2011 05 11 hpm tweetchat transcript
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  • 1. #hpmHealthcare Hashtag Twitter Transcript From: Wed May 11 18:00:00 PDT 2011 To: Wed May 11 19:00:00 PDT 2011 Customize transcript dates and layoutLearn more about #hpm at The Healthcare Hashtag Projectctsinclair Few days left: #Hospice is trouncing Electronic health records 68 to 32% in Modern Healthcares (fake) tourney http://hpm.md/jytCpf #hpm Wed May 11 18:00:20 PDT 2011MeredithGould @DNRstories Ugh...feel better. Migraine headaches bite. #hpm Wed May 11 18:00:21 PDT 2011MatthewsMichele @DNRstories sorry to hear that; Hope you feel better! Youll join us next week then? #hpm Wed May 11 18:00:44 PDT 2011hollyby For the next hour, Im tweeting from the #Hospice and #Palliative Medicine Tweetchat. Learn how http://bit.ly/dcA3ic via @ctsinclair #hpm Wed May 11 18:00:47 PDT 2011hollyby Welcome to the #Hospice and #Palliative Medicine Tweetchat! Let’s get started with some introductions. Im hosting tonight. #hpm Wed May 11 18:01:36 PDT 2011aliciabloom time for the #hospice and #palliative medicine tweetchat! #hpm Wed May 11 18:01:40 PDT 2011MeredithGould <--sociologist, keen on communicating health & building community; author; writer; gadfly. Also tweet as @HealthFaith #hpm Wed May 11 18:02:12 PDT 2011drpippa <---family doc, HPM doc, tweeting life and work from Boston. #hpm Wed May 11 18:02:49 PDT 2011ctsinclair Christian Sinclair, palliative MD @KCHospice, editor @Pallimed, CEO @KLXmedia, fan of sports not liked in US (soccer, hockey, #F1) #hpm Wed May 11 18:03:28 PDT 2011
  • 2. hollyby Hello! Holly Yang, HPM doc from @SanDiegoHospice. All tweets are my own. #hpm Wed May 11 18:03:38 PDT 2011ctsinclair RT @MeredithGould: Hey friends, will be chatting about hospice & palliative medicine for the next hr. All welcome to follow hashtag--> #hpm Wed May 11 18:04:14 PDT 2011MeredithGould @ctsinclair Ooo! I love soccer & hockey! #hpm Wed May 11 18:04:30 PDT 2011ctsinclair Hey @MeredithGould, @HollyBy, @Drpippa #hpm Wed May 11 18:04:39 PDT 2011drpippa @ctsinclair @MeredithGould @HollyBy @Drpippa hey yourself! #hpm Wed May 11 18:05:09 PDT 2011ctsinclair Might be typing slow tonight. My right thumb needs to be soaked from a pus draining wound. Dumb bike. #hpm Wed May 11 18:05:15 PDT 2011aliciabloom <-- hpm msw, lsw & clinical educator @VITASHospice in Philadelphia #hpm Wed May 11 18:05:28 PDT 2011hollyby Welcome @SheyontheBay @aliciabloom @MeredithGould @drpippa @ctsinclair @MatthewsMichele ! Great to see you! #hpm Wed May 11 18:05:31 PDT 2011hollyby @ctsinclair Gross. Hope you feel better. #hpm Wed May 11 18:05:48 PDT 2011ctsinclair @MedreditGould Are you going to Rochester in the fall? #hpm Wed May 11 18:05:54 PDT 2011MeredithGould Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:06:03 PDT 2011MatthewsMichele <--- Dir. of media and public policy comm @KLXMedia, #hpm/ #healthpolicy and #socialmedia enthusiast out of DC #hpm Wed May 11 18:06:12 PDT 2011PracticalWisdom Lisa, Speaker, Trainer, Presentation Designer, Rascal. Really glad to be with wonderful, Smart #HPM Group. #HPM Wed May 11 18:06:28 PDT 2011MeredithGould @ctsinclair Yes! Youre going to make it, yes?? #hpm Wed May 11 18:06:34 PDT 2011
  • 3. ctsinclair I just want to say I really like @Aliciabloom and her tweets. Everyone elses too, but alicia always seems to be on when I am looking. #hpm Wed May 11 18:06:34 PDT 2011MatthewsMichele Took the words right out of mouth! RT @hollyby: @ctsinclair Gross. Hope you feel better. #hpm Wed May 11 18:06:42 PDT 2011hollyby @DNRstories See you next week! Hope you feel better. #hpm Wed May 11 18:07:09 PDT 2011PracticalWisdom Ill be learning and chatting with #HPM for the next hour. #HPM Wed May 11 18:07:15 PDT 2011hollyby @PracticalWisdom Hi Lisa! #hpm Wed May 11 18:07:26 PDT 2011ctsinclair @hollyby I forgot HPM docs usually are not fond of gross out medical stuff. My ER wife on the other hand makes me quesy with stories #hpm Wed May 11 18:07:35 PDT 2011SheyontheBay @MeredithGould @ctsinclair Thats how rumors start.... #hpm Wed May 11 18:07:38 PDT 2011ePatientDave RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:07:49 PDT 2011PracticalWisdom Holly Hi, looking forward to your topics tonight. Thanks!RT @hollyby: @PracticalWisdom Hi Lisa! #HPM Wed May 11 18:08:06 PDT 2011MeredithGould @ctsinclair Who doesnt like gross out medical stuff?? LOVE it! As @drsnit would add: *confetti* #hpm Wed May 11 18:08:38 PDT 2011ctsinclair @MeredithGould Will be there. Only Monday though, debating if I can stay longer. (Conference BTW @Sheyonthebay) #hpm Wed May 11 18:08:48 PDT 2011PracticalWisdom Ying/Yang=G8 RT @ctsinclair: @hollyby I forgot HPM MD usually are not fond gross out med. stuff. ER wife makes me quesy with stories #HPM Wed May 11 18:09:01 PDT 2011Kaviraj2 RT @ctsinclair: RT @MeredithGould: Hey friends, will be chatting about hospice & palliative medicine for the next hr. All welcome to follow hashtag--> #hpm Wed May 11 18:09:04 PDT 2011Kaviraj2 RT @ctsinclair: Christian Sinclair, palliative MD @KCHospice, editor @Pallimed, CEO @KLXmedia, fan of sports not liked in US (soccer, hockey, #F1) #hpm Wed May 11 18:09:08 PDT 2011
  • 4. Wed May 11 18:09:08 PDT 2011EldrcareConsult Ill be learning and chatting with #HPM for the next hour. #HPM Wed May 11 18:09:25 PDT 2011ctsinclair @ePatientDave You are welcome to join us in #HPM tweetchat! #hpm Wed May 11 18:09:26 PDT 2011renee_berry Hi everyone! ---rb here, love this community, passionate about early palliative care, hospice volunteerism & advance care planning #hpm Wed May 11 18:09:26 PDT 2011chemosabe hey yall, keeping an eye on it today, but mostly stalking... #hpm Wed May 11 18:09:34 PDT 2011Kaviraj2 RT @ctsinclair: Few days left: #Hospice is trouncing Electronic health records 68 to 32% in Modern Healthcares (fake) tourney http://hpm.md/jytCpf #hpm Wed May 11 18:09:44 PDT 2011PracticalWisdom Look who is here. Long time no chat? @ePatientDave #HPM Wed May 11 18:09:50 PDT 2011SheyontheBay @ctsinclair @hollyby those gross ER stories shared by the parentsare great ways to teach your children by osmosis, ie,STDs and condoms #hpm Wed May 11 18:10:00 PDT 2011drpippa @renee_berry hello! has been so long! #hpm Wed May 11 18:10:10 PDT 2011hollyby @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult Welcome! #hpm Wed May 11 18:10:16 PDT 2011PracticalWisdom @chemosabe: So glad you R Here~from one chat to another right? #HPM Wed May 11 18:10:17 PDT 2011hollyby Moving to Topic #1 soon… #hpm Wed May 11 18:10:33 PDT 2011MeredithGould How cool am I? I finally get to meet -->@renee_berry in a couple of weeks! #hpm Wed May 11 18:10:56 PDT 2011chemosabe @PracticalWisdom thanks Lisa quite right, checked out of #ivchat and here I am #hpm Wed May 11 18:11:01 PDT 2011renee_berry :) yes! happy to see you!! RT @drpippa: @renee_berry hello! has been so long! #hpm Wed May 11 18:11:02 PDT 2011
