MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'end'. Sat, 03 Sep 2011 01:56:49 +0100 http://www.medworm.com/index.php?rid=5181738&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F30%2Fwhere-to-for-hospice%2F A column by New York Times columnist David Brooks titled “Death and Budgets,” read in combination with a recent report from the Office of the Inspector General (OIG) at the U.S. Department of Health and Human Services (“Medicare Hospices that Focus on Nursing Facility Residents”), makes painfully clear how urgently America must rethink the way [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181738 Tue, 30 Aug 2011 18:02:55 +0100 5181738 http://www.medworm.com/index.php?rid=5139673&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F17%2Fnarrative-matters-eleanor-clift-on-her-husbands-death-and-end-of-life-issues%2F In the newest Health Affairs Narrative Matters essay, prominent journalist Eleanor Clift writes about her husband Tom Brazaitis and his death from metastatic cancer at age 64. Clift describes the multiple ways in which she and her husband benefited from hospice care, in which Brazaitis spent the last four months of his life. Clift uses [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139673 Wed, 17 Aug 2011 18:19:54 +0100 5139673 http://www.medworm.com/index.php?rid=5139627&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F17%2Flocal-square-table-learning-and-evaluation-report%2F Title: Local square table learning and evaluation report Scan or click to download 'Local square table learning and evaluation report' The Skinny: Reports on the findings of open and honest discussion and increased understanding between those who provide children’s palliative care, those who experience it and those that play a wider part in supporting children, young people and families in a particular community. Finds that: Awareness and language is seen as a barrier to service access Parents say they struggle with the current assessment process Partnership working is seen as key to ensuring the best outcomes for lifelimited and life-threatened children and young people Workforce training and development is considered a priority by parents and professionals Parents f... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139627 Wed, 17 Aug 2011 15:43:14 +0100 5139627 http://www.medworm.com/index.php?rid=5139725&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FAyWAH4hu6eo%2F The following is a guest post by Janice Lynch Schuster who  works at the Altarum Institute, a new voice in the field of aging and end of life issues. This post orginally ran on July 14th on Health AGEnda. By Janice Lynch Schuster. When I was a little girl, country singer Glen Campbell had a variety show on television called “The Glen Campbell Good Time Hour.” As I remember it, it was a good time; in my young imagination, I often confused him with my father, who I thought was just as handsome and talented and fun as Glen. I loved his songs and wanted to learn to play guitar so I could be more like him. Sadly, Mr. Campbell has been diagnosed with Alzheimer’ disease. As most people know, Alzheimer’s is the primary cause of dementia, a gradual loss of brain function that becomes more ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5139725 Tue, 16 Aug 2011 13:17:07 +0100 5139725 http://www.medworm.com/index.php?rid=5130661&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fevaluation-of-learning-resources-for-end-of-life-care-in-extra-care-settings-executive-summary%2F Title: Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary Scan or click to download 'Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary' The Skinny: Summarises experiences from the use of learning resources developed to support end of life care in an “extra care” setting. Publisher: The University of York, Centre for Housing Policy Published: 13/07/11 Size: 6p. Filed under: Ooops Missed Category! Tagged: Behavioural sciences, Education, End of Life Care, Grey Literature, Medical Treatment, Palliative Care, Terminal illness, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130661 Mon, 15 Aug 2011 13:43:26 +0100 5130661 http://www.medworm.com/index.php?rid=5130666&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Ftransforming-community-services-transformational-guides%2F Scan or click to download 'Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services' Title: Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services The Skinny: Guide for use by frontline clinicians, commissioners and providers a based around a framework of ambition, action and achievement: Clearly setting out your ambition Taking action to deliver the ambition using the best available evidence (high impact changes) Demonstrating and measuring achievement (using quality indicators) The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles. Publisher: DH ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130666 Mon, 15 Aug 2011 08:09:01 +0100 5130666 http://www.medworm.com/index.php?rid=5107724&cid=t_147226_118_f&fid=34702&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmspblog%2F%7E3%2FgVDUE-B6AIo%2F The frail, elderly patient was so pale as to be nearly invisible against the crisp white sheets.  Any ability to give voice to his thoughts had been taken away by the ventilator tubes in his throat.  The soft restraints on his wrists prevented him from dislodging those tubes, either in confusion or by design.  Other tubes silently pumped fluids in or drained them out.  During his lucid moments he wondered how it had come to this… I sit on the Ethics Committee at my hospital; it is a group that deals with complex, challenging and sometimes heartbreaking dilemmas. Participants need a knowledge of state and federal law, an understanding of the essential workings of the healthcare system, and perhaps most importantly, wisdom and compassion. We are fortunate to be led by a p... MSSPNexus Blog blogs http://www.medworm.com/rss/comments.php?id=5107724 Mon, 08 Aug 2011 23:47:38 +0100 5107724 http://www.medworm.com/index.php?rid=5103529&cid=t_147226_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2011%2F08%2F06%2Fbrief-notes-from-the-land-of-the-knackered%2F 1. Normal Karyotype. 2. Interview done for College of Odds and Sods. Unfortunately I think number one above is probably the better item to dwell on for oh-so many reasons than the apty named number two because I theeenk I could have interviewed in a slightly less startled-rabbit manner. Well, I could have with a scotch or two on board and perhaps not directly on the back of huffing my pregnant high-heeled insane way fifteen minutes down a busy road and up a flight of stairs but I DID enjoy looking at my abdomen at the blessed end when the panel asked if I had any questions. I asked, as the least reproductively dangerous candidate on the grounds that I neither want to drive a mini-van or become a GP and I already own more children than the average female doctor even a GP, for their views o... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=5103529 Sat, 06 Aug 2011 12:07:00 +0100 5103529 http://www.medworm.com/index.php?rid=5096195&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FzXJoBE2ln2E%2F By Stephanie Mensh. We are bombarded with conflicting messages on food.  On one front, we have Michelle Obama railing against childhood obesity, and organizations like the American Heart Association and the federal government driving on diet-related diseases—diabetes, heart disease, stroke, and chronic conditions.  Countering these efforts all around us, are compelling mouth-watering advertisements for high calorie, high fat, high sugar foods.  Every activity—at work, at home, at the movies, at the mall, at the park, studying, watching TV—requires lots of food and sugary drinks. Resisting these omnipresent temptations requires an incredible amount of individual willpower or habits that go contrary to the average American routine.  Despite my active role in advocating for healthy ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5096195 Tue, 02 Aug 2011 13:15:28 +0100 5096195 http://www.medworm.com/index.php?rid=5069511&cid=t_147226_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FozgkpVS7Mt0%2Fshout-outs_26.html Center for Advancing Health (CFAH), Prepared Patient Forum, is the host for this week’s Grand Rounds. You can read this week’s virtual tour edition here (photo credit). Welcome to Better Health’s Grand Rounds Volume 7, Number 44! This is our second time hosting Grand Rounds and we’re excited about sharing the posts we received.  The theme of this week’s collection came from a recent Health Affairs blog post by CFAH president, Jessie Gruman, Patient Advocates: Flies In The Ointment Of Evidence-Based Care, which addresses a few of the many challenges of basing health care practices, policies, and decisions on evidence of effectiveness. ………. …………………………… Check out @globalsurgeon paper in July Bulletin of @AmCollSurgeons: Beyond Volunteerism �... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=5069511 Tue, 26 Jul 2011 13:40:50 +0100 5069511 http://www.medworm.com/index.php?rid=4975819&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fvra3c12TJyY%2F No Hearing: The Supreme Court yesterday rejected an appeal from insurers and other payers who said they paid too much for Eli Lilly’s antipsychotic drug Zyprexa because the drug company misrepresented the benefits of the medication, the WSJ reports. A lower court had ruled that there wasn’t a sufficient link between the high prices and Lilly’s marketing practices; the Supreme Court won’t hear a challenge to that ruling. Hospice Questions: There are concerns that commercial hospices are seeking out patients with better prognoses in an attempt to boost income, Kaiser Health News and the New York Times report. The inspector general of HHS is looking at “unusual patterns of hospice stays,” while whistleblower lawsuits have alleged efforts to keep patients in... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975819 Tue, 28 Jun 2011 10:57:19 +0100 4975819 http://www.medworm.com/index.php?rid=4952743&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F06%2F17%2Fnursing-times-2011-volume-107-no-18%2F This study explores nurses’ experiences of using the Preferred Priorities for Care (PPC) document. The article concludes that district nurses found the PPC an invaluable tool and it’s use should be extended to a wider range of healthcare professionals and not solely district nurses. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: District Nurses, End of Life, End of Life Care, Preferred Priorities for Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4952743 Fri, 17 Jun 2011 14:37:58 +0100 4952743 http://www.medworm.com/index.php?rid=4911475&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fm0PrHuvugis%2F Early last Friday morning Dr. Jack Kevorkian died at the age of 83. He was a Michigan pathologist who put assisted suicide in the forefront of medical ethics world. Kevorkian was often referred to as ”Dr. Death” as he was a staunch supporter of physician-assisted suicide and “right-to-die” legislation. He was charged with murder numerous times in the 1990s for helping terminally ill patients take their own lives and was convicted of murder in 1999 stemming for the death of a patient who suffered from Lou Gehrig’s disease. He was paroled four years ago in 2007. Note: There is a poll embedded within this post, please visit the site to participate in this post's poll. Related posts:Violent Death: Preventing Chronic Disease Isn’t Enough November... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4911475 Tue, 07 Jun 2011 13:22:46 +0100 4911475 http://www.medworm.com/index.php?rid=4853109&cid=t_147226_136_f&fid=35302&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FWhitePebble%2F%7E3%2FU_mx65ggpgY%2F How to think of the believers in the ersatz Rapture? I feel sorry for them, but only a little bit. They’re adults and entitled to make ridiculous spiritual choices. I’ve made a few of those myself. Ridicule? It’s so very hard not to. And there are, of course, serious things going on all the time that actually require our attention and efforts; the tornado in Joplin MO is the first thing that comes to mind. What I am left with, though, is worry for those whose lives were damaged by the people who believed in the nonsense rapture: the children of those people who spent their college funds on billboard signs, the mother who didn’t make plans for the baby she is about to have and whom she thought she would never see. I wish there was a way to hold people responsible whe... white pebble blogs http://www.medworm.com/rss/comments.php?id=4853109 Mon, 23 May 2011 13:58:55 +0100 4853109 http://www.medworm.com/index.php?rid=4775395&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-costs-does-your-doctor-know-when-youre-going-to-die%2F2011.05.01 One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea. Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775395 Sun, 01 May 2011 18:00:00 +0100 4775395 http://www.medworm.com/index.php?rid=4723808&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhospice-patients-spend-less-overall-time-in-hospital-but-more-days-in-the-icu%2F2011.04.16 Chronically-ill Medicare patients spent fewer days in the hospital and received more hospice care in 2007 than they did in 2003, but their intensity of care increased as well, according to a report by the Dartmouth Atlas Project. While in the hospital less, patients had many more visits from physicians, particularly specialists, and spent more days in intensive care units, as result of growth in intensive care and specialist capacity, the researchers said. Intensive interventions can lower a patients’ quality of life and cost more, the researchers noted. About one-fourth of all Medicare spending stems from the last year of life, and much of the growth in Medicare spending is the result of the high cost of treating chronic disease, the authors noted. Following patient preferences for ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723808 Sat, 16 Apr 2011 22:00:00 +0100 4723808 http://www.medworm.com/index.php?rid=4714825&cid=t_147226_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F04%2F15%2Fbest-of-our-blogs-april-15-2011%2F When I reflect back on my life, when I recall the really hard times, I think about how I was mere moments away from a breakthrough. If I was worried about a lack of work, I would get an assignment a few days later. If I was feeling upset and lonely, a friend would call that I needed to talk to. Sometimes ambiguity and uncertainty were hours away from answers. I just needed the patience and faith to wait those difficult times through. Although it’s a struggle to see hope in the midst of heartache, sorrow and pain, there is a light at the end of the tunnel. In fact, I am certain you already walked through that door before. This week take some time and reflect on your darkest moments and then think about how you were able to get through it. Maybe the memory of your past struggles and ho... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4714825 Fri, 15 Apr 2011 09:57:11 +0100 4714825 http://www.medworm.com/index.php?rid=4642566&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F28%2Fmedicares-embedded-ethics-the-challenge-of-cost-control-in-an-aging-society%2F The challenge of reining in the rising costs of the Medicare Program is particularly thorny because it confronts a recalcitrant societal tension between the necessity for cost control and the value of open-ended technology use for life extension in the later years. That tension is becoming more deeply entrenched because a growing number of older [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4642566 Mon, 28 Mar 2011 20:02:43 +0100 4642566 http://www.medworm.com/index.php?rid=4631445&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F03%2F24%2Fnursing-times-2011-vol-107-no-11%2F This article explores the experiences of carers of patients dying at home, in particular their expectations and preparedness for the dying process. Contact the Library for a copy of this article. Filed under: Ooops Missed Category! Tagged: Bereavement, Carers, Death, Dying Process, End of Life Care, Palliative Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4631445 Thu, 24 Mar 2011 12:15:42 +0100 4631445 http://www.medworm.com/index.php?rid=4627032&cid=t_147226_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2F2ViCT7cuwzg%2Feliminating-confusion-that-surrounds.html Advance directives, which allow people to plan ahead for end-of-life care, can be too vague to cover many medical situations. Now, a growing number of states are promoting another program to help guide physicians with a patient's specific instructions. The programs are known as Physician Orders for Life-Sustaining Treatment, or Polst. They are meant to complement advance directives, sometimes known as living wills, in which people state in broad terms how much medical intervention they will want when their condition no longer allows them to communicate. A Polst, which is signed by both the patient and the doctor, spells out such choices as whether a patient wants to be on a mechanical breathing machine or feeding tube and receive antibiotics. Polst programs are currently in use in 14 sta... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=4627032 Wed, 23 Mar 2011 13:34:00 +0100 4627032 http://www.medworm.com/index.php?rid=4605800&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F17%2Fa-challenge-to-congress-a-critical-care-blueprint%2F While Congress’ recent efforts to repeal the healthcare reform legislation signed by President Obama last year may have been ‘dead on arrival,’ efforts to dismantle the bill continue, and likely will for months to come. Rather than simply repeat the same battles again and again, legislators on both sides of the aisle might also take [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4605800 Thu, 17 Mar 2011 16:00:17 +0100 4605800 http://www.medworm.com/index.php?rid=4605862&cid=t_147226_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FK8nBbeJubaQ%2Flasting-gift.html This study suggests that there is an additional benefit as a protection for the family. Just leaving decisions up to the family may well be counterproductive and make it harder on the family, not easier." I and my siblings can attest to the lasting gift our mother gave us.  There is a peace in knowing we followed her wishes when she had the massive intra-operative stroke which ended her life. She repeatedly over the years told us what she wanted and what she didn’t want.  We are able to discuss it without feeling morbid.  My husband is not. My dear husband finds it uncomfortable when I want to tell him what my wishes are when the time comes for tough choices.  I tell my siblings and hope they will help him (and me) when the time comes. I don’t know what his wi... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4605862 Thu, 17 Mar 2011 11:15:00 +0100 4605862 http://www.medworm.com/index.php?rid=4592344&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F15%2Fcall-for-papers-the-care-span%2F Health Affairs has launched The Care Span, a new ongoing section of the journal, in its March 2011 edition. The Care Span will examine the topics of aging and disability, not as isolated experiences but as part of the full span of life. Toward this end, the journal aims to bring together the best current [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4592344 Tue, 15 Mar 2011 19:30:54 +0100 4592344 http://www.medworm.com/index.php?rid=4592350&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fh08O6IiOtIc%2F In the push to get more Americans to prepare advance directives outlining their end-of-life wishes, more states and regions are adopting a program known as Polst, for Physician Orders for Life-Sustaining Treatment, today’s Informed Patient column reports. Studies such as one published last year by the Journal of the American Geriatrics Society show that such documents — which become part of medical orders in a patient’s record and are co-signed by doctors — can help reduce the use of costly end-of-life care that isn’t wanted by patients. Research also shows that communicating wishes about end-of-life care to loved ones in any form can help relieve the stress on families of making decisions without knowing their loved ones’ preferences. Only about a third of Americans have s... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4592350 Tue, 15 Mar 2011 14:16:42 +0100 4592350 http://www.medworm.com/index.php?rid=4577906&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fred-light-cameras-save-lives%2F2011.03.12 Most people don’t like them. Privacy advocates abhor them. But, really– how many things can you name that save lives AND generate revenues for cash-strapped local and state governments? Red-light cameras are one such item. A recent study by the Insurance Institute for Highway Safety has shown that red-light cameras saved 159 lives over a four-year period in the 14 large U.S. cities where the study took place. The scientists claimed that more than 800 traffic fatalities would have been prevented during the course of the study if the cameras had been deployed in all large U.S. cities. The scientists compared fatal car crash rates in U.S. cities with populations of at least 200,000 for two four-year periods: 1992 to 1996 and 2004 to 2008. They excluded cities that had already deploy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4577906 Sat, 12 Mar 2011 15:00:34 +0100 4577906 http://www.medworm.com/index.php?rid=4570772&cid=t_147226_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2FdP1knIfBZLo%2Famericans-ready-to-talk-about-end-of.html A new report indicates that American’s are ready for more discussions about palliative and end of life care. The study, released at yesterday’s summit held by National Journal LIVE entitled “Living Well at the End of Life: A National Conversation,” surveyed hundreds of adults on issues relating to palliative care. According to the report, 96% of Americans surveyed thought that making palliative care a priority for the health care system was important. This percentage was even greater for those participants who had personal experience with palliative care. About 81% of respondents also believed that palliative and end of life care should be covered by Medicare. The survey demonstrated that opinions about end of life care were not shaped by political persuasion, but instead by wheth... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=4570772 Thu, 10 Mar 2011 12:35:00 +0100 4570772 http://www.medworm.com/index.php?rid=4565878&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F09%2Fthe-carespan-a-new-health-affairs-feature-on-long-term-care%2F Major changes lie ahead in the structure and delivery of long-term health care services and supports, accelerated by the Affordable Care Act. Among these are expanded options for people to receive services in their homes and communities; care coordination for the disabled population dually enrolled in Medicare and Medicaid; and the creation of a new [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4565878 Wed, 09 Mar 2011 18:22:18 +0100 4565878 http://www.medworm.com/index.php?rid=4560226&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F3EPAFOBr_E4%2F Last year we wrote about a study that found advanced cancer patients who received early palliative care in combination with standard care not only reported increased quality of life, but even lived a bit longer than those who didn’t. Now a study of  four hospitals in New York State finds that using well-established palliative care teams to coordinate the care of seriously ill Medicaid patients can save money, at least in the hospital; their use reduced inpatient costs by about $6,900 per admission for the average patient. The study, published in Health Affairs, looked at data from 2004-07 covering 485 Medicaid patients who received palliative care. Patients included people with metastatic cancers, HIV/AIDS with one of several secondary diagnoses and congestive-heart failure patients... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4560226 Tue, 08 Mar 2011 19:41:31 +0100 4560226 http://www.medworm.com/index.php?rid=4532184&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FKR5-0_Y65gE%2F   The point of naming a medical surrogate is to have someone around to express your preferences about care when you can’t. But not providing surrogates with enough information ahead of time can cause them emotional distress that may last for years. That, at least, is the finding of a review of existing literature on the impact on surrogates, most of them family members, of making treatment decisions. The 40 papers analyzed in the review, published in the Annals of Internal Medicine, aren’t perfect, the authors say right up front. Many of the study populations weren’t representative of the general population, for example, and there was sometimes a big time delay between when the decisions were made and when the study was conducted. That said, the authors write they w... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4532184 Mon, 28 Feb 2011 22:21:33 +0100 4532184 http://www.medworm.com/index.php?rid=4527712&cid=t_147226_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F02%2Fmeld-score%2F The MELD score (an acronym for model for end stage liver disease) was developed to rank patients being evaluated for liver transplantation and has now supplanted the use of the Child-Turcotte-Pugh score. The score is calculated using a logarithmic equation and includes only objectively measurable variables – bilirubin, creatinine, prothrombin time, age of patient, and whether the patient is receiving dialysis. The score range is 6 to 40 with higher numbers indicating more severe disease A MELD calculator can be accessed here. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4527712 Mon, 28 Feb 2011 03:19:20 +0100 4527712 http://www.medworm.com/index.php?rid=4813625&cid=t_147226_136_f&fid=37856&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FThePeacefulLiberal%2F%7E3%2FJFKRJHE1Yzk%2Fhappy-valentines-day-love-s-holiday.html I know it's been a while since I last posted and to be quite honest I have been busy dealing with lots of pain in my body and an abundant amount  of nausea. Part of the love that I feel so strongly for my husband is how aware he is of what is going on with my body.  He senses things that might not be right; he gets scared as most normally would in keeping his love alive or to be enjoying just one more day with her!  I am always grateful for that one more day; yes we are doing this one day at a time; we can't compound more stress than what is completely necessary.  It's very stressful for both of us.   I can't bite more than I can chew!) It's a blessing for me if I am able to get outside and experience walking around in a grocery store or even to go shopping.  ... ShoppingKharma: What comes around goes around blogs http://www.medworm.com/rss/comments.php?id=4813625 Tue, 15 Feb 2011 17:50:00 +0100 4813625 http://www.medworm.com/index.php?rid=4459955&cid=t_147226_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1343%2F0%2Fethicist-assisted-suicide.mp3 Podcast: ____ This is the third in a series of articles on End-of-Life Care and Covert Rationing.  The first two articles can be found here and here. ____ In his previous post, DrRich attempted to satirize the lame attempts of certain payers to “inform” certain of their “covered lives” that, among all the wonderful options available to them under their truly comprehensive health plans, the medical service of physician-assisted suicide would be compassionately offered and cheerfully paid for. DrRich even offered, thoughtfully as usual, some free though invaluable advice to payers on how they ought to go about marketing assisted suicide as a cost-saving strategy, and to do so in a far more sensitive and less ham-fisted way than they have managed so far. If the mark ... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4459955 Thu, 10 Feb 2011 16:36:02 +0100 4459955 http://www.medworm.com/index.php?rid=4450292&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-when-medicine-prolongs-dying-not-living%2F2011.02.08 The recent Washington Post article entitled, Who decides when medicine prolongs dying, not living? perfectly captures my earlier blog on why we’re afraid of death. An excerpt from the Post piece: [There's a] huge gap between Americans’ wishes about end-of-life care, as expressed in numerous public opinion polls, and what actually happens in too many instances–futile, expensive, often painful procedures performed on people too sick to leave the hospital alive–much less survive with a decent quality of life. Ninety percent of Americans say they want to die at home but only 20 percent do so. Half of Americans die in hospitals and another 25 percent in nursing homes, after a long period of suffering from chronic, incurable conditions that finally become untreatable. An ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450292 Tue, 08 Feb 2011 20:00:00 +0100 4450292 http://www.medworm.com/index.php?rid=4445799&cid=t_147226_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1326%2F0%2Fselling-assisted-suicide.mp3 Podcast: ____ This is the second in a series of articles on End-of-Life Care and Covert Rationing.  The first article can be found here. ____ In the summer of 2008, the Oregon Health Plan (the Medicaid plan in Oregon) injudiciously sent a letter to lung-cancer patient Barbara Wagner denying coverage for the expensive chemotherapy her doctor had recommended, and offering instead to cover palliative care “including doctor-assisted suicide.” Despite the fact that there were plenty of distractions at the time (including a presidential election and the world’s economy on the brink of Armageddon), that letter unleashed a firestorm of public outrage. (If you have forgotten the outrage, simply Google the search terms “Barbara Wagner” and “suicide.”) Indeed, the outrage was suf... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4445799 Mon, 07 Feb 2011 14:51:03 +0100 4445799 http://www.medworm.com/index.php?rid=4433099&cid=t_147226_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1292%2F0%2Fadvance-directives.mp3 Podcast: It is easy to have missed it, because it went by so quickly. On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual “wellness visit.” Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could no longer make medical decisions for him/herself. But on January 5, the new policy was suddenly revoked. It was revoked, CMS lamely explained, because it had not been implemented using the correct process. But, as anyone would know who watched Congress make Obamacare the law of the land, this could not possibly have been the real reason... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4433099 Thu, 03 Feb 2011 12:29:44 +0100 4433099 http://www.medworm.com/index.php?rid=4424270&cid=t_147226_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fj2Xo58-2k44%2Fshout-outs.html HL7Standards is the host for this week’s Grand Rounds! You can read this week’s edition here. As a blog dedicated to “engaging conversations on healthcare and technology,” this week’s edition of Grand Rounds is dedicated to posts discussing the relationship between health care and technology. Technology in health care has received more than a notable amount of press over the last few years and more than a few people have something to say about it. In response to Grand Rounds, we received a number of great submissions by health care bloggers, some positive and others negative, about the impact technology has had on how health care is perceived and understood, delivered and received. ……. ………… Next week I will host Grand Rounds.  There is no theme, but I would... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4424270 Tue, 01 Feb 2011 15:43:37 +0100 4424270 http://www.medworm.com/index.php?rid=4405747&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F26%2Fhealth-care-and-the-state-of-the-union%2F Below, Kavita Patel, former director of policy for the White House Office of Public Engagement and Intergovernmental Affairs, discusses President Obama’s State of the Union address and House Budget Committee chairman Paul Ryan’s (R-WI) Republican response. See other posts on this topic by Len Nichols and Joseph Antos.  