This document discusses issues with care for the elderly and terminally ill in hospice facilities. It notes that doctors often have high patient loads in these facilities, which can lead to overmedication of patients due to lack of communication between doctors. The document also discusses how Americans often want a quick medical fix, which can negatively impact elderly patients if they mix over-the-counter drugs with prescription medications or overdose on medications. Overall, the document examines some of the challenges around quality of care for vulnerable patient populations in end-of-life care facilities.
Sat 0810-gallagher-end-of-life-care- -parkIhsaan Peer
This document discusses end of life care options in British Columbia from the perspective of Dr. Romayne Gallagher, a physician director of palliative care. It provides an overview of palliative care and its benefits compared to physician assisted dying. While palliative care aims to relieve suffering, physician assisted dying is not considered a part of palliative care by definitions from the WHO. The document outlines concerns about assessing mental competence for physician assisted dying and potential risks of legalizing the practice.
This document discusses end-of-life care considerations for patients with advanced dementia. It finds that feeding tubes do not prevent aspiration pneumonia or malnutrition in these patients and may in fact increase the risk of pressure ulcers and restraint use. Instead, oral assisted feeding is recommended to overcome eating difficulties. The benefits of discussing goals of care and treatment options are emphasized over defaulting to invasive interventions like feeding tubes that do not improve quality of life.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care.
1. The document presents 12 graphs and diagrams that depict important issues in population health.
2. The graphs show how lifestyle and health behaviors are the dominant influences on health outcomes, and how gaps in care lead to disappointing results.
3. Additional graphs illustrate challenges such as low medication adherence, clinical inertia, the slow adoption of new medical knowledge, and the impact of health literacy on population health.
This document is an undergraduate thesis that examines the pharmaceutical industry and alternative medicine. It argues that while Western medicine has improved health outcomes for some acute illnesses, the over-reliance on drugs has significant downsides. Preventable medical errors are the third leading cause of death in the US, with pharmaceutical companies more focused on profits than patient safety. The document also suggests that several holistic doctors working on alternative cancer treatments may have been murdered to protect the financial interests of the pharmaceutical industry.
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes that many principles of antiepileptic drug therapy for non-disabled individuals also apply to those with developmental disabilities, but that treating physicians face additional challenges. These include a higher rate of difficult-to-control seizures, limited ability to do diagnostic testing due to cognitive impairments, and greater risk of adverse drug effects. It also discusses the trend toward deinstitutionalization and relocation of developmentally disabled individuals to community settings, increasing the need for community physicians to treat their medical issues like epilepsy. The role of legal guardians, family members, and group home staff in providing care and information is also covered.
Respiratory Symptoms in the Terminally Ill PatientVITAS Healthcare
The goal of this webinar was to educate healthcare professionals on interventions for cough, dyspnea, hemoptysis, and the “death rattle” in patients with end-of-life respiratory symptoms.
Developmental Disabilities and Community LifeRoss Finesmith
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and limited ability for testing in this population. It reviews factors like legal guardians, family involvement, group home staff, and challenges of medication administration and testing. It provides guidance on antiepileptic drug selection considering efficacy, side effects, and treating co-morbid conditions.
Sat 0810-gallagher-end-of-life-care- -parkIhsaan Peer
This document discusses end of life care options in British Columbia from the perspective of Dr. Romayne Gallagher, a physician director of palliative care. It provides an overview of palliative care and its benefits compared to physician assisted dying. While palliative care aims to relieve suffering, physician assisted dying is not considered a part of palliative care by definitions from the WHO. The document outlines concerns about assessing mental competence for physician assisted dying and potential risks of legalizing the practice.
This document discusses end-of-life care considerations for patients with advanced dementia. It finds that feeding tubes do not prevent aspiration pneumonia or malnutrition in these patients and may in fact increase the risk of pressure ulcers and restraint use. Instead, oral assisted feeding is recommended to overcome eating difficulties. The benefits of discussing goals of care and treatment options are emphasized over defaulting to invasive interventions like feeding tubes that do not improve quality of life.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care.
1. The document presents 12 graphs and diagrams that depict important issues in population health.
2. The graphs show how lifestyle and health behaviors are the dominant influences on health outcomes, and how gaps in care lead to disappointing results.
3. Additional graphs illustrate challenges such as low medication adherence, clinical inertia, the slow adoption of new medical knowledge, and the impact of health literacy on population health.
This document is an undergraduate thesis that examines the pharmaceutical industry and alternative medicine. It argues that while Western medicine has improved health outcomes for some acute illnesses, the over-reliance on drugs has significant downsides. Preventable medical errors are the third leading cause of death in the US, with pharmaceutical companies more focused on profits than patient safety. The document also suggests that several holistic doctors working on alternative cancer treatments may have been murdered to protect the financial interests of the pharmaceutical industry.
