This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
A group of health plans, policymakers, and insurance companies recently told the Center for Medicare & Medicare Innovation (CMMI) that they needed a standardized definition for palliative care in order to improve access. Centers for Medicare & Medicaid Services (CMS). There are different domains of care that need to be addressed.
To delve into these questions, we spoke with Hope Wechkin, medical director of EvergreenHealth home hospice, who authored an article describing a process of Minimal Comfort Feeding (MCF) for patients who have expressed an interest in not wanting to live with advanced dementia. Alex 00:14 We have a very full house today. Hope 00:31 Thanks.
How definitions bind us, for example the division between chronic pain and palliative pain in much of the US. Rajagopal (goes by “Raj”), one of the pioneers of palliative care in India. Raj is an anesthesiologist turned palliative care doctor. We are joined by guest-host Tom McNally, a rehab and pediatric palliative care doc at UCSF.
However if you want to take a deeper dive, check out his website “ The Ink Vessel ” or his amazing twitter feed which has a lot of his work in it. If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be.
This article is based on a discussion with Anthony Spano, Director of Client Development at Netsmart and Nikki Davis, Vice President of Palliative Care Programs at Contessa Health. The conversation took place on April 20, 2023, during the Hospice News Palliative Care Conference. The article below has been edited for length and clarity.
Mariah 03:51 I like the SAMHSA definition as sort of a guiding definition for it, and I’m happy to read it. Well, being a pretty comprehensive definition. Kate 11:33 Yeah, I mean, definitely more indirect pathways than direct. Alex 00:03 This is Alex Smith. Eric 00:04 And Alex, we have somebody in the room with us.
Summary Transcript Summary. In day-to-day practice, It’s hard to imagine providing excellent hospice or palliative care services without access to a team social worker. But are we really taking full advantage of ALL social workers have to offer our field? by: Anne Kelly, LCSW, APHSW-C. Transcript. Eric: Welcome to the GeriPal Podcast. Barbara: Yay.
We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. Raele: Yep, they definitely can be. Eric: And why is it more common in hospitalized adults?
Because, if anybody hasn’t seen it, you’ve got a great Twitter feed that gives tons of pearls on palliative care and a lot on communication. Don, welcome to GeriPal. Welcome back, Abby. Abby: Thank you. Abby: Thank you. So glad to be here. Shunichi, welcome back to GeriPal. Shunichi: Thank you for having me. Eric: Yeah.
For a deeper dive, check out some of these other studies and resources we talked about in the podcast: The Influence of Nursing Home Culture on the Use of Feeding Tubes. The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. Archives of Internal Medicine 2010. Rehabbed to Death. Transcript. Bring it on.
Summary Transcript Summary On today’s podcast, we’ve invited four hospice and palliative care social media influencers (yes, that’s a thing!), all of whom focus their efforts on educating the general public about living and dying with a serious illness. Hsien, welcome to the GeriPal podcast. Hsien: Hey, great to be here. Sammy: Thank you so much.
Eric: Definitely MAID- Alex: Eric knows, MAID in Canada Eric: Medical Aid In Dying in Canada. So, in front of us today, we have a variety of hot sauces and chicken wings. They’ve all been laid out for you. Alex: Great Eric: These are the questions submitted by our audience? Anne: Right. So, we’re not totally winging it here.
Summary Transcript Summary Artificial Intelligence, or AI, has tremendous potential. We talk on this podcast about potential uses of AI in geriatrics and palliative care with natural language processing guru Charlotta Lindvall from DFCI, bioethicists and internist Matt DeCamp from University of Colorado, and prognosis wizard Sei Lee from UCSF.
How do you talk to them about these terms and these definitions? Naomi 14:50 I definitely think, and I love Jane, how you keep coming back to the moment, because that’s all we have. Alex 00:15 We are delighted to welcome Jane deLima Thomas, who was a co-fellow with me back in the day in palliative care. Thanks for having me.
How does the geriatric assessment lead to improved completion of advance directives, when the assessment doesn’t address advance care planning/directives at all? How does palliative care fit into all this? Precision medicine? What groups are being left out of trials? Welcome to GeriPal, John. John: Thank you. Alex: Terrific.
And Katie, I was going through your Twitter feed, and a tweet I noticed was this one, “All opioid guidelines caution long-term use in people with active substance use disorder.” Katie, welcome back to GeriPal. Katie: Oh my gosh, can’t believe I’ve been here more than once now. Bragging rights. That was from our what?