The Constitution mandates that the President “from time to time [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4405747 Wed, 26 Jan 2011 21:05:12 +0100 4405747 http://www.medworm.com/index.php?rid=4399528&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-planning-makes-it-easier-to-say-goodbye%2F2011.01.25 This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski. *********** End-Of-Life Planning Makes It Easier To Say Goodbye Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood. In our work with individuals and families facing death, we have seen too many people miss the op... Better Health blogs http://www.medworm.com/rss/comments.php?id=4399528 Tue, 25 Jan 2011 16:00:02 +0100 4399528 http://www.medworm.com/index.php?rid=4394415&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F-Xsvz-rGmL0%2F As few as 40% of patients with advanced cancer have a candid discussion about their prognosis with their physician soon after being diagnosed. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4394415 Mon, 24 Jan 2011 22:06:14 +0100 4394415 http://www.medworm.com/index.php?rid=4377615&cid=t_147226_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F14%2Fbest-of-our-blogs-january-14-2011%2F The first month of a new year is often filled with fear, anticipation and sometimes frustration. There’s a whole lot of things we didn’t yet accomplish that we often feel pressured to do this year (lose weight, make more money, find our true love). And there’s often a sense of grief associated with that as we slowly say good-bye to 2010 and reflect on what we’re proud of what what we regret. Speaking of regrets, a lot of you had very different views about this statement told to me by a relative: “You haven’t really lived, if you haven’t had regrets.” (You can read their opinions here and contribute your own on our Facebook page.) If you feel regretful and frustrated about last year, there are still lots of things you can do to remedy that. In... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4377615 Fri, 14 Jan 2011 12:38:52 +0100 4377615 http://www.medworm.com/index.php?rid=4349544&cid=t_147226_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F14%2Fbest-of-our-blogs-january-14-2010%2F The first month of a new year is often filled with fear, anticipation and sometimes frustration. There’s a whole lot of things we didn’t yet accomplish that we often feel pressured to do this year (lose weight, make more money, find our true love). And there’s often a sense of grief associated with that as we slowly say good-bye to 2010 and reflect on what we’re proud of what what we regret. Speaking of regrets, a lot of you had very different views about this statement told to me by a relative: “You haven’t really lived, if you haven’t had regrets.” (You can read their opinions here and contribute your own on our Facebook page.) If you feel regretful and frustrated about last year, there are still lots of things you can do to remedy that. In... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4349544 Fri, 14 Jan 2011 12:38:52 +0100 4349544 http://www.medworm.com/index.php?rid=4322506&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdeath-why-are-we-so-afraid-of-it%2F2011.01.07 My cousin’s mother-in-law is in her late 90s. She had horrible osteoporosis and can barely move. She has little cognitive function left. She requires nearly 24-hour care and no one would even attempt to say she has any quality of life left. She told her son years ago that she was “ready to go,” and had had enough. And yet when I asked my cousin’s husband if his mother had any do-not-resuscitate orders, or had ever completed an advanced director  outlining her wishes of what kind of end-of-life care she wanted, he said no. His sister, he said, just wasn’t ready for that yet. So what, I asked, will you do when/if your mother gets pneumonia? Will you treat it with antibiotics? Will you put her on a respirator? If she is no longer able to eat, will you feed her t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322506 Fri, 07 Jan 2011 22:00:00 +0100 4322506 http://www.medworm.com/index.php?rid=4318303&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FR5RWavCqETg%2F Some 28% of home health care patients, 65% of nursing home residents and 88% of discharged hospice patients had at least one advance directive on file. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4318303 Thu, 06 Jan 2011 19:14:55 +0100 4318303 http://www.medworm.com/index.php?rid=4318300&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F06%2Ffact-vs-fiction-in-advance-care-planning-take-two%2F For the second time, a proposal to pay health care providers to counsel Medicare beneficiaries on future care options and end-of-life planning has fallen victim to the politics of the health care debate. The House included language to pay physicians and other providers for such “advance care planning” in its version of the Affordable Care Act, last [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4318300 Thu, 06 Jan 2011 16:53:19 +0100 4318300 http://www.medworm.com/index.php?rid=4314001&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Fwww.aannet.org%2Ffiles%2Fpublic%2FAAN%2520Policy%2520Brief%2520-%2520Advance%2520Care%2520Planning.pdf By Diana J. Mason, PhD, RN. I was quite distressed to read in this morning’s news that the Obama Administration had reversed the new Medicare regulation that would pay for periodic conversations between physicians and patients about preferences for end-of-life care.  According to today’s New York Times, Speaker John Boehner said that  “the provision could be a step ‘down a treacherous path toward government-encouraged euthanasia.’” Sara Palin started this rhetorical myth when she declared efforts to incorporate paying for such conversations under Medicare in the House health care reform bill (not included in the final law) as creating “death panels”. This lie is undermining advances that advocates for better end-of-life care have worked on ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4314001 Wed, 05 Jan 2011 18:11:39 +0100 4314001 http://www.medworm.com/index.php?rid=4314002&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F9XB021KoOpo%2F The following is a post by guest blogger Judith Redwing Keyssar, RN, BA. She is the Director of the Palliative and End of Life Care Program at Jewish Family and Children’s Services of the San Francisco Bay Area. As a “midwife to the dying” she draws upon twenty years of nursing experience in oncology, critical care, and hospice–working in hospitals, non-profits, and as a private consultant. Ms. Keyssar has taught courses in all aspects of care of the dying, has published numerous articles, and presents nationally on Palliative and End of Life issues. She is also an author. “Love and Death are the great gifts that are given to us; mostly they are passed on unopened.” RM Rilke, translation by Joan Halifax I published a book this year called, “Last Acts of Kin... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4314002 Wed, 05 Jan 2011 13:55:38 +0100 4314002 http://www.medworm.com/index.php?rid=4313985&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FJQel5xbQ2d4%2F Also: reversal on end-of-life planning; the menthol wars heat up; walking faster to live longer. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4313985 Wed, 05 Jan 2011 13:34:45 +0100 4313985 http://www.medworm.com/index.php?rid=4300551&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fremembering-gene-goldwasser-discoverer-of-epo-a-cure-for-anemia%2F2010.12.30 Gene Goldwasser died last week. He was 88, and he was my friend. I wrote previously about a series of conversations I conducted with Gene and Rabbi A.J. Wolf a few years ago. I met Gene one spring day after calling to invite him to sit in on a class I was teaching to a small group of medical students about social issues in healthcare. I’d read about him in a book called “The $800 Million Pill,” by Merrill Goozner. In the book, Goozner writes the story of Gene’s two-decade hunt to isolate the hormone erythropoietin (EPO). Part of the story relates how Gene tried to interest traditional big pharma companies in his discovery, only to be brushed aside. Instead, Gene wound up sharing his discovery with what became Amgen. The company went on to make a windfall from recomb... Better Health blogs http://www.medworm.com/rss/comments.php?id=4300551 Thu, 30 Dec 2010 16:00:00 +0100 4300551 http://www.medworm.com/index.php?rid=4300539&cid=t_147226_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FvLJOQQm0vRE%2F By Michael F. CannonRich Lowry has the right take on the Obama administration’s decision to have Medicare cover end-of-life counseling despite Congress’ rejection of the idea. The Real Problem with Those Non-Death Panels is a post from Cato @ Liberty - Cato Institute Blog (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4300539 Thu, 30 Dec 2010 15:33:27 +0100 4300539 http://www.medworm.com/index.php?rid=4265738&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmay-we-all-die-so-well%2F2010.12.17 Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying. She lived for him. She was always telling me of his pain, frustrated with the fact that he didn’t tell me enough. She was anxious about each complaint of his, wondering if this was the one that would take him away from her. Many of her problems were driven by this anxiety and fears, and she spent many hours in my office giving witness to them through her tears. As his health failed, I wondered about her future. He was the center of her life, the source of her energy, joy, purpose. How could she manag... Better Health blogs http://www.medworm.com/rss/comments.php?id=4265738 Fri, 17 Dec 2010 16:00:23 +0100 4265738 http://www.medworm.com/index.php?rid=4205936&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-wishes-how-to-engage-with-grace%2F2010.11.27 As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again. And again.  This weekend the “Engage With Grace” message is being broadcast virally, through a “blog rally,” at a time when many people are with family and friends over the long weekend. The point is: We all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating healthcare decisions. CNN ran a story on “Engage With Grace” yesterday. End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a r... Better Health blogs http://www.medworm.com/rss/comments.php?id=4205936 Sat, 27 Nov 2010 13:00:00 +0100 4205936 http://www.medworm.com/index.php?rid=4203155&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FK5VDLgfqurY%2F By Alexandra Drane. For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes. The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family. At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post.  They’re not easy questions, but they are important – and believe it or not, most people find they actually enjoy discussing their answers with loved ones.  The key is ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4203155 Fri, 26 Nov 2010 14:48:22 +0100 4203155 http://www.medworm.com/index.php?rid=4200622&cid=t_147226_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2FlK-qxFlKcaw%2Fthanksgiving-2010-will-you-engage-with.html Will You Engage with Grace this Thanksgiving weekend? I hope so. For the third year running I am participating in the Thanksgiving holiday Engage with Grace Blog Rally. A viral effort to communicate the importance of having a conversation with your family and loved ones around end of life care wishes. Would you prefer to die in a hospital, or at home? Can your family correctly describe how you would want to be treated in the case of a terminal illness or sudden traumatic accident? Does your family know where you keep your living will and advanced directive? At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. They’re not easy questions, but they are important. The key is having the conversation before it’s too late. Througho... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4200622 Thu, 25 Nov 2010 14:39:01 +0100 4200622 http://www.medworm.com/index.php?rid=4162988&cid=t_147226_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fms-plus-depression-does-not-have-to-equal-suicide%2F Hemingway used to refer to the times when depression held him to the very brink of self-murder as “black ass days.” Comments in the past week have brought this topic to the fore of our attention in a very personal way, and I feel compelled to address what is often taboo, but must be spoken. A 1991 Canadian study looked at MS patients who died between 1972 and 1988 and found that people with multiple sclerosis died from suicide at a rate seven-and-a-half times higher than age-matched people in the general population. According to a 2005 Danish report, people with multiple sclerosis committed suicide at a rate twice as high as that in the general population. That study looked at 10,174 people in whom multiple sclerosis was diagnosed between 1953 to 1996; a significant finding was tha... Life with MS blogs http://www.medworm.com/rss/comments.php?id=4162988 Fri, 12 Nov 2010 20:22:52 +0100 4162988 http://www.medworm.com/index.php?rid=4118863&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FTMNo1cXBBp4%2F Wall Street Journal health blogger Katherine Hobson will take questions from readers in a live chat on Monday, Nov. 1 about the TEDMED conference in San Diego.  Ask your questions now. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4118863 Fri, 29 Oct 2010 18:27:37 +0100 4118863 http://www.medworm.com/index.php?rid=4118869&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FggWExmMNL6E%2F Drane has five questions for you to answer about your own death. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4118869 Thu, 28 Oct 2010 23:27:12 +0100 4118869 http://www.medworm.com/index.php?rid=4105830&cid=t_147226_118_f&fid=34702&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmspblog%2F%7E3%2FvR7n5RaPJ48%2F The view through the double glass doors is of a lovely garden; the autumn colors striking against the blue October sky.  Our friend rests peacefully in the room’s only bed, and we each spend a few moments with her.  At times it seems she knows we are there, although we come mostly now to comfort her family.  It is a sad time; we grieve for the loss we are all about to share, and seek ways to comfort those she held most dear. We are all thankful that she is here, in this quiet, restful place.  A nurse stops by to tell family how she did during the night, and to share what they’ve done to make her more comfortable.  Someone comes by a moment later with a sandwich, encouraging our friend’s husband to take care of himself, reminding him that there is coffee ... MSSPNexus Blog blogs http://www.medworm.com/rss/comments.php?id=4105830 Mon, 25 Oct 2010 14:47:58 +0100 4105830 http://www.medworm.com/index.php?rid=4097885&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F21%2Fnarrative-matters-refusing-mammograms-and-caring-for-elderly-parents%2F Which groups of women, if any, should get regular mammograms to screen for breast cancer? This question has been the subject of passionate debate. For example, when the United States Preventive Services Task Force recommended that women without special risk factors begin regular mammograms at age 50, rather than 40, it unleashed an uproar that threatened [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4097885 Thu, 21 Oct 2010 15:48:00 +0100 4097885 http://www.medworm.com/index.php?rid=4074149&cid=t_147226_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F10%2F15%2Fbest-of-our-blogs-october-15-2010%2F Do you smell it? That’s change in the air. There may have been slight shifts and evidence lurking for some time now, but now here it is. If you resist change, life feels so much harder. Like walking uphill or swimming against the current, for example. But accepting something unfamiliar can be so anxiety provoking that we’d rather look the other way. Instead, you may forget about that looming bill and stuff it in a drawer. Or your dog’s illness may be so overwhelming that the thought of his death is too much to handle. A few months later the bills are piling up and your best pet pal dies. How do you deal with the change? These are difficult times. Yet, there is hope. The light at the end of the tunnel is nearby and there are resources that can get you through it. Here&#821... