Tag Archives: Hospice

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    Learning to Let Go

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    Article By Author Paula Span, New York Times“>

    Article By Author Paula Span, New York Times

    The conversation took place two years ago, but Dr. Daniel Matlock still recalls it quite vividly. You tend to remember when a physician colleague essentially brands you a Nazi.

    Dr. Matlock, a geriatrician who specializes in palliative care, had been called in to consult when a woman in her 70s arrived at the University of Colorado Hospital, unresponsive after a major stroke.

    She’d done what we’re forever chiding people for not doing: She’d drafted a very specific advance directive and had even taken the trouble to have it notarized. It unambiguously said: no life support, no artificial nutrition or hydration, no nursing home.

    The ambulance crew had put her on a ventilator — standard procedure. After the palliative team removed it, she was able to breathe on her own, which isn’t uncommon. She even opened her eyes, though she couldn’t track or follow objects and remained unresponsive. That’s when the prominent surgeon directing her care ordered intravenous fluids.

    Dr. Matlock, alarmed at this direct contradiction of her preferences, tells the rest of the story in a post on the GeriPal blog, published by geriatricians and palliative care docs at the University of California, San Francisco. After talking with the patient’s sister, who held her medical power of attorney, he called the surgeon to suggest stopping the IV. Continue reading →

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      Called To Care

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      Since childhood, RN and Clinical Manager Jan Duhon has followed in her mother’s footsteps. She remembers caring intently for every animal and baby doll that had a scratch and nursing them back to health.

      “My mom is 75 years old and still works as a nurse full-time,” she said. “She is definitely my inspiration.”

      To Jan, working for Solaris Hospice is not just a paycheck. After 17 years as a nurse, Jan has developed what she calls a ‘hospice heart’. “My mom always told me that you’re never too good to do the dirty stuff,” she said. To this day, Jan carries her mother’s words with her. “Death is a part of life that people are not very comfortable with,” Jan said. “I don’t just want to take care of their physical needs but their mental, emotional, and spiritual needs, too.”

      One of the reasons Jan came to work for Solaris was the faith that she shared with the Solaris team and family. “I firmly believe that what’s on the other side is my Lord and Savior,” she said. “I believe this is my missionary work. This is where God wants me to be.”
      Jan truly feels hospice care is her calling and believes she has been blessed with an amazing team of caregivers. “We see people at their worst and their best. This job takes a lot of patience and kindness,” she said. “But, most of all, it takes a lot of love.”

      The love Jan shows for her patients is largely accredited to not only her love of the job but also her love for her husband, Malcom. “I like to call him my ‘hospice husband’,” Jan said. “ No matter what time of day it is when I get a call, he’s always so supportive.”
      Though Jan may have a demanding or stressful day at work, she still shows undeniable compassion for her patients.

      “It’s not about me. It’s about them,” she said. “It may be tough, but it’s so rewarding.”

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        Fear: Pain’s Loud Friend

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        One of the biggest fears we see faced by patients and their loved ones over and over in hospice care is the fear of pain. Not just the fear of being IN pain, but the fear that comes with not having a good understanding of pain and how it can be managed. Of course, it doesn’t have to be this way.

        Most fear associated with pain can be alleviated through improving both the patient’s and family’s understanding of pain. Below are some common myths about pain addressed in a new website produced by a division of the National Hospice & Palliative Care Organization (NHPCO) called Caring Connections. A special area of their website, called LIVE without pain, is focused on improving pain education among the general public, but particularly among those in end of life care (including family caregivers).

        Some people think that pain is a natural part of aging or illness – that is a myth. There is almost always a reason for the pain and most physical pain can be managed.   Learning the truth about pain and what you can do to manage your pain can help you focus on other parts of your life and enjoy your days. 

        The following statements and answers provide some facts about pain and pain management. Continue reading →

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          Taking Responsibility For Death

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          Taking Responsibility for Death

          By: Susan Jacoby, OP-ED contributor for The New York Times

           

           

           

          “The hospice room and pain-relieving palliative care cost only about $400 a day, while the average hospital stay costs Medicare over $6,000 a day. Although Mom’s main concern was her comfort and dignity, she also took satisfaction in not running up Medicare payments for unwanted treatments and not leaving private medical bills for her children to pay.
          A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month. Those figures would surely be lower if more Americans, while they were still healthy, took the initiative to spell out what treatments they do — and do not — want by writing living wills and appointing health care proxies.
          …end-of-life planning is one of the few actions within the power of individuals who wish to help themselves and their society.
          As someone over 65, I do not consider it my duty to die for the convenience of society. I do consider it my duty, to myself and younger generations, to follow the example my mother set by doing everything in my power to ensure that I will never be the object of medical intervention that cannot restore my life but can only prolong a costly living death.”

           

          For full article click here.

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            Is This A Shift In Oncology Thinking?

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            A recent article titled “Oncology group stresses need for palliative care, not aggressive treatment, at end of life” may represent a shift in thinking among oncologists. The hospice and palliative care world has long observed our medical culture’s aggressive approach to treating as long as possible, often up until the final hours of life. The unnecessary tests and treatments recognized by the medical coalition in this article is a welcome change in thinking. More than anything it may simply encourage physicians, particularly oncologists, to open lines of communication early with their patients regarding the true objective benefits, or lack thereof, of continued treatment. As the article points out, this is particularly needed in late-stage cancer patients. Honest and open communication with patients regarding the truth about their condition and its trajectory is not a sign of a bad doctor, or of giving up hope. It’s a much needed step in improving end-of-life care.

            The Philadelphia-based American Board of Internal Medicine Foundation and a coalition of nine medical societies released their top-five recommendations Wednesday for unnecessary tests and treatments that should be reduced to cut costs to the healthcare system.

            The recommendations suggests late-stage cancer patients who stand to benefit little from chemotherapy should be taken off anti-cancer drugs and given hospice care at the end of life.

            According to the recommendations, as many as ten to 15 percent of cancer patients receive chemotherapy in the last two weeks of life. Continue reading →