Palliative Pearls

DNAR Not Required

DNAR Not Required

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

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The “H” Word

The “H” Word

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

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Time to Dust Off the Surprise Question

Time to Dust Off the Surprise Question

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...

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It Takes Time

It Takes Time

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...

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The Three P’s in Dementia

The Three P’s in Dementia

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 When patients with dementia are unusually agitated or unusually withdrawn, check for constipation, urinary retention and untreated pain.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...

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What Would We Do Without UpToDate?

What Would We Do Without UpToDate?

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...

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When the Cough Won’t Stop

When the Cough Won’t Stop

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...

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