#38: Hospice and palliative care: How to manage end of life symptoms
The Curbsiders Internal Medicine Podcast
The Curbsiders Internal Medicine Podcast
4.8 • 3.3K Ratings
🗓️ 8 May 2017
⏱️ 64 minutes
🧾️ Download transcript
Summary
Recognize and manage end of life symptoms with competence and confidence. In this extensive discussion with Dr. Brooke Worster, Assistant Professor of Medicine at Sydney Kimmel Medical College and Medical Director, of the Palliative Care Service at Thomas Jefferson University Hospitals we discuss scripts for having difficult conversations, managing patient/family expectations, what comes in the hospice “E” kit, terminal delirium, the “death rattle”, air hunger, and more.
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Time Stamps
00:00 Intro
03:10 Rapid fire questions
08:33 Defining hospice and palliative care
11:28 Case discussion
21:28 Gunderson, MI and Respecting Choices
24:25 How to counsel patients about home hospice?
37:10 Hospice “E” kit and how to use it
42:09 Air hunger, terminal delirium, death rattle, and Cheyne Stokes breathing
52:48 What is the PCM’s role while patient is on hospice?
58:19 Cancer survivorship and palliative care
60:33 Take home points
62:20 Outro
Tags: assistant, care, doctor, end, education, family, foam, foamed, health, hospice, hospitalist, hospital, internal, internist, life, nurse, medicine, medical, palliative, physician, practitioner, primary, resident, student, symptom
Transcript
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| 0:00.0 | This is our pre-recording, Paul. |
| 0:02.0 | So we can, I can give you your exact address out on air if you want. |
| 0:05.5 | I feel like we probably should. |
| 0:07.0 | I get like, I get several emails each week requesting where your address is, Paul. |
| 0:14.0 | So I haven't given it out yet, but now maybe I will. |
| 0:17.0 | Welcome back to the Curvesiders, the Internal Medicine Podcast that uses expert interviews |
| 0:32.9 | to bring you clinical pearls and practice changing knowledge. |
| 0:36.4 | I'm Dr. Matthew Wato, uninterrupted, meaning Dr. Stewart Ken Brigham is not joining us tonight. |
| 0:43.4 | But don't fret, I am here with Dr. Paul Williams. |
| 0:47.4 | Hi, Paul. |
| 0:48.4 | Hey, Matt. How's it going? |
| 0:50.4 | It's going very well. |
| 0:52.4 | We just had a long conversation with Dr. Brooke Worcester. |
| 0:58.4 | She is an assistant professor of medicine at the Sydney Kimmel Medical College at Thomas Jefferson University. |
| 1:04.9 | She is also the medical director of palliative care services at Thomas Jefferson University hospitals. |
| 1:11.4 | She completed an internal medicine residency and chief residency at Temple University Hospital |
| 1:16.4 | before going on to a pain in palliative medicine fellowship at Massachusetts General Hospital. |
| 1:22.4 | I asked her here this evening because I feel that having difficult conversations around hospice and palliative medicine is quite challenging |
| 1:31.4 | and also can be one of the most rewarding things you can do as a physician. |
| 1:36.4 | Brooke is here to teach us about how to broach some of these difficult conversations. |
| 1:41.4 | We also talk about symptom management at the end of life and what exactly home hospice looks like because I know that's something that most of us don't have much exposure to during our training. |
| 1:54.4 | And it's helpful to know what we're sending patients to. |
... |
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