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A Tribute to Sandra Dawson
Sandra Dawson passed away on October 2, 2018. You may not recognize the name, but hundreds of thousands of people have been touched by her efforts on behalf of mental health and suicide, most notably behind the @unsuicide handle on Twitter.
With nearly 25,000 Twitter followers and over 26,000 tweets in the past 10 years, she highlighted resources and help for countless numbers of people in the depths of depression. She also ran the unsuicide wiki, which offered those resources in a more static environment. Sandra was 51.
Here’s what the Neurocritic had to say of Sandra’s passing:
Sandra was taken from this ear...
Source: World of Psychology - October 17, 2018 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: General Mental Health and Wellness Suicide Depression sandra dawson Source Type: blogs
On the Importance of Mental Health Check-Ups for Palliative Care Clinicians
by Polly ChesterAs silly as this may sound to people who have never experienced a mental health issue, when one is used to a dystopian inner world, feeling happy for a consistent period of time can be a bit of a worry. For those of us who ’ve had mental health concerns in the past and a baseline mental state that just allows us to lurch through life in a state of veritable chaos, calm and pleasant periods of time are a source of anxiety because we wonder if the next mental health calamity is just around the corner. One might consid er psychological temperature-taking should be done just like going to your general practit...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 3, 2018 Category: Palliative Care Tags: chester grief mental health The profession Source Type: blogs
A 60 year old patient with large T-wave inversions
Written by Andrus Alian and Pendell Meyers, with edits by Steve SmithA female in her 60s with history of stage IV lung cancer presented to the ED with 3/10 chest pain and dyspnea waxing and waning for the last 24 hours. She had no personal or family history of coronary artery disease, drug use, HTN, or dyslipidemia. She did have a history of smoking. She recently had a 2 hour flight. She denied diaphoresis, nausea, or back pain. Vital signs were stable and she was afebrile.Here is her initial ECG (during persistent 3/10 active chest pain):Large T-wave inversions. What is their distribution? What is distinctive about them? ...
Source: Dr. Smith's ECG Blog - October 1, 2018 Category: Cardiology Authors: Pendell Source Type: blogs
International Palliative Care Education - EPEC-Peds
By Stacy S. Remke (@StacyRemke)In about 2004, our program embarked on a regional pilot project to teach healthcare workers – doctors, nurses, social workers, chaplains, and others – to provide pediatric palliative care. Our region is the Upper Midwest: Minnesota, Iowa, Wisconsin, North and South Dakota. “Join pediatric palliative care,” we joked, “and see the world!!”Little did we know.From these first steps began a truly humbling and inspiring journey across many continents and into many communities.Much of this started when a project I was involved with –Education in Palliative and End of Life Care for Pedi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 21, 2018 Category: Palliative Care Tags: international pediatrics remke Source Type: blogs
Mandated Queries of the Florida Prescription Drug Monitoring Program: Early Experiences from a Cancer Center-based Outpatient Palliative Medicine Clinic
This article describes our e xperiences in the first month of experience with the new law, although we plan to examine queries for a total of three months before closing this QI project.For the purpose of this QI project, we have documented patients ’ demographics, including each patient’s age, gender and limited identifying information, such as patient names and identification numbers; this data will be de-identified for any statistical analysis planned in the future. We also recorded patients’ main diagnosis and pain symptoms, the numbe r of prescribers listed by the PDMP as well as the dose of the patient’s opio...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 14, 2018 Category: Palliative Care Tags: kollas opioids pdmp quality improvement The profession Source Type: blogs
Lay Health Workers Increase Documentation of Care Preferences
by Ben SkochReview of Effect of a Lay Health Worker Intervention on Goals-of-Care Documentation and on Health Care Use, Costs, and Satisfaction Among Patients with Cancer. A Randomized Clinical Trial. Patel MI, Sundaram V, Desai M, et al. JAMA Oncology July 2018. doi:10.1001/jamaoncol.2018.2446I ’m sure many, if not most health professionals who have spent time around an oncology unit have encountered patients receiving care in the late stages of their disease and had the thought, “Is this really helping?” Or possibly, “Has anyone asked this patient how they feel about this treatmen t?” As a palliative ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 5, 2018 Category: Palliative Care Tags: advance care planning journal article pallimed writing group skoch Source Type: blogs
Evidence-Based Prognostication
by Christian Sinclair (@ctsinclair)We are prognosticating beings. It is how we survive. Many everyday decisions begin with an estimation of likely future outcomes. If my first clinic appointment is at 9:15am, and my drive from the hospital to the clinic usually takes 25 minutes, then I need to leave by 8:50am at the latest to give myself time to spare for bad traffic light timing, lack of a good parking spot or some other problem that may delay my arrival. I make my estimates, and go with the safest choice. I could go with my gut and my experience or I could use Waze, an app where I can select where I am leaving from, wher...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 27, 2018 Category: Palliative Care Tags: hpmchat journal article prognosis research sinclair tweetchat twitter Source Type: blogs
Does Colace (docusate) Work For Constipation? No!
