Choosing a health care agent is an important place to start advance care planning. Decision making can get messy if this choice isn’t made before a crisis. This graphic below shows the hierarchy for surrogate decision making under Washington state law if otherwise...
As we enter a new year, this is a worthy time to remember to practice self-care, to take care of ourselves as providers for others. We shared this years ago and feel it is worth revisiting. Double-booked patients, charts, emails, curbsides, phone calls, meetings. . ....
We recognize the long dark days of December can dampen spirits. We appreciate all you do to help patients despite heavy workloads and busy waiting rooms. Wishing you some peace over the holidays! Beannacht: Blessing for the New Year by John O’Donohue On the day when...
For elderly and frail patients, hours of quality life saved by starting dialysis may not stack up well when compared to medical management of chronic kidney disease. Many studies show that for patients over 75, starting dialysis leads to poorer functional status and...
Fear is a major component of the suffering patients feel when breathless. Consider our Breathlessness Action Plan to help palliative-care-minded patients and families with the anxiety. Stay calm: Quiet the room. Speak slowly in a calm voice. Reposition: Usually...
There’s a helpful rule of thumb for prognosis near end-of-life, but first . . . It’s always a good idea to ask what’s behind the question. Many patients who ask this may be hunting for something else. We tend to follow up with a question like: “Could you tell me...
The nice thing about books: you can take one home and it waits patiently for the right time. Open it when you’re ready. Close it when you like. Come back to it when it’s helpful. Hospice of the Northwest’s lending library is open to the public. We have over 1500...
“What are we doing? He would never want to live like this!” For patients with advanced dementia, consider recommending feeding for comfort rather than medicalized nutrition. This means: Choosing foods that the patient responds to with pleasure Stopping feeding when...
Supporting families (and ourselves) with loss may be some of the most difficult work in healthcare. Here are phrases we find helpful. “I am so sorry for your loss. As much as you can, give grief the reins. Give it all the time it needs.” “Many people experience anger,...
Medical situations with ill patients can change quickly and communication missteps are common. Here are our favorite phrases to repair/re-establish rapport. “I think I just said something unhelpful. Let me try that again.” “I have been using a lot of technical jargon....