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes that many principles of antiepileptic drug therapy for non-disabled individuals also apply to those with developmental disabilities, but that treating physicians face additional challenges. These include a higher rate of difficult-to-control seizures, limited ability to do diagnostic testing due to cognitive impairments, and greater risk of adverse drug effects. It also discusses the trend toward deinstitutionalization and relocation of developmentally disabled individuals to community settings, increasing the need for community physicians to treat their medical issues like epilepsy. The role of legal guardians, family members, and group home staff in providing care and information is also covered.
Respiratory Symptoms in the Terminally Ill PatientVITAS Healthcare
The goal of this webinar was to educate healthcare professionals on interventions for cough, dyspnea, hemoptysis, and the “death rattle” in patients with end-of-life respiratory symptoms.
Developmental Disabilities and Community LifeRoss Finesmith
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and limited ability for testing in this population. It reviews factors like legal guardians, family involvement, group home staff, and challenges of medication administration and testing. It provides guidance on antiepileptic drug selection considering efficacy, side effects, and treating co-morbid conditions.
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and potential for adverse effects from medications. Care is now provided in community settings like group homes rather than institutions. Physicians must work with legal guardians, family members, and caregivers to effectively manage patients' epilepsy and understand historical factors. Choosing antiepileptic drugs requires considering seizure type, psychiatric comorbidities, previous medication responses, and ability to administer medications properly in community settings. Neurodiagnostic testing can be challenging but helps identify seizure type and guide treatment.
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and potential for adverse effects from medications in this population. It reviews factors like legal guardians, family involvement, group home staff, and challenges with diagnostic testing. It provides guidance on antiepileptic drug selection considering efficacy, side effects, and treatment of any co-morbid conditions.
This document discusses three approaches to tackling diabetes in specific populations: seniors in the Bronx, NY, veterans, and American Indians/Alaska Natives. For seniors, it highlights the importance of diabetes education programs to help patients better manage their condition and medications. It describes a program at Montefiore Medical Center that provides group education sessions. For veterans, it discusses a research study providing group appointments for diabetes monitoring and education. Finally, it notes the high rates of poverty, substance abuse and diabetes among American Indians/Alaska Natives and the need for innovative care approaches for this population.
This document discusses self-care in end-of-life care. It defines self-care as maintaining one's usual practices to deal with problems independently. Exploring self-care empowers patients to learn about their condition and identify support needs. Benefits of self-care for cancer patients include improved health, reduced symptoms, and feeling in control. However, psychological distress and caregiver strain can prevent self-care. Key self-care strategies discussed are maintaining normality, preparing for death, managing physical symptoms, accepting the illness, and relying on social support from family and other patients. The document emphasizes empowering patients through self-care.
This document discusses the challenges of diagnosing and managing cognitive impairment in older patients. It emphasizes that a careful evaluation is needed to identify potentially reversible causes before diagnosing dementia. Screening tests like the Mini-Cog and Mini-Mental State Exam can help evaluate cognition. While medications for cognitive impairment and behavioral issues related to dementia have limitations, non-drug approaches like cognitive stimulation can help patients and caregivers cope and should be considered first.
This document discusses dialysis in elderly patients. It notes that biological age is more important than calendar age when evaluating elderly patients for dialysis. Initiation of renal replacement therapy requires consideration of comorbidities, mental status, quality of life, life expectancy, vascular access, and socioeconomic factors. Dialysis in elderly patients is associated with higher rates of comorbidities like atherosclerosis and fewer vascular access options. Conservative care without dialysis is an alternative for some elderly patients with multiple comorbidities. Quality of life assessments are important when considering dialysis for elderly patients.
The document discusses current end-of-life care in the United States and potential solutions. It finds that primary care physicians may not be adequately involved in end-of-life issues due to lack of training and comfort discussing death. As a result, patients, families, and caregivers often experience suboptimal care, feelings of abandonment, poor communication, and high financial burdens. Potential solutions proposed include increased education, advanced care planning, greater hospice utilization, and healthcare models that facilitate primary care physician involvement in end-of-life care coordination and decision making.
Caring for all in the last year of life: making a difference.Bruce Mason
Inaugural presentation by Prof. Scott A. Murray, St Columba's Hospice Chair of Primary Palliative Care, Primary Palliative Care Research Group, Centre for Population Health Sciences: General Practice Section, University of Edinburgh. April 21, 2009
Success Principle 12: End of life care for COPDNHS Improvement
A series of mix and match cards providing practical examples of changes you can make and how to implement them to improve care and quality at every step of the pathway for patients with COPD and asthma.
directly affects cancer outcomes, some data do suggest
that patients can develop a sense of helplessness
or hopelessness when stress becomes overwhelming.
This response is associated with higher rates of death,
although the mechanism for this outcome is unclear.
It may be that people who feel helpless or hopeless
do not seek treatment when they become ill, give up
prematurely on or fail to adhere to potentially helpful
therapy, engage in risky behaviors such as drug use, or
do not maintain a healthy lifestyle, resulting in premature
death.
The document discusses the evolution of mental health services from the 20th to 21st century. It describes how quality of care, community-based services, and clinical governance were prioritized in restructuring an Irish mental health service based on a mission of independent, human rights-based and recovery-focused care. Key metrics like length of stay, readmission rates, and user satisfaction improved under this new model.