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4074149 Fri, 15 Oct 2010 13:56:18 +0100 4074149 http://www.medworm.com/index.php?rid=4013101&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F09%2F29%2Fnursing-times-2010-vol-106-no-37%2F This article considers how nurses can support patients by acknowledging and validating their spiritual needs. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Death, End of Life Care, Patient Choice, Spirituality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4013101 Wed, 29 Sep 2010 12:26:50 +0100 4013101 http://www.medworm.com/index.php?rid=4013125&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F28%2Fremembering-robert-butler%2F On July 7, Robert Butler died of leukemia. Butler was the founding director of the National Institute on Aging, a Pulitzer Prize-winning author, and one of the nation’s leading authorities on aging and geriatrics. This post, by William Hazzard, Professor of Medicine at the University of Washington and Director of Geriatrics and Extended Care for the VA [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4013125 Tue, 28 Sep 2010 17:28:47 +0100 4013125 http://www.medworm.com/index.php?rid=4013459&cid=t_147226_136_f&fid=39025&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Feverythingchangesbook%2F%7E3%2FpW3KMMp3GaU%2Fcancer-humor I first posted this piece last summer, but knew I had to revive it when I got a great request from ChronicBabe for posts on the theme of chronic illness and humor: Last week, I was interviewed in a Newsweek article about young adult cancer humor. I’m, not a very funny person. I’m just not. Don’t worry, I’m not being harsh on myself. I think I’m smart, compassionate, and fairly attractive. But, I’m just not very funny. I love to laugh, but my humor is particular, maybe even stubborn. I can’t rent dvds from the comedy section; I just don’t find them funny. Nor do I find cancer jokes very funny. So, it was really hard when Newsweek asked me to contribute some jokes to the blog that accompanied the article. Here’s what I sent: *What do you call a young adult cancer patient wi... Everything Changes blogs http://www.medworm.com/rss/comments.php?id=4013459 Tue, 28 Sep 2010 13:52:45 +0100 4013459 http://www.medworm.com/index.php?rid=3993903&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FX0F1UoYKOuc%2F By Alexandra Drane.  About a year ago, as key elements of the health reform bill were in debate, some savvy political strategists coined the term “Death Panels.”  It was both brilliant and damning – positioning end-of-life care as an incredibly personal decision put in the hands of a big government.  And it was catchy – to the point of scoring a cameo appearance on Saturday Night Live …even proving worthy of parody by Bill Maher. What those savvy politicians forgot was that  sometimes even the best laid plans can be put to rest (pun absolutely intended). Because as frustrating as it was to see end-of-life issues exploited for political purposes, in the end, the Death Panel fiasco actually served to breathe life into the very opposite movement.   It did those of us telling o... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3993903 Tue, 21 Sep 2010 13:28:32 +0100 3993903 http://www.medworm.com/index.php?rid=3980972&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F09%2Fa-reply-sort-of-who-is-trinity-hathaway.html In response to my e-mail to blogcomments@citi.com, I received an e-mail from a woman named Trinity Hathaway, whose title is "executive response specialist." Does anyone know what that title means? She gets all the letters the big bosses don't want to deal with? Actually, probably not, because she isn't even at corporate headquarters. Trinity's e-mail, or at least the one she used to contact me, is: derusupport@citi.com, which makes me think she has little power in this organization, certainly not enough power to solve my problem.  She also has a phone number: 877-245-2511 Ext. 1809367 She has a fax too, so e-mail me if you want that number.  Trinity attached a letter to her e-mail. Now remember from my earlier post that the comment sent to my b... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3980972 Sat, 18 Sep 2010 00:17:50 +0100 3980972 http://www.medworm.com/index.php?rid=3938470&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F09%2Fseattle-university-educated-lawyers-to-foreclose-on-dying-cancer-patient.html Tonight I sent versions of this press release to Sanjay Bhatt at The Seattle Times and Clayton Holtzman at the Puget Sound Business Journal. I also sent it to Mark Niles, the dean of Seattle University's School of Law, and Lance Olsen, managing shareholder at Routh Crabtree Olsen, who is also a graduate of Seattle University's School of Law. SEATTLE--Sept. 6, 2010--Bellevue law firm Routh Crabtree Olsen, P.S. has been retained by Citi to foreclose on cancer patient Jeanne Sather's Seattle home. According to Routh Crabtree Olsen's Web site, a total of seven lawyers with the firm received their law degrees at Seattle University, where Sather's younger son is currently a student.The seven attorneys are Heidi Buck, Janaya L. Carter, Lauren Davi... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3938470 Tue, 07 Sep 2010 01:48:51 +0100 3938470 http://www.medworm.com/index.php?rid=3933231&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F09%2Fapril-2010-letter-to-citibank.html TO: Citimortgage  RE: Loan #: XXXXXX  DATE: April 26, 2010  I would like to ask you to extend the temporary suspension of my loan payments through Citimortgage’s “Workable Solution” program for one year, if at all possible.  I have terminal cancer (stage IV metastatic breast cancer, which has spread to my bones, right lung, and lymph nodes) and have been on Social Security disability for several years. I am now approaching the end of my life and have run out of money to pay my mortgage. However, I do have about $100,000 equity in the house, so Citibank would not lose money by allowing me to stay in my home until the end of my life, at which time my sons would most likely sell the house. A real-estate agent recently appraised my house, and I have enclosed a cop... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3933231 Fri, 03 Sep 2010 23:20:35 +0100 3933231 http://www.medworm.com/index.php?rid=3920784&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F08%2F31%2Fnursing-times-2010-vol-106-no-32%2F This article focuses on a framework as a coordinated plan of care for those in the last 12 months of life identifying key actions to support it’s implementation in primary care. Contact the Library for a copy of this article. Filed under: Journals Tagged: End of Life Care, Gold Standards Framework, Palliative Care, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3920784 Tue, 31 Aug 2010 09:19:51 +0100 3920784 http://www.medworm.com/index.php?rid=3914951&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F30%2Frobert-butlers-legacy%2F Editor’s note: Earlier this summer, on July 7, Robert Butler died of leukemia. Butler was the founding director of the National Institute on Aging, a Pulitzer Prize-winning author, and one of the nation’s leading authorities on aging and geriatrics. With the essay below by Christine Cassel, president and CEO of the American Board of Internal Medicine, Health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3914951 Mon, 30 Aug 2010 19:01:06 +0100 3914951 http://www.medworm.com/index.php?rid=3880818&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FzDY68DCnrsk%2F It's not totally clear what led to the increased survival among patients receiving palliative care alongside standard cancer treatment. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3880818 Wed, 18 Aug 2010 21:29:09 +0100 3880818 http://www.medworm.com/index.php?rid=3862151&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F08%2Fwrapped-in-love.html I try not to get mushy--and it's not really my style--but after yesterday's post about the three wise doctors, and the response to it both from friends and loved ones in the real world as well as from my readers ... Well, I feel wrapped in love. And quite invincible.So thank you. Not online much today, but I will try to respond to e-mails in a timely fashion. Younger Son and The Amazing Martha are teaming up to wash the outside windows for me today--which have not been done in a year and which are BOTHERING me. I am going to the post office to mail all my late jewelry orders, and this evening a group of us are going to see The Belle of Amhurst, partly because Younger Son and Megan, who is going, are both theater kids, and also as part of my newly revived int... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3862151 Thu, 12 Aug 2010 16:55:58 +0100 3862151 http://www.medworm.com/index.php?rid=3858329&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F08%2Fthree-out-of-three-doctors-agree-.html Over the past week, I've talked with the three oncologists who are central to my care--Dr. Doug Lee, Dr. Steve Eulau, and Dr. Brian Lee--and the three of them agree: I can expect to live at least another year! Now, if you don't have cancer, or you don't have metastatic cancer, that may sound like bad news to you. A death sentence, as it were. But, if you have metastatic or incurable cancer, as I do, and especially if you have lived with it for a long time, as I have, you will understand. And of course those of you who have lived with cancer in the family are going to get this one. So, what does this mean to me?It's not a guarantee, or a promise. Things could always go south at any time, and I understand that.... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3858329 Wed, 11 Aug 2010 18:39:56 +0100 3858329 http://www.medworm.com/index.php?rid=3827050&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FdaClbshrCAY%2F How might palliative and emergency medicine mix in the frantic setting of the ER? (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3827050 Thu, 05 Aug 2010 13:46:29 +0100 3827050 http://www.medworm.com/index.php?rid=3812949&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FCh4Fbu6woKk%2F If patients or their representatives want a ventricular assist device turned off, should doctors comply? (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3812949 Mon, 02 Aug 2010 22:11:30 +0100 3812949 http://www.medworm.com/index.php?rid=3808820&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F08%2Fdeath-and-cremation-a-conversation-.html We have a lot of interesting conversations around our house (some of you might consider them weird or creepy) but for me and my sons and friends, these are pretty normal.  Yesterday morning my friend Laurie came over--the original plan was to walk Constant and to do a few errands together, but I was too tired--and we were talking, me still in my jammies. Older Son came downstairs to join us, and we started talking about my Uncle Mick's memorial service and cremation.  Uncle Mick died a week ago, and he was my only surviving uncle. One of his two older brothers died of a heart attack, and Mick himself had had heart problems since his 40s. He was my favorite uncle, and I am very sorry he is gone. His memorial service is this coming week, in Olympia, which is about an hour ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3808820 Sun, 01 Aug 2010 21:45:43 +0100 3808820 http://www.medworm.com/index.php?rid=3807395&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-poem-about-an-ending%2F2010.07.31 She coughs and heaves a breathless goodbye into the bedside phone. Her lungs damp, bloated, sacked honeycomb wheeze with vanishing bees. The room of sensors and startling noise has not air to float upon. Morphine slakes a thirst for breathable sky and calms the panic within. The shame of living, of death smiling, savoring smoke and ash. Eyes closed she imagines her son, boy, man, precious evermore. Flowers. Beautiful white, red, and black from a husband who waits. Starstuff spinning in galaxies far, with summer lightning bugs. And then it is upon her, the moment, dreaded, practiced, boundless. We run through soft sands lit by moonlight, now tumbling under waves. All that matters doesn’t. And all that happens matters. The absence of pain and hunger the end of struggle and story mark an in... Better Health blogs http://www.medworm.com/rss/comments.php?id=3807395 Sat, 31 Jul 2010 14:00:06 +0100 3807395 http://www.medworm.com/index.php?rid=3798522&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F28%2Fend-of-life-savings-the-fools-gold-of-reform%2F Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life.  This is nothing new–the basic proportion has not changed since it was first noted in the 1970s.  Other nations that spend much less on health care nevertheless spend a similar [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3798522 Wed, 28 Jul 2010 20:12:46 +0100 3798522 http://www.medworm.com/index.php?rid=3784307&cid=t_147226_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F07%2F23%2Fbest-of-our-blogs-july-23-2010%2F It’s weird writing the date on today’s, “Best of Our Blogs.” Why? Because July 23rd is my birthday. It’s scary to think a whole year passed by. And what’s worse is that in light of another year gone by, it’s all too easy to ask those daunting, won’t-get-you-anywhere type of questions. Things like, “What have I really accomplished in a year?” or, “Why haven’t I reached all of my dreams yet?” Ever since I was a kid, I would view birthdays as a rite of passage, a way to measure this year against the one before. And that would inevitably lead to disappointment. Weighing all the ups and downs in one’s past is difficult, if not impossible to compare with the present. Somehow the past always seems more perfect. Wh... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3784307 Fri, 23 Jul 2010 10:53:28 +0100 3784307 http://www.medworm.com/index.php?rid=3780356&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-anesthesia-contribute-to-the-end-of-the-world%2F2010.07.22 In a development that may have you undergo your next medical procedure the old-fashioned way, two researchers from the University of California-San Francisco and the University of Oslo are reporting that inhaled anesthetics significantly contribute to the destruction of the ozone layer and add to the overall global warming gas content in the atmosphere. Moreover, the study’s authors conclude with some valuable advice for your own practice: “From our calculations, avoiding N2O and unnecessarily high fresh gas flow rates can reduce the environmental impact of inhaled anesthetics.” We’d like to venture even further. Not only would we recommend closed-circuit, low-flow anesthesia even with sevoflurane (damn those kidneys!), we’d also suggest that patients arrive b... Better Health blogs http://www.medworm.com/rss/comments.php?id=3780356 Thu, 22 Jul 2010 19:00:01 +0100 3780356 http://www.medworm.com/index.php?rid=3776382&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-doctors-letter-to-patients-with-chronic-disease%2F2010.07.21 Dear Patients: You have it very hard — much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I, too, can’t understand what your lives are like. How do you answer the question, “How do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality? I can’t imagine. But I do bring something to the table that you may not know. I do have ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3776382 Wed, 21 Jul 2010 12:00:02 +0100 3776382 http://www.medworm.com/index.php?rid=3762902&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-beauty-of-life-and-death-too-easily-forgotten%2F2010.07.17 Yesterday I had a university student shadowing me in the emergency department. AF is a bright student, a hard worker who will make a wonderful physician. She is always curious and insightful when I ask her questions, or show her new things. Today,  she saw something that was new for her, but perhaps too common for me. I walked into the room of an infirm, frail old gentleman who was gracious and polite, as was his family. It turns out he came to us with a terminal illness. I did not know it, but his physician was meeting him. So, as AF and I walked into the room, the patient’s physician walked in after us, and continued a conversation about hospice that he had apparently begun earlier in the day. Realizing I had nothing to add, and would not be needed, I slipped away with my shadow... Better Health blogs http://www.medworm.com/rss/comments.php?id=3762902 Sat, 17 Jul 2010 15:00:09 +0100 3762902 http://www.medworm.com/index.php?rid=3753787&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FRqZbywLiMDM%2F The U.S. was 9th on the quality of death index, primarily because of the high cost of end-of-life care. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3753787 Wed, 14 Jul 2010 22:51:19 +0100 3753787 http://www.medworm.com/index.php?rid=3736995&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F08%2Fpostgraduate-medical-journal-2010-vol-86-no-1014%2F Contents page Fade Fave: Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain Fade Skinny:Examines fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over. Finds that enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Palliateive Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3736995 Thu, 08 Jul 2010 14:32:57 +0100 3736995 http://www.medworm.com/index.php?rid=3736996&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F08%2Fpostgraduate-medical-journal-2010-vol-86-no-1013%2F Contents page Fade Fave: Improving end of life care for nursing home residents: an analysis of hospital mortality and readmission rates Fade Skinny:Considers survival and readmission rates of nursing home patients admitted acutely to general medicine and finds survival rates in nursing home residents admitted to an acute medical unit are low. The article suggests measures to reduce inappropriate admissions and facilitate improved end of life care. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Hospital Admissions, Palliative Care, Residential Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3736996 Thu, 08 Jul 2010 14:28:40 +0100 3736996 http://www.medworm.com/index.php?rid=3794951&cid=t_147226_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator-2%2Fthe-big-news-in-dentistry-no-more-root-canals%2F You read that correctly. A recent journal article in ACS Nano tells us that, in research, a layered, nano-sized dental film is responsive to bringing dead tooth pulp back to life. This is not science fiction; this truth is better than fiction. The miracle substance is called alpha melanocyte stimulating hormone (alpha-MSH), and when mixed with a common polymer, we get a dental film that attacks inflammation in the fibroblasts found in dental pulp. It’s like little superheroes fighting a life-or-death battle inside a tooth. The alpha-MSH nano-film  also increased the number of fibroblasts to help renew life in dental pulp. This amazing finding could mean no more root canals! Source: MedicalNewsToday (Source: dental blog for dentists about dentistry) dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=3794951 Tue, 06 Jul 2010 13:51:17 +0100 3794951 http://www.medworm.com/index.php?rid=3678525&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-planning-and-care-one-family%25e2%2580%2599s-devotion-and-pain%2F2010.06.19 Esther and I went away last weekend for a much needed break from kids, the normal routine, and pets that can wake us up when daylight arrives here in the Pacific Northwest at 5am. We stayed at a quaint bed and breakfast called “The Blue Goose” in the small town of Coupeville, Washington, on Whidbey Island northwest of Seattle. It was restful and, with great sunny weather, rejuvenating. At a bed and breakfast, of course, you typically chat with other people over coffee, egg soufflé, and bran muffins. The experience can be tiresome and too chatty. But sometimes it can be riveting. It was the latter the other morning as we chatted with Diane about health matters and she shared her pain about two episodes in her life. (more…) *This blog post was originally published... Better Health blogs http://www.medworm.com/rss/comments.php?id=3678525 Sat, 19 Jun 2010 22:00:03 +0100 3678525 http://www.medworm.com/index.php?rid=3678644&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F06%2Fsome-random-notes-on-hospice.html I met with a social worker from hospice, Ann, two weeks ago, and I've been meaning to blog about it ever since, but something has gotten in the way. (Something emotional. I can't define it any better than that.) But I want to get this onto my blog, so I'm just going to read through my notes from the meeting and post everything that seems relevant. Laurie and Monica were part of the meeting, and, although they didn't say much, it was a help to have them there. I was not feeling all that great on that Monday morning, and at the time I thought it was because of stress from the meeting itself, but I had also gotten up during the night, needing to throw up. When I got out of bed to go to the bathroom, I blacked out briefly and fell, hitting my head. (I've done th... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3678644 Sat, 19 Jun 2010 19:32:18 +0100 3678644 http://www.medworm.com/index.php?rid=3676853&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F06%2Fmore-fun-on-friday.html I've spent the past couple of hours updating several lists. These are the list of friends and acquaintances I want notified when I am terminal (which is NOT YET, ladies and gentlemen), and another list (almost identical) of the people I want contacted with my funeral information. And then there's a third list--one of the friends whom I think can be asked to help when I am dying, since I plan to do that at home, with the support of Hospice, granted, but it still takes a lot of hands to have a good death. I realize that many of my readers are upset by the posts I've been writing lately about my end-of-life planning, but I can't apologize for this--who do you think is going to make these plans for me? My sons? I don't think so. They don't have the exp... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3676853 Fri, 18 Jun 2010 21:42:16 +0100 3676853 http://www.medworm.com/index.php?rid=3658919&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F14%2Fnursing-times-2010-vol-106-no-21%2F This article calls for all healthcare professionals to be trained in care of the dying as part of an organisations mandatory training programme. It further discusses the use of the Liverpool Care Pathway (LCP) as a tool to aid the provision of good quality care in the final days or hours of life. Please contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: End of Life Care, Liverpool Care Pathway, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3658919 Mon, 14 Jun 2010 11:05:21 +0100 3658919 http://www.medworm.com/index.php?rid=3658920&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F14%2Fnursing-times-2010-vol-106-no-22%2F This article looks at how services must adapt to meet the needs of patients at the end of life. Contact the library for a copy of this article Filed under: Current Awareness, Journals Tagged: Community Services, End of Life Care, Palliative Care, Patient Choice, Place of Care, Place of Death (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3658920 Mon, 14 Jun 2010 10:17:49 +0100 3658920 http://www.medworm.com/index.php?rid=3648749&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F06%2Fplanning-my-funeral-.html Today's fun project was to write up my funeral instructions and e-mail them to my two closest friends. Now, I had the plan I'd written back in 2004 to go on, and I'd also talked this through with Monica a week or so ago, so I wasn't starting from scratch. The interesting thing is that I went through the instructions I'd written six years ago and simplified them drastically. I want a very simple funeral. I'm not a religious person, so I don't want my service at a church, and I don't want a minister to preside. Also, even though I plan to be cremated, I want a funeral, not a memorial service or a "celebration of life." I think that could come later, but a funeral--to my mind--acknowledges the loss ... and I hate it when people skip over t... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3648749 Wed, 09 Jun 2010 17:53:14 +0100 3648749 http://www.medworm.com/index.php?rid=3644959&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F06%2Fmore-cheerful-topics-.html Just a quick post here, because I'm expecting Megan in an hour and I need to get ready. I think Megan and I are going to work in the garden--weeding, then spreading compost and mulch. I have two big bags of chicken compost now, thanks to Laurie, who dragged them over here, and all my fruits and vegetables need composting. Then we'll do some errands, and that will probably be it. If there's time, I'll ask her to walk Connie, but I probably won't go. So, that topic actually was cheerful, while I meant to be ironic and talk about the visit with a social worker from hospice yesterday. ... Yes, this is how I'm spending my days, preparing for the end of my days. For now, I'll just say that the social worker, Ann, was great, and she answered all... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3644959 Tue, 08 Jun 2010 16:59:26 +0100 3644959 http://www.medworm.com/index.php?rid=3641042&cid=t_147226_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F06%2Fauthentic-values-and-real-interests.html These are very brief notes from a talk I attended at the Osler Center Day this past Friday.Sulmasy presented what he calls the traditional tripartite view of EOL decision making, each part of which suffers from significant defects. The top of the pyramid, the optimum, is customarily held to be the living will (LW). However, living wills are both too vague ("no heroic measures") and too specific ("CPR but no counterpulsation"), involve interpretation of texts, and aren't done by most people anyway (current living-will rates are about 15%, per Sulmasy).The next best choice is held to be substituted judgment (SJ). Sulmasy pointed out that SJ (a) places significant psychological pressure on families, with attendant sequelae; (b) is difficult to instruct family members in, because its meaning i... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3641042 Tue, 08 Jun 2010 02:15:00 +0100 3641042 http://www.medworm.com/index.php?rid=3640984&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F07%2Fnarrative-matters-a-case-of-medical-homelessness%2F In a Narrative Matters essay in the May issue of Health Affairs, Jack Colwill, a physician, describes his brother-in-law John’s last months and eventual death.  Colwill, also a professor emeritus and former chair of the Department of Family and Community Medicine in the School of Medicine at the University of Missouri–Columbia, explains that the suffering of John and his wife, Jeanne, was needlessly magnified by John’s “medical homelessness”: None of the doctors seeing John ever accepted responsibility for providing and coordinating his overall care. … What John and Jeanne needed was a patient-centered medical home committed to meeting their needs—but they never had one. In reality, John was medically homeless, even though a primary care physician and a pulmonologist had maj... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3640984 Mon, 07 Jun 2010 16:32:29 +0100 3640984 http://www.medworm.com/index.php?rid=3635735&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FEeLtpse_ito%2F By Glenna Crooks. During my years in the Administration I was sometimes directed to draft responses the President would send in reply to letters he’d received from individual citizens. Sometimes, rather than drafting the letter for him, I’d be directed to reply on the President’s behalf. Such was the case when the White House directed I write to a young boy from Texas. His father – a young, healthy man – collapsed and died suddenly during an after-work run on the local high school track. Later, at the funeral home, the director complimented the boy’s Mother about her generosity in having donated her husband’s corneas. But there was a problem: it had not been her decision. In fact, until that moment she had not even know her husband’s corneas were removed. The ‘donation’... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3635735 Mon, 07 Jun 2010 13:00:07 +0100 3635735 http://www.medworm.com/index.php?rid=3635982&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F06%2Fupdating-my-obituary.html I've just spent the past hour updating and rewriting my obituary. Writing your own obituary has become something of a trend, as I've mentioned before, and it's also kind of fun. I got to list the accomplishments that are important to me (two master's degrees, my years working in Japan) and also state for the record how proud I am of my two sons. Self-written obits can be funny, and mine has a few spots that will make people who know me well smile. I don't think obits are a place to pay off old scores, or "set the record straight," and I've tried not to do any of that in mine. (My family gets a brief mention.)Those of you who are regular readers of my blog may have been wondering why I haven't been writing as much as usual lately. Partly, it... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3635982 Sun, 06 Jun 2010 18:09:25 +0100 3635982 http://www.medworm.com/index.php?rid=3614660&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Frewriting-my-endoflife-plans.html The last time I was hospitalized, in April, I sweated and stewed a lot about the fact that my end-of-life planning documents were seriously out of date. After all, I had written them in 2004, and then updated some of them the following year. (I wrote a will when I was first diagnosed, in 1998, so this was my second will.)I've been meaning to redo them ever since I can remember, and that intention got another kick in the pants when Dr. Lee suggested a family meeting shortly thereafter. So I got together with Laurie and Monica, who have volunteered to help me with all of this, and we had lunch and talked and took some notes. Then came the family meeting with Dr. Lee (the boys were included in that) and a second family meeting with my therapist (no boys). And finally, last wee... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3614660 Sun, 30 May 2010 20:09:14 +0100 3614660 http://www.medworm.com/index.php?rid=3607769&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fmy-funk-is-officially-over.html With today's good news about T-DM1 coming to Seattle, I would like to announce that My funk is officially over!  All it took was a little good news--well, potentially life-saving news!Thanks to all of you who held my hand during this latest, deepest funk, now it's time to enjoy life again. I'll be looking for play dates. @ Jeanne Sather 2010.  (Source: The Assertive Cancer Patient) The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3607769 Thu, 27 May 2010 17:24:51 +0100 3607769 http://www.medworm.com/index.php?rid=3603823&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fresponses-to-yesterdays-post-family-meeting.html One comment my therapist made yesterday that I forgot to include in the post, is that as people near the end of their lives, they may become fixated on things, and these fixations may or may not make much sense to the people around them. An example from my own life is how a couple of weeks ago I was so worried about finding a home for Constant, the Wonder Dog, my constant companion. I was upset, anxious, depressed, the whole catalog of mental issues ... and it didn't get better until a friend stepped up and said she would take Connie. Then I could relax. For more on this, see: A Bad Day Connie Has a New Home! I think that was my first end-of-life fixation--it will be interesting to see what the next one will be!