Palliative Pearls

A Favorite Recipe for Dry Mouth

A Favorite Recipe for Dry Mouth

January 2020 - Providing end-of-life mouth care is a high priority at Hospice of the Northwest. Mix together: 15 ml coconut oil 15 ml water 15 ml alcohol-free mouthwash Apply a small amount to dry mouth and tongue every hour as needed. We find this recipe both...

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Grief Support

Grief Support

December 2019 - 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.  Support is available regardless of...

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A Moment for Reflection

A Moment for Reflection

November 2019 - All of us have special people in our lives who have loved us into being.  Take just 10 seconds to think about all of the people who have helped you become who you are, those who cared about you and wanted what was best for you in life. Just 10 seconds...

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What Care Would I Want if I Develop Dementia?

What Care Would I Want if I Develop Dementia?

October 2019 - There are now advance directives designed to change as dementia progresses and goals of medical care change. A simple version that provides good overall guidance is available as a free download from www.dementia-directive.org. This directive does not...

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Hand-held fan for dyspnea

May 2017 - Treating dyspnea improves function in late stage COPD and CHF. Studies show the use a hand held fan directed to the face reduces dyspnea. Low dose opioids (not only morphine) also reduce dyspnea, usually at doses lower than typically needed to treat pain....

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The “Surprise Question”

April 2017 - “The point of prognostication is not to be right, but to help people prepare” - Atul Gawande, M.D. Asking -"Would I be surprised if this patient died in the next year?"—can improve end-of-life care by identifying patients with a poor prognosis who would...

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Dexamethasone After Falls

March 2017 - Frail elders can be disabled for days after a “non-injury fall”. A 7 day dexamethasone burst can improve function, mobility and comfort dramatically, easing pain with respiration, improving mobility and relieving other musculoskeletal pain, without the...

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Acetaminophen for Agitation in Dementia

February 2017 - Agitation in dementia may be a result of untreated pain. Use of scheduled acetaminophen has been demonstrated to reduce agitation significantly in nursing home populations of patients with dementia. Try acetaminophen 650 mg tid or qid on a schedule as...

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One minute functional assessment in advanced COPD

One minute functional assessment in advanced COPD

September 2019 - Showering often becomes the most difficult physical exertion in these patients. Asking one of the following questions can quickly help assess whether a patient may be hospice eligible, may need their blood pressure medications reduced to reduce the...

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NO CODE not necessary!

NO CODE not necessary!

August 2019 - DNAR is NOT a prerequisite to hospice admission. Most patients admitted to hospice as “Full Code” transition to “Do Not Attempt Resuscitation” while receiving hospice care.  Patients begin to understand that we offer treatments that make sense to their...

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