like I could talk with you for another hour. But why don't we end by just speaking about the next steps for this work, and how can we make everyone aware aside from publishing in the JCO and putting out this podcast? What else can we do? Dr. Harvey Max Chochinov: Well, hopefully, the approach gives people both the language and the ways in which we can start to implement this in practice. I would hope that it kind of catches or takes hold in medical curricula, but not only in medicine but really in any setting where individuals are being trained who have access to patients. This is not just about doctors. This is about anyone and everyone who has patient contact because the reality is that irrespective of whether you're the medical receptionist or the person making the first incision, you have the ability to either affirm or disaffirm the personhood of the individual that you're in the presence of. That's both a responsibility and, as well, an opportunity. So hopefully, dissemination of this work spreads word that this is an opportunity that we can take hold of, hopefully for the betterment of patients and families and healthcare providers themselves.  Dr. Shannon Westin: Great. Well, thank you so much. You've been such an inspiration. I can't wait to start utilizing these in my clinic just tomorrow. So I really appreciate you, and I know all our listeners do as well.   Listeners, we appreciate you. Thank you so much for tuning into JCO After Hours. Again, we were discussing the Comments and Controversies article “Intensive Caring: Reminding Patients That They Matter.” I hope you enjoyed it. Please do check out the website and check out any other podcasts that are ongoing and let me know what you think. Have a great day.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    

EPISODE 4: Dame Cicely Saunders **Trigger Warning** This episodes discusses end of life, death and grief.  Stories are the essential building block of empathy and human connection. Since the beginning of time, storytelling has been used to connect, engage, inspire, heal and create a brighter future.  We are convinced that it is stories that change our world. We have seen hearts change and opinions soften when real people and real stories are heard.  Beth received a church prize book called "Ten Girls that Changed the World" when she was a child and it is this book that inspired this all-new series from At the Table Podcast by Faversham Salvation Army.   You may know the stories of Christians like Martin Luther King jr, Florence Nightingale and maybe that of the Salvation Army's founders William & Catherine Booth but this series, we are hearing the stories that changed the world from people you may not have heard of. Continuing through this series, we are looking at a pioneer and founder of a really important part of care and medicine; Dame Cecily Saunders. Dame Cecily was a great example of starting something that was so important for someone at the end of their life but also families as they deal with grief. This episode was a time for us personally to reflect and thank the wonderful palliative nurses who took care of us and Jon's father who passed away in 2021 with Leukaemia. We thank one of our listeners for sharing this person with us! Tune in on your favourite podcast platforms from Apple to Spotify, to Google to Audible.  Journey with us as we learn something together - at the table. Follow us on social media by searching 'Faversham Salvation Army' or 'At the Table - Podcast' 

In this week's episode, I had the privilege of interviewing renowned author, Philip Yancey. In his books, Philip has explored the most basic questions and deepest mysteries of the Christian faith, including award-winning titles such as The Jesus I Never Knew, What's So Amazing About Grace? and Prayer: Does It Make Any Difference? He currently has more than 15 million books in print, published in over 50 languages worldwide, and his books have garnered 13 Gold Medallion Awards from Christian publishers and booksellers.Philip began his writing career as a journalist in Chicago, where he worked for about twenty years, writing for a wide variety of magazines including Reader's Digest and Christianity Today. As a journalist, he interviewed people such as President Jimmy Carter, Habitat for Humanity founder Millard Fuller, and Dame Cicely Saunders, founder of the modern hospice movement. In my time with Philip, we talk about his new book, Where the Light Fell, and why he believes it is the one book he was put on earth to write. We also talk about how his life story has shaped his writing, how beauty transformed his faith and relationship with God, and how his experiences around the world have shaped his views on beauty. This conversation was such a gift to me. My hope is that Philip's wisdom and words might bring so much light into your life as well.

November is National Hospice and Palliative Care Month! We're talking about the history of hospice, including medieval hospice houses, Dame Cicely Saunders, Florence Wald, and the modern hospice movement.  The rich history of hospice began in medieval times as monks and nuns of the religious orders of the time created hospice houses where travelers along the road who were ill or injured were cared for until they died. Through the founding of St. Christopher's Hospice in London, Dame Cicely Saunders launched the modern hospice movement.  Florence Wald helped to get hospice started in the U.S along with clergy, healthcare leaders, and other community leaders.  Dr. Elisabeth Kubler-Ross was instrumental in changing end of life care with her ground-breaking work in the stages of death and dying.  The Medicare hospice benefit was created in the mid-1960's in the U.S., allowing hospice care coverage for those who were terminally ill.  Hospice has a rich history around the world!  Hear more about St. Christopher's Hospice in our interview with Joint Chief Executive Sean O'Leary:  https://theheartofhospice.libsyn.com/rediscovering-the-roots-of-modern-day-hospice-with-shaun-oleary-episode-085 Find information about the Elizabeth Kubler-Ross Foundation:  https://www.ekrfoundation.org/ Receive The Heart of Hospice podcast in your email here: https://www.theheartofhospice.com/connection/ For podcast sponsorship opportunities contact us: host@theheartofhospice.com Find more episodes from The Heart of Hospice here: https://theheartofhospice.libsyn.com/

