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When Is the Best Time to Start Hospice Care?
Hospice provides compassionate care for people facing a end of life illnesses or injury.Hospices use a team-oriented approach to medical care, and pain management. Hospice care also provides emotional and spiritual support tailored to the needs of both patient and family caregiver.Many people think of hospice care as something provided to people who have terminal cancer or another such illness.Hospice can also be immensely helpful for people living with Alzheimer ’s.Is Hospice Care an After Thought in Dementia Care?By Marie MarleyAlzheimer's Reading RoomHospice care is designed to improvequality of life for the person wi...
Source: Alzheimer's Reading Room, The - March 31, 2017 Category: Neurology Tags: alzheimer's awareness alzheimer's care Alzheimer's Dementia alzheimers hospice dementia hospice end of life care Hospice Care hospice care definition hospice services what does hospice care man Source Type: blogs

Looking Forward to #hpm Chats in 2017
InJuly 2010, Christian and I had a conversation about finding ways to bring people together online to connect, collaborate and learn more about topics in hospice and palliative care. We had seen some fascinating discussions with#hcsm, the health care social media community and decided to launch the#hpm chat as a weekly interdisciplinary discussion of issues in hospice and palliative care. I never imagined how this idea would develop into such a vibrant community where caregivers, doctors, nurses, social workers, volunteers and people with a variety of experiences have joined in to discuss topics on our weekly conversations...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 28, 2017 Category: Palliative Care Source Type: blogs

Missing the Moment of Passing Can Make Some Family Members Feel Guilty
Dear Carol: My dad had been fighting cancer for years. Eventually, there was no more hope for a cure, so we agreed to ask for hospice care to keep Dad comfortable during his last weeks of life. He surprised us by doing well under hospice care, living beyond the doctor’s expectation, but, of course, he eventually died. What bothers me is that I wasn’t with him at the moment he passed. He was in a nursing home at the time and the staff was wonderful. They called the family together when it was determined that Dad was close to the end. My siblings and I sat with Dad for two days around the clock. We brought in food ...
Source: Minding Our Elders - March 18, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Failure of Mitophagy and Mitochondrial Function in Kidney Disease
We modern humans are comparatively lightly affected when it comes to kidney failure as an age-related cause of death; it ranks fairly low in the list. We are primarily killed by cardiovascular issues and cancer. In some other species, such as domestic cats, kidney failure is a leading cause of mortality, and near all older individuals are significantly impacted by the consequences of declining kidney function whether or not it is the final cause of death. Still, a comparatively low toll for humans is no great comfort to the many who suffer, especially since there is little in the way of medical technology available at pres...
Source: Fight Aging! - March 16, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

What this physician learned from a dying patient
Propelled in part by the unalloyed hopes I cultivated in medical school, I got through my internal medicine residency training largely free of questions about medicine’s limitations. Ailing strangers entered my life in the hospital and I helped them leave nearly restored to health. This was exactly the kind of physician I expected to be. That changed when I met Janice Wilson during my current fellowship in cancer (hematology and oncology). Janice (not her real name) became pregnant with her first child near the end of 2014. A few months before her baby’s due date, her right breast began to feel different and she detect...
Source: Kevin, M.D. - Medical Weblog - March 1, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jalal-baig" rel="tag" > Jalal Baig, MD < /a > Tags: Physician Palliative care Source Type: blogs

The importance of being present
An excerpt from Attending: Medicine, Mindfulness and Humanity. Sometimes a simple gesture and a few well-placed words can signal presence. One day on rounds in the hospital, as we walked into the room, Laura Hogan, a nurse-practitioner on our palliative care team, said three words to the patient: “What beautiful flowers.” The patient looked at the flowers and smiled. The previous day the patient had had a biopsy that would let her know whether her cancer had progressed; she was still awaiting the results. We all feared that the news would not be good. Laura’s comment communicated that even in dire circumstances it i...
Source: Kevin, M.D. - Medical Weblog - February 24, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/ronald-epstein" rel="tag" > Ronald Epstein, MD < /a > Tags: Physician Hospital Source Type: blogs

A Million Jobs in Healthcare ’ s Future
By PRAVEEN SUTHRUM “The Future is Here. It’s Just Not Evenly Distributed.” It’s true. Science fiction writer William Gibson said that right. We simply have to look around enough – now – to find out what the future holds. The future may never be evenly distributed. But it’s surely becoming the present faster. What would you do when… Here are a series of what-would-you-do-when questions to think about. Each of these are a reality today, somewhere. There’s more medical data than insight Kaiser Permanente presently manages 30 petabytes of data. Images. Lab tests. EHRs. Pat...
Source: The Health Care Blog - February 21, 2017 Category: Consumer Health News Authors: John Irvine Tags: Tech Uncategorized Source Type: blogs

