“What are we doing? He would never want to live like this!” For patients with advanced dementia, consider recommending feeding for comfort rather than medicalized nutrition. This means: Choosing foods that the patient responds to with pleasure Stopping feeding when...
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,...
Medical situations with ill patients can change quickly and communication missteps are common. Here are our favorite phrases to repair/re-establish rapport. “I think I just said something unhelpful. Let me try that again.” “I have been using a lot of technical jargon....
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...
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...
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...
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,...
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...
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...
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...
