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Exploring Team Composition in Palliative Care
By Brianna Morgan (@BriannaMorganNP) and Elise Tarbi (@EliseConant)Amidst rapid growth in the number of palliative care programs,the December 2017 issue of the Journal of Palliative Medicine calls for a pause to consider the blueprints for how we build moving forward. In the issue,Kousaie and von Gunten (2017) compare two hospitals, one that has an established advanced practice nurse only model of palliative care delivery (APN model), and a second hospital implementing an interdisciplinary team including physicians, APNs, social workers, chaplains, and pharmacists (team model) for the same purpose. Compared to the APN mode...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 27, 2018 Category: Palliative Care Tags: advance apn morgan nurse physician research tarbi team teamwork The profession Source Type: blogs

My husband was dying. I was being ignored.
It was a long December. A few years ago, my husband of 37 years got his death sentence: recurrence of liver cancer with mets to his lungs and lymph nodes. He had a “Whipple” — a surgical procedure for pancreatic cancer — on Dec 24, 2015, and the surgeon discovered liver cancer too. So it was a 16-hour surgery. We were told he might die on the table. His eyes haunted me as I kissed him good luck for surgery. I didn’t know if this was our last moment together. The surgery was successful, and chemo and radiation followed along with two heart attacks. 95 percent LAD and 90 percent circumflex the next year. Contin...
Source: Kevin, M.D. - Medical Weblog - January 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/debbie-moore-black" rel="tag" > Debbie Moore-Black, RN < /a > Tags: Conditions Oncology/Hematology Palliative Care Source Type: blogs

It ’s Not the Death, It’s the Dying: Moral Distress in Palliative Care
by Vickie LeffEvery day, we get involved in unbelievable and incredible situations. Tragedy, sadness, horrific trauma, despair, and hopelessness all wrap themselves around the cases we drop into. We step onto the stage and become part of the story.Moral distress – the discomfort, angst, and frustration related to situations in which we think we know the “right thing” to do, but cannot due to the situation – is endemic to palliative care and hospice work. Some examples are:Aggressive chemotherapy for a dying cancer patient with days to live.Dumping the truth on a patient overwhelmed and alone.Following the trea...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 19, 2018 Category: Palliative Care Tags: moral distress social work social worker Vickie Leff Source Type: blogs

What do you say to somebody who knows that they are about to die?
I’ve had lots of practice comforting people. I’ve had to tell patients that their cancer is back in a busy emergency department. I’ve updated family members of patients who are being kept alive by machines in the intensive care unit. I’ve walked alongside patients as they get rolled into an operating room, and crouched down by a patient’s bed as they writhe in pain. There have been moments of fear, grief, sadness, and agony. Although the context is always unique, the messages are inevitably similar: I’m sorry that this is happening. We’re going to do everything we can to make this better. In almost all scenar...
Source: Kevin, M.D. - Medical Weblog - January 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nathaniel-fleming" rel="tag" > Nathaniel Fleming < /a > Tags: Education Medical school Palliative Care Source Type: blogs

Top 10 Pallimed Posts of 2017
by Christian Sinclair (@ctsinclair)Looking back at 2017, we didn ' t publish a ton of posts (only 50!*), but we had some that clearly resonated with people and continue to be popular since we keep seeing them show up on social media. Working closely with her, I already knew the great qualities Lizzy Miles brings to Pallimed as a writer and an editor, but looking at the top 10, her experience as a hospice social worker has led to a knack for insightful and practical posts. Her posts also seem to be meaningful to clinicians in multiple settings in addition to patients and families. So here are the top 10 posts of 2017 based ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 15, 2018 Category: Palliative Care Tags: delirium dignity film hospice LGBTQ meta sinclair The profession Source Type: blogs

Hospice Care is covered by Medicare and Most Other Insurance
Dear Carol: My dad has aggressive prostate cancer that has spread to his liver and bones. His oncologist isn’t very communicative and when I asked about hospice care he said that’s up to us. He told us that Dad won’t get better but that he can keep treating him if we want. The treatments make Dad miserable. If they won’t help, what’s the point? I feel strongly that Dad needs hospice care and have been trying to talk my mom into it but she’s dragging her feet. How do we go about getting the service? Which one do we choose? Will Mom have to go on Medicaid to get it paid for? This is her biggest fear. – ST...
Source: Minding Our Elders - January 14, 2018 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