End of life decisions are important issues that often require difficult conversations. While many patients prefer to die at home or avoid aggressive medical care, current practices often result in deaths in hospitals or with intensive interventions. However, research shows that discussing end of life options with physicians does not cause patients emotional harm and may result in care more aligned with patients' preferences. Such discussions can also benefit families by increasing their understanding and satisfaction with end of life care. While medical futility can be a complex issue, avoiding guesswork and ensuring quality end of life care options are available benefits both patients and families.
Critical care involves managing organ system failures while considering the overall clinical picture of the patient. Less invasive interventions are preferred when possible to avoid iatrogenic harm. Prognostication is difficult, and outcomes depend on the individual patient's values and preferences. Family meetings require skilled communication to make difficult end-of-life decisions. The goal is providing humane care that aligns with patient priorities through a team-based approach.
Carle Palliative Care Journal Club for 7/3/18Mike Aref
Journal club review of "Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial" by D. Hui et. al. in JAMA. 2017 Sep 19;318(11):1047-1056.
Scott Letendre, MD, of the UC San Diego HIV Neurobehavioral Research Program, presents "Overview of HIV & Aging" for AIDS Clinical Rounds at UC San Diego
The document discusses the effects of quarantine on the elderly population in the Philippines during the COVID-19 pandemic. It notes that the elderly are highly vulnerable physically and mentally to the impacts of isolation. Physically, quarantine can increase health risks like injuries from unguided exercise and progression of non-communicable diseases due to reduced healthcare access. Mentally, quarantine raises risks of stress, loneliness, and dementia. The document recommends management approaches like promoting physical activity and social connection through remote means to support healthy aging in place during social distancing.
A geriatrician is a primary care doctor with specialized training in treating older patients. They can coordinate overall care, manage all health issues of older patients through comprehensive geriatric assessments, and design care plans to address multiple conditions. Referral to a geriatrician is recommended for older patients with complex medical issues, peculiar manifestations of diseases, frailty, polypharmacy management, discharge planning, continuity of care including home care, palliative care, and institutional care needs. Their role includes managing complex comorbidities, investigating atypical symptoms, rationalizing medications, ensuring smooth care transitions, and optimizing functionality and independence.
A chronic condition is a disease or illness that lasts for a long time or recurs frequently. Common chronic diseases include arthritis, asthma, cancer, diabetes, and some viral diseases. Chronic conditions are distinguished from acute conditions by affecting multiple body systems long-term and not being fully responsive to treatment. They may involve periods of remission or relapse. Chronic conditions can hinder independence and create additional limitations. Lifestyle factors like diet, exercise, not smoking, and limiting alcohol can help prevent or manage chronic diseases.
An effective home care provider can help seniors with congestive heart failure through improved health literacy and self-management. By advocating for seniors and ensuring their understanding of their condition and treatment plan, home care providers can help prevent health complications and hospitalizations. They do this by communicating clearly, taking notes during doctor's appointments, reviewing materials, and teaching seniors self-management techniques like daily weight and symptom tracking. With a home care provider's assistance, seniors with congestive heart failure can better manage their condition and health at home.
This PPT is all about Something that we want to lear an discover new things in life which might be very useful and essential to do something so you can figure out and work on it so you will be able to do it simply great and awesome in life. After downlading the ppt please do not forget to reshare it with your friends families and morel
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and potential for adverse effects from medications. Care is now provided in community settings like group homes rather than institutions. Physicians must work with legal guardians, family members, and caregivers to effectively manage patients' epilepsy and understand historical factors. Choosing antiepileptic drugs requires considering seizure type, psychiatric comorbidities, previous medication responses, and ability to administer medications properly in community settings. Neurodiagnostic testing can be challenging but helps identify seizure type and guide treatment.
This document discusses community-based treatment of epilepsy in developmentally disabled individuals. It notes higher incidence of difficult-to-control seizures and potential for adverse effects from medications in this population. It reviews factors like legal guardians, family involvement, group home staff, and challenges with diagnostic testing. It provides guidance on antiepileptic drug selection considering efficacy, side effects, and treatment of any co-morbid conditions.
This document discusses three approaches to tackling diabetes in specific populations: seniors in the Bronx, NY, veterans, and American Indians/Alaska Natives. For seniors, it highlights the importance of diabetes education programs to help patients better manage their condition and medications. It describes a program at Montefiore Medical Center that provides group education sessions. For veterans, it discusses a research study providing group appointments for diabetes monitoring and education. Finally, it notes the high rates of poverty, substance abuse and diabetes among American Indians/Alaska Natives and the need for innovative care approaches for this population.
This document discusses self-care in end-of-life care. It defines self-care as maintaining one's usual practices to deal with problems independently. Exploring self-care empowers patients to learn about their condition and identify support needs. Benefits of self-care for cancer patients include improved health, reduced symptoms, and feeling in control. However, psychological distress and caregiver strain can prevent self-care. Key self-care strategies discussed are maintaining normality, preparing for death, managing physical symptoms, accepting the illness, and relying on social support from family and other patients. The document emphasizes empowering patients through self-care.
