What do you do when the advance directive doesn't make sense?
The wait was too long.  We had to change plans. I arrived home late after a long day at work and my wife asked if I wanted to go to that new restaurant everyone had been talking about.  We hopped into the car and drove off, not really thinking about a reservation.  We both groaned when the restaurant came into sight and we saw throngs of people waiting outside.  "Maybe it's not as bad as it looks," I said as I jumped out of the car to check, only to find out there was a 90 minute wait.  As I walked back to the car, I had already made up my mind to go down the road to an old standby. ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 31, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

The Search for Greener Grass: The Second Opinion in a Far Away City
You drive down a busy expressway amidst thousands of other vehicles and a billboard jumps out at you.  In the font of confidence, it reads, ""The first step in fighting cancer should be a second opinion."  The billboard informs you of the location of the nearest Cancer Treatment Center of America (CTCA), "only" about 130 miles from the billboard. When I saw this billboard, my initial response was to recall a recent article about CTCA which challenged their dubious centerpiece claim: Patients with cancer who receive treatment there survive longer than those who don't.  The article po...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 29, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

Palliative Care Triggers for Oncology
I read the ASCO Post when I’m on airplanes.  At least I do, below 10,000 feet… and after I have finished the Sudoku. The ASCO Post is the People magazine of oncology.  The articles are short… typically one page, with lots of pictures consisting mostly of the authors.  It is medical journal lite, with terms and prose simple enough for a layman to both understand and to not fall asleep by the end of the article.  It probably can be best described as Oncology for Dummies. (Also, to give the full extent of its look and feel… there is usually one or two ads attached with that go...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 28, 2013 Category: Palliative Carer Workers Authors: John Hennessy Source Type: blogs

Memorial Day
The exact origins of Memorial Day are not exactly agreed upon. Many cities claim to be the founders of this holiday. The tradition, however, dates back to Civil War times. At one time Memorial day was known as Decoration Day, as it was the day families and friends of fallen Civil War soldiers would choose place flowers and "decorate" the graves. The first official Memorial Day was May 30th 1868, after the day was declared by General John Logan, commander of the Grand Army of the Republic (a veterans' organization). The holiday was adopted by Michigan and New York and then by all the Northern states through the l...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 26, 2013 Category: Palliative Carer Workers Authors: Amber Wollesen, MD Source Type: blogs

Verb Selection in Code Status Discussions: A Potentially DisruptiveHospital Innovation
This study identifies two methods of framing. In 68% of encounters, life sustaining treatments featured as the first topic of conversation. The order in which options are presented represents an important frame and a nudge towards the first option listed. The modal verb serves as the other vehicle by which the decision is framed. Have you ever heard a physician say something like, "If the mask you are on doesn't keep your oxygen level up, we might need to place a tube in your throat and hook you up to life support to keep you alive, but we want to know if you want that." Some patients will declare a longstand...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 24, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

Verb Selection in Code Status Discussions: A Potentially Disruptive Hospital Innovation
This study identifies two methods of framing. In 68% of encounters, life sustaining treatments featured as the first topic of conversation. The order in which options are presented represents an important frame and a nudge towards the first option listed. The modal verb serves as the other vehicle by which the decision is framed. Have you ever heard a physician say something like, "If the mask you are on doesn't keep your oxygen level up, we might need to place a tube in your throat and hook you up to life support to keep you alive, but we want to know if you want that." Some patients will declare a longstanding ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 24, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

Cases: Working Through Moral Distress
Discussion: Moral distress occurs when the clinician knows the appropriate action to take, but is unable to carry it out, and feels forced to give care contrary to her values. It is more often described in the nursing literature, but is beginning to come to the awareness of physicians as well. Moral distress often occurs in end-of-life situations when the decision is made to provide aggressive life-sustaining treatments that are felt to put excessive burden on patients and families. Clinicians who see patients at the end of life may be particularly vulnerable to moral distress. For those of us who serve as consultants, o...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 22, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Tweetchat Is Terminal! Dying Victim Of Twitter API Changes
Twitter is changing how data can be accessed, which will more than likely lead to the demise of @tweetchat. :( — TweetChat (@TweetChat) May 4, 2013 I am not talking about our Wednesday 9pm EST (8pm CST /6pm PST)  HPM tweetchat.  Our live palliative tweetchat conversations are alive and well since the inaugural tweetchat  in June 2010.  We would love to have you join us! What is in a state of demise and is going away June 11 2013 is the web service www.tweetchat.com . This is a site that easily allows you to monitor one subject on Twitter organized around a hashtag. I have been an a...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 22, 2013 Category: Palliative Carer Workers Authors: Jeanette Ross Source Type: blogs