  • 5. EldrcareConsult Hey there everyone....Shon from Knoxville here....serving seniors and all of humanity..... #hpm Wed May 11 18:11:03 PDT 2011PracticalWisdom @hollyby @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult G8 Crew on the Ship tonight. Clear sailing ahead!! #HPM Wed May 11 18:11:04 PDT 2011MatthewsMichele Just FYI...Lurking (mostly) is my beat tonight too. RT @chemosabe: hey yall, keeping an eye on it today, but mostly stalking... #hpm Wed May 11 18:11:30 PDT 2011hollyby @SheyontheBay @ctsinclair Somehow scare tactics dont seem to work. :) #hpm Wed May 11 18:11:30 PDT 2011jessicajohanna Hi! Work @klxmedia. First tweetchat, may be lurking :) #hpm Wed May 11 18:11:31 PDT 2011renee_berry yes & @jessicajohanna & matthewsmichele! RT @MeredithGould: How cool am I? I finally get to meet -->@renee_berry in a couple of weeks! #hpm Wed May 11 18:11:32 PDT 2011PracticalWisdom @EldrcareConsult Our Southern Gentleman. #HPM Wed May 11 18:11:54 PDT 2011ctsinclair Hey @Chemosabe I always tell people about how you asked ?s from our tweets at @AAHPM conference in Feb from 1/2 way around the world #hpm Wed May 11 18:11:55 PDT 2011hollyby Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:06 PDT 2011drpippa Welcome! RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat, may be lurking :) #hpm Wed May 11 18:12:19 PDT 2011hollyby @jessicajohanna Welcome! #hpm Wed May 11 18:12:20 PDT 2011PracticalWisdom Welcome! How exciting. RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat, may be lurking :) #HPM Wed May 11 18:12:20 PDT 2011MatthewsMichele @jessicajohanna good to see you here!! :) WELCOME! #hpm Wed May 11 18:12:26 PDT 2011ctsinclair @EldrcareConsult Hey Shon. I didnt realize your name was spelled so uniquely. #hpm
  • 6. #hpm Wed May 11 18:12:26 PDT 2011MeredithGould RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:34 PDT 2011chemosabe @ctsinclair thanks Christian, nest best thing to being there! #hpm Wed May 11 18:12:43 PDT 2011renee_berry RT @hollyby Pre-T1: HPM providers (& others) think a lot about how our care impacts patients & families #hpm Wed May 11 18:12:48 PDT 2011EldrcareConsult @PracticalWisdom oh stop (yall) #hpm Wed May 11 18:12:48 PDT 2011bentleystewart RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:50 PDT 2011chemosabe anyone going to European Pallimed conference next week? #hpm Wed May 11 18:13:12 PDT 2011hollyby T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from patients would be useful to make care better? #hpm Wed May 11 18:13:20 PDT 2011hollyby @BentleyStewart Hi there! #hpm Wed May 11 18:13:36 PDT 2011aliciabloom @ctsinclair wow...thank you so much! im thrilled to have found the #hpm community. love tweeting & learning! Wed May 11 18:13:49 PDT 2011MeredithGould RT @hollyby: T1: What info from patients would be useful to make care better? #hpm Wed May 11 18:13:51 PDT 2011PracticalWisdom If you send the Jet! Ill pitch in for Gas!RT @chemosabe: anyone going to European Pallimed conference next week? #HPM Wed May 11 18:13:57 PDT 2011renee_berry RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from patients would be useful to make care better? #hpm Wed May 11 18:14:00 PDT 2011EldrcareConsult @hollyby T-1 A good view of the family dynamics..... #hpm Wed May 11 18:14:13 PDT 2011Pallimed Would love for any @Pallimed Twitter followers to join us right now in #HPM
  • 7. Pallimed Tweetchat. http://tweetchat.com/room/hpm #hospice Wed May 11 18:14:17 PDT 2011PracticalWisdom 1 of the best!RT @aliciabloom: @ctsinclair wow...thank you ! im thrilled to have found the #hpm community. love tweeting & learning! #HPM Wed May 11 18:14:40 PDT 2011renee_berry T1 Understanding that simply... #palliative care is comfort focused care (& that hospice is not one thing, but many organizations) #hpm Wed May 11 18:14:48 PDT 2011Pallimed RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from pts would be useful to make care better? #hpm Wed May 11 18:14:55 PDT 2011hollyby @chemosabe I cant go, but a poster and a presentation will be there. Look for @FrankDFerris #hpm Wed May 11 18:15:10 PDT 2011MatthewsMichele RT @EldrcareConsult: @hollyby T-1 A good view of the family dynamics..... #hpm Wed May 11 18:15:51 PDT 2011ctsinclair It seems to me in times of stress any help is appreciated, so average care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:15:51 PDT 2011MeredithGould T1 Families should be prepared & able to give docs/team info about how the patient communicates: auditory? visual? kinesthetic? #hpm Wed May 11 18:15:52 PDT 2011chemosabe Oh Im not going but the director of our Pall Care Service is #hpm Wed May 11 18:16:03 PDT 2011renee_berry T1 Listen to patient & family goals of care, before anything else #hpm Wed May 11 18:16:12 PDT 2011PracticalWisdom T1: Respect 4 all Health Care providers. Each is an important piece to build a solid foundation. PT Satisfaction can be impacted + or - #HPM Wed May 11 18:16:25 PDT 2011aliciabloom just today, a family said that the doctors often just "come in, talk at us, & leave." they were so grateful to have a dialogue & ask ? #hpm Wed May 11 18:16:51 PDT 2011hollyby Example: I got a survey from my docs office. Survey questions are not always helpful to improve care, but what questions would be? #hpm Wed May 11 18:16:58 PDT 2011MatthewsMichele agree! T1 Families should be prepared & able to give docs/team info about how the patient communicates via @MeredithGould #hpm Wed May 11 18:17:23 PDT 2011
