End of Life Care

Mar 15, 2017 Issue
Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care [POEMs]

For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

Mar 15, 2017 Issue
Palliative Care Through Illness Trajectory [Curbside Consultation]

Persons with multimorbidity often have unmet multidimensional needs related to their health. For example, Y.S. may also be experiencing poorly controlled symptoms, financial distress, and increasing anxiety. His family is likely distressed by his decline in health and unsure about what to expect nex...

Mar 1, 2016 Issue
When Physician Family Members Are Involved in Patients' Care [Curbside Consultation]

It is not unusual for physicians to care for patients who have physician family members. This can be advantageous for patients, their families, and the clinical team because physician family members often better understand the clinical situation, its severity, and the treatment options. They can als...

Apr 1, 2015 Issue
Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests [Curbside Consultation]

Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment decisions.

Jul 1, 2014 Issue
Pharmacologic Management of Pain at the End of Life [Article]

Learn how to provide safe and effective analgesic relief through the use of pain assessment scales and proper administration of opioid and nonopioid medications.

Jul 1, 2014 Issue
Beyond Analgesia in Palliative Care and End-of-Life Interventions [Editorials]

Family physicians need a basic skill set that includes facilitating discussions on advance planning and goals, identifying and treating depression and anxiety, and managing pain and symptoms at the end of life.

May 1, 2014 Issue
The Hospice Referral [Curbside Consultation]

Hospice is a program of care and support for persons facing life-limiting illnesses. Hospice care involves a team-oriented approach to medical care, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes.

Dec 15, 2013 Issue
Palliative Care: Benefits, Barriers, and Best Practices [Editorials]

Palliative care improves the quality of life for patients with a life-threatening illness and for their families. Despite documented benefits, palliative care is underutilized in the management of advanced or terminal illnesses.

Sep 15, 2013 Issue
Frailty as a Terminal Illness [Editorials]

Debility not otherwise specified (NOS) has surpassed lung cancer as the most common diagnosis in hospices. In August 2013, the Centers for Medicare and Medicaid Services issued a rule that debility NOS and adult failure to thrive can no longer be listed as principal hospice diagnoses, but rather, secondary comorbid conditions.

Mar 1, 2012 Issue
Implementing Advance Directives in Office Practice [Article]

Patients prepare advance directives in an effort to maintain autonomy during periods of incapacity or at the end of life. Advance directive documents are specific to the state in which the patient lives, but an effective strategy in the family physician’s office involves more than filling out a form...

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