But I'm a pediatrician. I don't do "death."
(A hearty welcome to Emily Riegel, MD (@emriegel) a Med/Peds physician who completed a hospice and palliative medicine fellowship a few years ago and is now at KU Medical Center helping lead pediatric palliative care in Kansas City.  Emily is a keen observer who could easily be writing the great next medical drama on TV, but until then I'm happy she is contributing to Pallimed - Sinclair) In the March issue of Pediatrics,  Jonna D. Clark, MD, and Denise M. Dudzinski, PhD, take on the audacious task of encouraging pediatricians to step into the role of decision maker for terminally i...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 22, 2013 Category: Palliative Carer Workers Authors: Emily Source Type: blogs

Cases: What to do after the patient is made comfort measures only (CMO)
Discussion:  Deciding to focus only on comfort is a major transition point for patients, families and health care providers.  After making this decision, most families are not sure what comes next.  They look to health care providers to reassure them that they are doing the right thing and to ensure that their loved one does not suffer and that they are prepared for the next few days. The following questions should guide one’s action after a patient is made CMO: 1.   Are the patient’s symptoms adequately treated/prevented? A standardized comfort measures only order sheet can optimize sy...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 8, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

What to do after the patient is made comfort measures only (CMO)
Discussion:  Deciding to focus only on comfort is a major transition point for patients, families and health care providers.  After making this decision, most families are not sure what comes next.  They look to health care providers to reassure them that they are doing the right thing and to ensure that their loved one does not suffer and that they are prepared for the next few days. The following questions should guide one’s action after a patient is made CMO: 1.   Are the patient’s symptoms adequately treated/prevented? A standardized comfort measures only order sheet can optimize sy...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 8, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

The Fault In Our Stars (TFIOS): An Insightful Depiction Of Teens Living With Serious Illness
I have to confess that even though I am a grown woman I seem to like many young adult–teenage books (I am still seventeen at heart). I am frequently asking my daughter and nieces about books they enjoyed when I’m looking for something to read. So far the books I have read include some teenage love stories happening in a futuristic dystopia in which the main characters are at risk of dying because of being in a arena fighting other children like in the hunger games; or being at risk of getting injured while performing difficult stunts like jumping from a train like in the divergent series. The Fault in Our Sta...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 8, 2013 Category: Palliative Carer Workers Authors: Jeanette Ross Source Type: blogs

The Fault In Ours Stars (TFIOS): An Insightful Depiction Of Teens Living With Serious Illness
I have to confess that even though I am a grown woman I seem to like many young adult –teenage books (I am still seventeen at heart). I am frequently asking my daughter and nieces about books they enjoyed when I’m looking for something to read. So far the books I have read include some teenage love stories happening in a futuristic dystopia in which the main characters are at risk of dying because of being in a arena fighting other children like in the hunger games; or being at risk of getting injured while performing difficult stunts like jumping from a train like in the divergent series.  The Fault in ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 8, 2013 Category: Palliative Carer Workers Authors: Jeanette Ross Source Type: blogs

Relief From Death Anxiety: In Your Medicine Cabinet Already?
The radio show Wait, Wait....Don't Tell Me! has a weekly segment called "Bluff the Listener" during which a caller listens to three unbelievable stories and then guess which one of the three is actually true.  Much to my surprise, this week's "true" (yet unbelievable) story is about evidence that acetaminophen might relieve existential angst. (Here's a direct link to the audio segment.) Julius Axelrod (Source: National Institutes of Health) Really?  Good ole' Tylenol might relieve bothersome thoughts about the ultimate threat to our existence?  How could I not investigate this furthe...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 5, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

Lung Cancer Guidelines With No Mention of Palliative Care?
(Ed. - Welcome Mr. John Hennessy to the Pallimed family.  His background in executive leadership of oncology programs brings a potential outsiders perspective to Pallimed.  Thankfully he is a strong ally and champion for hospice and palliative care as you will see from his first post. Great to have you here John. - Christian)  Disappointed…frustrated…we’ve all been there.  My most vivid memories are of birthdays at home, when books and socks were unwrapped rather than remote control model airplanes and car keys. It wasn’t my birthday this week, but my daily e-mails usually inc...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 2, 2013 Category: Palliative Carer Workers Authors: John Hennessy Source Type: blogs

