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LIFE IN THE END ZONE

LIFE IN THE END ZONE: A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD

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LIFE IN THE END ZONE | blog.drmurielgillick.com Reviews
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LIFE IN THE END ZONE | blog.drmurielgillick.com Reviews

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LIFE IN THE END ZONE: A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD

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Life in the End Zone: Putting the Genie Back in the Bottle

http://blog.drmurielgillick.com/2015/03/putting-genie-back-in-bottle.html

Life in the End Zone. A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. March 22, 2015. Putting the Genie Back in the Bottle. Discuss this phenomenon, calling it “the undiffusion of established practices.”. Describes how physicians jumped on the bandwagon of ordering noninvasive. What does all this tell us about “undiffusion? How do we change behavior? Going back is hard. Commenting on the articles in JAMA Internal Medicine. Frank Davidoff quotes D...

2

Life in the End Zone: December 2014

http://blog.drmurielgillick.com/2014_12_01_archive.html

Life in the End Zone. A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. December 28, 2014. The Role of the Rules. In a ringing endorsement of autonomy, the preamble. The right of the states to pass laws (and to promulgate regulations allowing for implementation of those laws) that further the. 8220;health, peace, morals, education and good order of the people.” But just who is it that the regulations would protect? Surely it is not the residents wh...

3

Life in the End Zone: January 2015

http://blog.drmurielgillick.com/2015_01_01_archive.html

Life in the End Zone. A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. January 28, 2015. What would a new benefit package for the frail, known as intermediate care, cost? How could we pay for it? See next blog post. Links to this post. January 25, 2015. Doing the Right Thing. Published in 1969, opened the curtains on life’s final act. Then came Sherwin Nuland in 1994, with How We Die: Reflections on Life’s Final Chapter. Who is in the gray zone?

4

Life in the End Zone: March 2015

http://blog.drmurielgillick.com/2015_03_01_archive.html

Life in the End Zone. A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. March 30, 2015. When Push Comes to Shove? There’s been a lot of talk about advance care planning lately, with Ellen Goodman’s Conversation Project, Atul Gawande’s book, Being Mortal. And very recently, Angelo Volandes’ book, The Conversation. Illness. A new study. Cases where the doctors simply never saw the advance directive. These are all cases in which the plan was not t...

5

Life in the End Zone: What We Believe

http://blog.drmurielgillick.com/2015/04/what-we-believe.html

Life in the End Zone. A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. April 12, 2015. For running an article about the. From the FrameWorks Institute, “Gauging Aging: Mapping the Gaps Between Expert and Public Understandings of Aging in America.” And shame on the NY Times. The Wall Street Journal. So what did they find? The experts see aging as presenting challenges, but also an opportunity for growth and the possibility of continued contribution...

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Secondhand Antibiotic Exposure in Nursing Homes | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/07/secondhand-antibiotic-exposure-in-nursing-homes.html

Thursday, July 9, 2015. Secondhand Antibiotic Exposure in Nursing Homes. But what about those living in the nursing home who aren’t prescribed these medications, is there a risk to them even if they aren’t the ones getting the antibiotic? A recent study that came out in JAMA IM. The authors of the study. The Take Home Point. Inappropriate antibiotic use for the treatment of things like asymptomatic bacturia not only affects the patient, putting them at risk for adverse outcomes, but also puts at risk the...

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Celebrate nurses week by stopping the customer satisfaction nonsense | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/05/celebrate-nurses-week-by-stopping.html

Sunday, May 10, 2015. Celebrate nurses week by stopping the customer satisfaction nonsense. By: Alex Smith, @AlexSmithMD. A special double happiness to the nurses who are also mothers today. This year, as we celebrate the awesome nurses in our lives, let's take a moment to consider what makes a terrific nurse. In a recent Atlantic article, titled " The Problem with Satisfied Patients. 8220;During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?