####The post also brought some very provocative comments ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3603823 Wed, 26 May 2010 17:34:12 +0100 3603823 http://www.medworm.com/index.php?rid=3599685&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Ffamily-meeting-with-my-therapist.html Laurie, Monica, and I went to the women's bathhouse last night to soak and eat Korean food in honor of Monica's birthday, and thank goodness we did, because this morning we had a second "family meeting," this one with my therapist.  I was expecting it to be a tough meeting, emotionally, but I could never have anticipated how tough.  This is the therapist I've been seeing since my cancer was diagnosed, and she is very smart and very empathetic, but at the same time she doesn't pull any punches. This is what she said.  We are discussing my end-of-life planning, which includes planning for my death, and I want to die at home. The first thing my therapist said is that we will have to be flexible in making these plans, and make sure we have o... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3599685 Tue, 25 May 2010 19:53:17 +0100 3599685 http://www.medworm.com/index.php?rid=3595839&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fcontinuing-the-conversation-stuck-in-the-surreal-.html After yesterday's post, Stuck in the Surreal, a friend e-mailed me to continue the conversation, and she said: "Sometimes I wonder how those movies about spending the last year of your life doing something remarkable ever got made. Does anyone actually ever do that?"I'd be glad just to go out for dinner."And her comments led me to ask the question: How do we make sure that we spend the last year of our lives doing something--if not remarkable--then at least something that has value for us?I don't, unfortunately, have the answer to this question, or even an answer, but I'll be working on it. Please feel free to contribute comments, ideas, or rants on this topic in the comments space below.For all the reasons mentioned in yesterday's post,... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3595839 Mon, 24 May 2010 16:07:24 +0100 3595839 http://www.medworm.com/index.php?rid=3592205&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FOTuQJZsv42s%2F I have always been a bit fascinated by people who make a living telling people what they want to hear.  To be perfectly honest, I actually think it is because I envy them. How nice is that for generating income: making people perky, reassuring them, telling them everything is fine, promising them they are right about everything, helping them keep their denial systems intact? My envy stems from my irritation with myself for choosing a different path. I have spent most of my life telling people what they need to hear, hence often what they don’t want to hear. I try for balance, noting all the “good stuff”, then offering the counterbalance.  I find one unwelcome message can drown out all the affirmative messages. People home in on that “bad” stuff with an inerrant tenacity. The di... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3592205 Mon, 24 May 2010 11:00:19 +0100 3592205 http://www.medworm.com/index.php?rid=3592376&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fstuck-in-the-surreal.html All of us who live with metastatic cancer live with this THING hanging over our heads--a sword, or a shoe that we are waiting to see drop ... however you choose to imagine it. We try to live somewhat normal, happy lives in the shadow of this shoe (or sword), and sometimes it's really, really hard.Some of us are waiting for our cancer to come back (and probably kill us). And some of us, like me, are waiting for an active cancer to progress (and probably kill me).But we can't just wait.This blog has been devoted to my life in the shadow of metastatic breast cancer. I think most of my readers would say I cope pretty well, and I would agree. I think I'm happy more days than not, which in itself is a pretty big achievement. But I do have bad days, and sometimes bad weeks.&#016... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3592376 Sun, 23 May 2010 19:52:36 +0100 3592376 http://www.medworm.com/index.php?rid=3566780&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fthe-family-meeting.html Well, we had the long-awaited "family meeting" with Dr. Lee this morning at 7:45. That is really early for me, and I was afraid I wouldn't wake up with my alarm. As a result, I couldn't fall asleep last night and only got about three hours of sleep. (I'm going to try to make up for that with a nap here.)The "family" in attendance was Older Son, Younger Son, Laurie, and Monica. Plus Dr. Lee and me, of course. I'll write more about it later when I'm not so tired. I thought it went well, although I thought Dr. Lee spent too much time talking about pain control and the various drugs plus the various ways they could be administered. I don't think pain control was at the top of anyone's agenda for this meeting ... even his. So may... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3566780 Fri, 14 May 2010 18:05:05 +0100 3566780 http://www.medworm.com/index.php?rid=3545591&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F05%2Fsorting-clothes.html One of my friends with metastatic cancer said something to me about not wanting to die with her house all in a mess. So she felt compelled to get things organized during the last days of her life. I laughed when I read that, but the reason I laughed is that I can't imagine having other people sort through MY stuff ... even my kids or my closest friends. But on the other hand, do I want to spend my time at the end of my life sorting and cleaning? I don't know the answer to that question yet. In the meantime, I'm treading some middle ground, because my house is a mess, and the spare bedroom--which will be needed soon for friends and caretakers who want to spend the night--has been a dumping ground for things I didn't want to bother to sort or put away.&#0160... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3545591 Fri, 07 May 2010 20:57:49 +0100 3545591 http://www.medworm.com/index.php?rid=3542605&cid=t_147226_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-look-at-the-history-of-microsurgery%2F2010.05.06 Facial transplants, hand replants, and free flaps are only possible in large part due to microsurgery.  I finally got around to reading the “History of Microsurgery.” The article is good reading for anyone interested in the history of microsurgery. The article, written by Susumu Tamai, M.D., Ph.D., (Japan) was received for publication in Plastic & Reconstructive Surgery on June 14, 2007. Microsurgery is relatively young, and Dr. Tamai breaks down the history into four periods. (more…) *This blog post was originally published at Suture for a Living* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3542605 Thu, 06 May 2010 18:00:00 +0100 3542605 http://www.medworm.com/index.php?rid=3515577&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F04%2Fsome-good-news-for-a-change-.html I went in to see Dr. Lee today, and also to get treatment (we're calling it targeted therapies light: reduced doses of Herceptin, Avastin, and Tykerb--the only one that bothers me is the Tykerb), and of course I had my list of questions for Dr. Lee. But he had a surprise for me: My CEA (tumor marker) has dropped substantially in just a couple of months! That means less cancer in my body. Now, I had asked to have this test a few weeks back, but with everything else that was going on, I kinda forgot about it. It was great to get some good news for a change. Dr. Lee said he wasn't sure why my marker had dropped so far, but we agreed that the radiation I had in January had probably reduced the total volume of cancer, or my tumor load, so the marker dropped. And ... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3515577 Thu, 29 Apr 2010 05:23:18 +0100 3515577 http://www.medworm.com/index.php?rid=3508393&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F04%2Fdifficult-conversations.html About five or six weeks ago, before my London trip and before my most recent hospitalization for dehydration, Dr. Lee surprised me during an office visit. He surprised me by bringing up a topic that we hadn't really discussed yet--my care at the end of my life. He said he was concerned for me because I don't have a caretaker, which is true. I don't have a husband or a partner, and my sons are too young to take on my physical care when I am dying (besides, I don't want them to--I feel very strongly about that).Then Dr. Lee--who was a hospice doctor at one point in his career--laid out my options as he saw them. These included periods of hospitalization and a hospice or nursing home. I told my therapist about this conversation during our next appointment, an... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3508393 Mon, 26 Apr 2010 18:13:28 +0100 3508393 http://www.medworm.com/index.php?rid=3499281&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F04%2Fthe-perils-of-good-news.html By Julie Mason Although Jeanne and I have different cancers – hers breast, mine ovarian – we share the same approach to the disease:  at this point in our lives with cancer, we want treatments that are effective enough to let us have good quality of life as we define it, then we want to be able to make the choice to stop if and when we feel it is time.  So I should have been delighted when my doctor began our monthly conversation (our first meeting after the CT scan that would tell if my new chemo combo was working) with “Do you want the good news or the good news?" I am responding very well to the treatment.  My lung mets are shrinking; my lung is reinflating; one of my liver mets has disappeared and the other has been stable for months; and even the stubb... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3499281 Fri, 23 Apr 2010 15:51:45 +0100 3499281 http://www.medworm.com/index.php?rid=3456770&cid=t_147226_117_f&fid=38158&url=http%3A%2F%2Fwww.twitter.com%2Famacupuncturehttp%3A%2F%2Famericanacupuncture.blogspot.com%2F2010%2F04%2Fdoctors-train-to-be-salesmen-of-death.html As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.NEW END OF LIFE FEDERAL GUIDELINESDoctors   are now trained to impl... Dr. Needles Medical Blogs blogs http://www.medworm.com/rss/comments.php?id=3456770 Fri, 09 Apr 2010 17:41:00 +0100 3456770 http://www.medworm.com/index.php?rid=3448858&cid=t_147226_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2010%2F04%2Fanother-brick-in-wall-pt-3.html I can't help but feel, again, that this is the death rattle of this blog. I just can't seem to find time to write it.It's not that I don't have the time. I patently do, but just can't seem to make myself write it. I'm not sure why. Maybe it has just had it's time. Outgrown me.I shall make one more, perhaps foolhardy effort to resurrect my blogging mojo, but can't quite shake the feeling I've said all I can usefully say.Watch this space. (Source: The KnifeMan) The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=3448858 Sat, 03 Apr 2010 21:27:00 +0100 3448858 http://www.medworm.com/index.php?rid=3435020&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F04%2F02%2Fjournal-of-the-american-medical-association-2010-vol-303-no-11%2F This article aims to determine the the availability and degree of integration of palliative care services and to compare between National Cancer Institute (NCI) and non-NCI cancer centers in the United States. This article can be accessed online using an NHS Athens password alternatively contact the library for a copy of this article. Filed under: Current Awareness, E-Journals, Journals Tagged: Cancer, End o Life Care, Integrated Care, Palliative Care, Service Provision, United States (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3435020 Fri, 02 Apr 2010 17:39:17 +0100 3435020 http://www.medworm.com/index.php?rid=3415986&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F29%2Fjournal-of-medical-ethics-2009-vol-36-no-1%2F content page Fade Fave: Rights, respect for dignity and end-of-life care: time for a change in the concept of informed consent Fade Skinny: The current concepts of autonomy, surrogate autonomy and informed consent often lead to futile and expensive care at the ends of life. They may impinge on the dignity of the patient as well as subject society to unwarranted expense. In order to provide affordable healthcare for all, these concepts are in need of modification (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Current Awareness, E-Journals, End of Life Care, Informed Consent (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3415986 Mon, 29 Mar 2010 11:20:25 +0100 3415986 http://www.medworm.com/index.php?rid=3386867&cid=t_147226_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2010%2F03%2Fnhs-blog-doctor-has-retired.html After much thought, I have decided to end NHS BLOG DOCTOR.  To stop any speculation, may I just say that there has been no serious precipitating event; no crisis, no illness, no threats and no pressure from anyone.  I have now retired from active practice within the NHS and am turning my mind to other things. The imperative to keep blogging about medical matters is no longer there. Nor will Dr Crippen be writing in the Guardian or not, at any rate, under a pseudonym.It's been fun. I've said a lot, and learnt a lot. I hope some of what I said was of value. I am immensely grateful to the writers of the thousands of comments I have received, critical and not so critical, over the years. I shall in particular always remember Christian Jago (Potentilla) Healthcare and the NHS is ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=3386867 Sun, 21 Mar 2010 01:00:00 +0100 3386867 http://www.medworm.com/index.php?rid=3350250&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F09%2Fshock-me-tube-me-line-me-an-er-doc-reassesses-dnrs%2F In “Shock Me, Tube Me, Line Me,” a Narrative Matters essay in the February 2010 issue of Health Affairs, emergency physician Boris Veysman sets forth his own version of an advance directive and challenges common perceptions about care at the end of life. An excerpted version of Veysman’s essay appears in today’s Washington Post Health and Science section, and it has provoked a vigorous conversation among commenters—just as it did among Health Affairs readers. Veysman recounts the exhilaration he feels after successfully resuscitating an elderly patient, followed by shock when the family appears and informs him that his patient is in the end stages of cancer and has standing “Do Not Resuscitate” and “Do Not Intubate” orders. “I get the story—several failed rounds of ch... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3350250 Tue, 09 Mar 2010 23:13:26 +0100 3350250 http://www.medworm.com/index.php?rid=3322324&cid=t_147226_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2010%2F03%2F02%2Fparents-consider-hastening-their-childrens-deaths%2F Filed under: Childhood Cancers, Hospice, Daily newsIf your child was in pain and dying what would you do? It's a situation most parents will never find themselves in, but for those whose children have cancer it's a scenario they might contemplate and, possibly, face. A study published yesterday in the March edition of Archives of Pediatrics & Adolescent Medicine showed that about 13 percent of parents whose children had died of cancer had considered asking about ending their child's life. Nine percent said they had discussed it with caregivers. Dr. Joanne Wolfe, a palliative pain specialist at the Dana-Farber Cancer Institute and the Children's Hospital in Boston who interviewed the parents of 141 now-deceased children, told the Associated Press that the study shows how difficult i... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=3322324 Tue, 02 Mar 2010 00:00:00 +0100 3322324 http://www.medworm.com/index.php?rid=3276032&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F02%2Fa-couple-of-painful-subjects.html This post, also, is for Julie.   