Making Palliative Care Stand out on Capitol Hill - Apr 27 - Virtual Lobby Day
by Christian SinclairSure all this political smack talk in a presidential election year has probably got you a little bit jaded and tired. Yet, you have a chance to make a difference in lives of people you will never see by helping solidify the foundation of education and training for palliative care and hospice.This Wednesday April 27, 2016 is designated as the Virtual Lobby day for PCHETA (Palliative Care and Hospice Education and Training Act). On Wednesday, advocates from over 30 different organizations are working together to tell their legislators about PCHETA and why it should be supported in both the House and the ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 25, 2016 Category: Palliative Care Tags: pcheta politics sinclair Source Type: blogs

" Why (not) me? " Why doctors do it differently......
In this study, almost 90% of surveyed physicians, presumably healthy, would forego resuscitation efforts for themselves. < o:p > < /o:p > < /span > < /span > < /div > < div class= " MsoNormal " > < span style= " color: #262626; font-family: & quot;helvetica & quot;; font-size: large; mso-bidi-font-family: SourceSansPro-Regular; " > < br / > < /span > < /div > < div class= " MsoNormal " > < span style= " color: #262626; font-family: & quot;helvetica & quot;; font-size: large; mso-bidi-font-family: SourceSansPro-Regular; " > In our next & nbsp; < b style= " mso-bidi-font-weight: normal; " > < i style= " mso-bidi-font-style: ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 18, 2016 Category: Palliative Care Tags: #hpm death dying medical services medicine models of care modern medicine palliative care Source Type: blogs

"Why (not) me?" Why doctors do it differently......
In this study, almost 90% of surveyed physicians, presumably healthy, would forego resuscitation efforts for themselves.In our next #hpm chat, on Wednesday, April 20th, 2016, let’s unpack this head-scratching situation together--not just for doctors, but for all of us…nurses, social workers, chaplains, program folks… that have reason to think differently about the nature of modern dying and our desired intensity of medical treatment.Topic 1: What do you think about those of us in healthcare, with knowledge about the limitations of modern medicine, choosing less of it?  Topic 2: What is your belief...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 18, 2016 Category: Palliative Care Tags: #hpm death dying medical services medicine models of care modern medicine palliative care Source Type: blogs

A Rose by Any Other Name...Complimentary Therapies in Palliative Care
by Susan Thrane, RN, PhDNon-western, non-medical, non-allopathic modalities have been called by many names: complementary and alternative medicine (CAM), integrative, supportive, adjuvant, placebo and hooey just to name a few. Whatever you call them (I prefer complementary or integrative), modalities such as massage, yoga, aromatherapy, guided imagery, meditation, energy therapies such as Reiki, Healing Touch, Therapeutic Touch, or creative art therapies (these include dance/movement, art, and music therapies provided by a trained therapist) do require training for the person providing th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 5, 2016 Category: Palliative Care Tags: adolescents alternative therapy cam children complementary therapy infants integrative therapy palliative care pediatric pediatrics symptoms Source Type: blogs

Physicians Recieving Botox Score Lower on Empathy and Patient Satisfaction
by Abe R. Feaulx, Pallimed Special Reporter Researchers published a new study in JMAC (The Journal of Middle Aged Concerns)  reporting interesting findings related to a recent study on the effect of various anti-aging cosmetic procedures on providers’ ability to emote empathy to patients and families. Providers in the study were randomized into two groups: one group received injections of an inactivated toxin commonly used as a facial muscle paralytic into their foreheads, while the second group received placebo injections. Over the course of the following month, the providers were scored, by their patients, on how...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 1, 2016 Category: Palliative Care Tags: feaulx Source Type: blogs

CDC Chronic Pain Guidelines: Not so bad, but...
by Tom QuinnIn case you didn’t notice, the US Centers for Disease Control published their long-awaited (dreaded?) “CDC Guideline for Prescribing Opioids for Chronic Pain.” It made a pretty big splash: Five editorials plus the full Guideline in the online Mar 15 JAMA, front page New York Times feature article, the first hour on NPR’s “Diane Rehm Show,” (Mar 17) and multiple others. It is specifically aimed at primary care prescribers, who write about half of the scripts for opioids in the US. It is intended to “support clinicians caring for patients outside the context of active cancer care or palliative o...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 30, 2016 Category: Palliative Care Tags: CDC ethics opioids pain quinn The profession Source Type: blogs

Do You Feel The Churn?
by Dr. Linda Liotti, D.O.Do you feel the Churn?  Over the last thirty years, there have been changes in the hospice and palliative care industry. Years ago, nurses carried a case load of 12 – 15 patients. Each patient was seen on a regular basis, their needs and concerns taken care of by the nurse and multidisciplinary team on a weekly basis. Most patients would be followed until death, however a few graduated from hospice when the IDT found they had stabilized.Recently speaking with several colleagues, we noted a trend which suggests the turnaround time from admission to death continues to shrink. When we attend th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 29, 2016 Category: Palliative Care Tags: churn compassion fatigue length of stay Source Type: blogs

