2014 annual fall conference proceedings adventist healthcare

Summer

2014 Annual Fall

Conference Proceedings

Adventist HealthCare

Center for Health

Equity and Wellness

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.

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/

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

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

Allan Hamilton, MD, University of Arizona

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.

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.

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

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

Deborah Witt Sherman, PhD, Florida International University

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

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

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.

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.

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.

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

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

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

Dr. Anna Maria Izquierdo-Porrera receives the 2014 Blue

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

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.

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:

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.”

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.

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.

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 Anthony.Akinlolu@medstar.net

Akpandak Ini Adventist HealthCare IAkpanda@adventisthealthcare.com

Alavaranga Philip

Alvarado Elena Montgomery County HHS Elena.Alvarado@montgomerycountymd.gov

Amoako-Atta Samuel Adventist HealthCare SAtta@adventisthealthcare.com

Anwar Ayesha Adventist HealthCare AAnwar@adventisthealthcare.com

Arunan Shelvan Adventist HealthCare SArunan@adventisthealthcare.com

Austin Saundra Adventist HealthCare SAustin@adventisthealthcare.com

Awan Raheel Adventist HealthCare RAwan@adventisthealthcare.com

Awkard Kathy Montgomery College Kathy.Awkard@montgomerycollege.edu

Bailey Melanie Adventist HealthCare MBailey@adventisthealthcare.com

Ballenger Keith Adventist HealthCare KBalleng@adventisthealthcare.com

Berman Linda Adventist HealthCare LBerman@adventisthealthcare.com

Berry Hawa Montgomery County HHS Hawa.Barry@montgomerycountymd.gov

Bierman Beverly Montgomery County HHS Beverly.Bierman@montgomerycountymd.gov

Bloom Marc Adventist HealthCare MBloom@adventisthealthcare.com

Breuer Cara Adventist HealthCare CBreuer@adventisthealthcare.com

Brito Perez Marta Adventist HealthCare MPerez@adventisthealthcare.com

Brochu Liz Adventist HealthCare LBrochu@adventisthealthcare.com

Brown Afryea Bon Secour Health System Afryea_Brown@bshsi.org

Brueck Mark University of MD School of Pharmacy MBrueckl@rx.umaryland.edu

Bui Jeffrey Adventist HealthCare JeffreyBui21@gmail.com

Butler Ruth Adventist HealthCare RButler@adventisthealthcare.com