It may not be an easy post for many of you to read, but I can't apologize for that. These are things that Julie and I--and a few other readers--are kicking around. And I'm in the mood to write about them now. Where I Was in NovemberWhen I came home from my trip to Omaha in early November, I knew I was really really sick. Monica and her partner picked me up at the airport, late at night, and I was so woozy I could hardly get my suitcase down the escalator. I actually threw it on the belt, and let it tumble down, because I was afraid I would fall if I tried to go down with it. So I was in bad shape. And I knew it, but I wasn't tracking well, either. The smart thing to have done, at that time, would have been to have M... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3276032 Tue, 16 Feb 2010 04:51:48 +0100 3276032 http://www.medworm.com/index.php?rid=3231422&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F02%2Fjournal-of-the-american-medical-association-2010-vol-303-no-4%2F  Contents Fade Fave: An 86-year-old women with cardiac cachexia contemplating the end of her life: Review of hospice care Fade Skinny: An 86-year-old women with progressive congestive heart failure and multiple chronic conditions who is experiencing worsening function and quality if life despite maximum medical therapies, seeks advice regarding control over the circumstances of the end of her life by suicide or under hospice care. An NHS Athens password is required to access this article online Filed under: Athens Password, Current Awareness, Journals Tagged: Burden of Care, Chronic Conditions, End of Life Care, Hospices, Suicide (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3231422 Tue, 02 Feb 2010 08:16:47 +0100 3231422 http://www.medworm.com/index.php?rid=3222414&cid=t_147226_46_f&fid=38788&url=http%3A%2F%2Fmsf.ca%2Fblogs%2FChrisH%2F2010%2F01%2F29%2Fthe-end%2F I left Papua New Guinea in the middle of October. I am writing this at the end of December. Since then I went to South East Asia with the intention of relaxing, but actually ended up partying all night most of the time. Later, I met with MSF to debrief and then with a psychologist to see if the mission had any adverse affect on my mental health. I also was invited to talk to MSF and others about the PNG mission, opportunities that I really enjoyed. During these talks I received some very thought-provoking questions. People wanted to know if it was difficult to fit into a society that was so different to my own, referring to the sorcery and violence. The truth is that it wasn’t that difficult to adapt to Papua New Guinea. The people were so friendly and warm towards me that it was leaving... MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=3222414 Fri, 29 Jan 2010 22:14:10 +0100 3222414 http://www.medworm.com/index.php?rid=3212267&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F27%2Fdelivering-better-care-at-end-of-life-the-next-steps%2F Title: Delivering better care at end of life: the next steps The Skinny: King’s Fund report addressing the challenges in implementing the government’s End of Life Care Strategy.  The report covers commissioning, hospice and hospital care, quality markers, challenges for providers and identifies 10 critical actions: Demonstrate the case for change with evidence Commission for outcomes Define the local model of care Identify care pathways and triggers for care Ensure timely access to care 24 hours a day Develop flexible solutions to meet a whole range of needs which include, but are not exclusively, health care solutions Improve care in all settings Improve workforce skills and confidence Ensure manageable and meaningful local measurement Completing the loop: has the national strat... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3212267 Wed, 27 Jan 2010 14:30:55 +0100 3212267 http://www.medworm.com/index.php?rid=3197627&cid=t_147226_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fu7rrPFIWFxU%2F The following guest post by Debra Gordon, an award-winning freelance medical writer, was recently featured on the Better Health blog. The original post can be found on Debra Gordon’s Musings on Medicine and Health Care blog. Back in the day when I was a newspaper reporter I completed a biomedical ethics fellowship at the University of Virginia Medical Center in Charlottesville, VA. In addition to sitting in on the hospital’s bioethics committee discussions, I spent much of the week shadowing a nurse in the ICU. They called her the Death Nurse because her job was to intervene with doctors, nurses, patients and families when the time came for a patient to move from the ICU to hospice. While her title was Supportive Care, she flat out told her me her job was to help people die; no... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3197627 Fri, 22 Jan 2010 15:14:41 +0100 3197627 http://www.medworm.com/index.php?rid=3162643&cid=t_147226_46_f&fid=38788&url=http%3A%2F%2Fmsf.ca%2Fblogs%2FChrisH%2F2010%2F01%2F11%2Fthe-end%2F I left Papua New Guinea in the middle of October. I am writing this at the end of December. Since then I went to South East Asia with the intention of relaxing, but actually ended up partying all night most of the time. Later, I met with MSF to debrief and then with a psychologist to see if the mission had any adverse affect on my mental health. I also was invited to talk to MSF and others about the PNG mission, opportunities that I really enjoyed. During these talks I received some very thought-provoking questions. People wanted to know if it was difficult to fit into a society that was so different to my own, referring to the sorcery and violence. The truth is that it wasn’t that difficult to adapt to Papua New Guinea. The people were so friendly and warm towards me that it was leaving... MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=3162643 Mon, 11 Jan 2010 17:42:34 +0100 3162643 http://www.medworm.com/index.php?rid=3153344&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F05%2Fhealth-affairs-examines-long-term-services-and-support%2F Congress is now debating whether to include in health reform a new program to help people pay for long-term care services and supports. At this propitious time, leading experts explore critical policy issues related to long-term care in a series of articles in the January 2010 edition of Health Affairs. (As of this issue, Health Affairs also moves from a bimonthly to a monthly publication in a substantially redesigned format.) The articles suggest that providing affordable, high-quality long-term care to the elderly and disabled continues to present formidable challenges to policymakers. This issue is funded by the SCAN Foundation and was released at a briefing on January 5 at the National Press Club in Washington, DC. The Community Living Assistance Services and Supports (CLASS) Act is ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3153344 Tue, 05 Jan 2010 17:25:17 +0100 3153344 http://www.medworm.com/index.php?rid=3145946&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F05%2Fhealth-affairs-examines-long-term-services-and-support%2F Congress is now debating whether to include in health reform a new program to help people pay for long-term care services and supports. At this propitious time, leading experts explore critical policy issues related to long-term care in a series of articles in the January 2010 edition of Health Affairs. (As of this issue, Health Affairs also moves from a bimonthly to a monthly publication in a substantially redesigned format.) The articles suggest that providing affordable, high-quality long-term care to the elderly and disabled continues to present formidable challenges to policymakers. This issue is funded by the SCAN Foundation and was released at a briefing on January 5 at the National Press Club in Washington, DC. The Community Living Assistance Services and Supports (CLASS) Act is ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3145946 Tue, 05 Jan 2010 17:25:17 +0100 3145946 http://www.medworm.com/index.php?rid=3133827&cid=t_147226_180_f&fid=38604&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmakeitgreat%2F%7E3%2FrMNMsjW2NJA%2F 2009 has been quite a ride for me, and hopefully you’ve had a great year too! Rather than rehashing the top 10 posts I wrote this year, I want to say thanks to everyone who comes here. Thanks for your attention – There are MANY places you could go online. I moved my blog in the past year, and though the traffic from search engines has decreased, overall traffic has actually increased thanks to your attention. Wow! Thanks for your sharing – Many amazing, inspiring comments here. Many private e-mails. Many people have shared my posts with their friends, co-workers, and others. Wow! Thank you. Thanks for you – Just for being you, in as many ways as you are. You are fantastic, and a blessing to me. Thank you! Here’s to a great 2010! I have MANY changes in store to... Phil Gerbyshak blogs http://www.medworm.com/rss/comments.php?id=3133827 Thu, 31 Dec 2009 14:09:05 +0100 3133827 http://www.medworm.com/index.php?rid=3825937&cid=t_147226_46_f&fid=38788&url=http%3A%2F%2Fmsf.ca%2Fblogs%2FChrisH%2F2009%2F12%2F29%2Fthe-end%2F I left Papua New Guinea in the middle of October. I am writing this at the end of December. Since then I went to South East Asia with the intention of relaxing, but actually ended up partying all night most of the time. Later, I met with MSF to debrief and then with a psychologist to see if the mission had any adverse affect on my mental health. I also was invited to talk to MSF and others about the PNG mission, opportunities that I really enjoyed. During these talks I received some very thought-provoking questions. People wanted to know if it was difficult to fit into a society that was so different to my own, referring to the sorcery and violence. The truth is that it wasn’t that difficult to adapt to Papua New Guinea. The people were so friendly and warm towards me that it was leaving... MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=3825937 Tue, 29 Dec 2009 22:14:10 +0100 3825937 http://www.medworm.com/index.php?rid=3129470&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F29%2Finternational-journal-of-palliative-nursing-2009-vol-15-no-12%2F This study aimed to identify the attitudes of community nurses to the care of the dying patient and to examine the factors that influence these attitudes. The study identified that 40% of community nurses held negative attitudes to care of the dying. These attitudes improved with training and education but were not significantly influenced by experience alone. Attitudes were also influenced by levels of support, workload and time constraints. Contact the library for a copy of this article Posted in Current Awareness, Journals Tagged: Community Nursing, Education, End of Life Care, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3129470 Tue, 29 Dec 2009 16:50:52 +0100 3129470 http://www.medworm.com/index.php?rid=3124512&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F28%2Fjan-5-briefing-on-long-term-services-and-supports%2F The January 2010 edition of Health Affairs focuses on long-term services and supports and the challenges of ensuring affordable, high-quality care to people with disabilities, including many of the nation’s aged. The journal has invited key lawmakers and leading experts in aging and health policy to discuss the policies and new approaches needed to address these challenges at a January 5th Health Affairs briefing. WHEN: 8:30 a.m. – 12:30 p.m. Tuesday, January 5, 2010 WHERE: National Press Club [Metro Center] The Ballroom 529 14th St. NW, 13th Floor Washington, DC 20045 RSVP for this event online. Health Affairs will offer live updates from the event on Twitter at #HA_LTC. Among the topics to be addressed: Will Congress adopt the Community Living Assistance Services and Supports (CLASS... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3124512 Mon, 28 Dec 2009 15:38:14 +0100 3124512 http://www.medworm.com/index.php?rid=3079309&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F10%2Fis-more-care-better-the-evidence-suggests-no%2F Editor’s Note: In the post below, Jonathan Skinner and Shannon Brownlee examine the relationship between health care spending and utilization in hospitals, on the one hand, and patient outcomes on the other. In an earlier post, John Wennberg and Brownlee rebutted claims that spending and utilization variations among academic medical centers are due to differences in patient income, race, and health status.  Many Health Affairs articles and Health Affairs Blog posts have addressed the relationship between spending/utilization and quality. For a sampling, go here, here, here, here, and here. Is more care better? Three decades of research at Dartmouth suggests that on average the answer is no. Now a newer paper, published in the journal Circulation, Cadiovascular Quality and Outcom... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3079309 Thu, 10 Dec 2009 21:18:41 +0100 3079309 http://www.medworm.com/index.php?rid=3079587&cid=t_147226_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fyou-might-be-happy%2F One Dead Day – The End of One Life, the Beginning of Another Imagine waking up one morning, on any given day, and realising you’re now merely spirit–you have no physical body left at your personal disposal; that is, you somehow died during your sleep. Everything feels quite normal but somehow everything has changed. You wake [...] (Source: Recovery Is Sexy.com) Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3079587 Thu, 10 Dec 2009 17:32:31 +0100 3079587 http://www.medworm.com/index.php?rid=3048062&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F02%2Finternational-journal-of-palliative-care-nursing-2009-vol-15-no-11%2F Fade Fave: The role of the home-care worker in palliative and end-of-life care in the community setting: a literature review. Fade Skinny: Home-care workers play a vital role in enabling people to be cared for in their own homes. However, there is a lack of research on their role, especially in the areas of palliative and end-of-life care. A broad literature search was undertaken to explore the role of the home-care worker in palliative and end-of-life care in the community. Many positive aspects to the role were found such as providing physical and social support, however some studies highlight negative aspects including limited availability of services, lack of continuity of care, time constraints, lack of flexibility and poor quality and communication with other services. Contact the Li... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3048062 Wed, 02 Dec 2009 10:16:39 +0100 3048062 http://www.medworm.com/index.php?rid=3036937&cid=t_147226_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Fadditional-breastfeeding-charitable-ideas%2F The other day I listed the top 5 reasons to give to La Leche League International now. There are several other options out there to make your money support breastfeeding around the world. One Dollar Coins Photo by Pfala1. The United States Breastfeeding Committee’s “One Dollar for Every New Mom” Campaign. The USBC aims to raise One Dollar for Every New Mom in the United States. The USBC says: With these funds, we will make mothers’ voices heard in ongoing national debates on health care, work-life balance, and consumer safety. The closer we come to representing each mother in America, the more clearly we can show the President and Congress: “Americans believe that EVERY MOTHER COUNTS.” Help us reach the goal of one dollar for each new mother. Please dona... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3036937 Sun, 29 Nov 2009 03:15:13 +0100 3036937 http://www.medworm.com/index.php?rid=3029783&cid=t_147226_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Ftop-5-reasons-to-give-to-llli-now%2F I am just going to come right out and say it: Please donate to La Leche League International as part of your charitable giving for 2009. Why? I will give you five good reasons why. 1. Double any gift given before December 31, 2009. Generous donors have agreed to match dollar-for-dollar any donation made between now and December 31, 2009. Your financial contribution will go twice as far in supporting breastfeeding mothers around the world. 