This document discusses the challenges of diagnosing and managing cognitive impairment in older patients. It emphasizes that a careful evaluation is needed to identify potentially reversible causes before diagnosing dementia. Screening tests like the Mini-Cog and Mini-Mental State Exam can help evaluate cognition. While medications for cognitive impairment and behavioral issues related to dementia have limitations, non-drug approaches like cognitive stimulation can help patients and caregivers cope and should be considered first.
This document discusses dialysis in elderly patients. It notes that biological age is more important than calendar age when evaluating elderly patients for dialysis. Initiation of renal replacement therapy requires consideration of comorbidities, mental status, quality of life, life expectancy, vascular access, and socioeconomic factors. Dialysis in elderly patients is associated with higher rates of comorbidities like atherosclerosis and fewer vascular access options. Conservative care without dialysis is an alternative for some elderly patients with multiple comorbidities. Quality of life assessments are important when considering dialysis for elderly patients.
The document discusses current end-of-life care in the United States and potential solutions. It finds that primary care physicians may not be adequately involved in end-of-life issues due to lack of training and comfort discussing death. As a result, patients, families, and caregivers often experience suboptimal care, feelings of abandonment, poor communication, and high financial burdens. Potential solutions proposed include increased education, advanced care planning, greater hospice utilization, and healthcare models that facilitate primary care physician involvement in end-of-life care coordination and decision making.
Caring for all in the last year of life: making a difference.Bruce Mason
Inaugural presentation by Prof. Scott A. Murray, St Columba's Hospice Chair of Primary Palliative Care, Primary Palliative Care Research Group, Centre for Population Health Sciences: General Practice Section, University of Edinburgh. April 21, 2009
Success Principle 12: End of life care for COPDNHS Improvement
A series of mix and match cards providing practical examples of changes you can make and how to implement them to improve care and quality at every step of the pathway for patients with COPD and asthma.
directly affects cancer outcomes, some data do suggest
that patients can develop a sense of helplessness
or hopelessness when stress becomes overwhelming.
This response is associated with higher rates of death,
although the mechanism for this outcome is unclear.
It may be that people who feel helpless or hopeless
do not seek treatment when they become ill, give up
prematurely on or fail to adhere to potentially helpful
therapy, engage in risky behaviors such as drug use, or
do not maintain a healthy lifestyle, resulting in premature
death.
The document discusses the evolution of mental health services from the 20th to 21st century. It describes how quality of care, community-based services, and clinical governance were prioritized in restructuring an Irish mental health service based on a mission of independent, human rights-based and recovery-focused care. Key metrics like length of stay, readmission rates, and user satisfaction improved under this new model.
End of life decisions are important issues that often require difficult conversations. While many patients prefer to die at home or avoid aggressive medical care, current practices often result in deaths in hospitals or with intensive interventions. However, research shows that discussing end of life options with physicians does not cause patients emotional harm and may result in care more aligned with patients' preferences. Such discussions can also benefit families by increasing their understanding and satisfaction with end of life care. While medical futility can be a complex issue, avoiding guesswork and ensuring quality end of life care options are available benefits both patients and families.
Critical care involves managing organ system failures while considering the overall clinical picture of the patient. Less invasive interventions are preferred when possible to avoid iatrogenic harm. Prognostication is difficult, and outcomes depend on the individual patient's values and preferences. Family meetings require skilled communication to make difficult end-of-life decisions. The goal is providing humane care that aligns with patient priorities through a team-based approach.
Carle Palliative Care Journal Club for 7/3/18Mike Aref
Journal club review of "Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial" by D. Hui et. al. in JAMA. 2017 Sep 19;318(11):1047-1056.
Scott Letendre, MD, of the UC San Diego HIV Neurobehavioral Research Program, presents "Overview of HIV & Aging" for AIDS Clinical Rounds at UC San Diego
The document discusses the effects of quarantine on the elderly population in the Philippines during the COVID-19 pandemic. It notes that the elderly are highly vulnerable physically and mentally to the impacts of isolation. Physically, quarantine can increase health risks like injuries from unguided exercise and progression of non-communicable diseases due to reduced healthcare access. Mentally, quarantine raises risks of stress, loneliness, and dementia. The document recommends management approaches like promoting physical activity and social connection through remote means to support healthy aging in place during social distancing.
A geriatrician is a primary care doctor with specialized training in treating older patients. They can coordinate overall care, manage all health issues of older patients through comprehensive geriatric assessments, and design care plans to address multiple conditions. Referral to a geriatrician is recommended for older patients with complex medical issues, peculiar manifestations of diseases, frailty, polypharmacy management, discharge planning, continuity of care including home care, palliative care, and institutional care needs. Their role includes managing complex comorbidities, investigating atypical symptoms, rationalizing medications, ensuring smooth care transitions, and optimizing functionality and independence.
