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This notion of offering specialized culture-specific hospice and palliative care programs is spreading quickly.  There are many communities that already offer culture-specific teams to care for particular ethnic groups or those sharing common languages, religious affiliations or traditions.

Now, Hospice of the Good Shepherd in Boston, Massachusetts, is accommodating Russian-speaking residents by offering a Russian-speaking team composed of a social worker, nurse, home health aides and art therapist.

Residents are presented with care options in their native language, meals of traditional foods, and medical advice within a culturally sensitive framework.  The program has been received with open arms and hearts by the patients and their families.

This program is of particular significance for the Russian-speaking community because of the infrequency of such practices throughout Russian history.

“The lack of palliative and hospice care for people with terminal illnesses in Russia is a problem that has not been addressed for decades.” says Olga I. Usenko, a Russian physician, “In addition, palliative medicine is still not recognized as a specialty in the Russian Federation medical system and the majority of medical professionals do not have adequate knowledge about modern methods of pain management.”

Anna Sonkin recently highlighted the challenges of accessing palliative care and the lack of resources in Russia, which is affecting children as well as the elderly.

Hospice of the Good Shepherd recognizes this need and is doing more than its part for the Russian-speaking community by expanding its initiative internationally.  In Moldova, for instance, they are helping to purchase equipment, conduct training exchanges and develop hospice programs which have only begun to grow in the last 10 years.


[Photo Credit: Tom Page, Flickr]

For a list of hospice and palliative care in Russia and CIS countries, see the list from (in Russian).

Medical Symbol Vector

Credit: vectorportal, Flickr

For a significant number of caregivers, their religion is intrinsically tied to their practice. For others, spiritual concerns arise from the patients seeking solace.  The University of Chicago, a world renowned medical institute, has created a Program on Medicine and Religion, a unique blend of theology and clinical care. From May 23 – May 25, 2012 the program held a conference in Chicago, USA, “Responding to the Call of the Sick: Religious Traditions and Health Professions Today”, much of which touched on palliative and hospice care.

The conference sought to reach a wide audience including physicians, nurses, clinical care professionals, scholars and other health care experts on an array of topics within religion, ethics, science and the practice of care.  Speakers came from around the world including Israel, Jordan, and Malaysia.

While addressing contemplations of the interplay between religion and medicine from a more academic perspective, the conference did surface some important questions for practitioners to consider: how do we balance practical care and faith?  How should caregivers respond to address spiritual concerns of patients?  These questions can help caregivers be more knowledgeable about how their work can affect their patient and equip them for challenges they may face in their work.

While we may not have the answers, Manya A. Brachear, a Chicago Tribune Reporter, shares experiences of caregivers’ contact with spirituality in their practice. The program’s latest project, titled Project on a Good Physician, will take on the moral and ethical questions of what makes a good physician. 

Please share your experiences and insights as well, right here on our blog.

The Woodstock care home in the Hague has recently made headlines for housing residents that are chemically dependent and have been termed “long term addicted with untreatable addiction”.  One of the goals of the facility is to alleviate homelessness in the elderly, as well as to promote social order and safety. The facility is managed under the direction of the municipal government as well as local health care manager Parnassia. The facility uses multiple parameters as admission criteria, and provides treatment for multiple co-morbidities. While residents must enter a behavioral agreement to ensure safety, they are permitted to continue to consume chemical substances in the program. “Our criteria state you can only get into Woodstock if you’re over 45 and after a medical examination declares you are beyond rehabilitation,” said psychiatrist Nils Hollenborg. (For beautifully haunting photos of residents, see these photos from Peter Van Beek). Municipal authorities argue that providing stability for this population helps reduce petty theft.

While “hard” drugs may not be on the menu, chemical dependency may be an emerging issue in elder care. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) released a report in 2009 that documented an increase in drug use among persons ages 50 – 64. As the “baby boomers” age, it is probable that elderly service providers will have to confront the issue of substance abuse among elders, as people who have consumed cannabis across their lifespan need services and supports. Complicating the issue from a provider policy standpoint, some states in the U.S. now allow for medical use of cannabis. Therefore, homes and care providers in California or Colorado might legally allow residents to consume cannabis while in their care. Such a home would be in compliance with state law but in violation of federal law. Residents of an advanced age may feel that rehabilitation in no longer a viable option and may prefer to continue their consumption. What do you think? Will “baby boomers” demand acceptance of chemical dependence as they age? What impact do you see this having on the aged care industry?


Woodstock Residence- Photo Courtesy Parnassia





A new deal is needed for people at the end of their lives to ensure they are treated well and receive high quality care and support, according to a report published recently by the National Council for Palliative Care [NCPC] in the UK.

Entitled No Dress Rehearsals, the report looks at how end of life care is measuring up 3 years after the publication of the UK’s End of Life care strategy.   The report finds that, despite many examples of excellent care,  there remains serious cases of neglect and ill-treatment.  No Dress Rehearsals calls for more open discussion about dying and death to make it a real priority, making it easier for people to receive end of life care and make training in end of life care a core part of the curriculum for all health and social care staff.

Does your country have an End of Life strategy?  Please share your thoughts and experiences with our readers.

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Virginia Nuessle, Study Tour Director

Majd Alwan, Director, CAST

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