Cases: Transdermal Granisetron for Refractory Nausea and Vomiting
Discussion: There were many factors that likely contributed to the dramatic improvement in Ms Emma N’s refractory nausea and vomiting. Better psychiatric care through the palliative care psychologist and psychiatrist almost certainly played a role in her overall clinical turn-around. The close attention, serial visits and supportive counseling she received in the Palliative Care clinic could also have been therapeutic. Up-titration of her olanzapine also likely was helpful. Olanzapine is an atypical antipsychotic that works on multiple receptors including dopaminergic, serotonergic, adrenergic, histaminergic and musc...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 1, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Pallimed Case Conferences is Moving (Here)
Editorial decisions and challenges in upkeep will mean Pallimed: Case Conferences will be moving over the next year to the main Pallimed website (www.pallimed.org). The first case is already (re-)published: Transdermal Granisetron for Refractory Nausea and Vomiting  When the Case Conference blog was first started in 2008, there was always hope to find an editor to oversee it, but early collaborations ultimately did not facilitate stable editorial leadership. The aim to use cases to illustrate important teaching points in palliative care is still an important one.  The University of Pittsburgh Palliative Care De...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 1, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Transdermal Granisetron for Refractory Nausea and Vomiting
Discussion: There were many factors that likely contributed to the dramatic improvement in Ms Emma N’s refractory nausea and vomiting. Better psychiatric care through the palliative care psychologist and psychiatrist almost certainly played a role in her overall clinical turn-around. The close attention, serial visits and supportive counseling she received in the Palliative Care clinic could also have been therapeutic. Up-titration of her olanzapine also likely was helpful. Olanzapine is an atypical antipsychotic that works on multiple receptors including dopaminergic, serotonergic, adrenergic, histaminergic and musc...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 1, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Raising Palliative Care Awareness Through Film Screeenings
(Ed. - Can you believe it another new author!  Please welcome Paul Tatum @doctatum, a family medicine physician board certified in geriatrics and palliative care who practices medicine in at the University of Missouri in Columbia.  Paul is no stranger to blogging and also posts at Geripal.  Please welcome him to Pallimed! - Christian) When I strike up conversation on the airplane and discussion turns to palliative medicine, the response tends to be either one of a blank stare and question about what is palliative medicine or a knowing smile and a ready story about how hospice and palliative medicine made a ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 1, 2013 Category: Palliative Carer Workers Authors: Paul Tatum Source Type: blogs

2013 TEDMED Report: What ideas could we help spread?
(Ed. - Please welcome another new blogger to Pallimed, Earl Quijada, MD (@equijada). Earl is a hospice and palliative care doctor in the Inland Empire of California. I first met Earl on Twitter and later at the 2011 AAHPM Assembly in Vancouver and I am very excited he is now a Pallimed contributor! - Sinclair) I know I’m not supposed to say this but I’ll say it once - we’re not a death denying society. I’m starting to learn about death in nonclinical settings. My mind is opening and I’m stoked. I just returned from 2013 TEDMED where the opening salvo encouraged me to drop my palliative car...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 26, 2013 Category: Palliative Carer Workers Authors: Earl Quijada Source Type: blogs

Pallimed Blog Updates
I'm sure some of you are surprised to see you email boxes filling up with Pallimed posts again.  Since coming back from the AAHPM/HPNA Annual Assembly we have been busily working on a few projects behind the scenes as we look to the future of this website. Energizing the base We had a great meeting of Pallimed contributors in New Orleans during the New Orleans meeting in March. There were many fresh commitments from some of our key contributors, and you can see that both Lyle Fettig and Suzana Makowski have started writing again.  The conversations sparked a energy which made all of us realize how satisfying, f...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 24, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

What's Your Vision of End of Life Care?
(Ed. - Today's post is the first from Renee Berry @rfberry at Pallimed who is a digital media specialist with a strong passion and extensive knowledge about hospice and pallaitive medicine. Renee and I co-host the weekly hospice and palliative medicine tweetchat on Wednesday nights (along with Alicia Bloom).  We are excited to have her input on the recent TEDMED conference where End of Life issues were featured. - Sinclair)  I noticed an interesting conversation starting on Twitter last week about an illustration drawn as a part of TEDMED's great challenges. TEDMED is an annual conference dedicated to breakthrou...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 24, 2013 Category: Palliative Carer Workers Authors: Renee Berry Source Type: blogs