Byun Caitlin Adventist HealthCare Caitlin_Byun@hotmail.com

Caballero Cristina dialog.div@prodigy.net

Cady-Harrington Irene IreneCadyH@athomecareinc.com

Campbell Georgina Adventist HealthCare GCampbel@adventisthealthcare.com

Campbell Jasmyne Adventist HealthCare JCampbel@adventisthealthcare.com

Carter Davis Weptanomah

Chaity Farhana Adventist HealthCare FChaity@adventisthealthcare.com

Chan Thomas Adventist HealthCare TChan@adventisthealthcare.com

Chatham Delvin Adventist HealthCare DChatham@adventisthealthcare.com

Chhangte Biaka Adventist HealthCare BChhangte@yahoo.com

Cimino Jo Adventist HealthCare JCimino@adventisthealthcare.com

Class Irisbel Sistema Universitario Ana G. Mendez Classi1@suagm.edu

Cochran Rob RobCochran11@gmail.com

Coleman Kathleen Adventist HealthCare KColeman@adventisthealthcare.com

Coleman Geoffrey

Collins Denise Kaiser Permanente Denise.J.Collins@kp.org

Cox Minnie Adventist HealthCare MCox@adventisthealthcare.com

Dalambert Gerdine Adventist HealthCare GDalambe@adventisthealthcare.com

Daly Marie MarieD@hospicecaring.org

Davidson Donna Adventist HealthCare DDavidso@adventisthealthcare.com

Delos Santos Lucila Adventist HealthCare LSantos2@adventisthealthcare.com

Derse Carrie Adventist HealthCare CDerse@adventisthealthcare.com

Dhanraj Khem Energy Federal Credit Union KDhanraj@energyfcu.org

Dietrich William William.C.Dietrich@gmail.com

Dinterman Jackie Frederick Memorial Hospital JDinterman@fmh.org

Dougherty Rose Mary RMDough@verizon.net

Ekpo Inem U.S. Food and Drug Administration

Elson Norton Adventist HealthCare Nelson@ahm.com

Elson Sandy Sandy@thewisdomofruth.com

Ephraim Chandradass Adventist HealthCare CEphraim@adventisthealthcare.com

Fanay Ropuia

Feldbush Mark Adventist HealthCare MFeldbus@adventisthealthcare.com

Fennel Gary Adventist HealthCare Oriongrf@gmail.com

Fink Rabbi Dr. Gary Montgomery Hospice

Firozvi Kashif Adventist HealthCare

Forde Terry Adventist HealthCare TForde@adventisthealthcare.com

Franzino Elizabeth Adventist HealthCare EFranzin@adventisthealthcare.com

Frelick Talya Adventist HealthCare TFrelick@adventisthealthcare.com

Galen Steven Primary Care Coalition Steve_Galen@primarycarecoalition.org

Gama Ismael Adventist HealthCare IGama@adventisthealthcare.com

Garrett Patrick Adventist HealthCare PGarrett@adventisthealthcare.com

Garvey Carol Garvey Associates, Inc. CGarvey@garveyassociates.com

Gladhill Penny Hospice Caring, Inc. Pennyg@hospicecaring.org

Glazer Emily Montgomery County HHS Emily.Glazer@montgomerycountymd.gov

Glover Susan Adventist HealthCare SGlover@adventisthealthcare.com

Goorevich Doria Adventist HealthCare DGoorevi@adventisthealthcare.com

Grant Tom Adventist HealthCare TGrant@adventisthealthcare.com

Gravley Veronica Adventist HealthCare VGravke1@adventisthealthcare.com

Hall Jenna Primary Care Coalition Jenna_Hall@primarycarecoalition.org

Hamilton Allan University of Arizona

Hanson Tricia Adventist HealthCare THanson@adventisthealthcare.com

Hardesty Elizabeth Children’s National EHardest@childrensnational.org