Growing up in a strict, fundamentalist church in the southern USA, a young Philip Yancey tended to view God as “a scowling Supercop, searching for anyone who might be having a good time—in order to squash them.” Yancey jokes today about being “in recovery” from a toxic church. “Of course, there were good qualities too. If a neighbour's house burned down, the congregation would rally around and show charity—if, that is, the house belonged to a white person. I grew up confused by the contradictions. We heard about love and grace, but I didn't experience much. And we were taught that God answers prayers, miraculously, but my father died of polio just after my first birthday, despite many prayers for his healing.”For Yancey, reading offered a window to a different world. So, he devoured books that opened his mind, challenged his upbringing, and went against what he had been taught. A sense of betrayal engulfed him. “I felt I had been lied to. For instance, what I learned from a book like To Kill a Mockingbird or Black Like Me contradicted the racism I encountered in church. I went through a period of reacting against everything I was taught and even discarding my faith. I began my journey back mainly by encountering a world very different than I had been taught, an expansive world of beauty and goodness. Along the way, I realized that God had been misrepresented to me. Cautiously, warily, I returned, circling around the faith to see if it might be true.”Ever since, Yancey has explored the most basic questions and deepest mysteries of the Christian faith, taking millions of readers with him. Early on he crafted best-selling books such as Disappointment with God and Where is God When it Hurts? while also editing The Student Bible. He co-authored three books with the renowned surgeon Dr. Paul Brand. “No one has influenced me more,” he says. “We had quite a trade: I gave words to his faith, and in the process, he gave faith to my words.” More recently, he has felt the freedom to explore central issues of the Christian faith, penning award-winning titles such as The Jesus I Never Knew, What's So Amazing About Grace? and Prayer: Does It Make Any Difference? His books have garnered 13 Gold Medallion Awards from Christian publishers and booksellers. He currently has more than 15 million books in print, published in over 50 languages worldwide.Yancey worked as a journalist in Chicago for some twenty years, editing the youth magazine Campus Life while also writing for a wide variety of magazines including Reader's Digest, Saturday Evening Post, National Wildlife, and Christianity Today. In the process, he interviewed diverse people enriched by their personal faith, such as President Jimmy Carter, Habitat for Humanity founder Millard Fuller, and Dame Cicely Saunders, founder of the modern hospice movement. In 1992 he and his wife Janet, a social worker and hospice chaplain, moved to the foothills of Colorado. His writing took a more personal, introspective turn even as his activities turned outward. “Writing is such an introspective act that I found myself looking for ways to connect with the planet bodily. My interests include skiing, climbing mountains, mountain-biking, golf, international travel, jogging, nature, theology (in small doses), politics, literature, and classical music.”This podcast was recorded on September 28th, 2021.

#026 - Join host Dr. Red Hoffman as she once again has the privilege of interviewing Dr. Balfour Mount, the founder of Palliative Medicine.  Bal recently released his 500-page memoir entitled Ten Thousand Crossroads:  The Path as I Remember It and he generously returns to the show to  talk about his book.  He discusses his friendships with both Dame Cicely Saunders and Elizabeth Kubler Ross and shares lessons he learned from both women.  He also reflects upon the many lessons he learned from his patients and  how his own journey with multiple cancers influenced his practice of medicine throughout his career. Bal is a cultural icon and it is a pure pleasure to sit back and listen to him reflect upon his life and his career.   I cannot recommend his book highly enough; besides stories about Dame Cicely Saunders and Elizabeth Kubler Ross, he also includes memories about meeting Viktor Frankl and the Dalai Lama, as well as a funny phone call with Mother Teresa.  To purchase Ten Thousand Crossroads:  The Path as I Remember It, go here.To learn more about the recently launched Surgical Palliative Care Society, visit the website at  www.spcsociety.org or twitter @spcsociety. To learn more about the surgical palliative care community, visit twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com or twitter @redmdnd.

