Pallimed: A Hospice and Palliative Medicine Blog Pallimed: A Hospice and Palliative Medicine Blog RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Blue Ribbon Patients: A Tool to Protect from Unnecessary Transitions
by Rick Strang (@rickstrang)Bed pressures in busy hospitals often means that less acute patients are moved to different wards in order to make space for patients admitted from the emergency department. We are often faced with some difficult decisions in our current NHS. End of Life (EoL) patients seem particularly at risk of being moved, which can be very distressing for families, friends, the patient and the care teams. It is also quite common for these moves to occur into the night or at weekends. These periods are covered by site managers, bed managers, and on-call clinicians rather than the usual ward teams and therefo...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 7, 2018 Category: Palliative Care Tags: actively dying death/dying England hospital strang transition Source Type: blogs

Diary of a New Hospice Volunteer
by Lizzy MilesI had forgotten that I had written about my first few days as a hospice volunteer. I just discovered it while I was looking through some old electronic files. Now, ten years later, with more education and a career in hospice, I still notice that some things never change. You would think that I would be more certain about things, but I don ' t think I am. However, I believe that uncertainty is a necessary part of the job. I ' ve written about howwe don ' t know death. When we are uncertain, that means we are evaluating our behavior and how it ' s perceived by others. I now believe it ' s good to be a little bi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 5, 2018 Category: Palliative Care Tags: hospice lizzy miles social work uncertainty volunteer volunteering Source Type: blogs

Diary of a New Hospice Volunteer
By Lizzy MilesI had forgotten that I had written about my first few days as a hospice volunteer. I just discovered it while I was looking through some old electronic files. Now, ten years later, with more education and a career in hospice, I still notice that some things never change. You would think that I would be more certain about things, but I don ' t think I am. However, I believe that uncertainty is a necessary part of the job. I ' ve written about howwe don ' t know death. When we are uncertain, that means we are evaluating our behavior and how it ' s perceived by others. I now believe it ' s good to be a little bi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 5, 2018 Category: Palliative Care Tags: hospice lizzy miles social work uncertainty volunteer volunteering Source Type: blogs

Palliative Care Resolutions for 2018
by Christian Sinclair (@ctsinclair)Happy New Year! As we look towards the future that is now 2018, many of us make promises which can be difficult to keep, but always with the purpose of working towards the best version of ourselves. (In a way it is kind of like a quality improvement project!) Often these resolutions are personal: exercise 5 times a week, eat more healthy, learn a new language, read more books, spend less time on my phone. Sometimes these resolutions reside in our professional spheres of influence. I thought it would be interesting to see what some hospice and palliative care colleagues are resolving to do...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 1, 2018 Category: Palliative Care Tags: meta sinclair Source Type: blogs

Moving Palliative Care Upstream - Can we ever be TOO early?
By Christian Sinclair (@ctsinclair)The growth of palliative care in the community and outpatient settings has been one of the more popular stories in our field in the past few years. No longer is palliative care only available to serve in the intensive care units, but the demand for person-centered, family-oriented, symptom-based care with an emphasis on communication and decision-making is being heard in the earlier stages of illness. Serving patients and families in clinics and in their home is unleashing the true potential of palliative care. Even in my own work leading our outpatient efforts in an academic cancer cente...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 27, 2017 Category: Palliative Care Tags: cancer clinic denmark europe hpmchat outpatient research sinclair tweetchat Source Type: blogs

Natural Disaster Planning for At-Risk Hospice Patients
This article is the first in a series about our hospice’s response to the storm emergency.We triaged patients to maintain their safety, based on their risk of flooding at home and the risk of electricity loss (especially for patients who relied on high oxygen flows). We moved high risk patients to care centers with low flood risks and back-up electrical generators. This included moving at-risk patients out of hospice care centers, assisted living, nursing homes, or their homes.At my care center, we took 16 single-occupancy rooms, and set it up for 30 patients and their families (double-occupancy for all but 2 rooms). Spa...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 18, 2017 Category: Palliative Care Tags: disaster emergency preparedness hospice hurricane inpatient rich room weather Source Type: blogs

Pallimed Roundup: #Endwell17 Attendees and Speakers Reflect on Personal Meaning of Ending Well
Curated by Lizzy MilesLast week, I attended theEndwell Symposium in San Francisco. (You could read my reviewhere). Collectively, we were examining how we can improve the end of life experience for all. It occurred to me as we talked about individual desire and diversity that the attendees might have unique expectations and hopes for their own personal ending. So I asked around. You ' ll note some trends, but also some very unique answers.What would it mean for you personally to “end well?”“Being present to the experience. I don’t want to control it, I just want to know.”-Karen Van DykeSenior Care by Design“To e...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 15, 2017 Category: Palliative Care Tags: conference endwell endwell 17 lizzy miles ostaseski roundup Source Type: blogs