Hartman Amy Adventist HealthCare AHartma2@adventisthealthcare.com

Hedges Caroline Adventist HealthCare CHedges@adventisthealthcare.com

Heitmuller Sue Adventist HealthCare SHeitmul@adventisthealthcare.com

Henning Andra Adventist HealthCare AHenning@adventisthealthcare.com

Hiner Kimberly State Health Department Kimberly.Hiner@maryland.gov

Hollman Louisa Adventist HealthCare

Ibanez Jean Adventist HealthCare Jean.Ibanez@gmail.com

Illig Debra Adventist HealthCare DIllig@adventisthealthcare.com

Izquierdo-Porrera Anna Maria Care for Your Health

Jacubec Don

Jepson Rob Adventist HealthCare RJepson@adventisthealthcare.com

Joseph Ian

Kasongo Eri Vankase@yahoo.com

Keech Catherine Adventist HealthCare CKeech@adventisthealthcare.com

Kendzior Abbey A.Kendzior@att.net

Kenney John Montgomery County HHS John.Kenney@montgomerycountymd.gov

Kershner Ruth Montgomery County HHS Ruth.Kershner@montgomerycountymd.gov

Kidwell Rachel Adventist HealthCare RKidwell@adventisthealthcare.com

Korto Margaret HHS Office of Minority Health MKorto@minorityhealth.hhs.gov

Koshute Lisa Adventist HealthCare LKoshute@adventisthealthcare.com

Krause Nancy Montgomery County HHS Nancy.Krause@montgomerycountymd.gov

Lall Anju Adventist HealthCare ALall@adventisthealthcare.com

Lam Betty Montgomery County HHS Betty.Lam@montgomerycountymd.gov

Larson Amber Adventist HealthCare ALarson@adventisthealthcare.com

Lawson Moira MD Department of Health & Mental

Hygiene

Moira.Lawson@maryland.gov

Lazo Reina Adventist HealthCare RLazo@adventisthealthcare.com

Lebedow Ellen Jewish Social Service Agency ELebedow@jssa.org

Lee James Adventist HealthCare JLee@ahm.com

Lee Esther Adventist HealthCare ELee4@adventisthealthcare.com

Leffingwell Ann Montgomery County HHS Ann.Leffingwell@montgomerycountymd.gov

Levy-Studsky Judy Adventist HealthCare JLevy-St@adventisthealthcare.com

Lewald Danielle Adventist HealthCare DLewald@adventisthealthcare.com

Link Kara Adventist HealthCare KLlink@adventisthealthcare.com

Litsinger Jim Adventist HealthCare JLitsing@adventisthealthcare.com

Lizarraga Karen Adventist HealthCare KLizarra@adventisthealthcare.com

Lopez Gloria Adventist HealthCare GLopez@adventisthealthcare.com

Lynk Marilyn Adventist HealthCare MLynk@adventisthealthcare.com

Madrid Dina Adventist HealthCare DMadrid@adventisthealthcare.com

Maglo Tenin Adventist HealthCare TMaglo@adventisthealthcare.com

Manisundaram Arumani Adventist HealthCare AManisun@adventisthealthcare.com

Marbury Ruben RubenMarbury@earthlink.net

Marbury Barbara Rubarb1023@gmail.com

Martin Christopher Law Offices of Christopher J. Martin cmartin@cjmartinlaw.com

Martin Emeobong Adventist HealthCare EMartin2@adventisthealthcare.com

Martinez Luis Montgomery County HHS Luis.Martinez@montgomerycountymd.gov

Matira Ariel Adventist HealthCare AMatira@adventisthealthcare.com

Maxham Gina Adventist HealthCare GMaxham@adventisthealthcare.com

Mcallister Donna Kaiser Permanente Donna.C.Mcallister@kp.org

McAndrews Kathleen Adventist HealthCare KMcAndre@adventisthealthcareCOM

McAtee Amelia Center for Cancer and Blood

Disorders

AMcAtee@ccbdmd.com

