palliative medicine

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.

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

AAHPM’s First RFS Representative’s Perspective on AMA Interim Meeting

My name is Devon Fletcher. I’m a Hospice and Palliative Medicine Fellow at the Virginia Commonwealth University Health Systems in Richmond, VA. I recently had the opportunity to attend the American Medical Association’s Interim Meeting in San Diego this November as the AMA’s first ever AAHPM representative to the Resident and Fellow Section (RFS). I’d … Read moreAAHPM’s First RFS Representative’s Perspective on AMA Interim Meeting

Happy 100th Anniversary, PC-FACS

The 100th issue of PC-FACS, an AAHPM signature service, represents a milestone. Celebrating this century issue, Editor-in-Chief Amy Abernethy commented on trends in palliative care since the digest’s inception. Read the 100th issue of PC-FACS. (1) Increasing acceptance of palliative care as a discipline. The palliative care philosophy now extends into diverse settings including mainstream … Read moreHappy 100th Anniversary, PC-FACS

Academy Voices Vital Role of Palliative and Hospice Care in Improving Quality of Health Care

Many health care initiatives launched by the Affordable Care Act focus on improving the quality of health care. The Academy and its members have been participating in these efforts, trying to bring wider visibility to the role that palliative care and hospice care can play in improving the quality of health care for patients with serious, advanced illness.

Palliative Care Grand Rounds 2.9

Welcome to the monthly edition of Palliative Care Grand Rounds the monthly review of the best of hospice and palliative care content from blogs. We started in February of 2009 and are almost done with our second full year. To see previous editions of Palliative Care Grand Rounds go the http://palliativecaregr.blogspot.com/. This summer has been … Read morePalliative Care Grand Rounds 2.9

Day Two of Intensive Review…

The second day was just as intense as the first- fabulous speakers and a review of important information. Here are some pearls from the second day of AAHPM board review course: Dyspnea: (Vincent Jay Vanston) -Total Dyspnea has 4 domains: Physical, Psychological, Interpersonal, Existential -Must address all domains to adequately control Dyspnea -When possible and … Read moreDay Two of Intensive Review…

“Two Days in the Joint”: A Visit to the Joint Commission

…the “newer and friendlier” JC have some progressive, visionary work for the future of healthcare. It was two day conference and networking opportunity for seventy invited representatives from a diverse healthcare contingent representing a variety of organizations from the American Hospital Association, to the CDC to the Undersea & Hyperbaric Medical Society, Inc. All a friendly lot and it was very nice to see the AAHPM represented.

Inside the Process of Authoring a Book: Diane Meier on Palliative Care: Transforming the Care of Serious Illness

Our recent book, Palliative Care: Transforming the Care of Serious Illness (Jossey-Bass, San Francisco 2010), has been a long time coming. I got the invitation from my co-editors Stephen Isaacs and Bob Hughes of the Robert Wood Johnson Foundation over three years ago. The book was to be another in an annual series of books on health reform in areas of significant investment by the Foundation. Prior volumes addressed the Campaign for Tobacco Free Kids and School-Based Clinics, among others.