September 2021 - Palliative Pearl - Acetaminophen for Agitation in Dementia Agitation in dementia may be a result of untreated pain. The use of scheduled acetaminophen has been demonstrated to reduce agitation significantly in nursing home populations of patients...
Palliative Pearls
Skip the Scope!
July 2021 Palliative Pearls – Skip the Scope! The scopolamine patch has little utility as a drying agent in palliative care. Scopolamine patches can cause severe delirium and other side effects. We rarely use them as they often bring a new symptom burden in someone...
Day-Night Reversal in Dementia
June 2021 - Caring for a loved one who is up all night is not sustainable. Using a low-dose stimulant, like methylphenidate, in the daytime to treat apathy and daytime drowsiness has helped patients normalize sleep patterns in case reports. ...
Wound Odor
May 2021 - When assessing palliative wounds- not expected to heal, sometimes managing the odiferous drainage can be the greatest kindness for patients and visitors. Non-healing wounds are common at end-of-life, whether from pressure ulcers, vascular disease, or...
Nonverbal pain
April 2021 - When assessing pain in a nonverbal or cognitively compromised patient, consider symptoms of agitation and fear as clues. Consider Mrs. Jones: She is getting more agitated with her transfers, strikes out at staff attempting to provide bed care, and...
My mom has dementia. How would hospice help?
March 2021 - Patients with dementia and their families benefit from specialized end-of-life support Hospice care provides: - Goal setting with families - Teaching on what to expect with the decline - Medication simplification - Techniques and medication to help...
Dust off the Digoxin
February 2021 - When palliating heart failure with difficult to control atrial fibrillation, remember our old friend digoxin. Consider Mr. Jones: His atrial fibrillation is marginally controlled but he can no longer tolerate any rate-controlling medications that lower...
A Gift of Self Care for 2021
January 2021 - “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” - Adapted from Marcel Proust As hospice physicians, we search for opportunities to improve self-care. The 10% Happier app has changed our lives. It is brief,...
2020, a year of loss for many
December 2020 - Grief counseling is available to the community at large from Hospice of the Northwest. Any member of our community can use Hospice of the Northwest for grief support. We offer both individual and group counseling via Zoom or telephone. Support is...
Computer Inspired Compassion
November 2020 - When your computer is tired and behaving badly, turn it off and count to 10. Always the first question from the IT help desk: “Did you try powering down?” Can we extend that to ourselves? Maybe even with the kind words: “You’ve been working hard, take...