Hospice and Palliative Medicine

Serotonin Antagonist: Should They Be Used in Palliative Medicine? (327)

Nausea and vomiting is a drag! Hope no one is feeling queasy since this talk is all about N/V. Dr. Eric Prommer is very knowledgeable about serotonin and the serotonin antagonist like ondansetron . Interestingly, serotonin, which is constantly being produced, can overcome the antagonist and this is why these medications may lose effectiveness. At … Read moreSerotonin Antagonist: Should They Be Used in Palliative Medicine? (327)

Rage against the Dying of the Light: Geriatrics, Palliative Care, and Dementia

Case based discussion dementia is a chronic illness but not recognized as a terminal illness. There are really not any good secondary prevention measures. Most people with dementia have symptoms if we look for them. Treating depression may reverse some of the cognitive decline. Tertiary Prevention: intensive case management can make a big difference in … Read moreRage against the Dying of the Light: Geriatrics, Palliative Care, and Dementia

Concurrent Palliative Care-Peace of Mind in the Setting of an Uncertain Prognosis; Part 3

This is Part 3, the final part, of a multi-part series. My mom remained in the ICU for a total of 3 weeks, failing extubation twice due to laryngeal edema requiring emergent re-intubation and eventually requiring a tracheostomy in order to facilitate ventilator weaning. She finally was able to wean off the ventilator after 3 … Read moreConcurrent Palliative Care-Peace of Mind in the Setting of an Uncertain Prognosis; Part 3

Entrenching Hospice and Palliative Medicine in the Firmament of Organized Medicine

How AAHPM relates to other organizations such as ACP, ACS, AAFP, AAN and AAP is something our members and leadership will further address over time. AAHPM staff have created a grid for the External Awareness Task Force of the external relationships that already exist and the nature of those relationships. Again, our members and leadership will decide how these relationships should be prioritized over time and what the nature of these relationships should be. Should there be liaison representation on the boards of some of the large organizations? Is that an appropriate way for hospice and palliative medicine to become more entrenched in the firmament of organized medicine? What will be the most efficient and effective way for AHHPM to utilize its limited resources in developing these relationships? Where do we get the most bang for the buck so to speak?

Diving into the Alphabet Soup of PQRI

Four Seasons Hospice has taken the plunge and begun to participate in the Physician Quality Reporting Initiative (PQRI) of Medicare. Since fall 2010, we have successfully been submitting data on three PQRI measures: #47 (Advance Care Plan), #154 (Falls risk assessment), and #155 (Falls plan of care). Our palliative care program extends across the inpatient … Read moreDiving into the Alphabet Soup of PQRI

One Voice, One Message

Hospice and Palliative Care Coalition Leaders Commit to Collaboration; Aim to Speak with “One Voice”

The organizational members of the Hospice & Palliative Care Coalition met in Washington DC in December 2010 to discuss recent, current and future opportunities for collaboration including ways to develop consistent and supportive messages on behalf of the entire field of hospice and palliative care whenever possible.

Concurrent Palliative Care-Peace of Mind in the Setting of an Uncertain Prognosis; Part 2

This is Part 2 of a multi-part series.

Approximately 1 week into her ICU stay, when my mom wasn’t making any progress on ventilator weaning, I was called by the palliative care team asking if they should “formally” consult. They had been visiting daily but not officially consulting – introducing themselves as “Jean’s friends” – who happened to be from palliative care. The ICU attending had tacitly agreed to the consult, telling the palliative care team, “whatever Jean wants”. My initial reaction was no, we didn’t need that, we knew that she potentially could have a poor outcome and were talking openly about it. If anything, I told the palliative care team, my dad needed a ray of hope, not a discussion about the “what if’s”. It was an eye-opening moment for me – to consider the “meaning” of requesting an official palliative care consult and to confront my own perceptions and biases, despite intellectually knowing better. Was I falling into the same “it’s not time yet” mindset that frustrates us so frequently as palliative care professionals? Why would making it “official” be any different from the daily visits that the team was already doing? How would my dad and my siblings perceive my request for an “official” palliative care consult? Would they think that I had “given up” by recommending a palliative care consult? Why didn’t I trust what we do so well in palliative care – starting with assessing the patient (if able) and family understanding of the current situation and addressing identified needs? Why couldn’t palliative care be as much about “hoping for the best” as it is about “planning for the worst”? I told the palliative care team that they needed to “hit me over the head” if I was in denial or not thinking rationally about this clearly reasonable request.

At the White House: ACA Implementation—An Opportunity to Advance Palliative Care

During my year as AAHPM President, I’ve had many opportunities to represent the Academy and have often been on Capitol Hill, looking to expand access to palliative care through the public policy process. On Dec. 17, the Obama administration held a meeting with community physicians at the White House to seek input about implementation of … Read moreAt the White House: ACA Implementation—An Opportunity to Advance Palliative Care

The Evolving Role of Hospice and Palliative Medicine Leadership

As hospices and palliative care services evolve into advanced palliative care organizations with greater scope and influence over late-life care within their communities, a “new” physician executive role is emerging along the career path for HPM physicians. This role is broader than the traditional senior medical director or chief medical officer positions, and is progressing toward what we refer to as the “chief community palliative care officer”.

HPNA/AAHPM Collaboration for Annual Assembly

For the past 6 years, AAHPM and HPNA have collaborated to provide an annual conference for members of the interdisciplinary team. As we would expect, the outcomes have improved annually. Last year’s conference in Boston, recorded the highest attendance, the most satisfied attendees and highest rating for presenters. Is it possible to improve? With any … Read moreHPNA/AAHPM Collaboration for Annual Assembly