A chronic condition is a disease or illness that lasts for a long time or recurs frequently. Common chronic diseases include arthritis, asthma, cancer, diabetes, and some viral diseases. Chronic conditions are distinguished from acute conditions by affecting multiple body systems long-term and not being fully responsive to treatment. They may involve periods of remission or relapse. Chronic conditions can hinder independence and create additional limitations. Lifestyle factors like diet, exercise, not smoking, and limiting alcohol can help prevent or manage chronic diseases.
An effective home care provider can help seniors with congestive heart failure through improved health literacy and self-management. By advocating for seniors and ensuring their understanding of their condition and treatment plan, home care providers can help prevent health complications and hospitalizations. They do this by communicating clearly, taking notes during doctor's appointments, reviewing materials, and teaching seniors self-management techniques like daily weight and symptom tracking. With a home care provider's assistance, seniors with congestive heart failure can better manage their condition and health at home.
This PPT is all about Something that we want to lear an discover new things in life which might be very useful and essential to do something so you can figure out and work on it so you will be able to do it simply great and awesome in life. After downlading the ppt please do not forget to reshare it with your friends families and morel
This document discusses ethical issues surrounding disclosure of diagnoses, specifically Alzheimer's disease, to patients and their families. It provides guidance on assessing a patient's understanding and desire to know their diagnosis before disclosure. When disclosing Alzheimer's, it is important to arrange a joint meeting with family, allow time for questions, discuss disease progression and care plans, and involve caregivers going forward. The case study describes one family's experience where the husband decided to disclose the wife's Alzheimer's diagnosis to her in the doctor's office, but she initially reacted with disbelief and later developed aggressive behaviors towards her husband caregiver.
This document discusses the mental health crisis among doctors in America. It describes high rates of depression, burnout, and suicide among medical residents and physicians. A pilot program at Stanford called Reflection Rounds aims to improve doctors' mental health by providing mandatory therapy sessions. The document also examines the culture of medicine that discourages vulnerability and weakness and contributes to poor mental health outcomes for physicians.
Senior Healthcare Consultant (Geriatric) class at Piedmont Hospitalsnomadicnurse
The first of a 2-day class on Geriatric issues for nursing staff at all 4 Piedmont hospitals funded by a HRSA Comprehensive Geriatric Education Grant 2009-2012.
Top 7 Insights from Years of Observing Real-world Healthcare Communication Ogilvy Health
Over the past 15 years, the Ogilvy CommonHealth Behavioral Insights team has used sociolinguistic techniques to study and improve healthcare communication. We spearheaded this research by studying dialogues between patients and healthcare providers using our proprietary methodology. Continue reading to better understand how to incite behavior change and improve healthcare communications.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
This document provides an overview of palliative care, including:
1) Palliative care aims to relieve suffering and improve quality of life for patients facing serious illnesses, and involves addressing physical, emotional, and spiritual needs.
2) As the population ages and chronic diseases increase, more patients will benefit from palliative care services to improve end-of-life experiences and outcomes.
3) Prognostication, or predicting a patient's life expectancy, is an important but challenging skill for physicians, and palliative care aims to improve care based on patient preferences near the end of life.
Why doctors prescribe opioids to known opioid abusersPaul Coelho, MD
- Prescription opioid abuse is a major epidemic in the US, with 60% of abused opioids obtained from physician prescriptions. Some doctors knowingly prescribe opioids to patients who are abusing or diverting the drugs.
- Factors contributing to this issue include a shift in medicine's philosophy to prioritize pain treatment, cultural attitudes that any pain requires treatment, and financial incentives to treat pain but not addiction.
- Short-term solutions proposed include requiring physician education on addiction, implementing prescription drug monitoring programs, and reimbursing physicians for addiction counseling. However, the problem will only be fully addressed when addiction is considered a treatable disease.
Importance of patient centered communication in Lifestyle DiseasesRitu Awasthi
This document discusses the importance of patient-centered communication in managing lifestyle diseases. It notes that lifestyle diseases like diabetes and heart disease have increased due to changes in living patterns and are difficult to treat as they require changes to lifestyle and mindset. Effective communication between doctors and patients is important for compliance, improved health outcomes, and reducing malpractice. Barriers to communication include patients not providing full medical histories and doctors interrupting patients. The ideal relationship is one of mutuality where doctors and patients collaborate as equal partners.
This document provides an introduction and overview of a master's project submitted by Beth C. Tomlinson to Bethel University. The project examines the use of prescription and nonprescription medications by the elderly population. Tomlinson conducted surveys of independent living facility residents and focus groups to understand participant awareness and perspectives on medication usage. She also consulted three geriatric nurses to gain insight from medical professionals. The document outlines the importance of understanding medication perception and provides context for Tomlinson's research on improving education for seniors and healthcare workers on appropriate medication use among the elderly.
End of life decision making and approaches to issues of futility power point Bernard Freedman
This document summarizes key topics related to end-of-life decision making, including:
1) Ethically sound and legally mandated end-of-life decisions as well as the responsibilities of surrogate decision makers.
2) What constitutes futile care and how to deal with cultural and religious needs in end-of-life care.
3) The importance of documenting end-of-life decisions in the medical record and giving patients and surrogates sufficient information to make informed decisions.
