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Hospice and Palliative Care
STUDENT VOICES | CHYNN PRIZE THIRD-PLACE WINNER By Maia Lauria I first stumbled upon the issue of palliative care during a particularly hard time in my life. I was twenty years old, and for the first time having to confront the realities of watching a loved one die. Up until then, death had been a … More Hospice and Palliative Care
Source: blog.bioethics.net - October 13, 2017 Category: Medical Ethics Authors: Ethics and Society Tags: Ethics Health Care bioethics cancer chemotherapy Chynn Prize dignity end of life euthanasia Fordham University Student Voices healthcare hospice hospice care human dignity medical ethics palliative care sedation syndicate Source Type: blogs

De-Medicalizing Death
There’s been an unexpected, and excellent, consequence to California’s new medical aid-in-dying law. For many terminally ill patients, immersion in the process of securing lethal drugs ultimately renders them unnecessary. How did this come about? Passed by the California legislature in late 2015, the End of Life Option Act allows physicians to prescribe a lethal concoction of drugs to some patients with terminal illnesses who meet certain criteria. The law, commonly described as providing “medical aid in dying,” took effect on June 9, 2016. It stipulates only that the requesting patient be considered terminal (less...
Source: Health Affairs Blog - September 28, 2017 Category: Health Management Authors: Jessica Nutik Zitter Tags: End of Life & Serious Illness California critical care End of Life Option Act intensive care unit medical aid in dying Palliative Care Source Type: blogs

Palliative Care in the Time of Hurricane Harvey
by Ishwaria Subbiah (@IshwariaMD)Trouble BrewingBetween the network news and many institutional emails on hurricane preparations, we at MD Anderson knew were in for something ‘big.’ Harvey made landfall on August 25th as a Category 4 hurricane about 190 miles southwest of Houston. The outer bands brought rain without any major disruptions to our practice. As expected, upon landfall, Harvey rapidly weakened but stalled over Texas. The subsequent two days brought a level of rainfall best described as apocalyptic. The institution’s leaders activated the ‘ride-out’ team where the core essential physicians and staff r...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 27, 2017 Category: Palliative Care Tags: disaster hurricane subbiah The profession weather Source Type: blogs

Lorazepam, Haloperidol, and Delirium
JAMA Internal Medicinehas published a double-blind,randomized, placebo-controlled trial of adding lorazepam to haloperidol in patients with advanced cancer and agitated delirium. (We had a heads up about this trial because it waspresented at ASCO earlier this year.) If there ever was a sort of consensus in HPM about how we should be treating delirium, my sense is that it ’s been shattered by the recentRCT of low-dose haloperidol vs risperidone for delirium in Australian palliative care unit patients, showing those drugsworsened delirium symptoms. So, it seems like we should all see what we can learn from this newly publi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 25, 2017 Category: Palliative Care Tags: antipsychotics delirium research issues rosielle Source Type: blogs

The Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs

The High Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Cardiac surgery High-risk Quality Reporting Source Type: blogs

“Going Palliative” is Not a Thing
by Staci MandrolaI love the segment onLast Week Tonight with John Oliver called “How is this still a thing?” His snarky Britishness targets everything from the Sports Illustrated Swimsuit issue to ‘Why do we dress up as other races?’ The skits start out funny but leave you questioning and unsettled.I hope “going palliative” ends before it shows up on “How is this still a thing?” How do I know " going palliative " is a thing? The phrase is popping up in the academic medical center where I practice palliative care. [And many other hospitals too - Ed.] PT/OT has signed off patients who have a palliative c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 18, 2017 Category: Palliative Care Tags: culture hospice mandrola palliative Source Type: blogs