Time of Death: Some Patients Prefer to Die Alone
This article is the fourth in a series of articles where I will take each assumption from the original article and explore the concept in greater depth to include implications and possible interventions.  In my last article, I wrote about the assumption Family will want to be with their loved one when they are dying.Here is our next assumption: People don’t want to be alone when they die.This may be an unpopular assertion within my own hospice industry for me to advocate for leaving a patient alone sometimes. Hospices have entire programs devoted to assuring patients and families that they will not ever be alone. Ma...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 28, 2016 Category: Palliative Care Tags: assumptions hospice lizzy miles NODA social work social worker time of death Source Type: blogs

Thank a Clinical Social Worker Today
By Vickie LeffMarch is Social Work Month – a great excuse to take a moment and celebrate the work that clinical social workers do in palliative care. But, hang on, perhaps we should be doing more than that. Can we adjust our lens settings and challenge ourselves to see clinical social work differently?Palliative Care is a team sport; the standard model of practice includes an MD, NP and CSW. My challenge to all of you would be to make sure you are all equal partners in our unequal medical world. CSW’s can’t bill for in-patient visits, we can’t generate RVU’s for the hospital system, and it’s often hard to quant...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 27, 2016 Category: Palliative Care Tags: clinical CSW palliative social work social worker Vickie Leff Source Type: blogs

NephMadness and Palliative Care - A Novel Education Concept
In this study the entire cohort showed a survival advantage with dialysis care but on further subgroup analysis, patients over the age of 80 did not gain additional time on earth by choosing dialysis. In this case dialysis did not extend life. Nephrologists need to start to train ourselves away from the reflex that dialysis is a way to extend life. In some easily identifiable patient groups it provides as much harm as benefit. And this is just counting days alive. If you compare the quality of those days, perhaps by looking at Tamura's Functional status study, dialysis begins to look especially grim. This makes me happy th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 23, 2016 Category: Palliative Care Tags: #hpm education hpmchat nephrology topf tweetchat twitter Source Type: blogs

Palliative Care in Nephrology - So Many Opportunities!
by Christian SinclairIf you asked most people to name what types of illness would most likely benefit from palliative care support, cancer is probably at the top of that list, followed by cardiac disease, and possibly neurologic disorders. Nephrology on the other hand is not often seen as a common area for the approaches of palliative care. At most HPC conferences I go to, I may see only one topic exploring the unique palliative issues surrounding renal disease, despite the significant functional and symptom burden of advanced kidney disease.Thanks to social media I have found a group of nephrologists who are open to the c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 21, 2016 Category: Palliative Care Tags: nephrology sinclair Source Type: blogs

Depression matters - we should ask about it
by Kristina Newport, MDAs we care for patients with serious illness, we frequently encounter depressed mood. Multiple studies have shown depression independently contributes to morbidity and mortality, and yet most of us do not systematically screen for it. This is again illustrated in Lloyd-Williams’ et. al recent study of 629 patients with advanced cancer attending palliative care day centers in England. Patients in this study identified as moderately to severely depressed on the PHQ-9 died three weeks sooner than those with no or only mild depression. A similar result was identified in patients who reported conside...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 1, 2015 Category: Palliative Carer Workers Tags: depression newport psych Source Type: blogs

Why the thickened liquid challenge is important
Empathy via participation is a technique that probably deserves wider attention in health professions education. Drs Eric Widera and Alex Smith and the team at UCSF have come up with the ingenious Thickened Liquids Challenge. Thickened liquids can be a treatment that is overly used and poorly understood for any person who has swallowing difficulties. Most clinicians will be familiar with the terms ‘nectar-thickened’ and ‘honey-thickened’ from any experience in geriatrics or neurology. So taking the popularity of the ALS Ice Bucket Challenge and mashing it up with a likely non-harmful* experiential opportunity for ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 29, 2015 Category: Palliative Carer Workers Tags: geriatrics speech Source Type: blogs

National Drug Facts Week with Pharmacy Professor Mary Lynn McPherson!
by Mary Lynn McPherson, PharmD, MA, BCPSThis week is National Drug Facts Week! Why do we tell patients to take furosemide on an empty stomach? Ok, it’s not quite “why did the chicken cross the road” but it’s still an important drug fact! The answer is that taking furosemide on an empty stomach doubles the bioavailability and clinical response! If you want to learn about additional awesome drug facts – tune in this Wednesday evening, January 28, 2015 at 6 pm PST/9 pm EST for the #hpm tweet chat! We’ll also be talking about the utility/futility of medications as patients approach the end of life. What s...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 28, 2015 Category: Palliative Carer Workers Tags: mcpherson opioids pharmacy Source Type: blogs

2015 Pallimed and GeriPal Party - Philadelphia!
Time to gather your peers and join fellow readers of Pallimed and GeriPal for our annual party at the Annual Assembly of AAHPM and HPNA (and anyone still in town after SWHPN's conference on Monday and Tuesday!). Since the last two years were such a success with the progressive party, we will be doing that again this year. We will begin at McGillin’s at 8pm. After that follow the hashtag #HPMparty or our Facebook event page where we will be posting updates on the next location. All are welcome, this is no exclusive crowd. There will be many writers from both websites at the party and we always like to meet readers and ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 26, 2015 Category: Palliative Carer Workers Tags: meta sinclair social networking Source Type: blogs