This whitepaper proposes a specialized clinical practice to facilitate improved healthcare for the elderly through pairing electronic health records with Medicare-approved wellness exams. Several barriers currently prevent many seniors from taking advantage of wellness visits and preventative care, including lack of clarity on exam types, limited health literacy, and socioeconomic factors. The proposed service aims to close gaps in healthcare disparities and generate universal access to medical records using network-based EHR technology.
Ethical Issues Regarding Nutrition and Hydration in Advanced IllnessMike Aref
Be able to discuss and clarify “pleasure feeding” with patients and their families
Identify ethical issues with continuing or stopping artificial nutrition and hydration
Understand complications of artificial nutrition and hydration that are not ethically justifiable
Be able to discuss issues of self-dehydration and self-starvation
This document describes the "Five M's" approach for teaching diabetes self-management skills to patients in the hospital. The five categories are: Meter (blood glucose monitoring), Meds (medication management), Meals (meal planning), Move (physical activity), and More (problem-solving skills and reducing health risks). For each M, the summary provides when to address it, questions to ask patients, and how to individualize teaching for that skill. The approach aims to give patients "survival skills" in a simple format using teachable moments before discharge.
an informed patient is an empowered patient … with the goal of achieving improved health outcomes.
… shared or informed decision-making, evidence-based patient choice, or concordance.
This document discusses several key topics in medical ethics including:
1. The basic concepts of medical ethics including beneficence, non-maleficence, autonomy, justice, and informed consent.
2. Historical events that shaped modern medical ethics such as the Tuskegee Syphilis Study and the Doctors' Trial at Nuremberg.
3. The role of Institutional Review Boards in ensuring ethical research and protecting human subjects.
4. Common ethical issues in healthcare like end-of-life care, advance directives, withdrawal of life-sustaining treatment, and resolving disagreements between patients/families and physicians.
The document discusses definitions and terminology related to alternative medicine, quackery, and evaluating health claims. It defines key terms like alternative, quackery, nontraditional, complementary/integrative, and holistic. It also discusses how to identify questionable health claims and products, like looking for promises of quick results without side effects. The document aims to help readers critically evaluate alternative medicine claims and practices.
This document discusses the history and principles of bioethics. It begins by explaining how advances in medicine raised new moral issues that ethicists worked to address. Notable cases of unethical human subject research helped establish principles like informed consent and respect for persons. Guidelines like the Nuremberg Code aimed to prevent future abuses. The document then examines key bioethical principles like autonomy, beneficence, nonmaleficence, and justice. It explores how these principles guide issues like informed consent, respecting patient values, avoiding harm, and fair allocation of resources. The challenges of applying principles to complex real-world cases are also discussed.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Osteoporosis - Definition , Evaluation and Management .pdf
Senior research project essay
1. Cooley 1
Ra’Quayle L. Cooley
Susan Lester
Adv. Lit/ Comp.
26 September 2011
Hospice: Caring for the Elderly and Terminally Ill
“For 20,000 Washingtonians every year, hospice is an end-of-life care option that
provides dying patients and their loved ones with comfort, compassion and dignity” (Neuberger
4). Hospice is a care facility for individuals who are terminally ill. Hospices all across the world
tend to focus on the care of the individual and the philosophy of care for the individual through
palliative care. Hospice care has been seen as an institution were an individual can die peacefully
in his or her own home. Hospice care however is not just limited to those who are terminally ill.
It is also for the elderly, mentally incapacitated, and for those who are in need of assistance.
However inrecent years a hot topic issue is the care of the very individuals who are the elderly,
mental incapacitated, and those who can’t assist themselves. As a result, care facilities such as
nursing homes, retirement homes, and even hospices have been under scrutiny for the care that
they are giving these individuals. It is not uncommon for nanny cams to be placed in an
individual’s home by the family of an elderly citizen who is being suspected of being abused by
the care facilitator. The burning question for many individuals is that “Have the care for those
who are incapacitated, elderly or can’t fend for themselves have been compromised by the very
individuals who care for them? If so has this been a direct affect from Western Civilization and
medical practices implemented?”