  • 8. hollyby RT @ctsinclair: ... in times of stress any help is appreciated, so avg care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:17:26 PDT 2011MeredithGould T1 Thought the question was what should families provide for providers? Did I get this wrong? #hpm Wed May 11 18:17:27 PDT 2011renee_berry RT @hollyby: Example: I got a survey from my docs office. Survey questions are not always helpful to improve care, but what questions would be? #hpm Wed May 11 18:17:32 PDT 2011hollyby @MeredithGould You are spot on. #hpm Wed May 11 18:17:50 PDT 2011ctsinclair T1: hearing you are all angels frequently can lead to poor self-analysis of skills, might be a weakness of feedback to #hospice staff #hpm Wed May 11 18:17:51 PDT 2011hillaryboucher @PracticalWisdom what is #hpm ? Wed May 11 18:17:56 PDT 2011EldrcareConsult @renee_berry That is a great point....LISTEN #hpm Wed May 11 18:18:11 PDT 2011PracticalWisdom @hollyby: Holly are the questions open ended or not. Need Specific Feedback in order to Feed Forward. #HPM Wed May 11 18:18:13 PDT 2011renee_berry @hollyby @ctsinclair that is such a crucial aspect to understand, #hospice CEOs please see this comment... #hpm Wed May 11 18:18:24 PDT 2011renee_berry RT @hollyby: RT @ctsinclair: ... in times of stress any help is appreciated, so avg care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:18:30 PDT 2011ctsinclair @hollyby I find many surveys about medical care have to deal with the delivery/mechanics, not necessarily deliver/humanity #hpm Wed May 11 18:18:38 PDT 2011drpippa T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:18:49 PDT 2011MeredithGould T1 Families should be prepared & able to provide info about the patients spiritual perspective, religious practices, faith & beliefs #hpm Wed May 11 18:18:50 PDT 2011PracticalWisdom @hillaryboucher Hospice and Palliative Medicine. Great group. Good to see you. #HPM
  • 9. Wed May 11 18:19:01 PDT 2011chemosabe T1 reponsiveness of staff 2 admit requirements. availablitiy of allied health staff. time to spend with client & family non-clinically #hpm Wed May 11 18:19:19 PDT 2011renee_berry agree RT @EldrcareConsult @renee_berry That is a great point....LISTEN #hpm Wed May 11 18:19:38 PDT 2011MeredithGould T1 Let docs/teams know if there are estranged family members who might be brought back into conversation/relationship at this point. #hpm Wed May 11 18:19:45 PDT 2011jessicajohanna @aliciabloom its rare. though today my doctor asked me about my job, hobbies and love life #hpm Wed May 11 18:19:54 PDT 2011bgood64 RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:19:58 PDT 2011LVADone RT @ctsinclair: It seems to me in times of stress any help is appreciated, so average care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:20:02 PDT 2011ctsinclair On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high emotional stress, not b/c of poor skills #hpm Wed May 11 18:20:17 PDT 2011renee_berry @drpippa that is so important, so many families I think are not prepared to simply say what they think or are feeling #hpm Wed May 11 18:20:21 PDT 2011renee_berry RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:20:27 PDT 2011EldrcareConsult RT @MeredithGould: estranged family members who might be brought back into conversation/relationship at this point. EXACTLY! #hpm Wed May 11 18:20:43 PDT 2011drpippa I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:20:59 PDT 2011Pallimed RT @MeredithGould: T1 Let teams know if estranged family members who might be brought back into conversation/relationship #hpm Wed May 11 18:21:03 PDT 2011MatthewsMichele t-1. patient general temperament, mood, the way they prefer to communicate...things that are intuitive to family members... #hpm Wed May 11 18:21:12 PDT 2011
  • 10. hollyby RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high stress, not b/c of poor skills #hpm Wed May 11 18:21:13 PDT 2011PracticalWisdom Might be in Shock RT @renee_berry: @drpippa so many families I think R not prepared e simply say what they think or are feeling #HPM Wed May 11 18:21:25 PDT 2011SheyontheBay RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:21:41 PDT 2011ctsinclair @MeredithGould This is such a touchy area. I often will ask about other family who cannot be present. Can be a touchy area. #hpm Wed May 11 18:21:43 PDT 2011ctsinclair @MeredithGould Sorry my record player skipped. My record player skipped! ;-) #hpm Wed May 11 18:22:08 PDT 2011MeredithGould @ctsinclair Very very touchy area, which is why chaplains should be involved & on the team. #hpm Wed May 11 18:22:13 PDT 2011EldrcareConsult RT @PracticalWisdom: Might be in Shock Good point Lisa..... #hpm Wed May 11 18:22:23 PDT 2011MeredithGould @ctsinclair sok sok #hpm Wed May 11 18:22:24 PDT 2011Pallimed RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:22:29 PDT 2011jessicajohanna RT @drpippa: I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:22:39 PDT 2011aliciabloom the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm Wed May 11 18:22:44 PDT 2011PracticalWisdom @hollyby @ctsinclair: When people really feel they are listened to the scores many times go up. Think Social Workers/Clergy can help #HPM Wed May 11 18:22:49 PDT 2011PracticalWisdom RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #HPM Wed May 11 18:23:03 PDT 2011MeredithGould RT @drpippa: I also want to hear about the patient/family before the illness. Helps
  • 11. MeredithGould with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:23:07 PDT 2011drpippa RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm Wed May 11 18:23:09 PDT 2011hollyby Wonderful! Getting two things from this 1) quality improvement help from pts, 2) questions to ask pts to ensure complete picture. #hpm Wed May 11 18:23:10 PDT 2011LVADone “@HPHHospice: Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual... http://t.co/tUdDd49” #hpm Wed May 11 18:23:11 PDT 2011EldrcareConsult @ctsinclair Its very touchy...hardest conversation I have to have with my families....who to/who not to include in the decisions #hpm Wed May 11 18:23:19 PDT 2011ctsinclair Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:25 PDT 2011MatthewsMichele @ctsinclair @MeredithGould Very touchy! Caused my fam to close ranks & not open up as much to docs when our matriarch was ill #hpm Wed May 11 18:23:29 PDT 2011hollyby RT @ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:43 PDT 2011renee_berry RT @drpippa: I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:23:45 PDT 2011MatthewsMichele RT @ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:46 PDT 2011SheyontheBay often pts/family have difficulty HEARing in crisis, understand also difficult to articulate values and goals without gentle guidance #hpm Wed May 11 18:23:46 PDT 2011PracticalWisdom RT @jessicajohanna: RT @drpippa: want 2 hear re: patient/family b4 illness. Helps with goals/plans/preserving dignity and humanity. #HPM Wed May 11 18:23:49 PDT 2011LVADone RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high emotional stress, not b/c of poor skills #hpm Wed May 11 18:24:00 PDT 2011renee_berry RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm
  • 12. builds rapport, provides insight into values. #hpm Wed May 11 18:24:01 PDT 2011MatthewsMichele @ctsinclair seems counter intuitive doesnt it? #hpm Wed May 11 18:24:16 PDT 2011ctsinclair @MatthewsMichele @MeredithGould Yes i have seen the discussion of estranged family alienate communication ability #hpm Wed May 11 18:24:20 PDT 2011chemosabe @ctsinclair we do during care...but my client base is not post terminal event! #hpm Wed May 11 18:24:24 PDT 2011MeredithGould Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:24:29 PDT 2011PracticalWisdom RT @SheyontheBay: often pts/family have dif. HEARing crisis, understand also difficult to articulate values/goals without gentle guid #HPM Wed May 11 18:24:37 PDT 2011drpippa RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:24:52 PDT 2011EldrcareConsult RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! Yep! #hpm Wed May 11 18:24:57 PDT 2011ctsinclair @MatthewsMichele Patients and families dont take lessons on how to communicate best. Many HC profs dont either though... #hpm Wed May 11 18:25:00 PDT 2011MatthewsMichele YES! RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:25:02 PDT 2011renee_berry always yes on advance care planning! RT @MeredithGould: Touchy subjects: all the more reason to #HaveTheaTalk! #hpm Wed May 11 18:25:13 PDT 2011PracticalWisdom @ctsinclair @MatthewsMichele @MeredithGould Families are complex and now often live many miles away #HPM Wed May 11 18:25:17 PDT 2011aliciabloom "@ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during." puzzling, really. #hpm Wed May 11 18:25:19 PDT 2011MeredithGould @ctsinclair @MatthewsMichele Ok, so do NOT say: "Who does your loved one despise who should nevertheless be here?" #hpm Wed May 11 18:25:34 PDT 2011 @hollyby I had plans to lurk but your T1 has drawn me in! #hpm
  • 13. @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:25:38 PDT 2011MatthewsMichelemojonimbus RT @aliciabloom: "@ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during." puzzling, really. #hpm Wed May 11 18:25:44 PDT 2011ctsinclair Clarify last statement,not to say that patients and families should improve or change their comm styles, just that we need to adjust #hpm Wed May 11 18:25:48 PDT 2011hollyby We are going to get started with Topic #2 soon… #hpm Wed May 11 18:26:07 PDT 2011renee_berry hahaha! great!!!! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:26:11 PDT 2011ctsinclair RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! "Like a vaudville lasso....invisible but powerful." #hpm Wed May 11 18:26:27 PDT 2011PracticalWisdom T1: Its been my experience that most organization need better survey tools. Filling in the bubbles is not Valuable feedback #HPM Wed May 11 18:26:31 PDT 2011hollyby Agree! RT @PracticalWisdom: T1: ... most organization need better survey tools. Filling in the bubbles is not Valuable feedback #hpm Wed May 11 18:27:00 PDT 2011hollyby Hooray! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:27:10 PDT 2011PracticalWisdom T1: Feedback would be great through the entire process. Are families debriefed by Pall care teams afterward? #HPM Wed May 11 18:27:18 PDT 2011EldrcareConsult RT @PracticalWisdom: Families are complex and now often live many miles away When the end is near they come out of the woodwork #hpm Wed May 11 18:27:21 PDT 2011MatthewsMichele @ctsinclair so true! #hpm Wed May 11 18:27:27 PDT 2011MeredithGould @ctsinclair Really...simply knowing how everyone best communicates is big, i.e., dont yak endlessly at someone who prefers reading #hpm Wed May 11 18:27:37 PDT 2011MeredithGould @MatthewsMichele Yeah, I always mean to lurk and get totally sucked in by this great group & convo! #hpm Wed May 11 18:28:06 PDT 2011
  • 14. hollyby Topic #2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:28:09 PDT 2011LVADone RT @PracticalWisdom: @ctsinclair @MatthewsMichele @MeredithGould Families are complex and now often live many miles away #HPM Wed May 11 18:28:16 PDT 2011Pallimed RT @PracticalWisdom: T1:my experience that most orgs need better survey tools. Filling in the bubbles does not = Valuable feedback #hpm Wed May 11 18:28:31 PDT 2011renee_berry RT @hollyby: Topic #2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:28:36 PDT 2011PracticalWisdom @EldrcareConsult: Hopefully come for good reasons. Have seen when was a clergy Family Member the Good, Bad and ugly reasons! #HPM Wed May 11 18:28:37 PDT 2011MatthewsMichele RT @MeredithGould: @ctsinclair Simply knowing how everyone communicates is big, i.e., dont yak endlessly at someone who prefers reading #hpm Wed May 11 18:28:38 PDT 2011hollyby @PracticalWisdom Not always, and not always well, but that goes for most of medical care I think #hpm Wed May 11 18:28:51 PDT 2011mojonimbus #HPM I think concurrent Feedback could prevent misunderstanding and sone patient hostility toward health care workers, better care for all Wed May 11 18:28:59 PDT 2011MatthewsMichele RT @hollyby: T2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:29:08 PDT 2011aliciabloom if we just ask patients & families if they feel heard & have any questions/concerns/fears, it can open up the lines of communication. #hpm Wed May 11 18:29:14 PDT 2011MeredithGould T2 Think it would depend on the chronic disease? #hpm Wed May 11 18:29:20 PDT 2011EldrcareConsult RT @PracticalWisdom: Hopefully come for good reasons. Have seen when was a clergy Family Member the Good, Bad and ugly reasons! Me 2! #hpm Wed May 11 18:29:25 PDT 2011ctsinclair T2: may free of some of the medical limitations to control the chronic disease as in the case of cholesterol or diabetes meds #hpm Wed May 11 18:29:51 PDT 2011
