Friday, July 13, 2007

Potpourri for Friday

A couple of quick items for the end of a nice summer week (in Kansas City at least):

The Washington Post has an article on Palliative Care at GWU Hospital. First national PC piece that I have seen that quotes Cameron Muir, current AAHPM president, which is nice to see. It also includes the go-to quote getters for most national PC articles: Diane Meier, Sean Morrison, but surprisingly no Ira Byock. When is the West Coast or Midwest going to get some love? Good to see PC getting any good press though of course. It is surprising that they chose a palliative care team that does not have a strong MD component. The physician input is from residents/fellows or occasionally some geriatricians with PC cert who come into the hospital when needed. What I am curious about is the article was written by Joanne Kenen who has a media fellowship in hospice and palliative care. I did not know those existed.

While I do not know of any hospice chaplains with blogs, a voluntary hospital ER chaplain shares some thoughts on grief and medical loss after preparing to teach a class on that same subject. There are a couple of good links in her post for top ten things not to say to grieving people.

Here is an idea for a novel research paper in prognosis and hospice/palliative care patients: Hand-grip strength is a predictor of all-cause mortality in middle-aged and the elderly. Although the study itself isn't very clinically applicable (full of hazard ratios and quartiles which don't translate well in doctor-patient discussions), maybe this could be studied as an objective indicator for prognosis? Hand grip strengths at hospice admission and every month afterwards? Better work on your handshake.

Rarely do abstracts inspire or impress, but Dr. Pam McGrath and the Australian Journal of Rural Health do quite a great job in reviewing Aboriginal people's preference for location of death. Here is a great quote from that abstract in regards to the desire to die at home:

"...including the strong connection with land and community, a belief in ‘death country’, the importance of passing on sacred knowledge to the appropriate family member, the significance of ensuring that the dying individual's ‘animal spirit’ is able to return to the land, and the imperative that the ‘right person’ in the family network is available to provide the care."

From the previous post about hastened death in the news, Dr. Crippen at NHS Blog Doctor posts more information about the UK physician who was accused of hastening the death of two infants. Be sure to read through the comments section. And here you can find a BBC update.

And get ready for a big Pallimed surprise coming soon!

Nice summer picture courtesy of user: acastellano

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