Today on All Home Care Matters, we are going to be talking about how hospice helps families. If you want to learn more about hospice, you can watch or listen to our previous episodes, What is Hospice, or What is Palliative Care. You can find them on our website, wherever you get your podcasts, or on our YouTube channel. Today we're going to go over what hospice is, how it began, and how it is helping families today. Now let's move on to the rest of the show.   The American Cancer Society describes hospice care as a special kind of care that focuses on the quality of life for people and their caregivers who are experiencing an advanced, life-limiting illness. Hospice care provides compassionate care for people in the last phases of incurable disease so that they may live as fully and comfortably as possible. Hospice's goal isn't to treat the disease but to treat the symptoms and make the end-of-life as comfortable and fulfilling for the patient as possible.   The founder of the first modern hospice, Dame Cicely Saunders, said that “You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully but also to live until you die.”   Dame Cicely Saunders established the first modern hospice in West London in 1967. She did not invent hospice, as it had been around for some time, but she did make it what it is today. Before her, those that were dying and in pain had to wait until their painkillers wore off before they could be given their next dose. People feared addiction for those that were suffering, which seems odd today, but before 1967 was commonplace. Dame Cicely Saunders saw that her dying patients were being forced to suffer through their pain until their inevitable deaths and worked to change how end-of-life care was managed. She created an approach that emphasized pain management, emotional and spiritual support and family counseling. She insisted that dying people needed dignity, compassion, and respect, as well as rigorous scientific methodology in the testing of treatments, and abolished the philosophy that the patient must be cured, and if they were unable to, they must be lied to about their prognosis.   One of Dame Saunders patients transferred from another hospital to her hospice care facility said that “[the previous hospital] used to see how long I could go without an injection. I used to be pouring with sweat because of the pain. I couldn't speak to anyone and I was having crying fits. I think I've only cried once since I've been here . . . The biggest difference is feeling so calm. I don't get worked up or upset."   Dame Saunders' Hospice made such a difference in the end-of-life care of patients, and it has only improved since then. Today, hospice's philosophy revolves around palliative and not curative care. It focuses on the care and comfort of the patient by managing the symptoms and not the disease. Its goal is to improve and uphold the patient's quality of life instead of the amount of time the patient has left and neither postpones nor hastens death. Hospice also aims to educate and support the patient, the family, and other caregivers throughout end-of-life care.   When thinking about hospice care for your loved one, first you must determine their eligibility. A social worker will likely come and assess your loved one to see if they are ready for end-of-life care, but there are a few things you can check on your own. If their doctor has anticipated six months or less for the remainder of your loved one's life, assuming the illness takes its projected course and if your loved one chooses to forego life-prolonging, aggressive treatments for the terminal illness  and related diagnoses, they most likely qualify for hospice.   Once your loved one has been accepted into hospice care, they will receive care wherever they are, in their own home, in the hospital, in a facility, or any other place they may be. They will be given a primary caregiver, along with hospice staff, and will have the option to have 24/7 care. They will also be monitored by an interdisciplinary team and have an end-of-life plan tailored to fit their needs.   Hospice supports not only the patient but everyone involved. They will help you through the end-of-life process, so you don't have to go through it alone. They can give you resources and suggestions that can help you make the most of the time you have left with your loved one.   As the older population in the United States grows, more and more families are going to be considering end-of-life care. In 2015, 1.43 million Americans received hospice care and that number is steadily climbing each year. Hospice care requires 24/7 caregivers and a caregiving team involving a somewhat large amount of people. It can be quite expensive, and that financial burden may be weighing heavy on you right now but try not to worry about the money too much. There are a few ways your loved one can get free care or help covering the costs of hospice care. If your loved one is on Medicare, they can be provided hospice care at no cost to them. Medicare will cover 100% of the costs. Medicaid and private insurances will cover the costs, but you will have to talk to your insurance agent and doctor to see what they will cover. Some hospice care groups offer discounted rates or even free care, so be sure to check with the hospices in your area to see what their rates are and how they can work with you. Some organizations and non-profits will help you cover the costs. You can check with your local senior center or united way for more information on programs or resources they offer.   There are non-profit and for-profit hospices. They both run on the same philosophies and carry out treatments the same way, but they differ on the financial side. The Medicare Hospice Benefit established in 1983 provides Medicare beneficiaries with access to high-quality, end-of-life care services. This benefit is what allows Medicare to completely cover the costs of hospice care, but it also recognized hospice care as a viable concept and form of healthcare service for terminally ill patients in the United States.   Hospice took a while to gain traction in the United States, possibly because of its philosophy to only treat the symptoms and not treat the disease, but by 1983, it was widely accepted in the country. With this benefit passed, millions of Americans were finally given access to quality end-of-life care, something many would have been unable to afford otherwise.   According to Crossroads Hospice, the biggest difference between for-profit and non-profit hospices is that non-profit hospices are not required to pay taxes to state or federal governments on the funds they receive from Medicare. Tax exemption is a standard of all non-profits and is not exclusive to hospice care. For-profit hospices are also prohibited from using donations to directly pay for patient care. Non-profit hospices mainly run on donations, holding fundraisers and soliciting donations from the community to pay for patients' care.   Since for-profit hospices are not allowed to use donations to pay for patient care, many for-profit hospices create a non-profit foundation that is separate from the hospice to collect donations. The for-profit hospice foundations must each have a specialized mission, like securing supplies to help patients with special needs or providing hospice education to area healthcare providers.   Regardless of whether the hospice is for-profit or not, you want to make sure you are selecting the right program for your loved one. Each hospice is different and has its own structure for care teams, programs, and even philosophies. When searching for a hospice provider, you should contact and interview several in your area before you decide on one. Your loved one's doctor may also help you make this important decision by helping you figure out what the most important parts of care are for your loved one. For some, it could be having a nurse on hand at all hours, but others may only need a nurse at certain times of the day, if ever.   It is also important to note that hospice care may lapse if your loved one's illness improves or your loved one outlives their prognosis with no changes. Especially now, hospice care providers are hard to come by. The Covid-19 pandemic has many hospice providers, as well as most other healthcare providers, severely understaffed and they are struggling to provide care to all the patients they already have, let alone prospective patients.   So please be patient during this process. Hospice care providers and other caregivers are trying their best to make sure your loved one has the best quality of life, but they are also doing the same for numerous other families.   Hospice cares for patients with serious illnesses and diseases at the end of life, but what does that really mean? A 2017 study by the National Hospice and Palliative Care Organization found that 27% of patients had been diagnosed with cancer, while 18.7% had cardiac and circulatory, another 18% had dementia, 11% had respiratory issues or diseases, 9.5% were stroke patients, and 15.6% had other unlisted illnesses or diseases. If your loved one suffers from any of these illnesses or diseases and has been told they are nearing the end of their time, hospice may be the right care provider for them.   Choosing the right hospice for your loved one and yourself gives your many things: care support, the backing of an expert team, respite care, grief support, help with planning, less stress, better health, and peace of mind. Since hospice care is provided wherever the patient is, oftentimes it is in their own home, and the family, you, are the caregiver. According to Daily Health Wire, hospice care teams visit the patient in the home on a routine basis to assess, monitor and treat symptoms, and they train the family and loved ones how to care for the patient when medical personnel isn't around. When care is provided in a nursing home, the hospice team provides care in addition to the care the patient receives from nursing home personnel.   Hospices don't just have nurses, but they also have other trained professionals, including physicians, social workers, chaplains, and personal care specialists. Many even have volunteer support. The entire team works with the patient to meet their physical, emotional, social, and spiritual needs, along with the family, to improve the quality of life for both you and your loved one.   As a caregiver, you know how important is to take care of yourself while taking care of your loved ones. If you need help figuring out ways to help manage your stress or balance caregiving with your life, we have several episodes on the subject that can be found on our website, YouTube channel, or wherever you get your podcasts. If you need a break, whether you just need an hour to run errands or you need a few days away for whatever reason, respite care is something you might find useful.   A hospice caregiver can come into the home and watch over your loved one for a few hours while you are away. Many hospices also have a facility where your loved one can stay if you need to leave for a few days. Check with the hospice providers in your area to see what is available and to ask if they are able to provide these services.   We also need to make mention that when a family has hospice service that the hospice provider does not replace the home care support that a family may already have in place. This can become confusing for families and this is something that we have found families that we provide care for have thought that by having hospice come on-board to provide services for their loved one that they would no longer need or require home care because of this. This is not accurate.   When a family has hospice care this does not replace the home care support that they had prior to hospice. Whether it is hospice, home health care, or home care all three of these professions and services work independent of each other. If you have more questions or are interested in more information make sure to visit our website and there you'll find a secure fillable form that you can fill out and someone will reply to you and answer any questions that you may have or provide any resources or information that you request.   Linda Hickey, the daughter and full-time caregiver of Ruth, appreciated having a respite-care option. "My sisters and I had split up the responsibilities, but at times, it still felt overwhelming. Caring for her full time was exhausting," she explained. A local hospice cared for Ruth as a respite care patient, giving the family time to recharge. Time away, even just a little bit, can help you come back refreshed and ready to continue caregiving.   Another thing that hospice provides is grief support. The end-of-life stage is difficult for both you and your loved one and the right hospice can help you both through it - through emotional and spiritual support. Social workers, chaplains, and volunteers are all available to help your loved one come to terms with their situation and help you through the bereavement process. Even once your loved one has gone, they usually offer support to you and your family, because they treat each patient as an individual, and not a statistic.   They can also help with the planning that may be overwhelming for you. They can help with the power of attorney and a living will, as well as helping with the creation and follow-through of an individualized care plan.   Having a hospice provider on your side alleviates some of the caregiving burden and stresses that come with it, allowing you to enjoy more of the time you have with your loved one, rather than worrying about caregiving and other responsibilities.   Perhaps one of the greatest things that hospice provides is peace of mind for both you and your loved one. With hospice, you know that someone that cares is always on hand, or just a phone call away, allowing family members the chance to spend precious quality time with their loved one. And even during this sad and difficult time, many families have made great memories with their loved ones, thanks to hospice care.   Finding the right hospice provider for your family and your loved one can make all the difference in their lives, so don't wait too long. Get started today so you can enjoy tomorrow with your loved one.   We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode and please make sure to share it with them.   Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Join us next time on All Home Care Matters where we will explain what Medicare is and what it isn't.   Sources:   https://www.trihealth.com/dailyhealthwire/health-topics/well-being/7-ways-hospice-care-helps-families   https://www.cancer.org/treatment/end-of-life-care/hospice-care/what-is-hospice-care.html   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072234/   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072234/?report=printable   http://www.nnecos.org/resources/Documents/2018%20SLIDES/NNECOS%20Hospice%20101.pdf   https://casahospice.com/the-history-of-hospice-care/   https://www.bmj.com/content/suppl/2005/07/18/331.7509.DC1   https://www.cdc.gov/nchs/fastats/hospice-care.htm   https://www.crossroadshospice.com/hospice-resources/education-for-families/non-profit-vs-for-profit-hospices-what-is-the-difference/      

