2014 Annual Fall Conference Proceedings Adventist HealthCare

Summer

2015

2014 Annual Fall

Conference Proceedings

Adventist HealthCare

Center for Health

Equity and Wellness

2

2014 Annual Fall Conference Proceedings 2014 Annual Conference Proceedings

Acknowledgements

The Adventist HealthCare Center for Health Equity and Wellness would like to thank all of

the 2014 participants, speakers, panelists and sponsors for their continued support of the

Center’s activities. We are grateful to M&T Bank, Montgomery County Health and Human

Services, and the Primary Care Coalition of Montgomery County for providing financial

support for this year’s meeting as our Silver Level Sponsors and to the exhibitors who shared

their materials and services with the conference participants. We express additional gratitude

to the conference planning committee, especially our collaborative partners in the Mission

Integration and Spiritual Care Department. We appreciate our Center staff and interns for

their contributions, support and efforts throughout the year to plan this event. We were

honored to have Dr. Allan Hamilton provide the keynote address and Dr. Deborah Witt

Sherman delivered the conference closing address. Additionally, we were pleased to welcome

our morning and breakout session speakers and moderators:

Melanie Bailey, MDiv; Weptanomah Carter Davis, MS; Geoffrey Coleman, MD; Patrick

Garrett, MD; Rabbi Gary Fink, DMin; Kashif Firozvi, MD; Anna Maria Izquierdo-Porrera,

MD, PhD; Christopher Martin, Esq.; Randall Wagner, MD; Acacia Salatti, MDiv; Mary

Wassman, RN. Their invaluable contributions are what helped make this conference a

success.

2014 Annual Health Equity Conference Proceedings

The Adventist HealthCare Center for Health Equity and Wellness’ 8th Annual Health

Disparities Conference was held on November 12, 2014 at the Hyatt Regency Bethesda in

downtown Bethesda, Maryland. The 2014 Conference Proceedings summarize the day’s

events. The program agenda included presentations, concurrent panel sessions, and the 2014

Blue Ribbon Award presentation. A list of attendees is included at the end of the proceedings

to facilitate networking and continuing conversations with colleagues on end of life care and

services.

NOTE: The opinions and thoughts expressed here are those of the speakers and do not

necessarily reflect the positions of the Adventist HealthCare Center for Health Equity and

Wellness or Adventist HealthCare, Inc.

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2014 Annual Conference Proceedings

Acknowledgements

Authored and designed by the Adventist HealthCare Center for Health

Equity and Wellness Staff:

Ayesha Anwar

Coordinator, Youth Health Services

Mehnaz Bader

Research Intern

Marilyn Lynk, PhD

Director of Operations

Eme Martin, MPH

Project Manager, Cultural Competence

Gina Maxham, MPH

Project Manager, Community Benefit

Marcos Pesquera, RPh, MPH

Executive Director

Deidre Washington, PhD

Research Associate

To download additional copies of the proceedings or learn about the activities of the Center

for Health Equity & Wellness, visit the Center’s website at:

http://www.adventisthealthcare.com/health/equity-and-wellness/

http://www.adventisthealthcare.com/health/equity-and-wellness/

TABLE OF CONTENTS

Acknowledgements…………..……………………………………………………………………………………………...…. 2

Sponsors and Exhibitors………………………………………………………………………………………………..…… 5

Planning Process…………………………………………………………………………………………………..………….... 6

Morning Panel: Cultural and Spiritual Perspectives of Death and Dying……………………………………………………………

Anna Maria Izquierdo-Oirreram MD, PhD, Care for Your Health, Inc.

Rabbi Gary Fink, DMin, Montgomery Hospice

Kashif Firozvi, MD, Capital Oncology and Hematology

Moderator: Weptanomah Carter Davis, PhD(c), Today’s Minister’s Wife

8

Keynote Address: Escaping the Gulag – Unlocking the Loneliness of the Dying…………………………………………………...

Allan Hamilton, MD, University of Arizona

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2014 Blue Ribbon Award............................................................................................................................. ............................... 13

Afternoon Breakout Sessions

Track I: Community Connections—Understanding End-of-Life Care Decisions Medically and Legally………….

Kashif Firozvi, MD, Capital Oncology and Hematology

Christopher J. Martin, Esq., The Law Offices of Christopher J. Martin, LLC

Moderator: Patrick Garrett, MD, Adventist HealthCare, Inc.

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Track II: Providing Guidance and Counseling at the End of Life (for Clergy)……..…………………………..…...

Deborah Witt Sherman, PhD, Florida International University

Rabbi Gary Fink, DMin, Montgomery Hospice

Acaia Salatti, MDiv, Office of Faith-Based Partnerships

Moderator: Melanie Bailey, MDiv, Adventist HealthCare, Inc.

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Track III: Caring for the Terminally Ill Patient (for Providers)……………………………………………………….

