Palliative Care Grand Rounds June 2011

Palliative Care Grand Rounds is back after a brief hiatus.  Thanks to last month's host Tim Cousounis for restarting PCGR with a bang.  Let's jump right into the best of the blogs featuring hospice and palliative care from the last month.

• Melissa Sweet from Australia blogs for Croakey (the health care blog of the site Crikey).  She recently featured  Palliative Care Australia and their efforts to develop a national consensus statement on palliative care. From the first post a larger discussion on the use of social media to help palliative care grow in Australia led to a second post.  (Found via @GroundSwellAus)

• Blog posts written from personal experience are so helpful in understanding how health care is experienced from the other side of the Electronic Medical Record.  Nora O'Brien-Suric, a geriatric social worker, writes about delirium in her father after bypass surgery on "health AGEnda" the John A Hartford Foundation blog. She writes:

So my family members asked physicians they knew the same question and reported back to me that a cardiologist, a neurologist, and an internist had said that my father should not be experiencing any confusion after surgery and therefore he must have dementia. This came as a complete surprise to me, as I just assumed that all health care professionals, especially those who work with older people, would know what I knew.

• From this post I found out there is a brand new group looking at this issue in more detail, the American Delirium Society.  Can you believe it?  This is one symptom that needs more attention and I am so glad to hear this. They just finished up their first conference this week.

• Tara Parker-Pope at the blog "Well" (NY Times) features the great multimedia mini site from the New York Times on Childhood Cancer.  It features pictures and audio recordings of 6 children (via Krista Renenger at the HFA's Hospice and Caregiving blog)

• GeriPal was on fire in may with some great posts.  Alex Smith with 'Your Tax Dollars Are Being Wasted by Medicare' makes a compelling argument why talking about the role of money in our health care system needs to be part of a larger discussion.  I also enjoyed Eric Widera's post on choosing between two different specialties, in his case Geriatrics and Palliative Care.  Well at least we know what happens when those two get together, you get GeriPal and we all like that!

• Empathy is a common theme in communication training for any palliative care trainee, but Dr. Shock emphasizes that etiquette and not empathy might be the more appropriate 'e' word:

Empathy or the ability to appreciate someone else’s emotions and express this emotional awareness is a capacity that differs amongst individuals. It’s clear that doctors who can communicate well with patients will be more effective. Communication is an important competence educated during med school. This is mostly about etiquette instead of empathy.

• And here is a bonus from Dr Shock: the video 'Beards and Bow Ties.'  I'm thinking we might need something like this for hospice and palliative care.  Reading the comments you can see even something like this is controversial.

• Garr Reynolds is well-known in speaking and presentation circles for his books like Presentation Zen.  (NB: all people who present at conferences can benefit from reading his books.  Please. No more boring slides. Please.) He recently wrote about the importance of Grandmothers in his post "The Eternal Power of Relationships"  There is much in this post any palliative care advocate would like and probably find something to take away with them. And one of them has to do with a Japanese song called "Toilet Goddess." You should read the English lyrics. 

• Fresh Widow blogs about the integration of LGBT families into grief support groups.  The civil rights of the LGBT community have very real consequences when it comes to health care but also in the aftermath of an illness and death.  She challenges organizations who care for grieving people: 

Civil rights IS an issue for organizations that support the grieving. Gay families are families. I challenge organizations that support grieving people to accept love and families of all stripes and to STATE their non-discrimination policies up front. Because sad as it is, you can lose a partner and STILL get turned away from free, peer-based support, and you can make that call without ANY idea how you'll be received.

• Now here is a post that should spark your imagination for some research studies and maybe feedback to trainees. The Talk-o-Meter iPhone app that measures how much each person in a two-person conversation is talking.(via GOOD magazine) I'm thinking it could be helpful in IDT if it could track multiple voices. Speak up chaplain!

• What is the role of scientist in explaining research to the public?
• What are the barriers to communicating this well?
• How does one read a scientific paper?
• And why should we all understand statistics a little bit better?
• Why don't professional media outlets rarely cite the author or journal or title of articles they quote?
• Why should you never draw your conclusions solely from the tables and figures of a paper? 

I love this quote from Freed:

Now listen: most non-scientists see a table like this and freak out. They take around 3 seconds to decide they can’t understand it, get scared of feeling stupid in the face of all those numbers, and so they calm down by skipping over it and back to the words. Scientists have a huge advantage over their non-scientist friends on this front: they don’t expect to understand this table in three seconds. Or even three minutes. They look at it the way a piano player might look at a Bach score, or an art lover might look at the Mona Lisa.

Thanks for tuning into to another edition of Palliative Care Grand Rounds. Look for us in July on another great hospice and palliative care blog.  For updated schedules and past PCGR see http://www.palliativecaregrandrounds.org/