We're thrilled to talk with our guest Shaun O’Leary, Joint CEO of St. Christopher’s Hospice in London as he shares how St. Christopher’s is building on its rich history to move hospice care forward into the future.  Founded by Dame Cicely Saunders, St. Christopher’s was the first modern hospice center and acted as a model for hospice care in the U.S.  Shaun uses the wisdom he’s acquired over 15 years of working in end of life care to steer St. Christopher’s Hospice.  He acknowledges there are challenges that hospice agencies in the U.K. face, such as fund raising, misinformation, and the need for community education about hospice philosophy.  St. Christopher’s is providing that education through a brand new center - the Centre for Awareness and Response to End of Life (CARE).  The CARE Centre opened on January 15 of 2021. According to the St. Christopher’s website, visitors can “enjoy viewing art exhibitions, participate in a book club or simply take some time out in one of the many quiet and intimate spaces included in the building.  The high-tech Skills Lab provides a facility for doctors, nurses and carers to demonstrate practical skills such as using a syringe driver or moving someone safely in a bed. With cameras fitted all around this space, learners of all kinds will be able to access a fully immersive experience.”  You can find more information about St. Christopher’s history and CARE by visiting their website: stchristophers.org.uk.  To find more podcasts from The Heart of Hospice, visit theheartofhospice.com.  We’re here to support your hospice journey, with support and encouragement. There’s information on advance care planning, self care, caregiving, and the basics of hospice philosophy.  No matter where you are in your hospice journey, The Heart of Hospice is here to help. 

