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Economic Evaluation of Palliative Care in Ireland

December 7, 2015

This report examines the cost of providing palliative care in Ireland for individuals facing life-threatening illnesses, outcomes for patients and families resulting from that care, and the patterns and variations among the measures studied. Focusing their examination on three regional areas, researchers found:Wide variations in the availability of palliative care services across the regions.Significant differences in how those services are resourced and models of care.Despite the variation in availability and models of care, costs remain broadly the same across regions.Among the conclusions from examination of key outcomes for the patients:High patient satisfaction with palliative care services across all regions.Where available, hospice care is easier to access and rated more highly on every quality measure than in-hospital care.The ability to access in-hospice services in the last three months of life would be preferable for patients and may provide savings within hospitals.

Insufficient Palliative Care Staff/Physicians; Lack of Facilities/Beds; People in Hospice; People in a Hospital

Longer Lives Better Health: Helping Seniors Preserve Their Physical, Mental and Social Well-Being

July 1, 2015

This ROOTS is intended to celebrate the work the Foundation has done with many good partners to re-envision aging. By addressing the physical, social, technological, and environmental factors that minimize disability and foster prevention, we aim to change the trajectories of decline and dependence. But our aspirations go further. We believe that the years post-65 can be truly golden. Worries and challenges of youth and middle age are in the past. There can and should be much joy in the present. But our systems of care must change to better meet the needs of those who want independent living and community engagement. My hope is that this ROOTS will inspire others to join us in enhancing the well-being of older adults. And I encourage other foundations -- if not already engaged -- to contemplate the satisfactions of an aging agenda. If we do it right, while advances in medicine and technology are adding years to life, we can also add life to years.

Additional Research on Needs of Specific Communities or Populations; Community Education About the Need for Advanced Care Planning

Lessons From the Local Level: DACA's Implementation and Impact on Education and Training Success

January 5, 2015

This report examines the ways in which local educational institutions, legal service providers, and immigrant youth advocates have responded to the first phase of Deferred Action for Childhood Arrivals (DACA). Based on extensive interviews with stakeholders in seven states -- California, Florida, Georgia, Illinois, Maryland, New York, and Texas -- the report identifies initiatives undertaken by educational institutions and other community stakeholders to support DACA youth's education and training success, and examine the impact of deferred action on grantees' academic and career pursuits. It provides examples of promising practices, additional challenges, and key takeaways at the high school, postsecondary, and adult education levels, as well as an exploration of the nature and scope of DACA legal outreach initiatives.

The Role of Philanthropy in the U.S. Immigrant Rights Movement

December 1, 2014

As the Ford Foundation marks 25 years of involvement on U.S. immigration issues, it is a good time to take stock of what has occurred and to examine more closely philanthropy's role in supporting the growth of a national immigrant rights movement. There are many reasons for the field's rapid growth, including extraordinary leadership by those who have headed the movement. But the support of numerous foundations and other donors has played a vital part in fueling the field's expansion. Contributions have come from all parts of the philanthropic community. Smaller foundations, for example, have played a significant role in strengthening the capacity of regional and local immigrant-serving organizations that are backbone of the movement.To help tell the story of philanthropy's contribution to the development of an immigrant rights field in United States, the Ford Foundation commissioned journalist Louis Freedberg, with assistance from Ted Wang, to write this report. It describes how Ford initially entered the field, the challenges the Foundation and its grantees faced in the early years, how funders have worked together to support an emerging but vibrant movement, and the lessons learned to help inform future efforts to support the field. The authors' observations are their own and do not necessarily reflect the opinion of the Ford Foundation. They point out that the power of philanthropic grantmaking in this area has come from a combination of factors: committed long-term funders who have supported this field for many years; a willingness to fund a wide range of organizations that provide complementary activities; flexibility to adjust grantmaking to changing conditions; and an openness among funders to collaborate with each other and as well as with grantees to achieve a shared vision.

Campaign for a Moral, Balanced Immigration Overhaul (CAMBIO), Strategic Review

November 1, 2014

In March 2014, Campaign for an Accountable, Moral, and Balanced Immigration Reform (CAMBIO) commissioned us to conduct an external review of the CAMBIO campaign. This report summarizes findings based on data gathered during an in-person focus group conducted with members of the CAMBIO Steering Committee in May 2014; a review of approximately 20 CAMBIO corporate documents and 36 internal meeting minutes; and 41 semi-structured telephone interviews conducted principally in June and July 2014.