Geoffrey Coleman, MD, Montgomery Hospice

Mary Wassmann, RN, Montgomery Hospice

Moderator: Randall Wagner, MD, Adventist HealthCare Washington Adventist Hospital

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Closing Address: Cultural Competence and Patient-Centered Care at End-of-Life………………………………………………

Deborah Witt Sherman, PhD, Florida International University

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Conference Evaluation Summary…………………………………………………………………………………………… 21

Conference Attendee List…………………………………………………………………………………………….…….. 22


SponsorsSponsors

Amerigroup

Care First Blue Cross and Blue Shield

Energy Federal Credit Union

Hospice Caring

Walden University

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Planning Process

Shortly following the Adventist HealthCare Center for Health Equity and Wellness (the Center)

seventh annual fall conference, leadership from the Center met with leadership from the Mission

Integration and Spiritual Care Department to discuss potential collaboration. After identifying a

mutual topic of interest, the two bodies formed a planning committee and began a monthly series of

one-hour planning meetings (January 2014 through November 2014) to outline the meeting day

objectives, format, and content. Members of the planning committee are as follows:

Linda Berman, MS

Donna Davidson, MPH

Ismael Gama, MS, MBA

Sue Heitmuller, MA

Louisa Hollman

Amber Larson, RN, BSN, MSeD

Danielle Lewald

Marilyn Lynk, PhD

Dina Madrid, DrPH

Eme Martin, MPH

Marcos Pesquera, RPh, MPH

Clarencia Stephen, MSW

Ray Tetz

Harish Vadiya, PhD

Randall Wagner, MD

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Morning Panel Summary

Ms. Weptanomah Carter Davis moderated the conference opening presentation, “Cultural and

Spiritual Perspectives of Death and Dying”, a panel discussion featuring Rabbi Dr. Gary Fink, and

medical doctors Kashif Firozvi and Anna Maria Izquierdo-Porrera.

Rabbi Dr. Gary Fink opened the discussion with brief highlights of Jewish culture and traditions

around end-of-life issues. Rabbi Fink noted the diverse perspectives on death and dying within the

religious sect (e.g., Hasidic, Orthodox, Conservative and Reform). In his role as a rabbi, Dr. Fink

serves as a guide, but his advice can be disregarded based on where people fall along the religious

identity spectrum – if at all.

Rabbi Fink noted that Jewish views on medical interventions during end-of-life care are broadly

similar to Christian views with a primary focus on preventing or diminishing suffering, especially

when death is inevitable. There is a time for being born and a time for dying. Nevertheless, while

withdrawal and withholding of treatment is permitted, views vary from family to family and Rabbi

Fink noted that it is best to “never assume, never infer, but always ask”. Rabbi Fink encouraged

medical providers to discuss end of life care with the patients well before it is necessary. Although

the subject matter can be uncomfortable to discuss, practitioners should initiate the conversation at

an appropriate time, such as when a patient transitions from pediatrics into internal medicine. Rabbi

Fink concluded by noting that, given the diversity of views among families, it is best to “always ask,

always assess, and always inquire”.

Dr. Kashif Firozvi, a medical oncologist, provided an Islamic perspective on end-of-life care. He

began by providing an overview of three core principles that define a Muslim’s approach to death

and dying. First, one must accept the will of God in all matters, including the end of life. Second, it

is forbidden to accelerate one’s death since life is a gift from God and only He can take it away.

Third, relatives play an important role in decision-making, including decisions in end-of-life care.

In addition to these key components, Dr. Firozvi noted that health care providers should be mindful

that Muslims place a significant emphasis on modesty and cleanliness at all times, including during

medical treatment and hospitalization. Dr. Firozvi concluded by noting that despite the challenges

one may encounter around end-of-life care, it is important to balance delivering quality standards of

medical practice with the faith and beliefs of each patient.

9


Dr. Anna Maria Izquierdo-Porrera shares

insights during the morning panel.

Morning Panel Summary (cont’d)

The last panelist, Dr. Anna Maria Izquierdo-Porrera, shared thoughts from her perspective as a geria-

trician. She noted that medical practitioners must keep in mind that it is not their role to keep people

alive forever, but to keep them comfortable as long as they live. Towards the end, they should give

consideration to four things: first, realize when the end of life is near and focus appropriately on

making the transition to death easier; second, ask the patient and his or her family relevant questions,

especially when the patient’s background and culture is not familiar to the care providers. In this

connection, linguistic competency may turn out to be more important than even cultural familiarity.

Third, keep the family informed as family members are just as important as caregivers and decision

makers. Finally, care for the caregivers as well as they need to be healthy in order to deliver

competent care and understand the full picture of the options available to their loved ones.

Following the opening remarks from each panelist, the moderator allowed questions from the

audience. Select questions and answers are featured below:

Question 1: Is it acceptable to withhold certain information from the patient about their medical

condition and prescribed treatment at the request of family members?

Dr. Firozvi stated that it is important for the patient to be informed about their medical condition and

treatment plan, especially if they so desire. Rabbi Fink agreed, further suggesting that providers ask

their patients about the level of information they would like to know. Dr. Izquierdo-Porrera

reinforced this idea, noting that she prefers to have a series of conversations rather than an isolated

dialogue with her patients to convey necessary information about their health outcomes and

treatment plans.

