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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.

A State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals

January 1, 2015

This Report Card examines variation in access to palliative care at the state level in order to help both the public and policymakers increase the availability of these services for all Americans in need

Insufficient Palliative Care Staff/Physicians; Integration into Community-based Settings; Lack of Knowledge About Palliative Care Options; People Living in Underserved Regions

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

The Hospice Friendly Hospitals Programme

April 29, 2014

This report describes how care for people who die in Irish hospitals is planned and provided for; and how those processes evolved over the period 2007-2013. The report details a journey and we do not claim to have reached journey's end. The 'Hospice Friendly Hospitals' (HFH) programme, as an aspiration or an idea, meets with very little resistance. Its aim - to transform the culture of hospital care for dying patients is a shared and transparent aim which we believe has now made its way into Irish discourse. While the aim may be agreeable, the means for change are not so straightforward.

Greater Coordination Between Providers; Greater Knowledge Sharing; Increased Community Awareness About Palliative Care Options; National Palliative Care Policies; Palliative Care Training for Medical Staff; People in a Hospital

Until That Time Comes

January 27, 2014

Patients with with life-limiting illnesses experience emotional distress not just from physical pain. Pressing concerns can include the future of their property, access to health services and social benefits, care of their children, patient confidentiality, and how much freedom they will have to choose their treatment.Addressing these legal concerns is part of palliative care's holistic approach. Palliative care aims to improve the quality of life for these patients and families by relieving suffering through physical, spiritual, and psychosocial support.That's why the Kenya Hospices and Palliative Care Association (KEHPCA) began training health care providers to become paralegals. It empowers them to identify legal issues, give basic legal advice -- like how to draft a will or establish power of attorney -- and refer more complicated cases to pro-bono lawyers.KEHPCA has now trained over 300 paralegals and established a pro-bono network of attorneys with relevant expertise. The organization also developed a series of informational pamphlets that cover how to draft a will, patients' rights, and power of attorney.In the video above, Nyeri Hospice shows how legal services can be integrated into care for patients and their families, both at the hospice and at home. Pro-bono attorneys run legal aid clinics at the hospice and follow up with patients on a personal basis as needed. And Nyeri's health care providers include legal assessment as a component of care when visiting a patient at home.Addressing the legal needs of patients and families offers peace of mind. This in turn improves health and well-being. Human dignity, in illness and at the end of life, must remain at the center.

Bereavement Support; Community Education About the Need for Advanced Care Planning; Cultural & Religious Discrimination; Increased Community Awareness About Palliative Care Options; Integration Into Disease Control Strategies; Integration into Community-based Settings; Lack of Knowledge About Palliative Care Options; Lack of Legal Recognition; People Living in Underserved Countries; Psychosocial Support; Recognition of Legal Rights of Specific Populations

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