Palliative Pearls

Encountering Loss

Encountering Loss

Supporting families (and ourselves) with loss may be some of the most difficult work in healthcare. Here are phrases we find helpful. “I am so sorry for your loss. As much as you can, give grief the reins. Give it all the time it needs.” “Many people experience anger,...

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Get Out of Jail Free Code: Z51.5

Get Out of Jail Free Code: Z51.5

Using ICD-10 code Z51.5 (Encounter for Palliative Care) as the first code in your documentation can help you care for your patients better. It can be used by any primary care provider or specialist. It alerts your partners that this patients goals are comfort...

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“I’d like to get Dad on hospice.”

“I’d like to get Dad on hospice.”

March 2022 - Patients and families can (and do!) refer themselves for hospice care. The percentage of referrals we receive from patients, families and caregivers (rather than from medical providers) has increased from 20% five years ago to 25% in 2021. Our community...

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Our old friend, propranolol

Our old friend, propranolol

February 2022 - Our old friend, propranolol Propranolol is effective in palliating panic/anxiety in elders who are sensitive to the sedation and delirium side effects of benzodiazepines. Consider Mrs. Li: She has moderate dementia and is struggling with the recent...

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Say What?

Say What?

January 2022 - Hearing impairment can look like dementia or depression, and makes both of those worse. SuperEar® is a personal sound amplifier (for around $60) that can be cleaned and reused for patients with hearing deficiency. Great for clinic visits, hospital care,...

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A Thank You

A Thank You

December 2021 - A Thank You A poem, as we enter the darker days of winter, holding the suffering of so many. Blessed are you who bear the light in unbearable times, who testify to its endurance amid the unendurable, who bear witness to its persistence when everything...

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Communication Tip:  Address the emotion you see

Communication Tip: Address the emotion you see

November 2021 - Palliative Pearl - Communication Tip: Address the emotions you see “May I ask what’s going through your mind?” When we notice strong emotions, uncertainty, or closing down, our natural tendency is to explain more. Good evidence shows effective...

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We Love Torsemide!

We Love Torsemide!

October 2021 - Palliative Pearl - We love Torsemide! We see torsemide provides better diuresis and better quality of life in many of our CHF patients. Torsemide is better absorbed and has a longer time of action than furosemide. Some studies show patients who use it...

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Acetaminophen for Agitation in Dementia

Acetaminophen for Agitation in Dementia

September 2021 - Palliative Pearl - Acetaminophen for Agitation in Dementia Agitation in dementia may be a result of untreated pain.   The use of scheduled acetaminophen has been demonstrated to reduce agitation significantly in nursing home populations of patients...

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