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Morning Panel Summary (cont’d)

Question 2: What are some different perspectives on hospice care?

Rabbi Fink addressed this question by briefly discussing hesitance toward hospice care that some

African-American families may possess due to a history of medical mistrust. He concluded his

response by emphasizing the importance of informing patients about the revocable nature of advance

directives and noted that more education for the community is needed to reduce stigma and

skepticism about hospice care.

Question 3: Does palliative care overlap with hospice care? Rabbi Fink clarified that hospice care is a subset of palliative care. It focuses on the comfort and

quality of life for patients with less than six months to live. Palliative care refers to a broader concept

of pain management relating to the treatment of symptoms, including physical and spiritual

considerations.

Question 4: Would it be okay for a nurse to offer to pray with a patient?

Dr. Firozvi said that it would be best to ask before offering to pray with the patient and to inform

them about one’s spirituality. Rabbi Fink suggested that one should not initiate the prayer or pray in

one’s own fashion. Rather, one should take the cue from the patient and ask about their preference.

Dr. Randall Wagner poses a question to the

members of the morning panel.

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Dr. Allan Hamilton (center) poses with (L-R)

Terry Forde, Dr. Deborah Witt Sherman,

Marcos Pesquera, and Ismael Gama

Dr. Allan Hamilton, professor at the University of Arizona, author, surgeon, veteran, and medical

script consultant for ABC’s Grey’s Anatomy, began his remarks with the premise that we (the living)

are uncomfortable with those who are dying, and that we have to overcome this feeling to confront

death in the most dignified manner.

His title, Escaping the Gulag: Unlocking the Loneliness of the Dying, was inspired by the Gulag

System of the former Soviet Union, a system of forced labor camps and colonies to which prisoners

were sent. Estimates suggest that 10 million people died in this system from the end of World War II

through the early 1960s. Today, in the United States, there are about 50,000 residential care settings

and nursing homes, and the numbers are increasing. In 2013, about 2.5 million Americans are in

these residential settings. Dr. Hamilton suggests that we, too, have created a place separate from

ourselves where the dying can be assigned.

Dr. Hamilton stated that there are three basic ways that humans deal with death: Mythology, Denial,

and Confrontation. He relayed the Biblical story of Adam and Eve, and different mythological

stories, to illustrate how the processes of dying and death have been explained historically.

Keynote AddressKeynote Address

Escaping the Escaping the

Gulag:Gulag:

Unlocking the Unlocking the

Loneliness of Loneliness of

DyingDying

12

Dr. Hamilton signs copies of his book,

“The Scalpel and the Soul” for

conference attendees.


Denial includes the denial of everything that leads to parting or separation. Dying is not a singular

event, but a process or transition. People die in stages; Dr. Hamilton suggests the six (6) stages of

degeneration, disease, debilitation, disability, dependency, and dying. As we continue to isolate the

dying and elderly, they face the cooling of relationships and decreased socialization. The segregation

also sends a message that they now have less value, which can lead to a lower sense of self-worth,

security and control for them. He went on to explain how we focus more on the scientific and

medical aspects of dying, as opposed to the social and spiritual aspects. He gave as an example the

U.S. response to the recent Ebola epidemic.

He also spent much time exploring the position that the elderly hold within the family unit, and with-

in society in general. At one time, the elderly held positions of extreme respect, power, and status.

This is still the case in some cultures. However, we often value them less than we once did, because

we feel the same knowledge and wisdom that they possess can be garnered from sources like the

Internet. With the fast-pace of technological change that we are currently living with, we see

information from 20-30 years ago as essentially obsolete. We can now isolate our wise and sage

elders, and suffer less of loss of the resource, because they are less valued in society.

There are many barriers to confronting death, but Dr. Hamilton suggests how we can begin to do so.

Using peer-review scientific articles, he posits that we need to do a better job of palliative care, and

that true palliative care needs to start at the time of diagnosis, not just at the time of death. Palliation

in general has to have a more central role in our health care system. It should be embedded in

allopathic medicine, and integrated into both acute and chronic care settings. It should be part of the

hospitalization and after-care process. Hospice services should become more decentralized (less of a

place, more of a service). Medical students should have more exposure to geriatric training and

real-life situations. These things will help in our ability to provide the timely, comfortable, and

dignified death that we ourselves would want.

Finally, Dr. Hamilton concluded his remarks by describing how love allows us to unlock the doors of

the gulag and confront death: we can prevent those we love from dying alone in isolation, we will

have the courage to allow a piece of us to die with our loved one, and we will collect the political

will to ensure that all of us can die in peace and comfort.