Prevention and Palliation: Together Forever
What do the following patients have in common? A 45 year old man who has a 60 pack-year history develops lung cancer and is diagnosed at an advanced stage.* A 33 year old woman with post-traumatic stress disorder who has been drinking since the age of ten and develops fulminant hepatic failure. An 82 year old man ends up in the surgical intensive care unit after a self-inflicted gunshot wound three months after his wife of 60 years dies. The mother of a 55 year old woman with morbid obesity, obstructive sleep apnea, and pulmonary hypertension laments that the park nearby isn't safe for people to use. All four patients ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 15, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

How Does Physician Assisted Dying Work? Beyond philosophy and rhetoric
The New England Journal of Medicine released an article this week on the experience of implementing a Death with Dignity program in Washington at a University based Cancer Center. In the Fall of 2008, the voters of Washington State passed the Death with Dignity act allowing for the legal practice of prescribing medications for the self-administration by a person with a terminal illness with the goal of ending their life. This can be described using a variety of briefer terms: physician-assisted suicide, physician-assisted death, medically hastened death and others. (For the record it is not technically euthanasia since tha...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 10, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

End of Life in the News: Where are all the Palliative Care Teams?
by Suzana Makowski By now, many of you may have heard or read Charles Ornstein,(@charlesornstein) a Pulitzer Prize-winning senior reporter, on NPR or in ProPublica on "How Mom’s Death Changed My Thinking About End-of-Life Care."  He tells of his mother's final days in the hospital, after having aspirated during the placement of a naso-gastric tube that resulted in cardio-pulmonary arrest and subsequent days in the ICU.  He speaks to the sense of being alone and the lack of guidance in the process of end-of-life decision-making.  My heart dropped when hearing this story - for his (and hi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 9, 2013 Category: Palliative Carer Workers Authors: Suzana Makowski Source Type: blogs

Basketball, The Presence of Suffering, and the Practice of Medicine
It's the first week of April, and we're on the verge of the penultimate games of the NCAA Basketball Tournaments.  Since only four teams remain, chances are good that your favorite team is out of the tournament.  As someone who has experienced that feeling 25 times over the years (but who's really counting?), I offer my condolences.  To the few who still have a team in the tourney, condolences are pending for 75% of you. In honor of March Madness, I offer a challenge.  Watch the video below and follow the narrator's instructions to count the number of times the team with the white shirts passes the bal...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 4, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

Death Panels a Solution to Unwanted Intrusion at End of Life
by Abe R Feaulx, Special Reporter When death is near, and no cure is available, more and more patients are turning to hospice to meet their end-of-life needs. To meet those needs, more and more hospice agencies are building hospice homes. These state-of-the-art facilities provide a place for patients to spend their final days, away from the commotion of the hospital or the dreariness of the nursing home. A hospice home is a free-standing facility designed to provide a private and comfortable setting where patients can die peacefully, often surrounded by friends and family. Yet many hospice homes are finding that privacy c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 1, 2013 Category: Palliative Carer Workers Authors: Abe R Feaulx Source Type: blogs

State of the Science from the 2013 AAHPM Annual Assembly
The State of the Science plenary is one of my favorite traditions at the AAHPM Annual Assembly.   This year, Jay Horton and Kim Johnson took the lead in presenting analyses of some of the previous year's most important hospice and palliative medicine research.  For those attendees interested in seeing their slides again, you can find them here. Some of the research below further confirms our previous understanding of the state of the science (for instance, the studies on the low utility of feeding tubes in many circumstances).  Other studies provide quality randomized controlled trial data on questions whic...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 17, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

David and Debbie Oliver's AAHPM Plenary: Comforting Others While Living With Illness
One could write pages about David and Debbie Oliver's remarkable plenary presentation Friday at the American Academy of Hospice and Palliative Medicine Annual Assembly in New Orleans.  David has stage IV nasopharyngeal carcinoma and has taken his cancer journey to the public.  Before I go any further, I'll refer you to David's book, "Exit Strategy: Depriving Death of Its Strangeness," Paul Tatum's Interview with David at Geripal from August 2012, and below, see a clip from David's Cancer Videoblog in which he talks about cancer and palliative care. Of the many themes which arose from their presentatio...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 15, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs

7th Annual Pallimed and Geripal Gathering
Are you excited about the AAHPM/HPNA/SWHPN 2013 Annual Assembly this week?  I hope you or at least your colleagues are able to attend.  We will be continuing the tradition of gathering readers and contributors to this blog and Geripal.  It has grown over the years naturally and we are excited to meet other people you may only nknow by a screen name or email address. There will be a strong Pallimed contingent this year with Drew Rosielle, Lyle Fettig, Jeanette Ross, Holly Yang, Suzana Makowski, Thomas Quinn, and Amber Wollesen in attendance, so please rech out and say hello. We do have a date and time for t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 11, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

What The AAHPM Annual Assembly Means To Me
I really love my field. Both sides hospice and palliative medicine. Both sides academic and community. Both sides profit/not for profit. Both sides friends and soon to be friends. Because to me they are not really sides or artificial tribes that exist because we humans really like to label things into groups.  To me this is one whole big family and the Annual Assembly feels like a really good family reunion to me. Not the family reunion of TV or movie tropes where everyone dreads it, but the real type of family reunion where you see people you have not spoken with in a year or more, but you drop right into a regular c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 11, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Prognosis: Weeks to Months – On the End of an Era at San Diego Hospice
On February 14th, 1977, a group of volunteers offered support to 10 patients who were nearing the end of life, and in doing so formed the foundation of what would grow into the largest academic hospice in the US – caring for upwards of 1000 patients each day at its peak, and training hundreds of hundreds of clinicians in the specialty of palliative care.  Just a day shy of its 36th anniversary, it was announced that San Diego Hospice would be closing. As an alumnus of the fellowship program at San Diego, I am one of many who are grieving this news.  I write here, not so much to share my grief, but rather...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 14, 2013 Category: Palliative Carer Workers Authors: Suzana Makowski Source Type: blogs

PPS Trajectories in Hospice
Functional status is all the rage in research these days, especially with the impending but often delayed roll out of ICD-10. Any seasoned hospice and palliative care (HPC) clinician will tell you how critical functional status is to understanding trajectories of patients as function has been part of our assessment for quite a long time.  Most of us know functional assessments through the more clinical acronyms of ADL (Activities of Daily Living) and the PPS (Palliative Performance Status).  On a whole HPC staff routinely use function as a key metric of prognostication, but we have not really had a lot of data th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 27, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

The 2012 #HPM Year on Twitter
Ed. - Please welcome the first Pallimed post by Dr. Jeannette Ross (@RossJeanette), a geriatrics and palliative medicine specialist from San Antonio, TX.   I recently read a webpost called 20 Twitter Stats From 2012 noting some interesting statistic about the amounts of tweets thru the 2012 year, the most retweeted tweet (Obama’s victory tweet), the most followed twitter account (@ladygaga with 32 million+), and others. I was curious about what are the twitter statistics for our field as measured by the HPM hashtag. I went to the Symplur Healthcare Hasthtag Project and ran the #HPM 2012 analytics and di...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 16, 2013 Category: Palliative Carer Workers Authors: Jeanette Ross Source Type: blogs

Committee on Transforming End of Life Care is Incomplete
In conclusion, I'm really glad the IOM is revisiting this issue after almost two decades.  I have great confidence in the expertise of the committee so far, and expect great outcomes from the process.  But if you think there needs to be a little bit more diversity now is your chance to give input. Reference: Summary table of different characteristics of the panel via Google Docs (Source: Pallimed: A Hospice and Palliative Medicine Blog)
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 16, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

The Best Free Hospice and Palliative Care Info for your Inbox
Are you drowning in information about hospice and palliative care?  It seems like every day there is a new aggregator of articles, highlights and tweets. The criteria to the list below is: 1) The information must be primarily related to the clinical practice of hospice and/or palliative care, 2) The information must be able to land in one's inbox via email subscription, 3) The information must be available without paying for it directly or indirectly (membership), AND 3) The information should be posted with a regular frequency. And here is the list in alphabetical order: Blogs Hospice and Pall...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 6, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Sendak: I cry a lot because they die and I can't stop them
I'm always struck at the end of a year how much we pay tribute in words and video to those who have died in the prior year.  Famous people always get the lion's share of the attention understandably as we focus on what they have achieved in their career.  Rarely do we get to hear from them in the months leading up to their death about their fears and dreams. In September 2011, Maurice Sendak, noted children's author and illustrator was interviewed by Terry Gross for NPR's Fresh Air.  During this interview, Sendak is very upfront with his mortality and what matters most to him as he has grown...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 6, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs