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...
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...
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...
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. ...
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...
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...
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...
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...
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,...