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The first thing to remember with medicine is that the patient always comes first. A
question that many ask is “How have a doctor’s prognosis been compromised when working in a
care facility?”With the condition of the elderly in the United States along with the mentally
incapacitated and individuals who can’t physically help themselves in facilities like a nursing
home, psyche wards, or even in a rehabilitation facility it is very common for doctors to be
responsible for more than fifty patients at one time. In facilities such as a nursing home where
elderly patients are in need of physical rehabilitation are prescribed drugs by doctors can be
overwhelmingly dangerous just as Cruikshank points out, “Although adverse drugs reactions
affect the old who live independently or with families as well as those who are institutionalized,
the problem is especially serious among nursing home residents. Since this population is largely
female, the problem of overmedicating in nursing home residents is a woman’s issue. Some
drugs have similar names, resulting in mix-ups. Many falls in nursing homes result from
overmedication”. (Cruikshank 5). The issue with doctors seeing 50 elderly patients at one time is
that the doctor might overmedicate the patient without even knowing that they did. This is a
result of more than one doctor prescribing one patient at one time due to the lack of
communication that exists between them. A simply way of fixing this issue is passing a state law
that requires for doctors to double check their patients records and current medication. By doing
so and having doctors ask their patients if they are currently seeing more than one doctor will
greatly reduce the risk of the patient overdosing from overmedication. Granted that many doctors
make medical errors when prescribing medication that could be potentially fatal to the patient a
grave mistake that is very common is when doctors often overlook signs and symptoms of
patients that have fatal illnesses. What isn’t a shock to most individuals is that out of any group
of doctors the ones that make the most medical mistakes are the generally the ones that just
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graduated from medical school. As a result some states are beginning to pass laws that require
physicians to obtain more sleep at so that less medical errors are being made on the job. As the
Philadelphia Inquirer points out in the article New rules prescribe shorter hours for young
physicians the author, Gregory Thomas, states that “The mandate is billed as a means of
enhancing patient safety and residents' quality of life by reducing physician fatigue and errors.
But it will also boost hospital costs and further reduce the long hours that some doctors believe
are critical to learning”.Doctors often make mistakes for various reasons some of the top reasons
they make mistakes when making a prognosis with a patient is that they miss common signs.
They are often overwhelmed and stressed because as a doctor they feel the need to not make a
mistake. In their profession it has become a dangerous liability to have too many mistakes with
patients which could lead to a malpractice suit or even worse--- being forced out of practice.
Being blacklisted as a doctor and being forced out of practice is just some of the consequences
that can end a doctor’s career. Some of the mistakes doctors make are not always medical
mistakes but are often sometimes thinking mistakes that can mentally blocking them from
making the correct prognosis for their patient. This can be extremely potent in their field,
especially when they are working with elderly or mentally disabled patients that are unable to
correct doctors on simple mistakes that they might make with their patient. A common mistake
in this area is not discussing preventative measures to elderly patients.Most doctors believe,
“Why should I prescribe this patient medication to lower their cholesterol when their health is
already failing?” The fact of the matter is that every patient can and most likely will benefit from
any programs or medication that the doctor places them on. Usually, it is common for doctors to
see elderly patients who are often on multiple medications and don’t know about their patients’
medical history. One way to prevent the doctor from making a mistake with elderly patients is to
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have a relative or care-taker that is current on the individual’smedical history. By doing so, this
will make the physician more aware of the patient’s medical history and as a result the physician
will make less medical errors when speaking with the patient. While some mistakes such as
prescribing the wrong medication and not being knowledgeable on the patient’s history is
primarily the doctor’s fault. What is even worse is the medical quick fix that can often be out of
the doctor’s control. Americans, now more than ever have be known for wanting to have a
medical quick for their health, especially the elderly.
Secondly, compared to other countries and cultures, America, has been known for
wanting to quickly solve things and move on to another topic. To many it seems that this has
occurred in medicine as well. The number one question that is being asked is “How has the direct
link between Americans wanting a quick fix (prognosis) and the elderly affected the quality of
care for individuals in facilities like hospice?Many hardworking Americans place their health
aside and commonly choose to use over-the-counter drug prescriptions for diseases such as the
common cold, the flu or something as a mild as the chicken pox’s.However what are the side
effects to the elderly when the beginning to use over-the-counter medication along with their
prescribed medication. In a CNN report, Dr. Donna Fick, stated that “The number of prescription
medications an older person takes is the strongest predictor of their risk for future drug-related
problems” (Harding). A common problem for elderly patients and taking medication is that in
conjunction with already taking their medication they also take over-the-counter medication. For
example a common medication that people over the age of 57 to 85 take is warfarin. Warfarin is
often used as an anti-coagulant to prevent blood clots from forming or growing in the blood and
in the vessels. If warfarin is used along with aspirin the two medications will counteract each
other causing the patient to severe bleeding hemorrhoids. A great alternative to having elderly
5. Cooley 5
patients on different medications that could cause them unnecessary pain and suffering is to have
them talk to their doctor and ask questions about what type of medication is acceptable to take
while there are on certain medications. Another issue with the elderly taking their medications is
not the fact that they are mixing medication with nonprescription medication but rather that the
elderly are overdosing on their medication. As a result of overmedication some elderly patients
experience a likelihood of “falls and metal confusion, but nondrug therapies can help reduce the
use of such medications” (Harding). The major issue with elderly patients overdosing on
medication is that it can not only cause them become disoriented and confused but it can also
increase the decline of the health. Many doctors or nurse practitioners would often tell their
elderly patients to take it easy on their medication. Elderly patients should at all times take their
medication with supervision of their caretakers and should also be advised to not take more than
prescribed daily amount. A lasting issue with elderly patients consuming their medication is the
issue of adverse and inverse reactions that comes along with overdosing on mediation Harding
points out that, “while any single drug might help people live longer, healthier lives, experts
worry that combination of drugs, along with over-the-counter products and dietary supplements
could be a recipe for disasters in terms of drug interactions. Statistically, one in three American
adults’ ages 57-85 are taking at least more than five prescription drugs a day. In nursing homes,
if the wrong medication is given to an elderly patient by an orderly an adverse reaction could
occur that could result in that patient’s death. A solution to that problem is to always have the
patient double check their names on the medication bottles when they are asked to take their
prescription this will also cause them to have a daily ritual with knowing what medications they
should be taking. This will cause them to become more aware as to what type of prescription
they are supposed to be taking. For the purpose of teaching the elderly of how to properly take
6. Cooley 6
their medication a topic that should be discussed is the caretakers who help them take their
medication.