  • 15. drpippa You assume it does - often it doesnt - that is the problem. How does life-threatening dx change the mgmt of chronic dis? For the team? #hpm Wed May 11 18:29:57 PDT 2011hollyby Example: A diabetic person with new advanced cancer diagnosis. #hpm Wed May 11 18:30:09 PDT 2011RossJeanette Hi all joining late t2 goals for chronic illnesses such as Diabetes & high cholesterol dont need to be tight #HPM Wed May 11 18:30:14 PDT 2011PracticalWisdom RT @mojonimbus:#HPM think concurrent Feedback could prev. misunderstanding/sone pt hostility 2ward health care folks, better care 4 all #HPM Wed May 11 18:30:34 PDT 2011hollyby True! RT @drpippa: You assume it does - often it doesnt - that is the problem. #hpm Wed May 11 18:30:47 PDT 2011MeredithGould Wont change it at all if the chronic disease is basically unmanageable/untreatable to begin with (e.g., #fibro) #hpm Wed May 11 18:30:52 PDT 2011ctsinclair T2: 1 of most intriguing discussions: how to safely minimize burdensome treatments for preventing long term complications of disease #hpm Wed May 11 18:30:57 PDT 2011MatthewsMichele RT @aliciabloom: if we just ask patients & families if they feel heard & have any questions/concerns/fears, it can open up the lines of communication. #hpm Wed May 11 18:30:57 PDT 2011hollyby @mojonimbus Thanks for joining us! #hpm Wed May 11 18:31:01 PDT 2011aliciabloom it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:11 PDT 2011MeredithGould RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:24 PDT 2011PracticalWisdom RT @drpippa: You assume it does often it doesnt thats the problem. How does life- threatening dx change mgmt chronic dis? 4 team? #HPM Wed May 11 18:31:28 PDT 2011hollyby RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:30 PDT 2011ctsinclair RT @mojonimbus: concurrent Feedback could prevent misunderstanding, some hostility toward health care workers-> better care for all #hpm Wed May 11 18:31:46 PDT 2011
  • 16. Wed May 11 18:31:46 PDT 2011hollyby @RossJeanette Welcome Jeanette! Glad you could make it! #hpm Wed May 11 18:31:50 PDT 2011PracticalWisdom @ctsinclair; Like Feeding Tube Issue? #HPM Wed May 11 18:32:02 PDT 2011RossJeanette T2 I like to put patients in the everything you want to eat diet as opposed to the diabetic renal cardiac... Diet its about QOL #HPM Wed May 11 18:32:04 PDT 2011drpippa must tread lightly - often can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:32:25 PDT 2011MeredithGould @RossJeanette Gee, may I be on that diet now??? #HPM Wed May 11 18:32:31 PDT 2011renee_berry RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:32:45 PDT 2011chemosabe T2 shouldnt the focus be the clients decisions about there death and dying and therefore symptom management that complies with this? #hpm Wed May 11 18:32:58 PDT 2011ctsinclair Hi @RossJeanette Hello @mojonimbus glad to meet you! #hpm Wed May 11 18:32:59 PDT 2011PracticalWisdom Practical Wis.RT @RossJeanette:T2 I like 2 put pts everything U want 2 eat diet as opposed 2 diabetic renal cardiac Diet its about QOL #HPM Wed May 11 18:33:12 PDT 2011drpippa absolutely! RT @renee_berry: RT @aliciabloom: it should be about the benefits vs burdens of on-going mgmt of the chronic condition. #hpm Wed May 11 18:33:16 PDT 2011renee_berry @aliciabloom for that particular person, & not necessarily how the family perceives benefits vs burdens #hpm Wed May 11 18:33:19 PDT 2011MeredithGould Id like to be told to eat massive amounts of high quality dark chocolate & bags of Cheez Doodles. Oh wait, this isnt about me? #hpm Wed May 11 18:33:28 PDT 2011ctsinclair @PracticalWisdom Yes even feeding tube goals can be readdressed, are we aiming for long term nutrion goals or short term pleaure #hpm Wed May 11 18:33:45 PDT 2011MatthewsMichele RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the
  • 17. MatthewsMichele RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:33:46 PDT 2011PracticalWisdom RT @chemosabe: T2 shouldnt focus b clients dec. re:t their death and dying and therefore symptom management that complies with this? #HPM Wed May 11 18:33:53 PDT 2011renee_berry RT @RossJeanette: T2 I like to put patients in the everything you want to eat diet as opposed to the diabetic renal cardiac... Diet its about QOL #HPM Wed May 11 18:33:58 PDT 2011ctsinclair @MeredithGould Oh its all about you! Autonomy rules in American Health Care System. #hpm Wed May 11 18:34:15 PDT 2011hollyby Goals of care are always important. RT @chemosabe: T2 shouldnt the focus be the clients decisions... #hpm Wed May 11 18:34:51 PDT 2011ctsinclair RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:34:56 PDT 2011EldrcareConsult BRB guys...work calls! #hpm Wed May 11 18:35:19 PDT 2011aliciabloom @renee_berry excellent point! although, patients often make treatment decisions for their families. #hpm Wed May 11 18:35:29 PDT 2011renee_berry really?! I hope it does, not sure though.. RT @ctsinclair @MeredithGould Oh its all about you! Autonomy rules in US Health Care System #hpm Wed May 11 18:35:32 PDT 2011hollyby @drpippa Agree that there is a huge emotional component of changing management of long-standing illness #hpm Wed May 11 18:36:08 PDT 2011MeredithGould @renee_berry I think hes goofing on me. How unusual, right? #hpm Wed May 11 18:36:10 PDT 2011SheyontheBay @RossJeanette We call that the diet of the dying. I remember a dying chocoholic, couldnt eat - we swabbed Hershey syrup on her lips #hpm Wed May 11 18:36:25 PDT 2011PracticalWisdom Bat Phone must have Rang! Batman to the Rescue! Dedicated to his Clients RT @EldrcareConsult: BRB guys...work calls! #HPM Wed May 11 18:36:36 PDT 2011RossJeanette Agree with @drpippa be careful with readdressing goals and being perceived as "doing nothing" #HPM Wed May 11 18:36:59 PDT 2011
  • 18. Wed May 11 18:36:59 PDT 2011ctsinclair @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:37:08 PDT 2011Pallimed RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:37:18 PDT 2011MeredithGould @SheyontheBay Now THAT is compassionate care. Absolutely! But Hersheys? Not Godiva? #hpm Wed May 11 18:37:21 PDT 2011renee_berry RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:37:35 PDT 2011chemosabe T2 dont know about mx up there, but, separation of client on physician for chronic illness mx down here v diff. attachment issues #hpm Wed May 11 18:37:37 PDT 2011PracticalWisdom Loving RT @SheyontheBay: @RossJeanette Diet of the dying.Remember a dying chocoholic, couldnt eat we swabbed Hershey syrup on lips #HPM Wed May 11 18:38:02 PDT 2011LVADone RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:38:10 PDT 2011EldrcareConsult @PracticalWisdom Its not the Bat Phone I mind, but these flashing strobe lights kill me! #hpm I may be a while.................. Wed May 11 18:38:12 PDT 2011RossJeanette @SheyontheBay Ill have to remember thatchocolaye syrup swab good idea #HPM Wed May 11 18:38:13 PDT 2011SheyontheBay @MeredithGould @SheyontheBay Does Godiva make syrup? Too risky to melt chips #hpm Wed May 11 18:38:17 PDT 2011mojonimbus #hpm nice to meet you all too Wed May 11 18:38:17 PDT 2011drpippa RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:38:32 PDT 2011MeredithGould @SheyontheBay I believe Ghiradelli (sp?) makes syrup. #hpm Wed May 11 18:38:58 PDT 2011ctsinclair It is interesting many HC professionals feel autonomy overrides often, whereas