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Flags of Grief | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/06/flags-of-grief.html

Friday, June 19, 2015. By: Genevieve Flagello, LMSW, ASW. Though moving and helpful, something has been missing from our ritual. Another staff member, a veteran himself, has been reorganizing the process so that when a veteran dies anywhere in our facility, the veteran is draped in an AMERICAN FLAG, followed by the procession. This might not seem like much of a change to an onlooker, but to me, it made a world of difference. Was I crying for my patient who just died or for all of my patients? No more bac...

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A better way to care for frail patients: Independence at Home | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/06/Independence-at-Home.html

Wednesday, June 24, 2015. A better way to care for frail patients: Independence at Home. Last week the Centers for Medicare and Medicaid Services (CMS) released a report that I think will change how geriatric palliative care will be delivered in the United States. What is the report? CMS released the results. From the first performance year of the Independence at Home Demonstration. What were the results of the first performance year of Independence at Home (IAH)? According to CMS' analysis, all 17 parti...

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Length of Stay in Nursing Homes at the End of Life | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2010/08/length-of-stay-in-nursing-homes-at-end.html

Thursday, August 26, 2010. Length of Stay in Nursing Homes at the End of Life. One out of every four of us will die while residing in a nursing home. For most of us, that stay in a nursing home will be brief, although this may depend upon social and demographic variables like our gender, net worth, and marital status. These are the conclusions of an important new study published in JAGS by Kelly and colleagues. Many of whom are geripal contributors, including Alex Smith and Ken Covinsky). I think these f...

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July Mind, Beginner's Mind: Teaching Imminent Death | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2013/07/july-mind-beginners-mind-teaching.html

Friday, July 19, 2013. July Mind, Beginner's Mind: Teaching Imminent Death. Shunryu Suzuki by Robert Boni. Zen Mind, Beginner's Mind. Is a collection of talks by the late Zen Master Shunryu Suzuki. The book opens with the words:. In the beginner's mind there are many possibilities, but in the expert's there are few.". And how do you explain palliative care. How much time does he have? What physical changes can we expect? Can he still hear me? And bringing the patient into the room can be hard for new fel...

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How do you explain hospice? | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2012/07/how-do-you-explain-hospice.html

Friday, July 6, 2012. How do you explain hospice? It's early July, and so many of us are working with new trainees: fellows, residents, interns, medical students, nursing students.any kind of trainee. Last year at this time I wrote a post about explaining palliative care. To patients and their families, this year I thought I'd write about how we explain hospice. I'll put myself out there first and look forward to reading how others approach explaining hospice in the comments. Hospice is also a benefit&#4...

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ePrognosis 2.0: PPS and Cancer screening | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/08/eprognosis-20-pps-and-cancer-screening.html

Friday, August 7, 2015. EPrognosis 2.0: PPS and Cancer screening. By: Alex Smith, @AlexSmithMD. The geriatrics, general medicine, and palliative care communities have spoken, and we've been listening. Is the website we created to help clinicians in everyday practice calculate prognosis or life expectancy. Two things we've heard over and over about how we could improve ePrognosis. We want the PPS! EPrognosis doesn't have any really short term prognostic calculators.". From the main page. Outcomes from the...

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A Giant Thank You to CMS: Advance Care Planning Has Value | GeriPal - Geriatrics and Palliative Care Blog

http://www.geripal.org/2015/07/cms-advance-care-planning-has-value.html

Wednesday, July 8, 2015. A Giant Thank You to CMS: Advance Care Planning Has Value. Today it is time to celebrate! Today the Center for Medicare and Medicaid Services (CMS) announced that it is taking a tremendous step to improve the care of Medicare beneficiaries and ensure that patients receive care that matches their goals and values. CMS proposing to begin payment for advance care planning! In a call for ACP payments last year GeriPal cited:. There is now clear guidance to policy makers. Drs Bernacki...

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LIFE IN THE END ZONE

LIFE IN THE END ZONE. LIFE IN THE END ZONE: A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD. March 04, 2018. When Skim Milk Masquerades as Cream. Researchers at the University of Michigan surveyed just over 2000. People between the ages of 50 and 80 to find out whether they thought physicians prescribe too much, too little, or just the right amount. What they found is surprising. Links to this post. Labels: low value care; choosing wisely. This we...

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