Sunita: Oh, I was going to, just to clarify what I had said before, it’s definitely not that we based things solely on biology, for sure. Alex: We are delighted to welcome Jacky Kruser, who’s a pulmonary critical care doctor and health services researcher at the University of Wisconsin. Welcome to the GeriPal podcast. Eric: Yeah.
So we followed Gretchen Schwarze’s definition, which was 1% or higher inpatient mortality was considered high-risk. You’ll have a feeding tube. And we were specifically interested in looking at patients who had high-risk inpatient procedures. Eric: What are some examples of that? Alex: But I’m talking about-.
Eric 02:37 Feeding the beast, Matthew, feeding the beast [laughing] Alex 02:41 All right, here’s a little bit. Nicole 06:04 In a way, it definitely does. Eric 00:05 And Alex, who do we have with us today? Because I think we have someone special, a guest host. He’s in Boston. It’s awesome. Is this tension?
And whether tube feeding should be on there, that’s never an emergency decision. But the point is that EMS is a big piece of this discussion and national going forward, National POLST’s Collaborative is making that definitely a priority because it is forgotten a bit in some states. Kelly: Yeah, no, definitely.
He, his Twitter feed though is brilliant. Julien: I think that we should definitely be asking questions about patient goals, family goals, and trying to ensure that everything that we do is goal concordant, especially, and that starts… Well, it starts for me about whether they should even enter the ICU itself. Eric: Yeah.
Summary Transcript Summary Diabetes is common. When I’m on nursing home call, the most common page I receive is for a blood sugar value. When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. Goldilocks zone). Nadine: Thank you, guys.
I asked Rose after feeding her. “Me? Oh, I’ll definitely be going back. Research reported in the American Journal of Hospice Palliative Care concludes that p ositive general attitudes toward end-of-life dreams, visions, ( ELDV) and positive perceptions are correlated with better bereavement outcomes. I enjoyed myself a lot.” “Hey,
In this article, we review the definition of ALS, common ALS symptoms, and how you can better help and support your loved one by seeking the assistance of hospice care services. Eventually, all the muscles that a person can control are affected, forcing the person to use a ventilator and/or feeding tube. What is ALS?
Is there a formal definition, or one that you think about? ” So feeding them little soundbites that they might be able to take off the tip sheet and use if they had the opportunity. For the folks who haven’t listened to our past podcast, I really just want to start off with maybe two quicker answers. Ariel: Sure.
So, as kids would say, definitely my bad! Don't wake them up to feed them or give them water or take medicine, just let them sleep, the body's doing what it's supposed to do. My immediate thought was that while we do answer those questions in an episode here on the podcast. Important point here.
According to our surveys, caregivers with a lack of proper training on the subject find the following tasks the most challenging: handling violent or abusive behaviors, trouble communicating, challenging emotions, finding appropriate activities, and feeding/eating challenges. 7 popular topics are hitting the charts.
Danny 07:39 Yeah, definitely. So some of our approaches definitely altered based on the availability of what we could get done. Jennifer, welcome to the GeriPal Podcast. Jennifer 00:28 It’s great to be here. Sydney, welcome to the GeriPal Podcast. Sydney 00:41 Thank you. Sydney 06:37 Yes. Eric 06:38 Let me ask you this.
We could have talked for 4 hours and will definitely revisit this issue! They often have behavioral issues stemming from their disorder, their life circumstances, all sort of feeding into each other. We all have questions. We addressed as many of your listener questions as we could. Sometimes the drugs dont work. Alex 03:46 Thank you.
Most of the debate seems rather wonky, as honestly it feels like we are getting stuck in the weeds of semantics and definitions, like what counts as ACP versus in the moment decisions. Summary Transcript Summary. There is a lively debate going on in academic circles about the value of Advance Care Planning (ACP). Juliet: Thank you.
Summary Transcript CME Summary Weve talked a lot before about integrating psychiatry into palliative care (see here and here for two examples). Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. On this weeks podcast, we talk with two experts about palliative psychiatry.
Would such ethical guidelines foster or feed suspicion of the motivations of bioethics? . Ought we, in bioethics, create ethical rules for providing care that is illegal? Who will follow them, and what would be their incentive for doing so? We could have talked for hours. It’s bigger. George Annas piece mentioned on podcast. SPONSOR: .
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content