  • 19. ctsinclair It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:38:58 PDT 2011PracticalWisdom @EldrcareConsult: Its the piercing Alarm Sound that gets me! #HPM Wed May 11 18:39:04 PDT 2011renee_berry @ctsinclair agree though think OFTEN the case- autonomy is not possible w/o informed medical decision making... which I think is often #hpm Wed May 11 18:39:13 PDT 2011hollyby @chemosabe Can you say more? #hpm Wed May 11 18:39:26 PDT 2011renee_berry RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:39:29 PDT 2011MeredithGould @renee_berry @ctsinclair Or patients cant even conceive of Autonomy? #hpm Wed May 11 18:39:56 PDT 2011PracticalWisdom RT @ctsinclair: nteresting HC profess. feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #HPM Wed May 11 18:40:00 PDT 2011MatthewsMichele RT @renee_berry: @ctsinclair agree though think OFTEN the case- autonomy is not possible w/o informed medical decision making... which I think is often #hpm Wed May 11 18:40:04 PDT 2011thinkalot RT @PracticalWisdom: Practical Wis.RT @RossJeanette:T2 I like 2 put pts everything U want 2 eat diet as opposed 2 diabetic renal cardiac Diet its about QOL #HPM Wed May 11 18:40:38 PDT 2011ctsinclair RT @MeredithGould: @renee_berry @ctsinclair Or patients cant even conceive of Autonomy? "foreign concept?" #hpm Wed May 11 18:40:46 PDT 2011chemosabe @hollyby attachment to treating team, difficult to trust new hpm team to mx dz appropriately. particular if goal of care now comfort #hpm Wed May 11 18:40:51 PDT 2011renee_berry yes, how can they w/o clear information RT @MeredithGould @renee_berry @ctsinclair Or patients cant even conceive of Autonomy? #hpm Wed May 11 18:41:15 PDT 2011aliciabloom @ctsinclair HC providers often respect autonomy when pts make decisions they think are right. otherwise, they order psych consults. #hpm Wed May 11 18:41:39 PDT 2011MatthewsMichele @MeredithGould @renee_berry @ctsinclair Good point! Id guess pts often dont think they are in the drivers seat of their #healthcare. #hpm Wed May 11 18:41:44 PDT 2011
  • 20. Wed May 11 18:41:44 PDT 2011drpippa great point. RT @chemosabe: attachment to treating team, diff to trust new hpm team. particularly if goal of care now comfort #hpm Wed May 11 18:41:57 PDT 2011PracticalWisdom RT @chemosabe: @hollyby attachment 2 treating team, difficult 2 trust new hpm team 2 mx dz approp.. partic if goal of care now comfort #HPM Wed May 11 18:41:59 PDT 2011EOLnavigator Hey there. 20 mins is better than 0 mins #hpm Wed May 11 18:42:01 PDT 2011ctsinclair @chemosabe Agree with you. Have had patients say they went for more chemo in part because they like the staff, same with dialysis. #hpm Wed May 11 18:42:06 PDT 2011hollyby @chemosabe:Thx... so they actually switch care teams. That could be challenging. #hpm Wed May 11 18:42:07 PDT 2011LVADone RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:42:10 PDT 2011ctsinclair RT @EOLnavigator: Hey there. 20 mins is better than 0 mins "Glad you are here before the buzzer!" #hpm Wed May 11 18:42:29 PDT 2011renee_berry RT @MatthewsMichele: @MeredithGould @renee_berry @ctsinclair Good point! Id guess pts often dont think they are in the drivers seat of their #healthcare. #hpm Wed May 11 18:42:31 PDT 2011MatthewsMichele Definitely! You made it...glad youre here! RT @EOLnavigator: Hey there. 20 mins is better than 0 mins #hpm Wed May 11 18:43:02 PDT 2011HerHealthySelf RT @PracticalWisdom: Loving RT @SheyontheBay: @RossJeanette Diet of the dying.Remember a dying chocoholic, couldnt eat we swabbed Hershey syrup on lips #HPM Wed May 11 18:43:14 PDT 2011PracticalWisdom Remarkable. RT @ctsinclair: @chemosabe Agree Have had pts say they went 4# chemo because they like the staff, same with dialysis. #HPM Wed May 11 18:43:24 PDT 2011ctsinclair @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of a palliative care team. #hpm Wed May 11 18:43:37 PDT 2011MeredithGould How could patients possibly think they have any control/say? The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:43:38 PDT 2011
  • 21. Wed May 11 18:43:38 PDT 2011aliciabloom @ctsinclair @chemosabe agreed. they dont want to "disappoint" their physician & care team. #hpm Wed May 11 18:43:43 PDT 2011chemosabe @hollyby yep we tried models we called shared care where pt still sees both teams. can be just as difficult to mx as hand over #hpm Wed May 11 18:44:19 PDT 2011LVADone RT @aliciabloom: @ctsinclair HC providers often respect autonomy when pts make decisions they think are right. otherwise, they order psych consults. #hpm Wed May 11 18:44:20 PDT 2011hollyby True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of palliative care. #hpm Wed May 11 18:44:26 PDT 2011renee_berry RT @MeredithGould: How could patients possibly think they have any control/say? The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:44:44 PDT 2011PracticalWisdom @aliciabloom @ctsinclair @chemosabe: Sounds like some Boundary Issues or some other challenging dynamics at play. #HPM Wed May 11 18:45:08 PDT 2011hollyby Moving on to Topic #3 soon… ready to jump frames a bit? #hpm Wed May 11 18:45:22 PDT 2011aliciabloom good point. RT @ctsinclair: RE: Disagree with the doc = psych consult. See this less with good integration of a palliative care team. #hpm Wed May 11 18:45:38 PDT 2011lugstew At hbo screening of dying in Oregon. #hpm #hospice Wed May 11 18:45:51 PDT 2011EOLnavigator This is why open access is a better idea for hospice care RT @hollyby: @chemosabe:..switch care teams......challenging. #hpm Wed May 11 18:45:52 PDT 2011renee_berry patients deserve to know RT @aliciabloom @ctsinclair @chemosabe agreed. they dont want to "disappoint" their physician & care team #hpm Wed May 11 18:45:59 PDT 2011PracticalWisdom RT @chemosabe: @hollyby we tried models we called shared care where pt still sees both teams. can be just difficult 2 mx as hand over #HPM Wed May 11 18:46:16 PDT 2011EOLnavigator Clinicians dont know how to discuss options. RT @MeredithGould: The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:46:44 PDT 2011hollyby T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any