McBride Michele Adventist HealthCare MMcBride@adventisthealthcare.com

McGreevy Amy Adventist HealthCare AmyJMcgreevy@gmail.com

Micklos Monica MonicaMicklos@yahoo.com

Mighty Hugh Adventist HealthCare HMighty@adventisthealthcare.com

Millet Brenda Adventist HealthCare BMillet@adventisthealthcare.com

Milord Emmanuel Adventist HealthCare EMilord2@adventisthealthcare.com

Mistry Sheetal Adventist HealthCare SMistry@adventisthealthcare.com

Monforte Nadine Adventist HealthCare NMonfort@adventisthealthcare.com

Mora Sonia Montgomery County HHS Sonia.Mora@montgomerycountymd.gov

Moten Vera Kaiser Permanente Vera.Moten@kp.org

Mufuh Judith Adventist HealthCare JMufuh@adventisthealthcare.com

Mulchandani-West Anjali Adventist HealthCare AMWest@adventisthealthcare.com

Munoz-Cruz Ana Adventist HealthCare ACruz2@adventisthealthcare.com

Myers Betina Adventist HealthCare BPereira@louriecenter.org

Neal Katelyn Adventist HealthCare KNeal@adventisthealthcare.com

Nelson Aparna Adventist HealthCare ANelson3@adventisthealthcare.com

Norris Priscilla NorrisPriscilla2@gmail.com

O'Conor Carolyn Adventist HealthCare CarolynOConor@netscape.net

Oliveira Eliezer Adventist HealthCare EliezerOliveira@me.com

O'Reilly Erin ErinLynnOReilly@gmail.com

Panneerselvam Shanmugam

Pardue Cherie Adventist HealthCare CPardue@adventisthealthcare.com

Parrish Katie Children’s National Medical Center KParrish@cnmc.org

Pasard Gail Adventist HealthCare GPasard@adventisthealthcare.com

Pavlin Richard Pav9@verizon.net

Pesquera Marcos Adventist HealthCare MPesquer@adventisthealthcare.com

Peyton Mary Adventist HealthCare MPeyton@adventisthealthcare.com

Phillips Maria Adventist HealthCare MPhilli3@adventisthealthcare.com

Pickoff Laura Adventist HealthCare LPickoff@adventisthealthcare.com

Pineda Rocio Adventist HealthCare RPineda@adventisthealthcare.com

Powell Miriam Adventist HealthCare MPowell@adventisthealthcare.com

Presley Joleane Adventist HealthCare JPresley@adventisthealthcare.com

Pugh Steve PughBear08@verizon.net

Rahman Rudmila Adventist HealthCare RRahman@adventisthealthcare.com

Ramos Elena Adventist HealthCare ERamos@adventisthealthcare.com

Reynolds Dawn Adventist HealthCare KeyBoardLady2005@gmail.com

Roberts Allen Ursula Adventist HealthCare UAllen2@adventisthealthcare.com

Rocha Glenda Adventist HealthCare GRocha@adventisthealthcare.com

Rogelio Joseph Adventist HealthCare JRogelio@adventisthealthcare.com

Roy Ila National Institutes of Health Ila.Roy@nih.gov

Rubio Roberto Adventist HealthCare RRubio@adventisthealthcare.com

Ruiz Cristy Adventist HealthCare CRuiz@adventisthealthcare.com

Sabalbaro Marya Adventist HealthCare MSabalba@adventisthealthcare.com

Sachs Jonathan Adventist HealthCare JSachs2@adventisthealthcare.com

Sackett John Adventist HealthCare LEden@adventisthealthcare.com

Salatti Acacia U.S. HHS

Salmeron Olivia

Sama Noella Adventist HealthCare NSama@adventisthealthcare.com

Sanchez Idalia HHS Office of Minority Health ISanchez@minorityhealth.hhs.gov

Sandberg Gwendolyn Montgomery County HHS Gwendolyn.Sandberg@montgomerycountymd.gov

