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Palliative Pearls

What Care Would I Want if I Develop Dementia?

October 2019 – There are now advance directives designed to change as dementia progresses and goals of medical care change. A simple version that provides good overall guidance is available as a...

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One minute functional assessment in advanced COPD

September 2019 – Showering often becomes the most difficult physical exertion in these patients. Asking one of the following questions can quickly help assess whether a patient may be hospice el...

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NO CODE not necessary!

August 2019 – DNAR is NOT a prerequisite to hospice admission. Most patients admitted to hospice as “Full Code” transition to “Do Not Attempt Resuscitation” while receiving hospice care....

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How Long Has She Got, Doc?

July 2019 – Helping families understand a timeline for elders with dementia can relieve suffering and help with planning. Dementia Mitchell Mortality Risk Index Score Points/Risk factor 1.9 Comp...

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Beware of the F word – “Futility”

June 2019 – We find “Futility” is not a useful term when discussing treatment options. It is not well defined and tends to be inflammatory. It can mask value judgments by clinicians It can p...

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Isopropyl Alcohol for Nausea

May 2019 – Another new study showed inhaled isopropyl alcohol significantly reduced nausea, this time in patients in the ED. Several studies have shown inhaled isopropyl alcohol can provide rapi...

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Do-It-Yourself Palliative Care Consult – Part 2

April 2019 – When you would not be surprised if your patient died in the next year, it is time to take action to provide care that makes medical sense and is aligned with realistic patient goals...

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The Do-It-Yourself Palliative Care Consult – Part 1

March 2019 – Many patients in your practice may be interested in a palliative approach to care. Patients living with serious or life-threatening illness may be more interested in quality of life...

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Low Dose Opioids for Dyspnea

February 2019 – Treating dyspnea improves function in late stage COPD and CHF. Consider using low dose opioid 30 – 60 minutes before planned exertion to improve activity tolerance.  ...

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Moral Distress

January 2019 – That pit in your stomach means you need to talk to a team member or colleague about a patient’s care. Moral distress occurs when you think you know the right thing to do, but yo...

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