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Palliative Care

Palliative Care

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Verghese: Patients Have Two Hearts...... Dr. Verghese opens the American College of Cardiology Conference with an impassioned plea to hold on to the heart and soul of medicine. He acknowledges the challenge of the electronic medical record which, designed to achieve accurate billing, does little to improve patient care and consumes a tremendous amount of provider time.

Verghese: Patients Have Two Hearts

Their Dying Wishes - This New York Times blog piece is a great tribute to hospice volunteers everywhere.

Common Myths of Hospice Care Debunked | Next Avenue

Common Myths of Hospice Care Debunked

People say they would opt for less care if they had more knowledge of benefits and harms, studies show. Palliative care helps patients/families weigh the benefits / burdens of different treatment options. Patients often over-estimate benefits, and under-estimate burdens.

If Patients Only Knew How Often Treatments Could Harm Them

The call from my patient's daughter wasn't the first time a patient or family member had revealed to me a plan for an exit strategy.

Deciding On a Parent's Death

I could not resist this one!

A New York Times opinion piece well worth reading.... I was happy for all of us that this hideous struggle, which had extended past the most unreasonable expectations, was finally over. opinionator.blogs...; class="more-link">Read more...</a>

Finding Joy in My Father's Death

Here is an app designed to store, manage, and transmit living wills, POLST, DNR order, power of attorney, contact information, etc. The app can email or fax the information to a distant health care provider in minutes. It's from the American Bar Association and the documents are legal. You can store documents for multiple people so you can keep yours and your parents handy. Now, if we could only get more people to complete these documents in the first place.

My Health Care Wishes App

So... this is what an advance directives might look like if written by tech support.

Top 5 regrets of dying

How Long Have I Got Left? - A really interesting piece from palliative care/end-of-life perspective, particularly when we don't know when the end of life will be.

How Long Have I Got Left?

Hospice by the numbers

Andres' story: Finding a bond in his last journey

I am now face to face with dying. But I am not finished with living. Neurologist/author Oliver Sacks confronts his own mortality in this New York Times essay.

Oliver Sacks on Learning He Has Terminal Cancer

Superb debate on the Diane Rheem show regarding "death with dignity"legislation. Is it self-determination at its best, an ethical slippery slope, or a distraction from needed health care reform?

The Latest In The Debate Over "Aid In Dying" - The Diane Rehm Show

The overwhelming volumes of deaths during the Civil War created logistical, spiritual, and political challenges that transformed our views on death and dying. See WGBH American Experience | PBS . Death and the Civil War via this link.

WGBH American Experience | PBS . Death and the Civil War

Perspective from The New England Journal of Medicine — Death Takes a Weekend........ One of my favorite physician authors writes a moving account of how the weekend schedule in hospitals impacts patients and families -- illness, pain, and fear don't know it's the weekend.

Death Takes a Weekend — NEJM

Edvard Munch - The Sick Child, 1907. Oil on canvas. From the Tate Gallery: The Sick Child touches on the fragility of life. It draws upon Munch’s personal memories, including the trauma of his sister’s death, and visits to dying patients with his doctor father. He described the 1885 painting as ‘a breakthrough in my art’ and made several subsequent versions, of which this is the fourth.

Conversations about advance care planning are conversations that matter.

Daydreams : Photo

Hospice/palliative nursing has never been easy. I'm hoping this drink is for a patient.

One Last Hug Preview (HBO Documentary Films) - YouTube This HBO documentary captures the emotion and power of a well done children's grief camp. It makes me proud of our Camp-Begin-Again at Halifax Health Hospice in central Florida. Watch the whole documentary. Be prepared for some tears.

One Last Hug Preview (HBO Documentary Films)

The specialty of palliative care is relatively new. I remain eternally grateful to the pioneers who managed to define this type of care and create a cultural transformation in medicine by demonstrating how this care makes a dramatic difference for patients, families, other providers, and the entire health care system. For those starting programs, growing programs, or pushing palliative care in new directions, this bit of inspiration may be helpful . We all need to hang in there.

Complexities of Choosing an End Game for Dementia - This New York Times piece skillfully discusses the issue of "Voluntarily Stopping Eating and Drinking" (VSED) in dementia patients. How do we balance the right of self-determination with some of the troubling ethical issues.

Complexities of Choosing an End Game for Dementia

Back to basics: are we losing sight of what hospice care is all about? | GeriPal - Geriatrics and Palliative Care Blog Thank goodness for hospice nurses periodically reminding us what it is all about..

For-profit firms provide less in hospice care

Dying and profits: The evolution of hospice