“Though lovers be lost, love shall not, and death shall have no dominion”- Dylan Thomas

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Prior to the afternoon sessions, the 2014 Blue Ribbon Award was announced. Each year, the Center

for Health Equity and Wellness presents a Blue Ribbon Award to a person or organization that has

demonstrated extraordinary commitment and dedication toward the elimination of health disparities

and the achievement of health equity. The recipient’s body of work should exemplify innovation,

impact and outcomes, collaboration, and cultural and linguistic appropriateness. The 2014 Blue

Ribbon Award was presented to Dr. Anna Maria Izquierdo-Porrera, the Executive Director and

co-Founder of Care for Your Health, a clinic system in Maryland dedicated to providing high-quality,

patient-centered care for underserved communities. As a trained geriatrician, Dr. Izquierdo-Porrera

has a particular passion for meeting the needs of her elderly patients through all aspects of their

health conditions, including end of life care. We salute Dr. Izquierdo-Porrera for her decades of

competent and compassionate care for the geriatric community in the Washington, DC metropolitan

area!

Dr. Anna Maria Izquierdo-Porrera receives the 2014 Blue

Ribbon Award from Dr. Randall Wagner (left) and Marcos Pesquera (right)


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15

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Track I: Community Connections: Resources for Patients and Caregivers

The President of Adventist Medical Group, Dr. Patrick Garrett, served as the moderator for this

session featuring medical oncologist Dr. Kashif Firozvi and estate planning attorney Mr. Christopher

Martin.

The panel commenced with Dr. Firozvi’s remarks. At the outset, he noted that he is a champion of

hospice care, a rare feeling in his opinion, among his medical colleagues. He stated that many

medical professionals debate the usefulness or futility of various care treatments. Dr. Firozvi’s key

point was the importance of dialoguing about end-of-life care at the beginning of the diagnosis and

treatment plan, rather than toward the end. To illustrate his point, he provided two patient examples.

Dr. Firozvi’s first example described a 78 year old woman who presented at the hospital with chest

pains and confusion. The patient had no advanced directives or power of attorney but had two vocal

children with differing opinions regarding her medical treatment. During the course of the patient’s

illness, her children had many arguments around the appropriate care for their mother. The patient

received aggressive medical treatments but ultimately perished. Her surviving family is no longer on

speaking terms.

The second example involved a woman who suffered a painful death resulting from a terminal

cancer diagnosis. The patient’s husband, who suffered from dementia, and one of their daughters,

insisted on aggressive treatments, although the patient was opposed. The other two children of the

patient also preferred less intense methods. To limit contention, the patient accepted the aggressive

treatment plan. The patient died a few short months later and her surviving children are presently

engaged in an intra-family lawsuit over the disposition of her estate. These two examples illustrate

the potential outcomes when end-of-life planning and dialogues do not occur early or before a

devastating illness. Dr. Firozvi noted that from a physician perspective, having a discussion about

end-of-life care can potentially send mixed messages and as a result, the conversation should happen

during the intake process.

Mr. Christopher Martin began his presentation by noting that the scenarios presented by Dr. Firozvi

are not atypical. Unfortunately, every awkward issue gets resolved at an inopportune time, but his

remarks outlined means to avoid some legal complications resulting from an individual’s death or

incapacitation.

An estate plan ensures that your wishes regarding yourself, your children and your assets are known

and carried out in the event of incapacitation. It designates who has the authority to speak for an

individual and reduces stress and fighting among loved ones. Further, it can help facilitate a smooth

transition of decision-making authority and property and save time and money in the process.

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The main components of estate planning are:

(a) During life: i) power of attorney agreement; ii) advance medical directives and iii) trust.

(b) After death: i) will and (ii) trust or legal entity that can hold property

An estate plan overcomes several obstacles including:

1. Misconceptions about how authority is granted.

2. Social stigma attached to incapacitation and death.

3. Belief that they do not have sufficient assets for planning.

4. Financial burdens

In addition to reviewing key points of an estate plan, Mr. Martin also discussed some cost effective

alternatives for addressing end-of-life care concerns:

Self-drafting documents regarding one’s wishes.

Statutory documents

Maryland legal aid

Prepaid legal services

Legal shield and legal resources

Bar association pro-bono events (i.e. Wills for Heroes).

Individual documents within an estate plan rather than a full estate planning package.

Track II: Providing Guidance and Counseling at the End of Life

(for Clergy)

This track session addressed the unique challenges of providing end-of-life guidance for the clergy

community. Moderated by Ms. Melanie Bailey, senior chaplain of Washington Adventist Hospital,

the panel included Rabbi Dr. Gary Fink, Ms. Acacia Salatti, and Dr. Deborah Witt Sherman.

Ms. Bailey introduced each panelist who then took a few moments to speak about their unique

backgrounds related to end-of-life care. Although the panelists came from different backgrounds and

experiences, they unanimously agreed on the importance of caring for people with love during end-

of-life treatment. The panel also collectively spoke on the importance of including family in the

treatment of the patient experiencing end-of-life care. Ms. Bailey moderated the panel by posing

several questions. The question and answer dialogue follows below:

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Question 1: What guidance would you give to spiritual leaders to deliver patient- and family-

centered care?

Rabbi Dr. Fink responded first by suggesting that the spiritual advisor accompany the patient

throughout their end-of-life journey, listening first before advising. He further suggested that rather

than imposing individual spiritual beliefs, spiritual leaders should inquire about what gives meaning

to the life of the patient. Dr. Sherman discussed bringing our “authentic selves” to the treatment

scenario, understanding that providers are entering a patient’s “safe place”, and it is necessary to

establish trust to help the patient feel as comfortable as possible.