Lastly, the most important thing to remember with healthcare and the elderly is the
quality of healthcare they might receive. Another question many might ask is “How has the
quality of palliative care compare to other countries around the world in facilities like
hospice?”Considering that, death, is treated and looked upon with much respect. However many
individuals question the amount of respect many Americans have for death. As Julia Neuberger
claims in her article, Caring for the Dying is inadequate in Western Society, she writes that Jews
and Muslims “tend to argue for doing everything to keep people alive, life itself being seen as the
most precious divine gift”.A concern for many individuals who place their loved ones in a
Hospice facility is that they will not be treated with the utmost care as far as their spiritual and
mental well being is concerned. Daily prayers and customs from different religions have become
completely unrecognized for some individuals who are devote Christians, Buddhists, Jews, and
even Taoist. A simple solution to this problem is for the caretakers to undergo extensive training
about different religions. By having the caretakers undergo extensive training on different
religions the will have a better understanding of how to treat patients from different religions.
With a concern to different religions around the world and patients who belong to those religions
is the concern of how those patients will die. How one individual might view death will severely
differ from another person. Kevin Irvine states in his article that the, “quality of life means one
thing for someone who is 42 and has been battling full-blown AIDS for five years, and
something entirely different for a 22-year-old with a spinal-cord injury may live 60 more years.
Different individuals from different religious backgrounds have various perspectives. As a result,
many people want to die differently. Family member or even caretakers can speak to their loved
7. Cooley 7
about their last rites and talk openly about their last days. Death is rite of passage for all human
beings and should not be revered because it is something that is unknown. More importantly,
when an elderly patient in a hospice facility is preparing their last moments some of them might
choose instead to go to a more controversial route, assisted-physician suicide. For some, it gives
them a sense of control over their last moments when they have long battled cancer and knowing
that they will die soon. As Kevin Irvine points out in his article, “While some people with full-
blown AIDS will not "get better," others with nonterminal disabilities will have symptoms and
life situations that wax and wane. One man with multiple sclerosis said he was seeking the so-
called [euthanasia] services of Dr. Jack Kevorkian to avoid having to go into "a rat-infested
nursing home”.The issue with the elderly and physician-assisted suicide is that some of the
elderly are often not in a healthy-state of mind. Most often they will choose to opt for physician-
assisted suicide instead of having to slowly die in a hospice facility or worse in a nursing home.
An elderly patient should always speak with a psychiatrist and their doctor before they consider
the decision of physician-assisted suicide. Most often, elderly men and woman choose to
decision because they feel neglected in some manner. The issue of euthanasia and the elderly
will always be present especially with those who are in hospice facilities.
With the many controversial issues that are in the medical field it is still worth the risk of
becoming a doctor. Most often the issues in the medical field are commonly moral issues such as
abortion, euthanasia, and even religion. Once an individual takes an oath as a doctor or becomes
a certified register nurse they have a moral obligation to aid the sick, dying, and disabled. The
medical field is not a career option for some who is strongly religious and is set against abortion
because as a doctor that they will encounter female patients opting for abortion. For some
individuals the medical field can and will compromise their faith, morals and who they are as an
8. Cooley 8
individual human being. As long as some one remembers not to sacrifice who they are as a
person anyone can become a doctor or nurse.
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Works Cited
Cruikshank, Margaret. “The Elderly Are Being Harmed by Overmedication .”Gale Opposing
Viewpoints in Context.Ed. Sylvia Engdahl.GreenhavenPress , 2009. Web. 12 Sept. 2011.
Harding, Anne. “Mixing Multiple Medications Causes Health Problems for Elderly
Americans.”Gale Opposing Viewpoints in Context. CNN, 23 Dec. 2008. Web. 3 Oct.
2011.
Irvine, Kevin. “Legalizing Patient-Assisted Suicide Would Lead to Patient Abuse.” Gale
Opposing Viewpoints in Context.Ed. Gail N Hawkins.Greenhaven Press, 2002. Web. 11
Sept. 2011.
Neuberger, Julia. “Caring for the Dying Is Inadequate in Western Society.” Opposing Viewpoints
Resource Center.Ed. Andrea C Nakaya.Green haven Press, 2005.Web. 12 Sept. 2011.
Thomas, Gregory. “New Rules Prescribe Shorter Hours for Young Doctors.” Gale Opposing
Viewpoints in Context. Philadelphia Inquirer, 1 July 2011. Web. 2 Oct. 2011.