Mar 15, 2018
by Harri Brackett, RN, MS, CNS, ACHPN
The CUPallCARE blog is starting a new series called “Pathways to Palliative Care”. We have all found our way to End-of-Life care and what we do for our patients is fascinating but just as interesting is how we all got here. In this new series we are encouraging all Palliative Care professionals to share their “pathway to palliative care”. What were your challenges, obstacles and lessons learned along the way?
Every aspect of the person is affected by serious and life-limiting illness. This is also true for family members who care for their loved ones in times of illness. Healthcare providers are typically comfortable addressing physical, mental, and emotional aspects of illness, but addressing the spiritual dimension still raises anxiety levels for many providers who don’t feel they are equipped to talk about spirituality with patients or their families. But talking about spirituality doesn’t have to be difficult.
I have been struggling to put in words what is most important to teach in palliative care. It is important to teach facts, such as 30 mg of morphine by mouth is equal to 10 mg of morphine IV. This is a useful fact that makes it possible to convert one form of medication to another.
Beginning on January 1, 2019, Physician Assistants can begin billing for their services and join hospice providers to care for our dying. In the early morning hours of February 9, 2018, the Medicare Patient Access to Hospice Act HR 1284 was signed, allowing PAs to be reimbursed for their services caring for hospice patients. [Collective sigh]…..It’s about time!
For the last four years, I served as a project manager for Drs. Stacy Fischer and Regina Fink’s American Cancer Society funded study that focused on improving palliative care outcomes for Latinos with advanced cancer. The randomized control trial used lay bilingual, bicultural patient navigators to deliver a culturally-tailored intervention to Latino patients with stage III or IV cancer.
It’s been quite a while since an end-of-life issue has caused such a buzz in the medical world or in the public conversation. Everybody from the New York Times to NPR and other news outlets have shown the image of the chest tattoo on a very ill patient presenting to an ER in Florida with alcohol on his breath, unconscious, with severe COPD and multiple other medical problems.
Summit for Soldiers (SOS) is a program put on by NOLS (National Outdoors Leadership School) in Landers, Wyoming. This is one of the many programs that have been developed to support the re-integration of military Veterans into civilian life. Mike Filman, a NOLS graduate and US Marine (retired) founded SOS to provide community for Veterans in part in response to the alarming rate of emotional and spiritual distress evidenced by depression, substance use disorder and tragically over 8000 suicides a year.
I am old enough to remember the thrill of the movie “The Great Escape.” Steve McQueen and his buddies are prisoners of war attempting an escape from a Nazi prison camp. Some of them make it to safety and some do not.
The “Internet of Things” describes the increasing trend to connect everything through the web. You can now remotely turn on your lights, adjust the temperature or even let a delivery or service provider into your home. In addition, you will be alerted when there is a “problem”. The Internet of Things is also interested in our bodies, recording the number of steps we take, stairs we climb, heartrate, and for me when and if I meditate or exercise. It seems to take joy in sending me cheerful reminders if I don’t.
On January 26, 2017 the University of Colorado Anschutz Medical Campus’ Graduate Council approved the expansion of the interprofessional Master of Science in Palliative Care (MSPC) to include an Allied Health Professional (AHP) Track. Since its inception, the MSPC has incorporated interdisciplinary faculty and teaching modules addressing psycho-social-spiritual-ethical issues within palliative care. Expanding the student body to draw from the disciplines of social work, spiritual care, psychology, gerontology, and ethics replicates the interdisciplinary palliative care team environment in which palliative care professionals work.
It was great meeting so many interested potential Masters of Science in Palliative Care (MSPC) and the Interprofessional Palliative Care Certificate (IPCC) students at the annual Assembly of the American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association (HPNA) last week.
Working for a hospice pharmacy benefit management (PBM) company in North Carolina specializing in geriatrics, Ellen Fulp, PharmD, sees a lot of patients who are dealing with life-limiting illnesses. These same folks are usually taking multiple medications.
Sep 28, 2016
by Carey Candrian and Kirsten Broadfoot
This Wednesday, September 28, at University of Colorado Hospital, Dr. Scott D. Halpern will be giving a Grand Rounds on a topic of great interest: Changing Choice Architecture to Improve Care for Seriously Ill Patients. What is choice architecture, and why might it be of interest?
Jul 14, 2016
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
I did not come to palliative care in the usual way. Most of my colleagues saw the need from an oncology or hospice perspective. I was just a primary care nurse practitioner working away, minding my own business, in an Internal Medicine Clinic. I loved the geriatric population and chronic illness. I educated and coached, cajoled and encouraged all my patients in an effort to empower them to manage their diseases.
When you work with patients/families who are trying to make difficult decisions, it is easy to slip into that reverie of “If they only knew what we know…”. We think that if only then we wouldn’t have to have this difficult discussion, they could make these decisions so much easier, we would all be out of this room. If only it was that easy.
The nation’s healthcare providers are ill-prepared for the oncoming “silver tsunami” – 75 million baby boomers entering their senior years needing individualized care and help making medical decisions, says CU professor Amos Bailey, MD.
Palliative care services are often lacking in rural settings. While I work at the University of Colorado on the Anschutz Medical Campus in Aurora, I live in rural Colorado and see this in everyday life. That is why I am supportive of improving education about palliative care to community providers.
Hi there, I am Regina Fink, one of the nursing co-directors of the new interprofessional Master of Science in Palliative Care Program (MSPC) at the University of Colorado. We are on an exciting journey – offering state-of-the-art palliative care education to working health care providers. We have also developed a Palliative Care Certificate program consisting of four courses that can get you started in palliative care and help you prepare for palliative care nursing certification.