2. Help fix what has gone wrong. The need for mother-to-mother breastfeeding support is greater than ever! As a breastfeeding advocate it saddens me that mothers continue to receive bad advice and misinformation from many of the medical professionals that provide care to new mothers and their nurslings. Somewhere along the way we lost the model of grandm... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3029783 Wed, 25 Nov 2009 19:36:12 +0100 3029783 http://www.medworm.com/index.php?rid=3026704&cid=t_147226_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FF6-rVtAWyk0%2Fengage-with-grace-blog-rally.html Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.Our original mission – to get more and more people talking about their end of life wishes – hasn’t changed. But it’s been quite a year – so we thought this holiday, we’d try something different.A bit of levity.At the heart of Engage With Grace are five questions design... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3026704 Tue, 24 Nov 2009 23:00:02 +0100 3026704 http://www.medworm.com/index.php?rid=3023245&cid=t_147226_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2F2X_SQvwxqog%2F2009-engage-with-grace-thanksgiving.html Last year Paul Levy, Matthew Holt and Alexandra Drane asked me to participate in the Engage With Grace Thanksgiving Blog Rally. My post last year describes the Engage with Grace project and tells my personal story of why end of life care is important for all of us to discuss with our family and loved ones.Along with my friends and health blogging colleagues, Paul, Matthew, Alexandra, Adam Bosworth, Christian Sinclair, Drew Rosielle, e-Patient Dave deBronkart, Jessica Lipnack, Ted Eytan and many others - we ask that you to take time to talk to your loved ones over this holiday weekend about these important end of life questions and carry out your wishes by executing a living will and medical power of attorney.How else can you participate in the Engage With Grace Thanksgiving Blog Rally?If y... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3023245 Tue, 24 Nov 2009 14:31:54 +0100 3023245 http://www.medworm.com/index.php?rid=3023069&cid=t_147226_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F24%2Fengage-with-grace-blog-rally%2F Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes. It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3023069 Tue, 24 Nov 2009 06:58:13 +0100 3023069 http://www.medworm.com/index.php?rid=3018942&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F23%2Fjournal-of-medical-ethics-2009-vol-35-no-11%2F content page Fade Fave: Autonomy at the end of life: life-prolonging treatment in nursing homes—relatives’ role in the decision-making process Fade Skinny: The increasing number of elderly people in nursing homes with failing competence to give consent represents a great challenge to healthcare staff’s protection of patient autonomy in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation. The lack of national guidelines and internal routines can threaten the protection of patient autonomy. (NHS Athens is required to access this article online) Posted in Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Autonomy, Current Awareness, Decision Making, E-Journals, End of Life, Nursing Homes (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3018942 Mon, 23 Nov 2009 13:02:56 +0100 3018942 http://www.medworm.com/index.php?rid=2939507&cid=t_147226_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2009%2F10%2Fbringing-her-closer-to-god.html It is my job as her only sonto take care of her,so I refuse to let them give her pain meds. If anything has a narcotic, I forbid it. They try and fool me with fancy Latinwords or generic namesbut I know how to ferret outwhat's really in the drugs things like opium,morphine and oxycodone. They try to convince me she is dying. I know that. A fool could see that.They argue that she is in painbut her silence belies their claims."See how still she is?" I say,"Not a moan or a cry out of her."But I know she hurts. I know it in the beadsof cold sweat under her lipand in her fluttering heart.It is my jobto protect her soul, to clean awayall the years of spite and neglectto burn her pure.  --Amy HaddadAmy Haddad is Creighton University's dir... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=2939507 Wed, 28 Oct 2009 17:49:52 +0100 2939507 http://www.medworm.com/index.php?rid=2911170&cid=t_147226_46_f&fid=38788&url=http%3A%2F%2Fmsf.ca%2Fblogs%2FChrisH%2F2009%2F10%2F21%2Flast-days%2F Every 6 weeks the team in Tari get a weekend rest, so the project  coordinator, the new logistician and the surgeon left me in charge for my  last few days. Saturdays are always nice because we start at 9am, which permits an extra  hour in bed. Because there is construction going on at the house, this  extra hour in bed tends to be too noisy to sleep, but I had given the construction workers the weekend off too, so Saturday started nicely. The  morning was not too busy and I decided to take the chance to do some “community relations” so I had a smoke with the hospital security guards outside the hospital gates. People in Tari love to talk and ask questions.  “When will MSF leave?” they asked me, so I explained that we did not have a leaving date, but will be i... MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2911170 Wed, 21 Oct 2009 14:06:54 +0100 2911170 http://www.medworm.com/index.php?rid=2882975&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F12%2Fbritish-journal-of-healthcare-assistants-2009-vol-3-no-10%2F This article looks at the common core competencies that have been identified by the Department of Health as a requirement for workers in delivering high-quality end of life care along with their future development. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: End of Life Care, Palliative Care, Skills Development, Strategy (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2882975 Mon, 12 Oct 2009 12:41:07 +0100 2882975 http://www.medworm.com/index.php?rid=2876326&cid=t_147226_136_f&fid=39025&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Feverythingchangesbook%2F%7E3%2FbIC8OY6mMp4%2Fend-of-life-cancer “Are you going to write in your book about the people who died?  It is so depressing,” a person in the publishing world asked while I was writing Everything Changes.  My answer: a polite version of “You better f***ing believe I am.” How could I write a book about cancer and exclude the people who died and their families?  Yep, it has its sad moments, but that’s why cancer sucks.  That’s why we raise money for research.  That’s why I write a blog and wrote a book, and promote young adult cancer organizations: all so we can support each other around the pissy hard times. Charissa is an recent widow who I’ve become friends with.  She is an incredible woman who I adore.  (See her recent post Mourning As A Young Adult?)  And I love my regular communication wi... Everything Changes blogs http://www.medworm.com/rss/comments.php?id=2876326 Thu, 08 Oct 2009 15:44:32 +0100 2876326 http://www.medworm.com/index.php?rid=2911171&cid=t_147226_46_f&fid=38788&url=http%3A%2F%2Fmsf.ca%2Fblogs%2FChrisH%2F2009%2F10%2F02%2Fleaving-lae-and-a-new-log%2F I’m currently back in Lae for the final time. I came back to help out with a few things and then the Cholera outbreak occurred. MSF responded full force and at the time of writing patient numbers have dropped to a couple per day. I am sure that our speedy action prevented the outbreak from mushrooming and I am very proud of what we all did. In the past few days my replacement has arrived. The team have been nervous about my replacement arriving for some time, but I am so relieved that not only is he enthusiastic and full of ideas but he is also half-Scottish! The new guy immediately advises that his bus journey from the airport was done at super high speed (as do many first time visitors) thinking that the drivers were a bit reckless. I explain that the airport road is a bit notoriou... MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2911171 Fri, 02 Oct 2009 13:55:24 +0100 2911171 http://www.medworm.com/index.php?rid=2800327&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F16%2Fhigh-quality-low-cost-care-an-interview-with-gundersen-lutheran-ceo-jeff-thompson%2F Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in America.” The conference was organized by four nationally noted health care improvement experts: Don Berwick, Elliott Fisher, Atul Gawande, and Mark McClellan. But that is only part of what has grabbed national headlines for this community that borders on the Mississippi River in Northwest Wisconsin.  La Crosse has become embroiled in a national controversy over end-of-life planning that has swirled around the health-care reform debate.�... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2800327 Wed, 16 Sep 2009 17:42:47 +0100 2800327 http://www.medworm.com/index.php?rid=2786301&cid=t_147226_180_f&fid=38604&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmakeitgreat%2F%7E3%2FtjDVRKIaMTg%2F One of the chapters of my book 10 Ways to Make It Great is “begin with the end in mind” where I discuss thinking about your last days on earth, and where I encourage folks in my speaking engagements to write their eulogy. I don’t get very descriptive about how, so when I got this article to share with you, I thought it would be be helpful in thinking about this. How to Write a Eulogy Guest article by Roberta Temes Ph.D., Author of Solace: Finding Your Way Through Grief and Learning to Live Again Are you preparing a eulogy? Here’s some help: It is an honor to commemorate the life of a person who has recently died. The eulogy serves many purposes for those in the audience: It fulfills the human need for ceremony to mark an occasion; the death should not go unrecognized. It co... Phil Gerbyshak blogs http://www.medworm.com/rss/comments.php?id=2786301 Fri, 11 Sep 2009 06:31:00 +0100 2786301 http://www.medworm.com/index.php?rid=2774593&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F07%2Ffact-or-fiction-advance-care-planning-in-health-reform%2F Patients with serious or advanced illnesses would be given more control over their care by language in health reform legislation passed by three House committees that would pay physicians, nurse practitioners, and other providers for counseling Medicare beneficiaries about advance planning for future care decisions. That was the unanimous opinion expressed by three respected geriatricians at a August 20 conference intended to clarify several issues at the heart of the current health reform debate. The conference, Fact vs. Fiction: Key Issues in Health Reform, was sponsored by Health Affairs. The participants in the panel dealing with end of life issues were Christine Cassel, MD, President, American Board of Internal Medicine; Diane E. Meier, MD, Director, Center to Advance Palliative Care,... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2774593 Mon, 07 Sep 2009 20:12:05 +0100 2774593 http://www.medworm.com/index.php?rid=2772564&cid=t_147226_109_f&fid=34795&url=http%3A%2F%2Fsoloshrink.blogspot.com%2F2009%2F09%2Fdocs-big-day-out.html The big day finally arrived last Thursday. I got out of the apartment for more than half a day at a time. This day had been awaited with much anticipation and no small amount of trepidation for over three months. It had been carefully prepared for by getting my grocery shopping done earlier in the week and a careful cost estimation such that I should not exceed my budget too badly. The day was so special that I even luxuriated in a full bath, rather than the shower which I almost always take. This unnerved Bittle and Stinky. They are used to hearing water spraying for a few moments and then staying out of my way while I try to dry myself, remain upright, and see without my glasses all at the same time. On this occasion, however, I simply submerged and temporarily disappeared. When I again ... Solo Shrink blogs http://www.medworm.com/rss/comments.php?id=2772564 Mon, 07 Sep 2009 17:25:00 +0100 2772564 http://www.medworm.com/index.php?rid=2765990&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FNAOpbdagkm8%2F Attention has been paid previously to La Crosse, Wis., and the work done there urging patients to focus on their end-of-life care while they are still healthy. But the Washington Post today, under the headline “The Unwitting Birthplace of the ‘Death Panel’ Myth,” takes a detailed look at what started in La Crosse resulted in controversy for health-overhaul efforts. After starting to push local attention to end-of-life issues as far back as the mid-1980s, La Crosse’s Gundersen Lutheran Health System more recently set out to change the federal rules to reward end-of-life planning, the paper notes. It continues: The hospital got its wish this spring when House Democrats inserted that provision into their health-care reform bill — only to see former Alaska governor Sarah P... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2765990 Fri, 04 Sep 2009 16:15:47 +0100 2765990 http://www.medworm.com/index.php?rid=2751893&cid=t_147226_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FUwz91YZC8uo%2F Having a physician’s help in dying will be declared a constitutional right in Montana if the state’s Supreme Court upholds a December lower court ruling, according to the New York Times. The state would be the first in the nation to declare it as a constitutional right, though Washington and Oregon also allow physician-assisted suicide. Montana’s constitution, which declares “the dignity of the human being is inviolable,” has already led the courts to decide, for instance, that anti-sodomy laws are a violation of privacy and to protect women’s right to choose abortion. At issue in the current case is the right of individuals to make their own decision about when they have suffered enough — the so-called right to die well — versus a variety of... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2751893 Tue, 01 Sep 2009 12:26:32 +0100 2751893 http://www.medworm.com/index.php?rid=2751839&cid=t_147226_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F01%2Finternational-journal-of-palliative-care-nursing-2009-vol-15-no-8%2F Fade Fave: Core attitudes of professionals in palliative care: A qualitative study Fade Skinny: ‘Core attitude’ describes the way in which a person perceives himself and the world, and forms the basis for his actions and thoughts. The aim of this article is to explore what core attitude means for palliative care professionals and whether there is a specific core attitude in palliative care. Contact the library for a copy of this article. Posted in Current Awareness, Journals Tagged: Attitudes, Core Attitude, End of Life Care, Palliative Care, Professionals, Qualitative (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2751839 Tue, 01 Sep 2009 11:29:40 +0100 2751839 http://www.medworm.com/index.php?rid=2741367&cid=t_147226_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F08%2F27%2Fhealth-affairs-briefing-fact-versus-fiction-in-health-reform%2F What exactly is the U.S. government’s role in health care and how might it change under health reform? What are the implications of slowing the rate of growth in Medicare spending and what would the impact be on beneficiaries? How do the issues involved in end-of-life care really look to the people and providers who live it? These issues were discussed at a Health Affairs briefing titled “Fact Versus Fiction: Key Issues in Health Reform,” held August 20 at the National Press Club. Video and audio of the briefing and speaker presentations are available on the Health Affairs Web site, as is a special Health Policy Brief examining the issues discussed at the briefing. Copyright © 2009 Health Affairs Blog. This Feed is for personal non-commercial use only. All material... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2741367 Thu, 27 Aug 2009 17:11:44 +0100 2741367