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The Case for Palliative Care in the ICU

Hospice News

An intensive care unit (ICU) stay often challenges everyone involved. Integrating palliative care could alleviate some of the suffering through symptom management, improved communication about goals and treatment, and better training and resources for staff. Nearly 75% of patients admitted to the ICU experience distressing symptoms.

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Caring for the Unrepresented: A Podcast with Joe Dixon, Timothy Farrell, Yael Zweig

GeriPal

Let’s say they’re in the ICU now on a ventilator. So on the clinical side, people are really focused on how long do they have to be on the ventilator and managing that. Eric 27:31 They are unrepresented, they’re in the ICU on a ventilator. Should we keep them on the ventilator? Thanks for having me.

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Who should get Palliative Care? Kate Courtright

GeriPal

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . Palliative care, in contrast, saw explosive growth in US hospitals. The National Palliative Care Research Center (NPCRC)and Palliative Care Research Cooperative (PCRC)were founded in part to meet this need. By diagnosis?

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Palliative Care in Liver Disease: A Podcast with Kirsten Engel, Sarah Gillespie-Heyman, Brittany Waterman, & Amy Johnson

GeriPal

Summary Transcript Summary In May we did a podcast on KidneyPal (the integration of palliative care in renal disease) , which made us think, hmmm… one organ right next door is the liver. Maybe we should do a podcast on LiverPal? (or or should we call it HepatoPal?) Alex 00:12 This is Alex Smith. Eric 00:13 And, Alex, who do we have with us today?

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. Eric: Okay.

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Done Right, Advance Care Planning Can Reduce High-Acuity Utilization

Hospice News

Those were a group of outcomes that we looked at that included mechanical ventilation, hospital admissions within the last 30 days of life, intensive care unit admissions, receiving cardiopulmonary resuscitation, and chemotherapy within the last two weeks of life. So these are generally seen as treatments that are futile.

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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Because we haven’t done our job to document the value of what we’re doing. On the other hand, I agree with Karl that the POLST has face validity, and anecdotal evidence is overwhelming. Welcome, Abby.

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