  • 22. hollyby T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:46:50 PDT 2011PracticalWisdom RT @renee_berry: pts deserve 2 know RT @aliciabloom @ctsinclair @chemosabe agreed. they dont want 2 disappoint" physician & care team #HPM Wed May 11 18:46:58 PDT 2011ctsinclair @MeredithGould spend some time rounding with your local doc and you will see the amount of deference to patient wishes #hpm Wed May 11 18:47:03 PDT 2011LVADone RT @hollyby: True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of palliative care. #hpm Wed May 11 18:47:28 PDT 2011apjonas RT @MeredithGould: T1 Families should be prepared & able to provide info about the patients spiritual perspective, religious practices, faith & beliefs #hpm Wed May 11 18:47:39 PDT 2011MeredithGould @ctsinclair May that be so! #hpm Wed May 11 18:47:56 PDT 2011ctsinclair T3: Threshold Choirs? Interesting name. Makes me think of Memorex...like you are testing a threshold of hearing. #hpm Wed May 11 18:47:57 PDT 2011renee_berry RT @ctsinclair: @MeredithGould spend some time rounding with your local doc and you will see the amount of deference to patient wishes #hpm Wed May 11 18:47:58 PDT 2011drpippa yes! truly extraordinary. music can help in ways that I can not. RT @hollyby: T3: I recently learned about threshold choirs #hpm Wed May 11 18:48:01 PDT 2011MeredithGould RT @hollyby: T3: Learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:48:17 PDT 2011RossJeanette T3 one of the hospice agencies has a harp player. She apparently plays tunes that calm patients. #HPM Wed May 11 18:48:20 PDT 2011PracticalWisdom @apjonas @MeredithGould: G8 Points Id also include understanding of culture. #HPM Wed May 11 18:48:28 PDT 2011renee_berry RT @drpippa: yes! truly extraordinary. music can help in ways that I can not. RT @hollyby: T3: I recently learned about threshold choirs #hpm Wed May 11 18:48:31 PDT 2011ctsinclair @MeredithGould And you will also see some steamrolling of patient preferences and dignity. Sadly. #hpm
  • 23. dignity. Sadly. #hpm Wed May 11 18:48:49 PDT 2011aliciabloom autonomy requires informed consent for which effective communication with patients & families is essential. #hpm Wed May 11 18:48:56 PDT 2011MeredithGould T3 Sounds wonderful. So many ways to ease transition. One pt I was with wanted to hold a kitty again before he died. #hpm Wed May 11 18:49:04 PDT 2011PracticalWisdom Know harp not choir RT @RossJeanette: T3 one of the hospice agencies has a harp player. She apparently plays tunes that calm patients. #HPM Wed May 11 18:49:10 PDT 2011MatthewsMichele @renee_berry @MeredithGould lets face it: takes lots of tenacity to get over doc knows best mentality to inform your own #healthcare #hpm Wed May 11 18:49:19 PDT 2011ctsinclair Any #MBTC or #MusicTherapy people want to come comment on Threshold Choirs? #hpm Wed May 11 18:49:27 PDT 2011SheyontheBay T3 I ve worked at a hospital where both a chaplain and a hospice nurse sang - sooooo soothing #hpm Wed May 11 18:49:32 PDT 2011apjonas RT @MeredithGould: T1 Let docs/teams know if there are estranged family members who might be brought back into conversation/relationship at this point. #hpm Wed May 11 18:49:42 PDT 2011PracticalWisdom T3: Our church has ladies who knit Prayer Shawls for very sick or dying. #HPM Wed May 11 18:49:47 PDT 2011MeredithGould @ctsinclair Which is why I liked serving as a patient advocate, especially in hospice situations. #hpm Wed May 11 18:49:52 PDT 2011ctsinclair Any #MTBC or #MusicTherapy people want to come comment on Threshold Choirs? (fixed hashtag) #hpm Wed May 11 18:50:03 PDT 2011renee_berry absolutely @MatthewsMichele @renee_berry @MeredithGould #hpm Wed May 11 18:50:05 PDT 2011renee_berry RT @MatthewsMichele: @renee_berry @MeredithGould lets face it: takes lots of tenacity to get over doc knows best mentality to inform your own #healthcare #hpm Wed May 11 18:50:12 PDT 2011aliciabloom @ a hospital where i do #palliative care consults there are music therapists and "musicians on-call." our #hospice unit has a harpist. #hpm Wed May 11 18:50:16 PDT 2011
  • 24. SheyontheBay T3 Calvarys music therapy does flute work for dyspnea #hpm Wed May 11 18:50:19 PDT 2011MatthewsMichele T3 havent heard about it, what has been the response from patients and families? #hpm Wed May 11 18:50:43 PDT 2011hollyby @MeredithGould One of the most powerful moments I had was with a pt who ignored me and just held his cat, who came to the hospital #hpm Wed May 11 18:50:50 PDT 2011chemosabe @SheyontheBay does it work... what is the science? #hpm Wed May 11 18:51:05 PDT 2011drpippa could have so much discussion on music - I have patients who are unresponsive to everyone/everything except music therapist. #hpm Wed May 11 18:51:12 PDT 2011hollyby @MatthewsMichele Havent hear the threshold choir here in San Diego yet. Hope to see them soon. #hpm Wed May 11 18:51:31 PDT 2011EOLnavigator T3. Need to embrace what is appropriate for the patient / family. Seen alot of things on an AIDS unit far off my Irish Cath mindset. #hpm Wed May 11 18:51:35 PDT 2011ctsinclair RT @drpippa: I have patients who are unresponsive to everyone/everything except music therapist. #MTBC #hpm Wed May 11 18:52:05 PDT 2011MeredithGould Id so love to be part of that kind of choir. What a blessing to sing in that context. #hpm Wed May 11 18:52:15 PDT 2011renee_berry RT @hollyby: T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:52:28 PDT 2011MatthewsMichele RT @ctsinclair: RT @drpippa: I have patients who are unresponsive to everyone/everything except music therapist. #MTBC #hpm Wed May 11 18:52:33 PDT 2011EOLnavigator We had a "llama" request....had to settle for a goat. RT @MeredithGould: T3 One pt I was with wanted to hold a kitty again. #hpm Wed May 11 18:52:38 PDT 2011PracticalWisdom T3: Again be aware of the Pts preference. Some might want Lenard Skynard vs. A choir. #HPM Wed May 11 18:52:52 PDT 2011MeredithGould @EOLnavigator Oh my! #hpm Wed May 11 18:52:57 PDT 2011