The Director of the U.S. Health and Human Services Center for Faith-based and Neighborhood

Partnerships, Ms. Acacia Salatti, approached this question from personal experiences with her

mother who was diagnosed with Stage IV Lung Cancer in 2010. Her approach to the question and

what a faith leader can do is not only take care of the patient, but also take care of families that are

going through the process as well. Each caregiver or family member is grieving differently, which

in turn affects how the patient receives care.

Question 2: Spirituality vs. religion: Is there a difference between the two and how does the

difference guide the care provided for patients.

Dr. Sherman discussed the spiritual well-being scale and the reluctance that some patients may have

to answer God-related questions on the vertical axis. She described the spirit as “the air and breath,

the life force inside ourselves that give us our personality and energy of existence.” Religion, to Dr.

Sherman, is the “roadmap, or moral compass, that helps us lead a life according to that of our spirit.”

Question 3: What are some effective counseling approaches that spiritual caregivers can use in dif-

ficult family situations?

Rabbi Fink answered this question by noting the varying approaches to living and dying. For exam-

ple, some people want to fight, some are in denial, and others fall some place in between; each

approach serves a purpose in that it provides comfort to the patient and their grieving family. Rabbi

Fink made the important point that “we must normalize what is scary for them.”

He also mentioned that caring for somebody at the end of life is very different than caring for some-

body during illness. He compared the situation to a world turned upside down. “When somebody is

ill”, he stated, “we want them to push and fight to gain strength, but when it is an end of life

situation that is not our goal, [fighting] could just make them suffer more. Allow them to sleep and

resist food or to do what is most comfortable for them.”

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Track III: Caring for the Terminally Ill Patient (for Providers) Dr. Randall Wagner, Chief Medical Officer for Adventist HealthCare Washington Adventist

Hospital, moderated the Track III discussion about end-of-life care strategies for healthcare

providers. The panel featured Dr. Geoffrey Coleman, medical director for Montgomery Hospice,

and Mary Wassman, registered nurse at Montgomery Hospice. To open the panel, Dr. Wagner

invited the panel to clarify the difference between palliative care and hospice care.

Dr. Coleman explained that palliative care encompasses hospice care. Palliative care is caring for a

patient with a chronic and serious medical condition, and aims to holistically improve the quality of

life of the patient. Palliative care includes not only symptom management, debility management,

and treatment guidance, but social and spiritual guidance as well. Dr. Coleman continued by

explaining that hospice care originally fell under provisions of Medicare Part A for individuals with

a prognosis of six months or less. While this definition still holds true, some insurance companies

are offering hospice to anyone with a terminal illness and not solely limiting it to the six month

prognosis. By offering hospice without the prognosis limit, the patient’s quality of life and length of

life will increase and medical expenses decrease.

Dr. Wagner then encouraged the panel to provide examples of palliative care in a non-hospice care

setting. Dr. Coleman referenced Stage I cancer diagnoses and Mary Wassman discussed heart

failure patients, both conditions where the outcomes can be fairly favorable and hospice care

permits more guidance in the treatment plan and social support.

As a follow up the previous question, Dr. Wagner asked the panel to provide insights on the

difference between pain management and palliative care. Dr. Coleman spoke briefly on the

differences between the two fields by suggesting that pain management deals solely with managing

symptoms that cause the patient pain, whereas palliative care encompasses a more holistic approach

that guides not only the patient through their illness, but the patient’s family as well. Palliative care

deals not only with symptoms that cause pain but also any symptoms that are presented with the

illness. Dr. Coleman went on to say that the schooling for the two is also different. Pain

management requires residency in any field followed by a fellowship in pain medicine. Palliative

medicine typically requires doing a primary care residency and a linear fellowship at an institution

that has palliative medicine.

Additional anecdotal discussions focused around the history of hospice care, approaches to an end-

of-life care case study and a medical-reviewed article on palliative care familiar to the panel and

moderator. A brief audience question and answer period engaged the panel around family

involvement in the hospice care process and local hospice options before the panel concluded.

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Deborah Witt Sherman, PhD, CRNP, ANP-BC, ACHPN, FAAN

Associate Dean of Academic Affairs,

Nicole Wertheim College of Nursing and Health Sciences

Florida International University

In her closing remarks Dr. Deborah Witt Sherman, Associate Dean of Academic Affairs at Florida

International University and a clinical specialist in palliative care, emphasized the importance of

cultural competence within palliative treatment. She noted that, in today’s America, patients needing

palliative care come from a wide variety of cultural backgrounds and health professionals should

make an attempt to understand these backgrounds and use this information to improve the care they

are called upon to provide.

Dr. Sherman then posed a rhetorical question: “Why does culture matter?” She stated that culture is

key in the end-of-life treatment plan because pain and distress at the end-stage of life is not only

physical, but existential or spiritual as well. A sympathetic and understanding health professional

who is attuned to the patient’s cultural and spiritual needs can be of great help in such circumstances.

She then posed another question: “How does a health professional become sensitive to such needs?”