Misleading Metrics
Editor’s Note: This essay contains excerpts from Extreme Measures: Finding a Better Path to the End of Life, coming February 21st, 2017 from Penguin-Random House. A few years ago, while at a family get-together, I sat across from a retired hospice social worker named Terry. I am a physician whose practice alternates between attending on the wards of an inner-city intensive care unit and serving as a consultant on the hospital’s palliative care team. I didn’t set out to practice this uncommon combination of medical specialties. I started out totally dedicated to using the miraculous technologies in my critical car...
Source: Health Affairs Blog - February 21, 2017 Category: Health Management Authors: Jessica Nutik Zitter Tags: End of Life & Serious Illness Health Professionals Hospitals 30-day mortality statistic advance directive Palliative Care Source Type: blogs

Can a dying patient be a healthy person?
The news was bad. Mimi, a woman in her early 80s, had been undergoing treatment for lymphoma. Her husband was being treated for bladder cancer. Recently, she developed chest pain, and a biopsy showed that she had developed a secondary tumor of the pleura, the space around one of her lungs. Her oncology team’s mission was to share this bad news. Mimi’s case was far from unique. Each year in the U.S., over 1.6 million patients receive hospice care, a number that has been increasing rapidly over the past few years. What made Mimi’s case remarkable was not the grimness of her prognosis but her reaction to it. When the me...
Source: Kevin, M.D. - Medical Weblog - February 20, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/richard-gunderman" rel="tag" > Richard Gunderman, MD, PhD < /a > Tags: Physician Palliative care Source Type: blogs

Warming Hearts, Cloaking Grief
By Lori RuderHe moves over and she snuggles in close to her fianc é. She pulls their blanket over them. A special blanket made just for this moment. “I love you” she murmurs, soaking in his face and his warmth. “Goodnight lovebirds,” his mother teases as she turns out the lights.This moment is both tender and tragic: tender because they are demonstrating their love for each other, tragic because this is happening in the ICU. Her fianc é is on life support and he is dying. He moved over because I moved him over to make room for her in his narrow hospital bed. I repositioned his ventilator tubing and central l...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 15, 2017 Category: Palliative Care Tags: blanket cancer comfort icu lori ruder Source Type: blogs

How Can We Increase The Use Of Palliative Care In Medicare?
In August, 2016, a 93-year-old woman—the grandmother of one of this Blog post’s authors—died of congestive heart failure, five weeks after she underwent surgery to receive a pacemaker. There were alternative care options, but they were not offered to her and her family in a timely manner, at least in part because of Medicare’s long-standing payment rules that value procedures over discussion of goals and alleviation of symptoms. Medicare paid for the surgery and pacemaker with no questions asked, even though the procedure was, in retrospect, unproductive, wasteful, and even harmful from the family’s persp...
Source: Health Affairs Blog - February 13, 2017 Category: Health Management Authors: Donald Taylor, Matthew Harker, Andrew Olson and Janet Bull Tags: End of Life & Serious Illness Medicare Alternative Payment Models Dying in America Medicare Part B Palliative Care Source Type: blogs

ASCO Supports Concurrent Palliative Care for People with Advanced Cancer
by Christian SinclairTheAmerican Society of Clinical Oncology recentlypublished the strongest call for concurrent palliative care in oncology. Released online on Halloween 2016, and published in the Journal of Clinical Oncology just last month, this Clinical Practice Guideline (CPG) should be in the pocket of every palliative care team as they meet with their oncology colleagues to collaborate on better care for patients.The guideline holds more weight and expands the scope compared to the 2012 Provisional Clinical Opinion which emerged after the Temel article. In 2010,NEJM published a randomized control trial (RCT) of pal...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 7, 2017 Category: Palliative Care Tags: ASCO guidelines non-pain symptoms oncology sinclair Source Type: blogs

We are mortal humans, we suffer and love, hopefully together, and then we each die.
by Drew RosielleI went into medicine because I thought it ' d be something practical, to help people.I majored in English and Religion at the University of Iowa in the early 1990s, and didn ' t have clear career plans. I guess I thought I ' d become an English professor. Late in my undergraduate days I was enamored with the more experimental sides of 20th Century poetry (Gertrude Stein, Lorine Niedecker) and figured I ' d go on to grad school. To make ends meet in college, I got a part-time job cleaning a group home overnight for teenage boys with profound developmental disabilities. I liked to stay up late, and I could cl...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 1, 2017 Category: Palliative Care Tags: ethics ethics/law politics rosielle Source Type: blogs

How States Can Expand Access To Palliative Care
Conclusion The policies discussed in this Blog post are intended to serve as a framework for policymakers and other stakeholders interested in doing more to support palliative care in their states. Here are a few considerations for those interested in exploring potential options: None of the policies and initiatives described above would have been possible without efforts from key stakeholders such as the state hospice and palliative care associations, and local funders, researchers, and advocates. Champions such as Colorado’s Center for Improving Value in Health Care (CIVHC), the Coalition for Compassionate Care of Cal...
Source: Health Affairs Blog - January 30, 2017 Category: Health Management Authors: Stacie Sinclair and Diane Meier Tags: End of Life & Serious Illness Long-term Services and Supports Medicaid and CHIP Payment Policy Quality California End-of-Life Care Palliative Care States Source Type: blogs