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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.
Mobile technology is not just used for documentation, but it’s really an integrated workflow for the caregiver at the bedside. They have so many more insights using technology from telehealth and telemedicine that’s feeding into that mobile device, which is so powerful for them. What drew you to this field?
In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. And I think that’s where we want to be.
Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. And whether tube feeding should be on there, that’s never an emergency decision. Because we haven’t done our job to document the value of what we’re doing. Welcome, Abby. Good to know.
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.
Daniel eventually passed away about eight years ago, but not before he was placed on that trach and peritoneal dialysis and feeding tube and many other interventions and, all the while, not really focusing on what he wanted as a good quality of life. Dr. Benton has a master’s degree in medical ethics and a doctorate in public health.
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?
Or is it the primary care document, who’s busy doing other things too, who probably won’t have the time to do a comprehensive geriatric assessment? How does the geriatric assessment lead to improved completion of advance directives, when the assessment doesn’t address advance care planning/directives at all? Precision medicine?
You’ve had three documented conversations to “clarify code status.” 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. Jacky: Thank you. It’s a pleasure. Bob, welcome back to GeriPal.
no feeding tube, but open to antibiotics) and your Health Care Proxy names the person who will follow those wishes and make decisions. The majority of people, even those who are seriously ill, haven’t talked about or documented their wishes. A living will is an advance directive that speaks to what care you want or do not want (i.e.
To provide context, we are joined by Karen Steinhauser, a social scientist at Duke who has been studying spirituality for years (and published one of the most cited papers in palliative care on factors considered important at the end of life , as well as one of my favorite qualitative papers to give to research trainees ). Lexy: Great to be here.
The process helps primary care professionals identify a person’s care goals and document and communicate their medical and personal preferences. “If Documenting care preferences in advance — Planning care early in the disease process is a meaningful way to identify, document, and communicate a patient’s goals.
Alex: But moving on from Jim Carrey and Dumb and Dumber, Samir, I wanted to ask you, someone once taught me, it’s possible it’s Joel, I’m not sure, someone once said that research is the meticulous documentation of the blatantly obvious. You’ll have a feeding tube. Alex: But I’m talking about-. Joel: Yeah.
He, his Twitter feed though is brilliant. Lauren: And then in the ED, you intubate and then you figure it out later or the patient never had an advanced care planning document and now the family’s making the decision and it’s really hard to watch your loved one die. That will be the last one in his life. Eric: Yeah.
The answer to that question determined whether the beer went down the feeding tube or was a savor and spit process. The patient is asked about their pain level and the clinician documents the current pain level. Sunday dinners involved feeding four generations. H ospice and Palliative Care Month has arrived.
Do you and your loved ones have an advance healthcare directive as well as the other documents necessary for managing legal and financial issues (e.g., This couple did not have advance healthcare directives nor were documents in place that would enable the wife to handle her husband’s independent financial accounts and property.
Do you and your loved ones have an advance healthcare directive as well as the other documents necessary for managing legal and financial issues (e.g., This couple did not have advance healthcare directives nor were documents in place that would enable the wife to handle her husband’s independent financial accounts and property.
Do you and your loved ones have an advance healthcare directive as well as the other documents necessary for managing legal and financial issues (e.g., This couple did not have advance healthcare directives nor were documents in place that would enable the wife to handle her husband’s independent financial accounts and property.
Encourage every caregiver to document personal details about each client in their care, such as how they like their eggs done, when they like to read their morning paper, how they like to spend their afternoon, and what types of tasks they expect to be done to guide any caregivers who may need to fill in while the assigned caregiver is unavailable.
Potential that documenting advance directives without a robust conversation about prognosis might have led to these findings. Jennifer 17:26 Documentation of end of life preferences. And we looked at newly documented end of life preferences. My goals will differ if I think I probably have 2 years to live vs 10 years.
Recognizing abnormal observations: What your caregiver decides to document can prove to be detrimental to their protection, the client’s health and safety, and your agency’s liability. Take the guessing game out of client records by clarifying which types of information your caregivers are expected to document on each caregiver visit note.
They often have behavioral issues stemming from their disorder, their life circumstances, all sort of feeding into each other. Alex 00:15 We are delighted to welcome back Janet Ho, who is a palliative care doc and addiction medicine doc and associate professor at UCSF. Janet, welcome back to the GeriPal Podcast. Janet 00:26 Thank you so much.
So one that the primary outcome was supposed to be documentation, which it improved documentation, it wasn’t powered to actually look at any utilization or hard outcomes. Painstaking work to go through each outcome and really characterize and document what works and what doesn’t. Summary Transcript Summary.
Areej 03:50 So at the state of the science, I was actually presenting a study that was focused on addressing sexual health concerns in transplant survivors, and I actually told the story of the state of the science for those of you who were there. She was off immunosuppression, her disease was in remission. So it was more of a social visit.
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