Dame Cicely Saunders is the founder of Palliative care. We're talking today all about Palliative care. Palliative care focuses on improving the overall wellness of individuals with serious illnesses. It addresses both the symptoms and the stress of living with a chronic disease. It may also involve support for loved ones or caregivers. Palliate comes from pallium, the Latin word for ‘cloak.’ To palliate is to cloak, or cover-up, the symptoms of an illness without curing it. This meaning grew into the idea of alleviating or reducing suffering. Interesting, yes? In this episode, you'll learn the difference between hospice and Palliative care. There is a time and a place for each type of care, understanding the difference is beneficial. We discuss the difference between Palliative care for people living with a disease like cancer versus Alzheimer's. It's a bit more difficult to know when to initiate Palliative care for someone living with dementia. By learning the differences in care options early you'll have a better idea of when the time is right. Being a caregiver to someone living with Alzheimer's can be a very long journey. Deploying all the help you can get when you need the extra assistance will help you keep your loved one home. Palliative Care Music Check out this link to the American Palliative Music Council (APMC), they have recordings of music specifically designed for people in Palliative care. Related Episodes Health Care Advocacy for Seniors! Talking with Psychology in Seattle Podcast Help Support Fading Memories We have partnered with Caregiver Chronicles to bring you a comprehensive 8-week course. This course covers diagnosis to transition. To learn more or to sign up go HERE   Some details about the course. Payment options include: PayPal or Venmo @dryvette-jackson Join Fading Memories On Social Media! If you've enjoyed this episode, please share this podcast with other caregivers!  You'll find us on social media at the following links. Facebook    Instagram    Twitter Be sure to subscribe to our YouTube channel. There you can see me in "action" and watch the bonus videos I share. Want to learn from Jennifer in person (or virtually)? Wherever you'd like a training session, Jen is available. Contact her at fadingmemoriespodcast@gmail.com

In Today’s episode, Saul and Joe talk with The Rev. Dr. Andrew Goodhead who works as the Spiritual Care Leader at St. Christopher’s Hospice in London, UK on the impact of Cicely Saunders and St. Christopher’s hospice around the world.