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An update from Tim:Here are the last few Facebook posts I made on Laurie ' s behalf over the last few months. Apologies for everyone who is not on Facebook or connected with me by email.November 16I would like to let you all know how Laurie is doing and what is going on health wise with her.Over the last few weeks Laurie has been suffering from some cognitive issues that has limited her ability to post and comment here, As these issues got more serious her oncologist scheduled an MRI to try and find out the cause and to make a plan to deal with it. The MRI showed that there are new tumours in her brain. I have not read&nbs...
Source: Not just about cancer - January 8, 2018 Category: Cancer & Oncology Source Type: blogs

Palliative Care Resolutions for 2018
by Christian Sinclair (@ctsinclair)Happy New Year! As we look towards the future that is now 2018, many of us make promises which can be difficult to keep, but always with the purpose of working towards the best version of ourselves. (In a way it is kind of like a quality improvement project!) Often these resolutions are personal: exercise 5 times a week, eat more healthy, learn a new language, read more books, spend less time on my phone. Sometimes these resolutions reside in our professional spheres of influence. I thought it would be interesting to see what some hospice and palliative care colleagues are resolving to do...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 1, 2018 Category: Palliative Care Tags: meta sinclair Source Type: blogs

Anniversary of Loved One's Death Especially Hard During Holidays
Dear Carol: This January marks one year since my mother died. My dad adored her, as we all did, but he’s having a harder time adjusting than we kids, which I suppose is to be expected. Mom had cancer but her treatments proved to be ineffective so she eventually went on hospice care. With hospice helping, Mom was coherent during the holidays last year. We got through it though, and dad did admirably well, considering the circumstances. I think he kept up a front for Mom’s sake. Once she died, which was mid-month, he fell apart and had only marginally recovered before this year’s holidays approached. ...
Source: Minding Our Elders - December 31, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Moving Palliative Care Upstream - Can we ever be TOO early?
By Christian Sinclair (@ctsinclair)The growth of palliative care in the community and outpatient settings has been one of the more popular stories in our field in the past few years. No longer is palliative care only available to serve in the intensive care units, but the demand for person-centered, family-oriented, symptom-based care with an emphasis on communication and decision-making is being heard in the earlier stages of illness. Serving patients and families in clinics and in their home is unleashing the true potential of palliative care. Even in my own work leading our outpatient efforts in an academic cancer cente...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 27, 2017 Category: Palliative Care Tags: cancer clinic denmark europe hpmchat outpatient research sinclair tweetchat Source Type: blogs

Physician-Assisted Death: Scanning the Landscape and Potential Approaches – A Workshop
Discussion with workshop  participants moderated by Linda Ganzini 10:30 a.m. Break 10:45 a.m. Definitional FrameworkLegal/Regulatory Landscape (20 mins)• David Orentlicher, Co-Director, UNLV Health Law Program and The Cobeaga Law Firm Professor of Law, University of Nevada, Las Vegas Key Terms and Taxonomy (40 mins)• Scott Kim, Senior Investigator, Department of Bioethics, NIH Clinical Center• Tom Strouse, Medical Director, Stewart and Lynda Resnick NeuropsychiatricHospital at UCLA 11:45 a.m. Discussion with workshop participants moderated by Linda Ganzini 12:15 p.m. LUNCH SESSION II: PROVIDER E...
Source: blog.bioethics.net - December 24, 2017 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs

The 1000th Thread!
This is the 1000th presentation to my bioethics blog since starting on Google Blogspot.com in 2004.There has been many topics covered. Though comments by the visitors has always been encouraged and, since as a " discussion blog " , comments leading to discussions I have felt was the definitive function here. Virtually none of the thread topics have gone unread and most have had some commentary, some with mainly particularly strong and emphatic opinions http://bioethicsdiscussion.blogspot.com/2013/01/should-pathologists-be-physicians.html, some with extensive up to 12 years long continued discussion http://bioethicsdiscussi...
Source: Bioethics Discussion Blog - December 24, 2017 Category: Medical Ethics Source Type: blogs