Why I'm Bored With the Debate About Physician Assisted Suicide
by Drew Rosielle (@drosielle)I ’m a little bored of all the discussion about physician-assisted suicide. Mostly it’s because legalizing PAS is going to have zero impact on nearly all of my patients, and I think the significant amount of press and energy it gets is a distraction from other things which actually would improve t he lives (and deaths) of the patients and families I care for as a palliative doc.The last time I blogged about PAS waspart of my euphemisms series last year, when I elaborated why I did not like terms like ‘assisted death’ or ‘aid-in-dying’ and prefer ‘assisted suicide’ and ‘euthana...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 13, 2017 Category: Palliative Care Tags: ethics euthanasia/suicide health policy rosielle Source Type: blogs

Conference Review: 2017 End Well Symposium – Design for the End of Life Experience
By Lizzy Miles (@LizzyMiles_MSW)End Well advertised itself as“a first of its kind gathering of design, tech, health care and activist communities with the goal of generating human-centered, interdisciplinary innovation for the end of life experience.”  I feel privileged to have been able to attend. The Symposium was capped at 400 attendees and sold out early. There was a serendipitous momentary technology glitch that allowed me and two friends to register after it was sold out. Fortunately, the organizers graciously agreed to squeeze us in since we had paid.The single-day event took place at the Intercontinental H...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 11, 2017 Category: Palliative Care Tags: end of life End Well miles Source Type: blogs

National Hospice and Palliative Care Month: Divide and Conquer
by Christian Sinclair (@ctsinclair)Now thatNational Hospice and Palliative Care Month (NHPCM) is in the books for 2017, December is a good time to reflect on what these awareness months can (and cannot) accomplish and how we can make a better strategy for the future. Awareness campaigns have blazed brightly through the bracelet and ribbon eras, and are firmly in the social media era with no signs of stopping (other than possibly fatigue from so much awareness about awareness campaigns.)No single group is technically is in charge of National Hospice and Palliative Care Month. Very few calendar-based advocacy campaigns (CBAC...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 4, 2017 Category: Palliative Care Tags: hospice palliative sinclair The profession Source Type: blogs

The Emotions of the Dying
By Lizzy MilesIn my role as a hospice social worker, I find that there are recurring concerns expressed by family and friends of the dying. These are some of my responses to their worries. Mostly I find that I am normalizing behavior that they find confusing or unsettling, while also validating their discomfort. Families often feel helpless and I do my best to reassure them that what is happening with the patient is part of the process of dying.I am careful to be mindful of faith/cultural beliefs of the patient and family so as to not suggest an explanation that is outside of their dogma.RestlessnessRestlessness is a commo...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 1, 2017 Category: Palliative Care Tags: dying emotions letting go life review lizzy miles restlessness social worker Source Type: blogs

Documentation Design: Palliative Care Notes in the EHR Era
by April Krutka (@April918) and Christian Sinclair (@ctsinclair)DOCUMENTATION...who knew this one word could provoke so many emotions among health care clinicians? Say this word, and you will hear stories of triumph and defeat. From universal required elements in the admission history and physical, progress notes and discharge summaries to the specialty specific language of advance care planning and pain assessments, there is a constant pressure to get all the pieces to fit correctly. Moving from analog to digital offered much hope, but also new problems. Before we even start typing or dictating a new note, most of the suc...
Source: Pallimed: A Hospice and Palliative Medicine Blog - November 27, 2017 Category: Palliative Care Tags: documentation krutka sinclair Source Type: blogs

LGBTQ at the End-of-Life: Needs and Challenges
By Vivian LamHolistic care is essential in the mission to fully meet a patient ' s needs. And a holistic perspective is the backbone of end of life and palliative care--it ' s the basis of having an interprofessional team that acknowledges that quality of life is multifaceted, and lives are diverse. But getting to know a patient enough to be able to be " holistic " can be difficult. And in the case of LGBTQ individuals, getting to know the patient as a whole is not only all the more important —it’s integral.According to a2016 Gallup survey, 4.1% of U.S. adults openly identify as LGBTQ, or around 10 million adults. Of t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - November 13, 2017 Category: Palliative Care Tags: closet end of life gay hospice lesbian LGBT LGBTQ palliative transgender vivian lam Source Type: blogs

Defining Dignity at End of Life: One Question to Ask Hospice Patients
By Lizzy MilesI start every new hospice patient interaction with a hello. I introduce myself and then ask for permission to sit and visit. It is not uncommon for the patient to start off on guard, wary. By the time patients meet me, they have been through a lot of medical interactions. They have been asked a lot of questions.I tell them I have just one question. I sometimes notice an exhale.Whew. She ’s not going to grill me.Dignity In Care, developed from research byDr. Harvey Max Chochinov, starts with the Patient Dignity Question (PDQ). It is a simple, open-ended question: “What do I need to know about you as a pers...
Source: Pallimed: A Hospice and Palliative Medicine Blog - November 4, 2017 Category: Palliative Care Tags: Chochinov Cubs dignity dignity therapy hospice lizzy miles social worker Source Type: blogs