The assisted suicide movement is, if anything, indefatigable. Not only is it undeterred by its failures, but it is now more energized than any other time in recent years. By the end of March of 2015, bills were introduced in twenty-five state legislatures to legalize assisted suicide. Defining the Subject Many people remain confused about the exact nature of assisted suicide advocacy, sometimes confusing it with other medical issues involving end-of-life care. Thus, to fully understand the subject, we must distinguish between ethical choices at the end of life that may lead to death and the poison of euthanasia/assisted suicide. 1.      Refusing unwanted medical treatment is not assisted suicide: Fear of being “hooked up to machines” when one wishes to die at home has traditionally been a driving force behind the assisted suicide movement. But we all have the right to refuse medical interventions—even if the choice is likely to lead to death. Thus, a cancer patient can reject chemotherapy and a patient dying of Lou Gehrig’s disease can say no to a respirator.  Indeed, in 1997, the U.S. Supreme Court ruled unanimously that the right to refuse medical treatment is completely different from assisted suicide.[9] 2.      Assisted suicide/euthanasia is not the same as a medical treatment for pain control: Because pain control may require strong drugs, which can cause death, assisted suicide advocates often claim that palliation and euthanasia are ethically the same under the “principle of double effect.” But this is all wrong: Any legitimate medical treatment can unintentionally lead to death, including pain alleviation. In assisted suicide death is the intended effect. We would never say that a patient who died during open-heart surgery was euthanized. Similarly, a patient who dies from the unintended side effects of pain control has not been assisted in suicide or euthanized. Pain control experts state that aggressive pain control generally does not shorten life. 3.      Assisted suicide/euthanasia is antithetical to hospice: Hospice was founded by the great medical humanitarian Dame Cicely Saunders in the late 1960s as a reform movement to bring the care of the dying out of isolated hospitals and into patients’ homes or non-institutional local care facilities. Its purpose is to provide dying people with proper treatment of pain and other disturbing symptoms as well as to render spiritual, psychological, and social support toward the end that life be lived as fully as possible until natural death. In contrast, assisted suicide is about rushing death, making it happen sooner rather than later through lethal actions. Or to put it another way: Hospice is about living. Assisted suicide/euthanasia is about dying. As the noted palliative care expert and assisted suicide opponent Dr. Ira Byock has written, “There’s a distinction between alleviating suffering and eliminating the sufferer — between enabling someone to die gently of their disease and ending that person’s life with a lethal pill or injection.” 4.      Assisted suicide/euthanasia are acts that intentionally end life: In contrast to the above, the intended purpose of assisted suicide and euthanasia is to end life, e.g., to kill. In assisted suicide, the last act causing death is taken by the person who dies, for example, ingesting a lethal prescription of barbiturates. In euthanasia, the death is a homicide, an act of killing taken by a third person, such as a doctor injecting a patient with poisonous drugs. From an Investigators Standpoint  Read More HERE

#001 - Join host Dr. Red Hoffman and co-host Dr. Matt Nielsen for the premiere episode of The Surgical Palliative Care Podcast as they interview Dr. Balfour Mount, the father of Palliative Care in North America.  Bal discusses his early days as a urologic oncologist, his work with Dame Cicely Saunders, his palliative care pilot project at the Royal Victoria Hospital and his experiences as a surgeon providing palliative care to his patients.   Prepare to be inspired!To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

Hospice care has been practiced for over 1,500 years. The creation of the “modern day” hospice is credited to Dame Cicely Saunders who, in England during the 1950’s, realized that managing pain at end of life was not enough. She recognized that there were psychological, social and spiritual aspects of the dying process that needed to be addressed as well. Be sure to check out this week's Changing Lives Podcast to learn more about Dame Saunders and the history of hospice care. About Hospice Quinte Hospice Quinte assists terminally ill individuals and their caregivers by offering them support and companionship. Visiting hospice services are offered in the person’s own home, long term care homes, retirement homes and both Belleville General and Trenton Memorial Hospitals. This care is provided by trained, experienced, and compassionate volunteers. Bereavement support groups are also offered. There are no fees for services to patients and their families. Hospice Quinte is a registered, non-profit charity whose volunteers are the heart of the organization. The Hospice Quinte service area includes Quinte West, Belleville, Deseronto, Tyendinaga Township and the Tyendinaga Mohawk Territory. To find out more visit HospiceQuinte.ca.Support the show (https://www.cognitoforms.com/HospiceQuinte/donatetohospicequinte)

Discussion with Dr Yvonne KayeI Believe in Miracles with Dr Yvonne Kaye About Yvonne Mother, grandmother, storyteller, writer, published author, thanatologist, humourist and former Philadelphia radio show personality, Dr. Yvonne Kaye has been involved with people since 1951 in her native England. A survivor of the Second World War, she uses her experiences in working with people in emotional pain, grief and loss, believing in the spiritual power of humor as a healing tool.Yvonne has also received countless prestigious awards over the years. Addressed schools, colleges and Universities. Is an International Speaker, and Involved with Veterans with PTSD and recovery.On this episode of My Perfect Failure (I believe in Miracles) we discuss Dr Kaye’s remarkable life. From being a survivor of the second world war, to moving from England to the America, to her training with hospice movement pioneers Dame Cicely Saunders and Dr. Elisabeth Kubler Ross, to her work with women and families and much more and why she believes in Miracles. Some of the areas we cover. · Dr Kaye’s training with hospice pioneers Dame Cicely Saunders and Elisabeth Kubler Ross.· Dr Kaye’s work helping people deal with grief, loss, the power of humour and healing · Her support for people with mental health challenges and addictions· We discuss Dr Kaye’s work with women and families To discover more about Dr Kaye’s extraordinary life and work· https://www.yvonnekayewisdom.com/Please leave a reviewPlease if you can leave a review at https://www.podchaser.com/MyPerfectFailure or the platform of your choice that would be great My Perfect Failure contact me Work with me: paul@myperfectfailure.comMPF Website: http://www.myperfectfailure.com/ Insta: follow: https://www.instagram.com/padsmpf/ Twitter: https://twitter.com/failure_perfect Facebook MPF Private Group: https://www.facebook.com/groups/377418129517757/

