Esther was living in a family group home at age 88. She had advanced dementia and suffered a previous stroke. Leann took care of Esther in her private caregiving home and was alarmed when Esther’s blood pressure dropped suddenly as she became sweaty and unresponsive. Paramedics arrived immediately and started IV fluids on the way to the ER. As … [Read more...] about End-of-Life Tools
Palliative Care
Bargaining in Your Patient’s Best Interest
Peter, a spry 91-year-old gentleman with progressive dementia, arrived in the ER after pulling out his feeding tube while sleeping. His daughter, Linda, stated, "He hates this thing. Does he really need it?" While hospitalized for a hip fracture, Peter’s nurses observed him choking while eating. A swallow study with contrast revealed he was at … [Read more...] about Bargaining in Your Patient’s Best Interest
Palliative Care Tools
Andy was just discharged from the hospital, but had to return to the ED when his breathing worsened. At 72, he had smoked most of his life and was also exposed to asbestos while working construction. While his doctors believed he had mesothelioma, the pathology report from a lung biopsy was still pending. Andy did not wish to stay in the hospital … [Read more...] about Palliative Care Tools
Adopt Your Caregiving Philosophy
Linda was aware that her mother, Rose, was not getting better. This was Rose’s third emergency visit in a month for shortness of breath. Rose was 86-years-old and had a bad heart valve that triggered congestive heart failure. After Rose described her symptoms to the physician, Linda prompted her mom to speak up by saying, “We need to talk about … [Read more...] about Adopt Your Caregiving Philosophy
Preventive Care Tools
It was no accident that Gwyn had to be her husband’s caregiver. She was a wellness instructor and understood the value of preventive care. The goal of wellness is to prevent illness. Gwyn had just turned 50-years-old and her husband was diagnosed with multiple myeloma. Gwyn knew the importance of creating balance in her life. But was she prepared … [Read more...] about Preventive Care Tools
3 Tips for a Yearly End-of-Life Assessment
When the ball drops in New York City on New Year’s Eve, will you be ready? When the bombshell of a cancer diagnosis hits you in the ER, what will you do? Listen to the doctor or follow an assessment and plan of your own? Sara was a 68-year-old woman who was not feeling well and had shortness of breath. The doctor thought she might have a blood … [Read more...] about 3 Tips for a Yearly End-of-Life Assessment
Practical Considerations Raised after Watching Netflix’s “Extremis” – Part 3
Few patients anticipate the need for critical care. Some people call 911 too late. Such was the case for Selena in the Netflix documentary “Extremis.” She was having chest pain and struggling to breathe, but she told her daughter not to call EMS. Selena stopped breathing on the way to the hospital. EMS responded and began CPR. A breathing tube was … [Read more...] about Practical Considerations Raised after Watching Netflix’s “Extremis” – Part 3
How to Draw the Red Line in the ER
Self-determination often escapes patients while not feeling well and being hoisted onto a stretcher: Ms. Lacy was 86-years-old and barely weighed 80 pounds. She had an anxious look in her eyes while having difficulty breathing. Her lung cancer was resistant to chemotherapy and had gradually destroyed her sense of well-being for 2 years. Her … [Read more...] about How to Draw the Red Line in the ER