The Show’s Over
August 9, 2012 | 
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"The show's over," he had muttered several times.
Whether he knew it or not, he was telling her it was time. Maybe it’s just that simple, though we usually don’t allow it to be so. Read the rest of this entry »
The fine line between son-in-law and doctor-in-law: by Nicky Quinlan, JPM Fellow-in-Training Columnist
Daisy is 68. In the past few years, she has experienced life with a neurological condition causing progressive functional decline, pain, visual impairment and other indignities. Surprisingly to me, she cut a rug into the wee hours at my sister’s wedding in Ireland recently. Other days, she sleeps a whole lot and needs much assistance with mobility and ADLs from her loving, dedicated spouse, Abe.
Her spirit remains strong, however.
Daisy is also my mother-in-law. Read the rest of this entry »
JPM Honors All Mothers Worldwide: Happy Mother’s Day
The unconditional love and compassion that is the cardinal aspect of a Mother's expression of her caring is also a key premise of palliative care. We take the opportunity today to thank all mothers worldwide for teaching us the caring and compassion we show all our patients and families. Read the rest of this entry »
Posted in Art of healing, Celebration, General, Geriatrics, Grief, Holistic healing, Humanistic medicine, Humanities, National Holidays, Opinions, Patient Centered Care | 
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“If the good Lord calls me home…”
Mary’s eyes widen, she all at once thinking that what she had thought was what anyone else might think.
Until, of course, it’s your turn to think.
“It’s not like on TV,” I say, pausing for an answer that doesn’t readily come.
“We’ll put a tube down your throat,” I continue, after waiting, “let a machine breathe for you,” her eyes, made wise by 95 years, suddenly recognizing what had not before been obvious. Read the rest of this entry »
Gen X Family Caregivers
By 2030 there will be 3 seniors for every "kid." And in an age of divorce, the caregiving complexities go up by the square (step-parents, half-siblings, step-siblings...). Nearly half of Boomers have been divorced, so their kids now have 2 households to juggle.
And many men are estranged from their children. In the divorce, "mom kept the kids," physically and emotionally. Read the rest of this entry »
American Board of Internal Medicine releases new MOC module on Hospice and Palliative Medicine
We have achieved a huge milestone for palliative care. Earn 10 MOC credits by completing of the new ABIM Hospice and Palliative Medicine Self Evaluation Module! This module consists of 25 multiple choice questions, rationale for the answer choices for each question and a set of references. Read the rest of this entry »
Palliative Care in LA Times
LA Times columnist Steve Lopez profiles a gentleman with end-stage cancer who, along with his family, is receiving palliative care support at home–”Not Ready To Die, But Prepared”. In this December 4th piece, Mr. Lopez also references some palliative care research, health care policy implications and questions why palliative care and hospice are often not positively represented in political discourse on these subjects.
While at the LA times site, its also worth reading Mr. Lopez’s other, more personal piece, “When Death is Certain, but Dignity is Not.” In response to his story, many readers have responded with their own.
Posted in Cancer, Death, Dying, Geriatrics, Health Policy, Media, Patient Centered Care, Policy, Quality of life | 
Tags: palliative care, Patient centered care | Comments Closed
Be Still
I would like to share some of the art I created during training as a way of reflection and self care . Read the rest of this entry »
Posted in Art of healing, Geriatrics, Humanistic medicine, Reflective practice, Self care | 3 Comments »
Dying Cancer Patients
Dying cancer sufferers should not be given “futile” and expensive drugs, experts have said in a warning over the “culture of excess” in treating the disease..... Read the rest of this entry »
When a parent is ready to let go, but the child isn’t
I see now, even long before her actual death, she was letting go. It was natural for her, not scary at all. More of her time was spent in her internal environment–meaning inside herself. As a healthcare professional who had worked with older individuals, this made absolute perfect sense. But as a daughter, it was hard to understand and accept that she was in the process of letting go, of, well, dying Read the rest of this entry »
Long Term Care of Older Americans
Great video about long term care options. May help clinicians unfamiliar with Geriatric care as well as families looking to better understand long term care. Read the rest of this entry »
World Health Organization report on Palliative Care for Older Adults
Looking for a document to use to spread awareness of palliative care?
The World Health Organization has recently released a report entitled Palliative Care for Older People: Better Practices (2011). It provides an interesting review of palliative care services throughout Europe (including a description of integrated palliative care in four Eastern European countries), and it includes sections on dementia, palliative care in the nursing home, and family caregivers. Of special interest is the description of England’s End of Life Care strategy, which includes advance care planning and coordination of care across settings.
Burdensome Transitions: Harry Potter and Health Care Reform: by Joan Teno, MD, MPH
Based on research and my clinical experience, my concern is the financial incentives of Medicare and Medicaid result in some health care providers hospitalizing NH residents to qualify them for SNF Medicare benefits. My fear is what you pay for is driving force in these health care transitions. Often this is not an explicit decision, but the middle-of-the-night reflex act of sending a frail, older patient to the ER. Read the rest of this entry »
Going Postal
An 86 year old patient with advanced malignancy is seen by palliative care for anemia, dyspnea, fatigue and pain. Patient is a very meticulous person and maintains pristine personal financial records and documentation. His fatigue has been getting worse. On questioning, Read the rest of this entry »
June 15th is World Elder Abuse Awareness Day
Mr. S, an elderly gentleman with terminal non-cancer diagnosis was admitted to the palliative care unit for terminal care. As is often the case, his functional status improved with good palliative care to the point that he was able to go out on pass. In one of his outings, he met a scam artist who claimed to be a real estate agent. She was a young women who convinced him to buy a house in her name and offered to move in with him into the house and provide care for him until he died after which she would take the house as payment. His children did not know about this arrangement and she told him to withhold the information from everyone. The patient who became very attached to the scam artist initiated paperwork to buy the home for the scam artist. Fortunately,.... Read the rest of this entry »
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