This study was highlighted in theGeriPal Top 25 articles in HPM.- Ed.)Randomized, Double-Blind, Placebo-Controlled Trial of Oral Docusate in the Management of Constipation in Hospice Patients. Tarumi et al. Journal of Pain and Symptom Management, 2013: 45(1), 2-13.Palliative care fellows may wonder about their attendings fixation on bowel movements. It may be because we do not ask medical students to disimpact patients any more or because, given the lack of ambulatory care many residents do, they do not see it as a big deal (Constipation a GREAT topic for those of us who like puns and dad jokes).For patients, how...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 20, 2018 Category: Palliative Care Tags: arnold constipation docusate geripal top 25 pallimed writing group senna Source Type: blogs
Professional Development for the Whole Team
by Karla Washington (@comokarwash)I entered graduate social work education in 1998. St. Louis Cardinals first baseman Mark McGwire broke the single-season home run record that year. Hearings were held regarding the impeachment of President Bill Clinton, and C éline Dion released a duet with R. Kelly, forming a collaboration that probably sounds preposterous to most people younger than 25. On the technology front, social media as we know it today was years away (Mark Zuckerberg was only 14). Google itself was less than a year old. Its corporate headquart ers were in a garage.Fast forward to 2018. I used Google to obtain 10...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 18, 2018 Category: Palliative Care Tags: social work social worker The profession washington Source Type: blogs
Health4TheWorld Named Tech Startup of The Year: Interview with Founders
Health4TheWorld, a Silicon Valley start-up providing education and technology solutions for resource-poor communities worldwide, has been named the 2018 Stevie Silver Award Winner by the American Business Awards for the category of Services. Created...
Source: Medgadget - August 9, 2018 Category: Medical Devices Authors: Michael Batista Tags: Exclusive Informatics Medicine Public Health Source Type: blogs
Rallying at the end of life
Let’s say your loved one is at the end of life. She’s 84, with advanced cancer that is no longer treatable.
A decision has been made to put her in hospice — which is a level of care more than an actual location. (Most hospice actually occurs at home.)
The patient waxes in and out of consciousness, sometimes lucid, but mostly not.
While no one is ready for her to die, this end-of-life process brings some solace — it’s what your loved one has indicated she wants, and the time at home without aggressive, often fruitless, medical treatment, allows other friends and family members to make visits and share stor...
Source: Kevin, M.D. - Medical Weblog - August 6, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/john-schumann" rel="tag" > John Schumann, MD < /a > Tags: Conditions Hospital-Based Medicine Palliative Care Source Type: blogs
How Proposed Changes to Medicare Documentation Regs Can Impact Palliative Care
by Amy Davis (@MaximizeQOL)(CMS open to comments until Sep 10, 2018. See end of post for details. - Ed.)Centers for Medicare and Medicaid Services (CMS) hasproposed sweeping reforms to documentation requirements, clinician reimbursement, and the Quality Payment Program (QPP), to begin in 2019. (1) If approved in their current form, the changes are likely to have dramatic net negative effects on outpatient palliative care reimbursement. A detailed review and analysis of all 1,473 pages of the Proposed Rule, plus its addenda, would not be practical here. The reader is referred to thecomplete text (1) andothers ’ asses...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 2, 2018 Category: Palliative Care Tags: billing CMS davis The profession Source Type: blogs
Ninjutsu for the Hospice Patient
The objectives of the ninjas are: first, to use ninjutsu to infiltrate the enemy’s camp and observe the situation.” (Hatsumi, 1988 p. 111).How it applies to hospice: Everyone involved in a hospice situation, including the patient, their loved ones, and the staff, are observing everyone else.* The patient often can be stuck in a role of observation whether they chose to or not because they may be too tired to interact, or the family will talk in front of them to staff.* The family is often on high alert, watching the patient for symptoms or watching the staff and timing our responses.* The staff members are observing th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 30, 2018 Category: Palliative Care Tags: hospice miles ninjutsu perseverance social work social worker spiritual Source Type: blogs
