Warming Hearts, Cloaking Grief

By Lori RuderHe moves over and she snuggles in close to her fianc é. She pulls their blanket over them. A special blanket made just for this moment. “I love you” she murmurs, soaking in his face and his warmth. “Goodnight lovebirds,” his mother teases as she turns out the lights.This moment is both tender and tragic: tender because they are demonstrating their love for each other, tragic because this is happening in the ICU. Her fianc é is on life support and he is dying. He moved over because I moved him over to make room for her in his narrow hospital bed. I repositioned his ventilator tubing and central lines out of her way, closed the side rail behind her for support, and helped her pull their blanket over them. This blanket was made by ICU nurses for moments like this: to have something to offer when medicine doesn’t.Using our own time and money, we gather together to make blankets. We make them in many colors and patterns, to match the many styles that come from all walks of life. They are simple fleece tie blankets, the kind a Girl Scout might make, but they are soft and warm. They are something soft amidst the harsh reality of critical illness and death, and something to provide warmth and comfort--to touch a loved one during last moments as if to capture their essence before they are gone. The blankets are a memento of touch to take with them when they leave this place and their loved one behind.We give our blankets wh...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: blanket cancer comfort icu lori ruder Source Type: blogs

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Although frequently performed, the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) for palliation of pain in pancreatic cancer is suboptimal. Recently, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been proposed as a palliative treatment option for pancreatic neoplasms. We performed a single-blind, randomized trial to compare the effectiveness of EUS-CPN and EUS-RFA for palliation of pain in pancreatic cancer.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Source Type: research
Trends in symptoms and functional ability are known towards the end of life, but less is understood about quality of life, particularly prospectively following service referral.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Original Article Source Type: research
Authors: Chan KS Abstract There is a great need for palliative care in the modern era of medicine. Despite medical advances, patients with life-limiting illnesses still suffer significantly. Palliative care emerged a half century ago as an ethos based on compassion and care for patients and their families to relieve their suffering. It entails a paradigm shift from the biomedical model to the biopsychospiritual model. Palliative care is recognised by the World Health Organization as an essential part of the continuum of universal health coverage. In 2014, the World Health Assembly approved a resolution on "Str...
Source: Hong Kong Medical Journal - Category: General Medicine Tags: Hong Kong Med J Source Type: research
by Amy Davis (@MaximizeQOL)(CMS open to comments until Sep 10, 2018. See end of post for details. - Ed.)Centers for Medicare and Medicaid Services (CMS) hasproposed sweeping reforms to documentation requirements, clinician reimbursement, and the Quality Payment Program (QPP), to begin in 2019. (1) If approved in their current form, the changes are likely to have dramatic net negative effects on outpatient palliative care reimbursement. A detailed review and analysis of all 1,473 pages of the Proposed Rule, plus its addenda, would not be practical here. The reader is referred to thecomplete text (1) andothers ’ a...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: billing CMS davis The profession Source Type: blogs
Cochrane Pain, Palliative and Supportive Care  (PaPaS)  group addresses the gap in knowledge on chronic  pain in childhood and helps push solutions forward.On July 12th  at the Wellcome Trust in London, UK,  world-leading experts came together to look at evidence, policy and practice in the area of childhood pain.Clinicians, researchers, funders and policy makers from charities, universities and hospitals discussed the lack of knowledge in this area and shared their collective ambition to increase the quality of evidence in this field.Professor Christopher Eccleston, Coordinating Editor of the Coch...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
CONCLUSIONS: This case shows the importance of patient compliance and timely treatment of SCC and surgical wounds in an immunosuppressed individual. PMID: 30059340 [PubMed - in process]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
We report this rare case to emphasize that mediastinal and retroperitoneal fibrosis can be a presentation of metastasis from various primary malignancies. We expect that appropriate diagnosis and treatment for metastatic mediastinal and retroperitoneal fibrosis can have a beneficial effect on disease course and prognosis of the patient.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
A notable gap in the evidence-base for palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in “real-world” settings. Health systems are desperate for guidance on effective, scalable models.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Publication date: Available online 30 July 2018Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Frédéric Sailhan, Solène Prost, Fahed Zairi, Olivier Gille, Hughes Pascal-Mousselard, Saad Bennis, Yann-Philippe Charles, Benjamin Blondel, Stéphane Fuentes, the French Spine Society (SFCR)AbstractIntroductionThe occurrence of spinal metastasis is a turning point in the progression of cancer. The optimal management has not been well defined. The aim of this study was to identify the various treatments currently being used in France and to determine the benefits of surgical treat...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Purpose of review To provide an update on recent studies about psychological interventions in palliative (mainly cancer) care with a focus on physical, psychological, spiritual, and social aspects. Recent findings Some promising psychological interventions for physical challenges, such as fatigue, pain, dyspnea, and insomnia do exist, but further research is needed. Regarding psychological aspects, current reviews showed small to large effects in the reduction of depression and anxiety symptoms through cognitive behavioral-based interventions, mindfulness-based interventions, and meaning-based interventions. Meaning-b...
Source: Current Opinion in Psychiatry - Category: Psychiatry Tags: PSYCHIATRY, MEDICINE AND THE BEHAVIORAL SCIENCES: Edited by Winfried Rief and Mohan Isaac Source Type: research
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