May 2021 - When assessing palliative wounds- not expected to heal, sometimes managing the odiferous drainage can be the greatest kindness for patients and visitors. Non-healing wounds are common at end-of-life, whether from pressure ulcers, vascular disease, or...
April 2021 - When assessing pain in a nonverbal or cognitively compromised patient, consider symptoms of agitation and fear as clues. Consider Mrs. Jones: She is getting more agitated with her transfers, strikes out at staff attempting to provide bed care, and...
March 2021 - Patients with dementia and their families benefit from specialized end-of-life support Hospice care provides: - Goal setting with families - Teaching on what to expect with the decline - Medication simplification - Techniques and medication to help...
February 2021 - When palliating heart failure with difficult to control atrial fibrillation, remember our old friend digoxin. Consider Mr. Jones: His atrial fibrillation is marginally controlled but he can no longer tolerate any rate-controlling medications that lower...
January 2021 - “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” - Adapted from Marcel Proust As hospice physicians, we search for opportunities to improve self-care. The 10% Happier app has changed our lives. It is brief,...
December 2020 - Grief counseling is available to the community at large from Hospice of the Northwest. Any member of our community can use Hospice of the Northwest for grief support. We offer both individual and group counseling via Zoom or telephone. Support is...
November 2020 - When your computer is tired and behaving badly, turn it off and count to 10. Always the first question from the IT help desk: “Did you try powering down?” Can we extend that to ourselves? Maybe even with the kind words: “You’ve been working hard, take...
October 2020 - “There’s nothing more we can do . . .” has no place in end of life care. Use language that offers care that is needed now: - Urgent and careful management of symptoms - Care that comes to your home - Support for your family - Help with important...
August 2020 - Time-limited trials of therapy are a powerful tool when the benefit/burden balance of treatment is uncertain. This approach has many benefits. - It names the elephant in the room: uncertainty. - It helps patients/families and providers think about goals...
July 2020 - Deliver a one-two punch: increase gut motility and stool moisture with scheduled meds. Constipation is predictable. Think hospitalization, immobility, newly prescribed opioids, traveling, hot weather. Constipation is miserable. Be a hero. Prevent it....
