November 2018 -There is a big difference between AICD deactivation and pacemaker deactivation. More patients (or their surrogates) are requesting the deactivation of cardiac devices at end of life. Some want a more natural death. Others hope for an easier or earlier...
October 2018 - Double-booked patients, charts, emails, curbsides, phone calls, meetings. . . Work late and start again the next day. It is important to find a way to rest in the middle of things. Stopping, even briefly, allows us to step out of our suffering and see...
September 2018 - A picture speaks a thousand words. (see above) All hospice is palliative care; not all palliative care is end-of-life or hospice care. For more information contact Dr. Leslie Estep or Dr. Anita Meyer at Hospice of the Northwest, 360-814-5550, or...
August 2018 - Providing serious medical information is challenging. Below are helpful steps and phases. 1. Use simple language. “I wish I had better news, but the biopsy showed cancer.” “I’m afraid you have had a miscarriage.” 2. Listen, use silence, and acknowledge...
July 2018 - De-escalating supplements can improve quality of life. Patients referred to hospice are often on multiple supplements. They are relieved when some pills can be stopped. Consider discontinuing the following supplements in your palliative patients: Calcium...
June 2018 - Falls are the number one cause of death from injury in patients over 65. A simple fall risk screen for elders developed by the CDC includes the following three questions: 1. Have you fallen in the past year? 2. Do you feel unsteady when standing or...
May 2018 - Make a recommendation. You can reduce your patient’s and family’s distress by making a recommendation about CPR based on what you know about CPR as a medical procedure. “Do everything, doctor!” may not mean full code. Patients may be expressing fear; they...
April 2018 - A patient’s past experience with CPR or intensive care is important. Before trying to complete a POLST, learn about your patient’s experience. Personal experience is more important to many patients than statistics. To find out what they’re thinking, try...
March 2018 - Use facts not fear to help your patients make a CPR decision. - CPR on TV looks easy and seems to be very successful; unfortunately, in real life, only 1 in 8 patients survive witnessed arrest. Many of the survivors have a reduced functional capacity...
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 can use concentrated sublingual medications. We generally provide an...
