There’s a helpful rule of thumb for prognosis near end-of-life, but first . . . It’s always a good idea to ask what’s behind the question. Many patients who ask this may be hunting for something else. We tend to follow up with a question like: “Could you tell me...
The nice thing about books: you can take one home and it waits patiently for the right time. Open it when you’re ready. Close it when you like. Come back to it when it’s helpful. Hospice of the Northwest’s lending library is open to the public. We have over 1500...
“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...