In 1967, Dame Cicely Saunders opened the first modern hospice in South London. St Christopher's inspired the creation of thousands of similar hospices around the world and its scientific research helped establish the modern discipline of palliative medicine. Simon Watts introduces archive interviews with Dame Cicely, who died in 2005.PHOTO: Dame Cicely Saunders (BBC)

Another chance to listen to the founder of the Hospice Movement speaking to Sue Lawley in 1995. Dame Cicely Saunders talks about her schooldays at Roedean, how she trained as a nurse and much later, as a doctor. When she was 29 she fell in love with a young patient dying of cancer, who bequeathed her a legacy of £500. Starting with that bequest, she raised enough money for a new kind of hospice dedicated to care for the dying. Favourite track: Symphony No 7 in A Major by Ludwig van Beethoven Book: The Oxford Dictionary of Quotations Luxury: Pen and paper

Are You Interested In How Whole Person Care Can Help Us With Pain And Dying? Do You Work With Others In Pain And Find Yourself Burned Out? Want To Learn How Diana And Yael Practice Self Care As Therapists? Join Us For And Interview With Palliative Care Physician Dr. Michael Kearney!  In this episode, Diana interviews Dr. Michael Kearney, a palliative care physician who takes an interpersonal, integrative approach to healing. Dr. Kearney shares with us how he has had to learn to "breathe underwater" and allow pain to move through him, and discusses his new book: The Nest in the Stream.  Michael Kearney MD  trained at St Christopher’s Hospice in London with Dame Cicely Saunders, pioneer of the modern hospice movement.  He later returned to his Ireland as medical director at Our Lady’s Hospice in Dublin.  In the early 2000’s he moved to North America, and now lives and works in Santa Barbara, California.  Throughout his career, Michael has been interested in whole person care and approaches that combine medical treatment with the innate healing potential of body, soul, and spirit.  He draws on depth psychology, mythology, Buddhist philosophy, indigenous wisdom and Earth-based spirituality. Michael has published three books, Mortally Wounded: Stories of Soul Pain, Death, and Healing, and, A Place of Healing: Working with Nature and Soul at the End of Life, as well as many articles and chapters. His most recent book, The Nest in the Stream: Lessons from Nature on Being with Pain, offers a way of being with pain and suffering that is infused with mindfulness, nature connection, openness, and compassion. Michael is married to psychologist, meditation teacher, and author Radhule Weininger, Ph.D. They teach and write together and share six adult children between them.  Resources: Dr. Micheal Kearney's website Image of the Nest in the Stream The Nest in the Stream: Lessons from Nature on Being with Pain Listen to meditations with Dr. Michael Kearney Palliative Care Consultants of Santa Barbara National Hospice and Palliative Care Organization

Tray and Mel are joined by Philip Yancey for episode 143 to discuss his story of leaving the faith due to the fundamentalist church he grew up with and what brought him back to Christ. Tune-in as one of the leading Christian voices of our day describes his journey from understanding God as a scowling super cop to a loving and gracious Father and the specific elements that God used to reveal Himself. Philip, Tray and Mel dive into a discussion of the beauty of sex in God’s plan for our lives and how he seeks to have a personal relationship with us. He often meets us in this unique and vulnerable place. They also reflect on how to not become slaves to earthly passions while still enjoying them as Christ did. Philip reflects back on his childhood and growing up in the fundamentalist church and how this eventually led to the hardening of his heart and caused him to turn away from faith entirely. Growing up in a strict, fundamentalist church in the southern USA, a young Philip Yancey tended to view God as “a scowling Supercop, searching for anyone who might be having a good time—in order to squash them.” Yancey jokes today about being “in recovery” from a toxic church. “Of course, there were good qualities too. If a neighbor’s house burned down, the congregation would rally around and show charity—if, that is, the house belonged to a white person. I grew up confused by the contradictions. We heard about love and grace, but I didn’t experience much. And we were taught that God answers prayers, miraculously, but my father died of polio just after my first birthday, despite many prayers for his healing.” Eventually Philip was brought back to God through nature, classical music and romantic love. These things brought Philip back to a true understanding of God his nature. Yancey worked as a journalist in Chicago for some twenty years, editing the youth magazine Campus Life while also writing for a wide variety of magazines including Reader’s Digest, Saturday Evening Post, National Wildlife, and Christianity Today. In the process he interviewed diverse people enriched by their personal faith, such as President Jimmy Carter, Habitat for Humanity founder Millard Fuller, and Dame Cicely Saunders, founder of the modern hospice movement. In 1992 he and his wife Janet, a social worker and hospice chaplain, moved to the foothills of Colorado. His writing took a more personal, introspective turn even as his activities turned outward. “Writing is such an introspective act that I found myself looking for ways to connect with the planet bodily. My interests include skiing, climbing mountains, mountain-biking, golf, international travel, jogging, nature, theology (in small doses), politics, literature, and classical music.”