Care When There is No Cure: Ensuring the Right to Palliative Care in Mexico

October 24, 2014

Almost 600,000 people die every year in Mexico, nearly half of them as a result of chronic illnesses such as heart and lung disease, diabetes, HIV or cancer. Hundreds of thousands more Mexicans battle with earlier stages of these and other chronic illness. Over the course of their illness many of these people experience debilitating symptoms such as pain, breathlessness, anxiety and depression. To ensure proper medical care for many of these individuals, access to palliative care and pain medicines is essential. Without these services, they will suffer needless pain and distress undermining their quality of life and that of their families in their final days of life.In Mexico, access to palliative care services and to medicines essential for pain treatment is very limited. Human Rights Watch found that currently only a few dozen public healthcare institutions in the country offer palliative care and even fewer provide it in patients' homes. Most healthcare personnel have received no training in the discipline, and few doctors are licensed to prescribe strong pain medicines that are essential for palliative care. Where palliative care is available it is often due to the efforts of individual physicians or advocates rather than the result of a deliberate policy of the government, health system or insurer.

Distance to Services; Drug Availability; Insufficient Palliative Care Staff/Physicians; Overly Restrictive Drug Policies/Laws; Palliative Care Training for Medical Staff; People Living in Rural Communities; Reform of Drug Control Regulations

Racial Attitudes in America and the Effects on Health Disparities: A Perspective

January 1, 2014

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications.Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end-of-life care in African American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families.

Medical Staff Discrimination/Ignorance; Poverty; Racial and Ethnic Discrimination; Train Staff in Culturally Sensitive Care

Advanced Illness and Orthodox Jewish Law: Approaches to Communication and Medical Decision Making

November 1, 2013

Interactions between Orthodox Jewish patients at the end of life and medical practitioners are frequently difficult. Orthodox Jewish law places a great emphasis on extending life, and many Orthodox Jews assume - sometimes incorrectly - that they must pursue aggressive care under all circumstances according to Jewish law.

Cultural & Religious Discrimination; Greater Trust and Awareness Through Existing Leaders; Lack of Knowledge About Palliative Care Options; Medical Staff Discrimination/Ignorance; Poor Communication Between Providers & Patients; Train Staff in Culturally Sensitive Care

Suffering at the End of Life: the State of the World

October 28, 2013

Our experience of dying may vary considerably depending on factors such as the cause of our death, whether we have family or friends to care for us, where we live in the world and the availability of good healthcare. This report was published to coincide with the first World Hospice and Palliative Care Day in 2005. Chapters include: 'Suffering at the end of life -- is it inevitable?'; 'Suffering at the end of life -- a picture of inequality'; 'Hospice/palliative care -- a response to suffering at the end of life'; and 'Global palliative care -- the way ahead'.

Drug Availability; Drug Costs; Greater Availability of Pain-relief Drugs; Inadequate Funding; Lack of Knowledge About Palliative Care Options; National Palliative Care Policies; People Living in Underserved Countries; Recognition of Legal Rights of Specific Populations

Abandoned in Agony: Cancer and the Struggle for Pain Treatment in Senegal

October 1, 2013

The 85-page report found that 70,000 Senegalese each year need what is known as palliative care to control symptoms related to chronic, life-threatening diseases. Morphine is an essential and inexpensive medication for treatment of severe pain, but Senegal only imports about one kilogram of morphine each year -- enough to treat about 200 cancer patients. Human Rights Watch also found that morphine is unavailable outside of Dakar, Senegal's capital. Frequent shortages limit access to the medication in the capital as well.

Cultural & Religious Discrimination; Distance to Services; Drug Availability; Greater Availability of Pain-relief Drugs; Insufficient Palliative Care Staff/Physicians; Integration Into Disease Control Strategies; Integration into Community-based Settings; Lack of Knowledge About Palliative Care Options; Overly Restrictive Drug Policies/Laws; Palliative Care Training for Medical Staff; People Living in Underserved Countries; People with Cancer

Profiles in Advocacy: How FIRM Has Moved Legislators on Immigration Reform

July 1, 2013

This report presents a series of case studies in moving legislators on immigration reform, including lessons learned on:Moving a legislator in a district with changing demographics;Converting a Senator from supporter to champion;Organizing a statewide framework to move conservatives;Moving and engaging first term legislators;Cultivating potential champions in the House;Cultivating Republican leadership.

Effectiveness and Cost-Effectiveness of Home Palliative Care Services for Adults with Advanced Illness and Their Caregivers

June 6, 2013

Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. . . . The results [of this study] provide clear and reliable evidence that home palliative care increases the chance of dying at home and reduces symptom burden in particular for patients with cancer, without impacting on caregiver grief. This justifies providing home palliative care for patients who wish to die at home.

Increased Community Awareness About Palliative Care Options; Integration Into Home-care Systems; People in a Home-based Care Setting