Palliative Pearls

A Gift of Self Care for 2021

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,...

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2020, a year of loss for many

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...

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Computer Inspired Compassion

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...

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Hospice Care is Aggressive Medical Care

Hospice Care is Aggressive Medical Care

October 2020 - “There’s nothing more we can do . . .”  has no place in end of life care. Use language that offers care that is needed now:  - Urgent and careful management of symptoms - Care that comes to your home - Support for your family - Help with important...

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Time Limited Trials

Time Limited Trials

August 2020 - Time-limited trials of therapy are a powerful tool when the benefit/burden balance of treatment is uncertain. This approach has many benefits. - It names the elephant in the room: uncertainty. - It helps patients/families and providers think about goals...

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Be a hero:  Make S**t Happen

Be a hero: Make S**t Happen

July 2020 - Deliver a one-two punch: increase gut motility and stool moisture with scheduled meds. Constipation is predictable. Think hospitalization, immobility, newly prescribed opioids, traveling, hot weather. Constipation is miserable. Be a hero. Prevent it....

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Methadone…worth the trouble.

Methadone…worth the trouble.

June 2020 - Methadone…worth the trouble. Don’t write off methadone as a pain medication – it may be life-changing for your palliative patients. A few reasons why: Methadone is the only long-acting opioid that comes in a liquid. For patients unable to swallow,...

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COVID infection order set and tools for the skilled facility

COVID infection order set and tools for the skilled facility

April 2020 - Skilled facilities are seeing more COVID infection. Residents with DNR/DNI and comfort-focused goals need not be transported to the hospital.  Below, please find an order set, caregiving tips, and comfort medication instructions to help facility staff...

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A proactive approach for COVID-19

A proactive approach for COVID-19

March 2020 - Do you care for vulnerable elders, memory care patients, the complex chronically ill, or nursing home residents? Tips for conversations about future care decisions during a pandemic: For frail nursing home patients: “Your father would not likely survive...

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Revisiting Advanced Care Planning

Revisiting Advanced Care Planning

February 2020 - Use the 6 D’s to trigger follow-up conversations with a surrogate decision-maker and to update POLST and living will. Review goals and documents Decade: Every ten years (some advocate for annual review). Diagnosis: When you develop a new serious...

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