… Halifax et. al. describe a contemplative end-of-life training program for health care professionals … Being with Dying. ” … bringing a present moment quality of presence to interactions has the potential to transform the care of dying people as well as the caregivers themselves. Cultivating this quality within themselves and others allows clinicians to […]
the power of presence … Read More »
… from Legrand and Walsh at the Cleveland Clinic. some pearls of practical guidance for the care of the dying … the first step is to diagnose the dying process … “Families have a need and a right to prepare for a death.” … also … signs of impending death (Table 2) … barriers to
comfort measures protocol for the dying … Read More »
… the Atlantic Monthly on Dr. John Ioannidis’ research on the quality of medical research – “Lies, Damned Lies, and Medical Science“. Ioannidis shows that over 3/4 of non-randomized and as many as 1/4 of randomized studies are wrong. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to
medical research itself under the microscope … Read More »
… Loprinzi and colleagues review a series of articles from the Journal of Clinical Oncology which addresses how to have difficult conversations (giving bad news, making life decisions). A recurrent theme highlights the importance of the physician working through his/her own needs and issues … eg “The article presents data from behavioral research that documents
compassionate honesty … Read More »
… a study that tried to improve end-of-life care in the intensive care unit with a series of education interventions concluded that “… this intervention was associated with no improvement in quality of dying … Improving ICU end-of-life care will require interventions with more direct contact with patients and family.” Shades of the SUPPORT study
palliative care in the icu … Read More »
… one of the great myths of our time? Manzi writing in City Journal “What Social Science Does – and Doesn’t – Know”. … with applications to evidence based medicine … “By about a quarter-century ago, however, it had become obvious to sophisticated experimentalists that the idea that we could settle a given policy debate
the experimental method … Read More »
… are best managed on a case-by-case basis after thorough evaluation, in general using behavioral approaches (not drugs). Some resources … An excellent monograph from the Alzheimer’s Assoc. A slide-set from the Int’l Pyscho-Geriatric Assoc. More than you want to know … including a primary care guide. A BPSD Handout.
behavioral & psych symptoms of dementia … Read More »
… is getting a lot of press … the NEJM article and editorial. … NYT … WSJ … Diane Rehm show with Diane Meier, Atul Gawande and the study authors. Alex Smith and GeriPal summarize … Tim Cousounis with an excellent summary … providing balance and caution … scroll down for Weissman’s warning of “over-interpretation” and
nejm study … palliative care in lung cancer … Read More »
… “Why do we make potentially inefficacious therapies the default and require patients to opt out to avoid them?” … asks Brauner in a JAGS editorial accompanying an article on comfort feeding. “By creating an alternative treatment order—comfort feeding only (CFO)—Palecek and colleagues1 have taken an important step toward improving the care of persons with
default medicine … Read More »
