Palliative Pearls

It can be hard to bring up “hospice” but it doesn’t have to feel like giving up. 

It can be hard to bring up “hospice” but it doesn’t have to feel like giving up. 

We are seeing more patients who are referred too late to benefit fully from hospice care. The surprise question is simple: “Would you be surprised if this patient died within the next year?” A “No” answer from a medical provider is more predictive than other...

Many interventions have a time to benefit interval. As people age they may not have time to benefit from some preventative measures. Keeping Hgb A1c less than 7 takes 8 years for most patients to prevent dialysis and retinopathy. This tool from UCSF can help put some...

Poop.  Pee.  Pain. When patients with dementia are unusually agitated or unusually withdrawn, check for constipation, urinary retention and untreated pain.  Behavior is communication. For more information, call our providers at 360-814-5550 or email: Erika...

UpToDate is filled with information about palliative management of symptoms and disease states. Just search with the words “Palliative care for . . .”, then the symptom or condition, such as cough or congestive heart failure. Bonus resource:  Palliative Care Network...

If a patient's cough won't stop, the first-line medication for palliative treatment is benzonatate (Tessalon Perles) After evaluating and treating the underlying causes of cough, treat the symptom of cough with benzonatate. Treating cough can be invaluable for the...

The long dark days of December can dampen spirits. We appreciate all you do to help patients despite heavy workloads and busy waiting rooms. Wishing you peace and renewal over the holidays! The Journey by David Whyte Above the mountains the geese turn into the light...

Making treatment recommendations that meet your patient’s goals requires that they understand their condition. We use the following phrases to assess understanding when discussing a difficult diagnosis or prognosis. “I have been doing a lot of the talking. Could you...

In dementia, when language and logic are failing, behavior communicates comfort and distress. Yelling in the middle of the night might be communicating many things: “Where am I?” “My hips hurt.” “I’m afraid.” “I’m cold.” Behavior is a two-way street. Keep it slow....