Savery Susan Adventist HealthCare SSavery@adventisthealthcare.com

Schoonover Steve Adventist HealthCare SteveSchoonover1@verizon.net

Schroeder Janet

Schwarzmann Michele Adventist HealthCare MSchwarz@adventisthealthcare.com

Schwenk Leslie Adventist HealthCare LSchwenk@adventisthealthcare.com

Scott Leah LScott@myalleghyeast.com

Senesie Kuma Center for Cancer and Blood Disorders KSenesie@ccbdmd.com

Shim Eunmee Adventist HealthCare EShim@adventisthealthcare.com

Sim CK Adventist HealthCare CSim@adventisthealthcare.com

Simpson Brent Self-Employed BrentMyAdvisor@gmail.com

Skrabhan Bozena Adventist HealthCare BSkraban@adventisthealthcare.com

Smothers Kevin Adventist HealthCare KSmothers@adventisthealthcare.com

Sohi Jast Wilmington Trust Jsohi@wilmingtontrust.com

Sparer Robin Adventist HealthCare RSparer@adventisthealthcare.com

Sparrow Lorraine Adventist HealthCare LSparrow@adventisthealthcare.com

Spence Weymouth Washington Adventist University WSpence@wau.edu

Stearns Allison Hospice Caring, Inc. AllisonS@hospicecaring.org

Sullivan Tammy Adventist HealthCare TSulliva@adventisthealthcare.com

Swanson Christy Adventist HealthCare CSwanso2@adventisthealthcare.com

Sweeney Tom Adventist HealthCare TSweeney@adventisthealthcare.com

Tabor Azeb Azeb.Tabor@yahoo.com

Taiwo Agnes Adventist HealthCare Ftaiwo@adventisthealthcare.com

Taka Milka Adventist HealthCare MTaka@adventisthealthcare.com

Talavera Melina Adventist HealthCare MTalaver@adventisthealthcare.com

Tate Kelly Adventist HealthCare KTate@adventisthealthcare.com

Tekle Lishan Adventist HealthCare LTekle@adventisthealthcare.com

Terrell Marybeth Adventist HealthCare MTerrell@adventisthealthcare.com

Tessema Zaena Adventist HealthCare ZTessema@adventisthealthcare.com

Tetz Ray Self Employed

Tinney Sarah Adventist HealthCare STinney@adventisthealthcare.com

Tolessa Ed Adventist HealthCare ETolessa@adventisthealthcare.com

Torres Yolanda Sistema Universitario Ana G. Mendez YoTorres@suagm.edu

Toupin Ann Adventist HealthCare AToupin@adventisthealthcare.com

Tran Vanessa Adventist HealthCare VTran2@adventisthealthcare.com

Trotter Elizabeth Kaiser Permanente Elizabeth.R.Trotter@kp.org

Troupe Kathryn Frederick Memorial Hospital Kcramer@fmh.org

Ugolini Paolo Paolo_Ugolini@hotmail.com

Uy Wilson Adventist HealthCare WUy@adventisthealthcare.com

Vaidya Harish Adventist HealthCare HVaidya@adventisthealthcare.com

Vaslow Peter PVaslow@gmail.com

Vo Anh Montgomery County HHS VoA@montgomerycountymd.gov

Warfield Fred

Walker Denise

Wallace Arlee MD Department of Health & Mental Hygiene Arlee.Gist@maryland.gov

Wangsness Erik Adventist HealthCare DKocher@adventisthealthcare.com

Washington Deidre Adventist HealthCare DWashin2@adventisthealthcare.com

Washington Richard HHS Office of Minority Health RWashington@minorityhealth.hhs.gov

Wassmann Mary Adventist HealthCare MWassmann@montgomeryhospice.org

Williams Judith JudySpencerWilliams@gmail.com

Williams Camille Adventist HealthCare CWillia6@adventisthealthcare.com

Witt Sherman Deborah Florida International University DeSherma@FIU.edu

Wyson Karen Adventist HealthCare KWyson@adventisthealthcare.com

Young Kevin Adventist HealthCare KYoung7@adventisthealthcare.com

Young Cheridan Mar3cy9@yahoo.com

Young Linda Adventist HealthCare LYoung2@adventisthealthcare.com

Zhang Yuqing Adventist HealthCare YZhang@adventisthealthcare.com

Zuckerman Mariam U.S. Renal Care MZuckerman@usrenalcare.com

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Documents

a patient’s guide - adventist healthcare › app › files...

beyond four walls - adventist healthcare...2016 annual...

adventist echo

cancer care outcomes report 2015 - adventist...

adventist heritage

call 1-800-610-2447 or visit adventist home health three...

adventist healthcare & you magazine (fall 2014)

special care nursery comes baby keiyana - adventist...

adventist healthcare mission initiatives and activities

adventist healthcare & you magazine (winter 2015)

functional healthcare design for mobilisation and ... ·...

partnering toward a healthier future - adventist healthcare

love matters - adventist health...castle is the first...

cancer care outcomes report - adventist healthcare ·...

cancer care outcomes report 2016 - adventist...

aalborg universitet digital healthcare empowering...

standards - adventist edge | adventist edge

making healthcare in the region 2 3 4 annual patient safety...

southern adventist university | southern adventist...

new medical staff orientation - adventist healthcare ·...