Fight Aging! Newsletter, September 11th 2017
This study developed the first procedure for the removal of epithelium from the lung airway with the full preservation of vascular epithelium, which could be applied in vivo to treat diseases of lung epithelium. Whole lung scaffolds with an intact vascular network may also allow for recellularization using patient-specific cells and bioengineering of chimeric lungs for transplantation. In addition to the clinical potential, lung scaffolds lacking an intact epithelial layer but with functional vascular and interstitial compartments may also serve as a valuable physiological model for investigating (i) lung development, (ii)...
Source: Fight Aging! - September 10, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Am I the first user of the Hospice Compare website?
In a terrible twist of fate, the very day that the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website went live, I found myself in a pulmonologist’s office with my parents, taking in the news of my mother’s advanced cancer and malignant pleural effusion. The shock of it, and the uncanny timing are beyond comprehension. You see, I’ve been leading research at RTI International and funded by CMS to develop the Hospice Quality Reporting Program and Hospice Compare since 2010. And now I stand to benefit from my own work in a way that I didn’t imagine would happen this soon in my life — as a...
Source: Kevin, M.D. - Medical Weblog - September 8, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/franziska-rokoske" rel="tag" > Franziska Rokoske < /a > Tags: Policy Hospital-Based Medicine Palliative Care Public Health & Source Type: blogs

How HBO ' s The Leftovers Parallels Our Work in Palliative Care
By Shayna Rich and J. MaggioThe HBO showThe Leftovers has a deceptively straightforward science fiction premise: What happens to people left behind after a Rapture-like event? The Rapture is an apocalyptic event prophesied in the New Testament where people chosen by God disappear into Heaven. In the show, roughly two percent of the world ’s population--about 140 million people--mysteriously disappear in an instant. Unlike the popular Christian book and film seriesLeft Behind, The Leftovers is agnostic to the cause of the sudden departure. Some characters believe it was the Christian Rapture, but other characters disagree...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 5, 2017 Category: Palliative Care Tags: arts leftovers media spirituality/religion tv Source Type: blogs

Survival and Grief
There is no transcendent moment of growth or meaning in watching a childhood friend die of cancer. There is no learning experience that will somehow make me stronger. Only horror, helplessness, loss, and grief. I am deriving no spiritual uplift from this experience, only depression and despair. If someone wants to talk to me about post-traumatic growth, I will spray paint their car.Others disagree with me, I ' m sure of it. For religious reasons. And I will respect their beliefs. There is no point in being a skeptical asshole to a grieving family.The most important point here is that dying patients should not have to suffe...
Source: The Neurocritic - September 4, 2017 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

An Educational Conversation
I had an interesting conversation. I am doing some research on hospices and palliative care (for someone else, not me). I met with a social worker who used to work for a hospice. She was very helpful.I had no idea how hospice care worked, especially at home. Basically hospice care includes palliative care. If you have hospice care at home everything comes to you. Doctors, nurses, social workers, and more. It lasts for up to six months. If, at the end of the six months you are still alive, you can be recertified for more hospice time (I think) unless you are too healthy and stable and then its back to reality.Hospice c...
Source: Caroline's Breast Cancer Blog - September 1, 2017 Category: Cancer & Oncology Tags: dying hospice palliative Source Type: blogs

Dying at home: The problem hospices have with stolen opioids
Nothing seemed to help the patient — and hospice staff didn’t know why. They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain. The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high on her mother’s medications, stolen from the hospice-issued stash. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - August 31, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/melissa-bailey" rel="tag" > Melissa Bailey < /a > Tags: Meds Pain Management Palliative Care Primary Care Source Type: blogs

12 tips for giving patients bad news
My partner Judith had pain in her sinus cavity caused by a tumor called a plasmacytoma. After her biopsy, her surgeon called Friday afternoon with the results. She asked him to wait fifteen minutes until I could be home with her to get the news. He had no flexibility and said he could speak either then or Monday. She chose to speak with him then on the phone still alone. He confirmed that the tumor was cancer of an unknown type. She hurried to the hospital to get more tests to learn what kind of cancer it was. That was a really bad day. Judith and I both work in the health care system. I am a palliative and acute care chap...
Source: Kevin, M.D. - Medical Weblog - August 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/chaya-gusfield" rel="tag" > Chaya Gusfield, BCC < /a > Tags: Conditions Hospital Palliative care Source Type: blogs