Terminal Velocity

This article offers a nice discussion of the dying process.
Nancy

Terminal Velocity on Journal of Palliative Medicine : a Multi-disciplinary Blog to Advance Palliative Care by Author VJ Periyakoil, MD, Senior Associate Editor, JPM

Article of Interest : The Quagmire

The Quagmire : How American Medicine is Destroying Itself.   CALLAHAN D, NULAND S.   New Republic [serial online]. June 9, 2011;242(8):16-18. Available from: Academic Search Premier, Ipswich, MA.  Accessed August 30, 2011.

Link to Full-text Article.  

Summary :   The article discusses what the authors consider to be an unsustainable trajectory in American medicine. In their view too many resources are being committed to the pursuit of cures for chronic illnesses not likely to be remedied for many years to come. They believe that medicine should adopt new priorities, starting with the goal of bringing everybody's life expectancy up to the age of 80. They maintain that geriatric care should focus less on postponing death and more on increasing the quality of life during one's final years.

Pain Resource Team Topics

Affinity Health System’s Pain Resource Nurse Team consists of RNs from the hospitals and clinics working to promote pain education for all staff at all sites and improve patient care. Dr. Nancy Homburg co-chairs this team and provides valuable input for us.

The Team has developed several topics to address some of the common side effects of opioids, treatment of pain in the older adult, and the Fentanyl patch. These evidence-based practice topics are for your reference and will also be available at each Nursing station and in the Clinics.

The Current Pain Topics are linked below on the "Pain Resource Team"  Webpage (35708)

Treating Pain in the Older Adult    (35702)

Opioid-Induced Nausea and Vomiting  (35705)

Opioid-Induced Constipation  (35706)

Transdermal Fentanyl   (35707)

If you have any questions or suggestions for other topics, please contact:

Caroline Alterman, MSN, RN, CNL - AHS Pain Management

Office phone: 223-1229 - Mercy Medical Center

738-2089 - St. Elizabeth Hospital

calterma@affinityhealth.org

Concurrent Care for Children Implementation Tool Kit by the NHPCO

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law enacting a new provision, Section 2302, termed the “Concurrent Care for Children” Requirement, the CCCR.  This means all children with a life threatening illness can receive full treatment and still have the support of hospice care. See links below for the tool kit.

Nancy

The National Hospice and Palliative Care Organization has a wonderful resource on concurrent care for children. You can find their toolkit on their website, or use this direct link.  

This can be a wonderful resource for developing guidelines, policies or procedures for implementing concurrent care for children.  

EOL Coalitions - Training Materials for Caring for Veterans at the End of Life

Hello all,

Thought I would send out a small introduction to a training tool that we have developed under a grant that is available free of charge to address the unique needs of veterans at end of life.     The finishing touches are being put on the DVD and audio CD so it will be a month or so before we will be mailing out the Tookit.

If you are interested, or know of anyone else that would have a use for these materials be send me your mailing address.    We will put one in the mail to you when the DVD and audio CD is complete.   

There will also be a presentation at the HOPE (the state hospice association) Annual conference that is scheduled for Oct 26 & 27 in Appleton where hospice providers will receive the completed toolkit.   For a review of some of the materials, you can also look at the HOPE of Wisconsin web site at https://hopeofwisconsin.org/ProgramsToolkits.aspx  and select Veteran Partnership.

[Offerings include some of the following documents : ]

Honoring Veteran Preferences in End-of-Life Care (pdf)

Intake / Admission - Identify Veterans upon Admission

          The Military History Pocket Card 

Quick Tips for PTSD/Anxiety (pdf)

Thank you for caring for our veterans

Teri Rostberg, Exec Director

Hope Hospice and Palliative Care

Medford WI

715-748-3434

[Posted with Teri's permission and encouragement.]

We are finding agencies that may use some of the materials useful as well beyond Veteran clients and their families.

Twin Cities Program Helps Patients Discuss End-of-Life Planning

Listen here :


Or read about it here.

Dr. Homburg says :   "This is a wonderful link. Exactly what we're hoping to do with the Fox Cities Foundation Grant." 

Treat the Pain

From their website :  "The disparities in access to pain treatment worldwide are staggering. Cancer deaths are expected to double by 2030 and many of those deaths will be in developing countries with little to no access to adequate pain treatment. Through the Treat the Pain campaign, we are advocating for effective pain control measures to be available to all cancer patients in pain. We invite you to join us in helping stop unnecessary suffering worldwide."

The initiative includes short videos from the LIFE Before Death Documentary Series that are meant to be shared in effort to spread the word and "treat the pain" of this global problem.

LIFE before Death : Free Training Films

These 50 powerful short films are freely available to any pain, palliative care, hospice and end of life health professionals around the world to download here and use for training and advocacy.

LIFE Before Death is a documentary project supported by the Lien Foundation, the IASP, the Mayday Fund, the UICC and the Institute for Palliative Medicine at San Diego Hospice.

These Short Films feature leaders from the field including Dr Kathleen Foley, Dr Balfour Mount, Dr Betty Ferrell RN, Dr Jim Cleary, Professor Michael Cousins, Dr Henry Ddungu and Dr Charles Von Gunten.

The Short Films will be releasing at a rate of one per week from May 2011.

Article of Interest : Treatment of Cancer Pain

Treatment of cancer pain  Russell K Portenoy MD
The Lancet, Volume 377, Issue 9784, Pages 2236 - 2247, 25 June 2011
Link to Full Text Article
SummaryIn patients with active cancer, the management of chronic pain is an essential element in a comprehensive strategy for palliative care. This strategy emphasises multidimensional assessment and the coordinated use of treatments that together mitigate suffering and provide support to the patient and family. This review describes this framework, an approach to pain assessment, and widely accepted techniques to optimise the safety and effectiveness of opioid drugs and other treatments. The advances of recent decades suggest a future that includes increased evidence-based targeting of specific analgesic interventions within an individualised plan of care that is appropriate throughout the course of illness.

Full-text Article available at : at :  http://www.sciencedirect.com/science/article/pii/S0140673611602365    

A Patient's Journey with Palliative Care Services

Affinity Palliative Care Nurse, Sally Marohn discovered this YouTube video that elegantly and eloquently explains what Palliative Care means to this patient. She  goes through all the emotions as she explains ...  Enjoy!