Serving Skagit, Island, San Juan, and Snohomish Counties
Mon-Fri 8am-5pm

Ready to Start Hospice?       |       HNW COVID-19 Resources

Palliative Pearls

Comfort Medications

February 2018 – For patients unable or unwilling to come onto hospice quickly, here is a basic toolkit of medications for typical end of life symptoms. Even patients who can no longer swallow ca...

Continue Reading »

“Good Enough” Prognostication

January 2018 – The point of prognostication is not to be right, but to help people prepare. Avoid the trap of exact numbers.  Develop a prognosis that is good enough to allow for important deci...

Continue Reading »

Anticoagulation in Frail Patients

December 2017 – The risk of intracranial or GI hemorrhage in a debilitated ambulatory patient at risk for falling likely exceeds the benefit of stroke reduction.* Most experts agree that anticoa...

Continue Reading »

Words Can Heal

October 2017 – VitalTalk Tips – A free app to help you with difficult conversations. VitalTalk Tips is free and easy to use. Its layered structure allows you to use it to quickly review a topi...

Continue Reading »

Your patients need your help

November 2017 – Patients are being referred too late to benefit fully from hospice care. Hospice of the Northwest patients are being referred very late in their illness.  35% of patients ad...

Continue Reading »

Taper BP Meds for Falling, Frail Elders

July 2017 – Study shows burden may outweigh benefit for managing hypertension in elders with a history of falls. Antihypertensive medications were associated with increased risk of serious fall ...

Continue Reading »

Use Senna as First Line for Opiate Induced Constipation at End-of-Life

September 2017 – Opiates cause constipation by several mechanisms: Binding intestinal mu receptors and slowing peristalsis Delaying gastric emptying Increasing anal sphincter tone Increasing wat...

Continue Reading »

Who Will Decide if You Can’t?

August 2017 – Establishing Durable Power of Attorney for Healthcare (DPOA-HC) is a gentle way to start advance care planning. In the state of Washington, if no DPOA-HC has been established, the ...

Continue Reading »

Olanzapine (Zyprexa) for Nausea

June 2017 – Olanzapine has “broad spectrum” activity for difficult to treat nausea. Olanzapine has broad activity at dopaminergic and serotonin receptors as well as activity along histaminic...

Continue Reading »

Hand-held fan for dyspnea

May 2017 – Treating dyspnea improves function in late stage COPD and CHF. Studies show the use a hand held fan directed to the face reduces dyspnea. Low dose opioids (not only morphine) also red...

Continue Reading »
We Honor Veterans
CHAP Provider
Seal of Transparency


Sign up to get interesting news and updates delivered to your inbox.

Sign Up Today!