Dr. Sherman discussed the importance of being open, listening, and laying aside personal beliefs and

assumptions about a patient based on their color, race, ethnicity, economic status, gender, age or any

other such characteristic in order to be a culturally competent provider. An open and receptive attitude

can help the health professional understand the aspects that matter most to the patient and how to

connect and communicate most effectively with the patient.

Dr. Sherman explained that religion and spirituality can be very important in some cultures.

Understanding this aspect can help a health professional be more effective in delivering palliative

care. Sometimes, praying with the patient or finding someone to pray with the patient can be much

more important than medicine in relieving pain. Being sensitive to these and other such concerns

helps ensure the patient’s intrinsic dignity at a time of great vulnerability.


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Conference Evaluation Summary The 2014 annual fall conference welcomed 200 individuals representing healthcare, academia,

policy, and urban development. Of those who attended, 42 percent (84 individuals) completed a

conference evaluation. Sixty percent of the respondents were employees of Adventist HealthCare;

similarly, 60 percent identified healthcare as their primary field of work. Most survey respondents

(97%) strongly agreed or agreed that the conference was relevant to their work and delivered in an

effective manner and that the conference presenters demonstrated expertise in their respective

subject matters pertinent to end of life care.

The majority of respondents (between 89 and 95 percent) felt that the three learning objectives for

the conference (i.e., diverse cultural perspectives on end-of-life care, strategies for delivering

patient-centered end-of-life care, information and support for patients and families, and guidance

and resources for caregivers) were met through the speakers and panel presentations delivered.

Nearly all (96 percent) of survey respondents strongly agreed or agreed that the conference keynote

speaker, Dr. Allan Hamilton, delivered a dynamic address that was in harmony with the conference

theme, “Our Sacred Journey: Advancing Cultural Competence and Patient-Centered Approaches in

End-of-Life Care”.

In the qualitative feedback provided, many respondents commented on the value of learning about

multicultural approaches to death, challenges faced by healthcare providers to address end-of-life

care issues, and the importance of respecting cultural beliefs, family beliefs and values during end-

of-life care. “Do not fear the death discussion,” an attendee noted, “meet the patient where they are

at and treat [them] with respect.” Overall, the survey respondents felt that the conference day

presentation was enriching. Perhaps the summary message is best reflected from one survey

respondent who commented that their current approach to “patients at the end-of-life care is a good

one, [but they] can always learn.”


Registered Attendees for 2014 Annual

Fall Conference

Last Name First Name Organization E-Mail

Aguilar Fiorella

Aguirre Luis

Akinlolu Anthony [email protected]

Akpandak Ini Adventist HealthCare [email protected]

Alavaranga Philip

Alvarado Elena Montgomery County HHS [email protected]

Amoako-Atta Samuel Adventist HealthCare [email protected]

Anwar Ayesha Adventist HealthCare [email protected]

Arunan Shelvan Adventist HealthCare [email protected]

Austin Saundra Adventist HealthCare [email protected]

Awan Raheel Adventist HealthCare [email protected]

Awkard Kathy Montgomery College [email protected]

Bailey Melanie Adventist HealthCare [email protected]

Ballenger Keith Adventist HealthCare [email protected]

Berman Linda Adventist HealthCare [email protected]

Berry Hawa Montgomery County HHS [email protected]

Bierman Beverly Montgomery County HHS [email protected]

Bloom Marc Adventist HealthCare [email protected]

Breuer Cara Adventist HealthCare [email protected]

Brito Perez Marta Adventist HealthCare [email protected]

Brochu Liz Adventist HealthCare [email protected]

Brown Afryea Bon Secour Health System [email protected]

Brueck Mark University of MD School of Pharmacy [email protected]

Bui Jeffrey Adventist HealthCare [email protected]

Butler Ruth Adventist HealthCare [email protected]

Byun Caitlin Adventist HealthCare [email protected]

Caballero Cristina [email protected]

Cady-Harrington Irene [email protected]

Campbell Georgina Adventist HealthCare [email protected]

Campbell Jasmyne Adventist HealthCare [email protected]

Carter Davis Weptanomah

Chaity Farhana Adventist HealthCare [email protected]

Chan Thomas Adventist HealthCare [email protected]

Chatham Delvin Adventist HealthCare [email protected]

Chhangte Biaka Adventist HealthCare [email protected]

Cimino Jo Adventist HealthCare [email protected]


Class Irisbel Sistema Universitario Ana G. Mendez [email protected]

Cochran Rob [email protected]

Coleman Kathleen Adventist HealthCare [email protected]

Coleman Geoffrey

Collins Denise Kaiser Permanente [email protected]

Cox Minnie Adventist HealthCare [email protected]

Dalambert Gerdine Adventist HealthCare [email protected]

Daly Marie [email protected]

Davidson Donna Adventist HealthCare [email protected]

Delos Santos Lucila Adventist HealthCare [email protected]

Derse Carrie Adventist HealthCare [email protected]

Dhanraj Khem Energy Federal Credit Union [email protected]

Dietrich William [email protected]

Dinterman Jackie Frederick Memorial Hospital [email protected]

Dougherty Rose Mary [email protected]

Ekpo Inem U.S. Food and Drug Administration

Elson Norton Adventist HealthCare [email protected]

Elson Sandy [email protected]

Ephraim Chandradass Adventist HealthCare [email protected]

Fanay Ropuia

Feldbush Mark Adventist HealthCare [email protected]

Fennel Gary Adventist HealthCare [email protected]

Fink Rabbi Dr. Gary Montgomery Hospice

Firozvi Kashif Adventist HealthCare

Forde Terry Adventist HealthCare [email protected]

Franzino Elizabeth Adventist HealthCare [email protected]

Frelick Talya Adventist HealthCare [email protected]

Galen Steven Primary Care Coalition [email protected]

Gama Ismael Adventist HealthCare [email protected]

Garrett Patrick Adventist HealthCare [email protected]

Garvey Carol Garvey Associates, Inc. [email protected]

Gladhill Penny Hospice Caring, Inc. [email protected]

Glazer Emily Montgomery County HHS [email protected]

Glover Susan Adventist HealthCare [email protected]

Goorevich Doria Adventist HealthCare [email protected]

Grant Tom Adventist HealthCare [email protected]

Gravley Veronica Adventist HealthCare [email protected]


Hall Jenna Primary Care Coalition [email protected]

Hamilton Allan University of Arizona

Hanson Tricia Adventist HealthCare [email protected]

Hardesty Elizabeth Children’s National [email protected]

Hartman Amy Adventist HealthCare [email protected]

Hedges Caroline Adventist HealthCare [email protected]

Heitmuller Sue Adventist HealthCare [email protected]

Henning Andra Adventist HealthCare [email protected]

Hiner Kimberly State Health Department [email protected]

Hollman Louisa Adventist HealthCare

Ibanez Jean Adventist HealthCare [email protected]

Illig Debra Adventist HealthCare [email protected]

Izquierdo-Porrera Anna Maria Care for Your Health

Jacubec Don

Jepson Rob Adventist HealthCare [email protected]

Joseph Ian

Kasongo Eri [email protected]

Keech Catherine Adventist HealthCare [email protected]

Kendzior Abbey [email protected]

Kenney John Montgomery County HHS [email protected]

Kershner Ruth Montgomery County HHS [email protected]

Kidwell Rachel Adventist HealthCare [email protected]

Korto Margaret HHS Office of Minority Health [email protected]

Koshute Lisa Adventist HealthCare [email protected]

Krause Nancy Montgomery County HHS [email protected]

Lall Anju Adventist HealthCare [email protected]

Lam Betty Montgomery County HHS [email protected]

Larson Amber Adventist HealthCare [email protected]

Lawson Moira MD Department of Health & Mental

Hygiene

[email protected]

Lazo Reina Adventist HealthCare [email protected]

Lebedow Ellen Jewish Social Service Agency [email protected]

Lee James Adventist HealthCare [email protected]

Lee Esther Adventist HealthCare [email protected]

Leffingwell Ann Montgomery County HHS [email protected]

Levy-Studsky Judy Adventist HealthCare [email protected]

Lewald Danielle Adventist HealthCare [email protected]


Link Kara Adventist HealthCare [email protected]

Litsinger Jim Adventist HealthCare [email protected]

Lizarraga Karen Adventist HealthCare [email protected]

Lopez Gloria Adventist HealthCare [email protected]

Lynk Marilyn Adventist HealthCare [email protected]

Madrid Dina Adventist HealthCare [email protected]

Maglo Tenin Adventist HealthCare [email protected]

Manisundaram Arumani Adventist HealthCare [email protected]

Marbury Ruben [email protected]

Marbury Barbara [email protected]

Martin Christopher Law Offices of Christopher J. Martin [email protected]

Martin Emeobong Adventist HealthCare [email protected]

Martinez Luis Montgomery County HHS [email protected]

Matira Ariel Adventist HealthCare [email protected]

Maxham Gina Adventist HealthCare [email protected]

Mcallister Donna Kaiser Permanente [email protected]

McAndrews Kathleen Adventist HealthCare KMcAndre@adventisthealthcareCOM

McAtee Amelia Center for Cancer and Blood

Disorders

[email protected]

McBride Michele Adventist HealthCare [email protected]

McGreevy Amy Adventist HealthCare [email protected]

Micklos Monica [email protected]

Mighty Hugh Adventist HealthCare [email protected]

Millet Brenda Adventist HealthCare [email protected]

Milord Emmanuel Adventist HealthCare [email protected]

Mistry Sheetal Adventist HealthCare [email protected]

Monforte Nadine Adventist HealthCare [email protected]

Mora Sonia Montgomery County HHS [email protected]

Moten Vera Kaiser Permanente [email protected]

Mufuh Judith Adventist HealthCare [email protected]

Mulchandani-West Anjali Adventist HealthCare [email protected]

Munoz-Cruz Ana Adventist HealthCare [email protected]

Myers Betina Adventist HealthCare [email protected]

Neal Katelyn Adventist HealthCare [email protected]

Nelson Aparna Adventist HealthCare [email protected]

Norris Priscilla [email protected]

O'Conor Carolyn Adventist HealthCare [email protected]

Oliveira Eliezer Adventist HealthCare [email protected]


O'Reilly Erin [email protected]

Panneerselvam Shanmugam

Pardue Cherie Adventist HealthCare [email protected]

Parrish Katie Children’s National Medical Center [email protected]

Pasard Gail Adventist HealthCare [email protected]

Pavlin Richard [email protected]

Pesquera Marcos Adventist HealthCare [email protected]

Peyton Mary Adventist HealthCare [email protected]

Phillips Maria Adventist HealthCare [email protected]

Pickoff Laura Adventist HealthCare [email protected]

Pineda Rocio Adventist HealthCare [email protected]

Powell Miriam Adventist HealthCare [email protected]

Presley Joleane Adventist HealthCare [email protected]

Pugh Steve [email protected]

Rahman Rudmila Adventist HealthCare [email protected]

Ramos Elena Adventist HealthCare [email protected]

Reynolds Dawn Adventist HealthCare [email protected]

Roberts Allen Ursula Adventist HealthCare [email protected]

Rocha Glenda Adventist HealthCare [email protected]

Rogelio Joseph Adventist HealthCare [email protected]

Roy Ila National Institutes of Health [email protected]

Rubio Roberto Adventist HealthCare [email protected]

Ruiz Cristy Adventist HealthCare [email protected]

Sabalbaro Marya Adventist HealthCare [email protected]

Sachs Jonathan Adventist HealthCare [email protected]

Sackett John Adventist HealthCare [email protected]

Salatti Acacia U.S. HHS

Salmeron Olivia

Sama Noella Adventist HealthCare [email protected]

Sanchez Idalia HHS Office of Minority Health [email protected]

Sandberg Gwendolyn Montgomery County HHS [email protected]

Savery Susan Adventist HealthCare [email protected]

Schoonover Steve Adventist HealthCare [email protected]

Schroeder Janet

Schwarzmann Michele Adventist HealthCare [email protected]

Schwenk Leslie Adventist HealthCare [email protected]

Scott Leah [email protected]


Senesie Kuma Center for Cancer and Blood Disorders [email protected]

Shim Eunmee Adventist HealthCare [email protected]

Sim CK Adventist HealthCare [email protected]

Simpson Brent Self-Employed [email protected]

Skrabhan Bozena Adventist HealthCare [email protected]

Smothers Kevin Adventist HealthCare [email protected]

Sohi Jast Wilmington Trust [email protected]

Sparer Robin Adventist HealthCare [email protected]

Sparrow Lorraine Adventist HealthCare [email protected]

Spence Weymouth Washington Adventist University [email protected]

Stearns Allison Hospice Caring, Inc. [email protected]

Sullivan Tammy Adventist HealthCare [email protected]

Swanson Christy Adventist HealthCare [email protected]

Sweeney Tom Adventist HealthCare [email protected]

Tabor Azeb [email protected]

Taiwo Agnes Adventist HealthCare [email protected]

Taka Milka Adventist HealthCare [email protected]

Talavera Melina Adventist HealthCare [email protected]

Tate Kelly Adventist HealthCare [email protected]

Tekle Lishan Adventist HealthCare [email protected]

Terrell Marybeth Adventist HealthCare [email protected]

Tessema Zaena Adventist HealthCare [email protected]

Tetz Ray Self Employed

Tinney Sarah Adventist HealthCare [email protected]

Tolessa Ed Adventist HealthCare [email protected]

Torres Yolanda Sistema Universitario Ana G. Mendez [email protected]

Toupin Ann Adventist HealthCare [email protected]

Tran Vanessa Adventist HealthCare [email protected]

Trotter Elizabeth Kaiser Permanente [email protected]

Troupe Kathryn Frederick Memorial Hospital [email protected]

Ugolini Paolo [email protected]

Uy Wilson Adventist HealthCare [email protected]

Vaidya Harish Adventist HealthCare [email protected]

Vaslow Peter [email protected]

Vo Anh Montgomery County HHS [email protected]

Warfield Fred


Walker Denise

Wallace Arlee MD Department of Health & Mental Hygiene [email protected]

Wangsness Erik Adventist HealthCare [email protected]

Washington Deidre Adventist HealthCare [email protected]

Washington Richard HHS Office of Minority Health [email protected]

Wassmann Mary Adventist HealthCare [email protected]

Williams Judith [email protected]

Williams Camille Adventist HealthCare [email protected]

Witt Sherman Deborah Florida International University [email protected]

Wyson Karen Adventist HealthCare [email protected]

Young Kevin Adventist HealthCare [email protected]

Young Cheridan [email protected]

Young Linda Adventist HealthCare [email protected]

Zhang Yuqing Adventist HealthCare [email protected]

Zuckerman Mariam U.S. Renal Care [email protected]

Join Us for This Year’s

Conference on

October 8, 2015!

Documents

2014 Annual Fall Conference Proceedings Adventist HealthCare