![]() An article, “The TLC Model of Palliative Care in the Elderly: Preliminary Application in the Assisted Living Setting” in the Annals of Family Medicine, describes 5 barriers to palliative care with the elderly who live in assisted living facilities. We can definitely generalize this to most situations where the elderly would benefit from palliative care. Basically, the 5 barriers to palliative care for them are:
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![]() Dr. Balfour Mount is to the palliative care movement what Dame Cecily Saunders is to the hospice movement. Of course Saunders came first and introduced Mount to the new philosophy of caring for the dying in 1973; but, it is Mount who is the father of palliative care in the hospital setting. He coined the term ‘palliative’ and it was he who first brought this type of care into a large university teaching hospital, the Royal Victoria Hospital in Montreal, Quebec, Canada. “What has surprised me is how little palliative care has to do with death. The death part is almost irrelevant. Our focus isn’t on dying. Our focus is on quality of living.” —Mount. I’m sending you to a couple of places to read about him. His influence and dedication is the very beginning of the hospital-based, pre-hospice palliative care movement that has been picking up speed in the last several years. A Moral Force: the story of Dr. Balfour Mount McGill University, Whole Person Care ![]() Here’s a great resource for people who are dealing with a family member or patient with advanced dementia–Palliative Care Dementia Resources. It separates the resources by topics and is easy to follow. To me, some of the most disturbing symptoms of dementia are emotional and mental pain. It can be devastating for everyone, but not as much as for the person who is sitting with that kind of discomfort. Medical professionals are getting better ![]() Morphine is one of many drugs that is used to treat moderate to severe pain and also it is used to treat shortness of breath. Not many people know that. In hospice medicine we use it all the time for both and it is one of the standards for the treatment of shortness of breath. If someone is allergic or for whatever reason cannot take morphine, there are other drugs in this same category to try. There is the thought in the medical community (outside of hospice) that ![]() The following e-mail that Gail Sheehy wrote could have been written by many people who are living with illnesses in their end-stages. She wrote about her and her husband’s experiences with frequent hospital visits and the medical predictions (that usually go with them) that often don’t pan out. Palliative care stops all this nonsense but few know about it. A person can be treated within the palliative care medical system and still do whatever they’d like as far as cure-directed treatments go….or not. The only right decision is the one we want. Know that comfort is possible before hospice is chosen. Palliative care is not just for hospice anymore. ![]() There’s some snobbery in a person judging if another person is in denial, don’t you think? Sitting around tables we shake our heads or we tsk-tsk or the like because some unfortunate soul is not coming to terms with their own death or with that of their loved one. How rude. Suffering, hope, depression, grieving, coping, etc. have faces and nuances we don’t always recognize or understand in people. To cope with hope….what’s wrong with that? ![]() The palliative care movement is the bridge from which research, findings, information and practical applications can flow back and forth between the 2 worlds (of acute care and hospice care) we have now. Palliative care is the vehicle to blend these worlds. Moving hospice information up to the pre-hospice world of serious illness…. moving palliative care along side of cure directed treatment to bridge total care of a person…moving the pre-hospice person to hospice without a crisis driven admission but rather from a quiet contemplation of choice. ![]() I was working as a case manager with a local hospice when my grandmother was diagnosed with lung cancer. She was in her late 70s, had been smoking for 60 years and had dealt with severe bouts of chronic bronchitis most of her life. The day she entered the hospital, I flew to Tampa. At first we thought she had a bad case of pneumonia. We thought she was dying. I slept on an air mattress in the room with her for about a week until we knew she would survive it. During this week we were told her pneumonia was due to a cancerous tumor obstructing her lower lung. She made it past the pneumonia, now all we had to deal with was her cancer. ![]() Regarding medical care, we are in technological wonderland in some areas and in others we are still behind. Regarding the management of dyspnea, (dyspnea is shortness of breath), we haven’t done so well in end-stage diseases which are not yet terminal. Research is showing that morphine and like drugs (opioids) are effective in its management so that people, no matter what their disease process, can live and have a quality life as well. In this discussion we are referring to the person who is not classified as terminal. ![]() Have you ever seen someone struggling to breathe as part of their illness? I’m referring to people living with ‘end stage’ lung or heart disease or advanced cancer with breathing difficulties. Living with end stage illness or late stage cancer does not necessarily mean you are terminal. Often, a person is not. People, especially those with the various chronic lung diseases struggle for several years like this. The anxiety that accompanies these attacks seems to be written off |
AuthorIn fall 2014, I moved some old blog posts here that I had written years ago from 2007 to 2010. Hope they are helpful. Archives
February 2010
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