  • 25. hollyby @MeredithGould There are many groups forming across the US. Anyone know of community group that are doing this internationally? #hpm Wed May 11 18:53:07 PDT 2011ctsinclair Just looked on Wikipedia for the disambiguation page for Threshold - lots of different connections. Esp Pain Threshold. #hpm Wed May 11 18:53:36 PDT 2011MeredithGould @hollyby I should check that out. (Like I have the energy.) Loved having opportunities to sing at funerals. #hpm Wed May 11 18:54:15 PDT 2011drpippa for sure! have heard some rousing tunes! RT @PracticalWisdom: T3: Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:54:18 PDT 2011ctsinclair I wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding experience. #hpm Wed May 11 18:54:26 PDT 2011hollyby They would have to have a wide repertoire :) RT @PracticalWisdom: T3: ... Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:54:28 PDT 2011ctsinclair RT @hollyby: There are many Threshold Choirs forming across the US. Anyone know of community group internationally? #hpm Wed May 11 18:54:56 PDT 2011katfulton @renee_berry @ctsinclair I have a #MusicTherapy friend who runs a threshold choir in Flagstaff! #hpm Wed May 11 18:55:04 PDT 2011EOLnavigator Staff wouldnt mind Lenard Skynard either! RT @PracticalWisdom: T3: Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:55:10 PDT 2011MatthewsMichele @MeredithGould ditto! if only i were blessed with good vocals! Singing is def not my ministry! #hpm Wed May 11 18:55:23 PDT 2011aliciabloom hearing is often the sense that stays w/ patients the longest. music can be soothing & powerful way to communicate with a patient @ EOL #hpm Wed May 11 18:55:37 PDT 2011MeredithGould @ctsinclair Always felt better after choir rehearsal and singing for worship, even if I felt like crap going in. #HPM Wed May 11 18:56:08 PDT 2011renee_berry @ctsinclair when I started as a #hospice volunteer, they asked what do you do to deStress, I said sing in the car..but I have no voice #hpm Wed May 11 18:56:16 PDT 2011
  • 26. SheyontheBay @chemosabe @SheyontheBay dont know the science behind it - it sure seems to work! I bet Andy at Calvary could tell you #hpm Wed May 11 18:56:17 PDT 2011RachelleNorman @ctsinclair Im just catching the tail end of this chat, but I can say that Ive actually never heard of Threshold Choirs. #googlingnow #hpm Wed May 11 18:56:17 PDT 2011MeredithGould @MatthewsMichele I miss it a lot. #hpm Wed May 11 18:56:26 PDT 2011ctsinclair @PracticalWisdom You could always make your own Last Playlist via Life Before Death http://hpm.md/lN2fKH #hpm Wed May 11 18:56:26 PDT 2011renee_berry RT @ctsinclair: I wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding experience. #hpm Wed May 11 18:56:29 PDT 2011apjonas @aliciabloom Hearing stays longer than touch? #HPM Wed May 11 18:56:33 PDT 2011katfulton Just arrived at #hpm. Thx for the invite, @ctsinclair =) Im a board-certified #MusicTherapy -ist. Loving this discussion so far! Wed May 11 18:56:44 PDT 2011LVADone :-) “@hollyby: They would have to have a wide repertoire :) RT @PracticalWisdom: T3: ... Some might want Lenard Skynard vs. A choir. #hpm” Wed May 11 18:56:51 PDT 2011drpippa RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a patient #hpm Wed May 11 18:56:54 PDT 2011MatthewsMichele Wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding exp. via @ ctsinclair. #hpm Wed May 11 18:56:57 PDT 2011JordanEM @RachelleNorman @ctsinclair Me either. More info please on Threshold choir #hpm Wed May 11 18:57:18 PDT 2011EOLnavigator All kinds of music does it for me too! RIP Bob Marley. RT @MeredithGould: @ctsinclair #hpm Wed May 11 18:57:28 PDT 2011katfulton True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a pt #hpm Wed May 11 18:57:35 PDT 2011MeredithGould @apjonas @aliciabloom Thats my question, too. Id think both hearing & touch last equally long. #hpm
  • 27. equally long. #hpm Wed May 11 18:57:42 PDT 2011PracticalWisdom RT @drpippa: RT @aliciabloom: hearing often sense stays w/ patients longest. music can b soothing, powerful way 2 communicate w/ PT #HPM Wed May 11 18:57:54 PDT 2011aliciabloom @apjonas hard to know for sure, but have seen patients completely comatose have increase in respiratory rate when a loved one speaks. #hpm Wed May 11 18:58:00 PDT 2011SheyontheBay My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) #hpm Wed May 11 18:58:06 PDT 2011MatthewsMichele RT @PracticalWisdom: RT @drpippa: RT @aliciabloom: hearing often sense stays w/ patients longest. music can b soothing, powerful way 2 communicate w/ PT #HPM Wed May 11 18:58:22 PDT 2011PracticalWisdom T3: Asked a PT who was actively dying about music preference. She looked me in the eye and said we will not discuss this! #HPM Wed May 11 18:58:40 PDT 2011ctsinclair @renee_berry Hopefully you have not had to sing too much lately! ;-) #hpm Wed May 11 18:58:43 PDT 2011hollyby Ok all! Thanks so much for the wonderful conversation! Last thoughts? FYIs? Twitter hugs? #hpm Wed May 11 18:58:46 PDT 2011MatthewsMichele LOL! RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) #hpm Wed May 11 18:58:47 PDT 2011aliciabloom @renee_berry i love to belt it out in the car, too...but i know it sounds terrible! #hpm Wed May 11 18:58:51 PDT 2011PracticalWisdom RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) #HPM Wed May 11 18:58:53 PDT 2011ctsinclair RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) "Sounds like my kids" #hpm Wed May 11 18:59:07 PDT 2011renee_berry T3 My first hospice patient used to sing a song so loud that doors would be slammed shut when I would visit & he would sing for me :) #hpm Wed May 11 18:59:12 PDT 2011RachelleNorman Wow, Threshold Choir looks like a beautiful ministry. As @PracticalWisdom said, the repertoire might be a bit narrow to meet all needs. #hpm Wed May 11 18:59:16 PDT 2011
  • 28. Pallimed Make sure to check out Palliative Care Grand Rounds (its back!) with @Daitpcg at Palliative Care Success http://hpm.md/lxIYWv #hpm Wed May 11 18:59:17 PDT 2011drpippa great tweetchat this evening! Many thanks @hollyby! now lets all go sing together. have a great night all. #hpm Wed May 11 18:59:32 PDT 2011aliciabloom @hollyby high fives & fist bumps for a great #hospice & #palliative medicine tweet chat! #hpm Wed May 11 18:59:44 PDT 2011MatthewsMichele RT @drpippa: great tweetchat this evening! Many thanks @hollyby! now lets all go sing together. have a great night all. #hpm Wed May 11 18:59:58 PDT 2011RachelleNorman True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a pt #hpm Wed May 11 18:59:59 PDT 2011