October 9-16 is Hospice Care Week in the United Kingdom, and we wanted to honor and recognize our hospice colleagues in Great Britain for the tremendous work that they do in end of life care.   The modern hospice movement was begun in Great Britain through the work of Dame Cicely Saunders in the 1950's.  Through her passion and efforts, St. Christopher's Hospice was founded in 1967, and they celebrate their 50th anniversary this year.   For more information about the tremendous work that's being done through the leadership of HospiceUK, please visit their website at www.hospiceuk.org.  You will also find more information about Hospice Care Week on their website.  Our sincere thanks and gratitude to Tracey Bleakley (CEO) and the member organizations of HospiceUK.  Congratulations on another great year.  

Dame Cicely Saunders was born on June 22, 1918 in the United Kingdom.  She is best known for creating the modern hospice movement that now serves terminally ill patients all over the world.   She was trained as a nurse, but also became a medical social worker, and also a physician.  Many of the hospice philosophies that are still followed today, were created by Cicely Saunders.   In this Five for Friday episode, we celebrate the birthday of this amazing woman, and the powerful legacy she created in hospice care.  She created the principle of holistic care for terminally ill patients, believing that pain control encompasses physical, social, psychological, and spiritual needs.   For more about Cicely Saunders, visit our website at www.theheartofhospice.com, or listen to podcast #002 on The History of Hospice.  Please like our Facebook page and Twitter account to receive regular updates about our blog and our podcast.  

In this Five for Friday, Helen and Jerry discuss the hospice terms that can be very confusing to patients and caregivers.  Hospice professionals use these terms on a daily basis, and we often forget that patients/caregivers may not understand what they mean.   To help relieve some of the confusion, we put together this short episode to define and explain some of the terms most often used in hospice.   Our spotlight this week is the 50th anniversary of St. Christopher's Hospice in England.  St. Christopher's Hospice was started by Dame Cicely Saunders in 1967 in London.  This is where the modern hospice movement began.  We also want to recognize the many hospice professionals in the UK who carry on the mission of hospice, including Tracey Bleakley, the CEO of HospiceUK; Julie Gorry, the CEO of Wirral Hospice; and Keelan Early, the volunteer coordinator at Claire House.  Don't forget to take a look at www.theheartofhospice.com for The Heart of Hospice blog, and resources that are provided there.  Please do us a favor by writing a review, or rating this podcast on iTunes.  Your review will help more people discover the information we share about hospice.  

Happy Friday everyone! Helen & Jerry discuss the power of numbers in this Five for Friday episode.  Numbers tell a story.  From a clinical perspective, numbers reveal the status of the body: blood pressure, respiratory rate, heart rate, blood sugars, etc. It's not all about the numbers, though.  Numbers matter, but we have to see the patient beyond just their numbers.   A quote by Dame Cicely Saunders reminds us of the humanity of our patients.  She said, "You matter because you are you, and you matter until the end of your life."  Here's a few other quotes from this episode. "We take care of people, not patients." --Helen Bauer "The most important number is "1".  Because the 1 patient, the 1 family, the 1 life that matters, is the 1 that's in front of you right now. That's the person that matters."  -- Jerry Fenter We need your help.  Would you take just a minute out of your busy day to rate our podcast?  The more ratings that we receive, the more people we have the potential to reach with the message about hospice.  Thank you for taking the time to help us.  Do you have questions, suggestions, comments for Helen & Jerry.  You can reach us by email at host@theheartofhospice.com or on our FaceBook or Twitter accounts.  We are always eager to hear from our listeners.  

Dame Cicely Saunders was known as 'the woman who changed the face of death'. At almost 6 foot tall, she could be intimidating, tiresome and relentless as she devoted her life to ensuring that terminally ill people could die with dignity and without pain. Championing the life of Cicely Saunders as her great life is the actress and writer Maureen Lipman. The expert witness is Professor David Clark, from the University of Glasgow. Matthew Parris is the presenter and the producer is Perminder Khatkar.

The castaway in Desert Island Discs this week is the founder of the Hospice Movement Dame Cicely Saunders. She'll be talking to Sue Lawley about her schooldays at Roedean, how she trained as a nurse and much later, as a doctor. When she was 29 she fell in love with a young patient dying of cancer, who bequeathed her a legacy of £500. Starting with that bequest, she raised enough money for a new kind of hospice dedicated to care for the dying. There are now 190 similar hospices throughout the country.[Taken from the original programme material for this archive edition of Desert Island Discs] Favourite track: Symphony No 7 in A Major by Ludwig van Beethoven Book: The Oxford Dictionary of Quotations Luxury: Pen and paper

The castaway in Desert Island Discs this week is the founder of the Hospice Movement Dame Cicely Saunders. She'll be talking to Sue Lawley about her schooldays at Roedean, how she trained as a nurse and much later, as a doctor. When she was 29 she fell in love with a young patient dying of cancer, who bequeathed her a legacy of £500. Starting with that bequest, she raised enough money for a new kind of hospice dedicated to care for the dying. There are now 190 similar hospices throughout the country. [Taken from the original programme material for this archive edition of Desert Island Discs] Favourite track: Symphony No 7 in A Major by Ludwig van Beethoven Book: The Oxford Dictionary of Quotations Luxury: Pen and paper