Discover and read the best of Twitter Threads about #palliativecare

Most recents (24)

Triggerwarnung: Sterben

Wir müssen über den Tod und die Gestaltung des Lebensendes reden...

Ich bin auf dem Land aufgewachsen. Jeder kennt jeden. Konservativ. Man geht in die Kirche und trifft sich viel auf dem Friedhof. Der Tod war für mich als Kind ein normaler Begleiter.
Er gehörte zum Leben dazu. Dadurch, dass man die Großeltern der anderen z.B. kannte, hat man auch mitbekommen, dass jemand gestorben war und was das bedeutete.

Hinzu kommt, dass meine Eltern uns auch immer zu den Toten in unserer Familie gelassen haben, damit wir uns
verabschieden können. Das hat sehr geholfen muss ich retrospektiv sagen. Für mich war auch als Kind immer klar: Der Tod ist endgültig.

Mein Opa hat sich nach dem Krieg in unserem Dorf niedergelassen und viel Sterbebegleitung gemacht, als das Konzept noch nicht bekannt war.
Read 21 tweets
Exclusive: Hospices are warning more people could die alone, without pain relief, as soaring costs and flat NHS funding means hospices are closing beds and making staff redundnant to fill a £186m blackhole 1/n… @hospiceuk #PalliativeCare
The Sunday Times spent a day with hospice workers, as @hmtreasury has rejected a £30m rescue pacakge bid proposal from @hospiceuk to try and stop services closing down 2/n…
“The hospice sector is subsidising the government’s health and social care system,” said Toby Porter who warned closing services would have consequences for the NHS as people face A&E admissions or dying on busy acute wards. 3/n…
Read 6 tweets
When you visit as many aged care facilities as often as I do, you would think that nothing would be a surprise and that after so many years I would always know what to expect. Not so. This week’s 🧵…
Constantly surprised to walk in to a facility in the middle of a weekday where there are more than 100 residents over three levels, to find that there is only one single RN and a single EN on each shift for the entire facility.
Totally surprised to be told that this is their new standard rostering. No wonder registered nurses are leaving in droves.
Read 13 tweets
#midazolam nonsense doing the rounds again. So here are some facts

“Midazolam shouldn’t be given to respiratory illness patients because it’s a respiratory depressant - it killed people” or some version of that is normally the tweet. We’ll look at why it’s a misunderstanding
Midazolam as a procedural drug:

Midazolam is used for procedures like endoscopy as sedation, in this scenario there are lots of medical people present, oxygen and ventilation equipment available, and a reversal agent flumazenil in the event a patients breathing is suppressed
Midazolam in critical care:

In this instance patients are ventilated, and midazolam is used as sedation. Contrary to popular belief people on ventilators aren’t all unconscious, but a ventilator is hard to tolerate entirely awake.
Read 9 tweets
It’s World Hospice & #PalliativeCare Day

For people facing life-threatening illnesses, palliative care provides:
💜practical help
💚physical care
💙spiritual & emotional support

It relieves suffering & helps patients & their loved ones.

#PalliativeCare requires services to focus on compassion as a glue that binds humans together.

Quality palliative care services are founded on:
💜 awareness of suffering
💚 empathy towards this suffering
💙 concrete action to alleviate this suffering

📌 Illustration of a father re...
It’s World Hospice & #PalliativeCare Day

Connection with loved ones in the final day of life can improve the #MentalHealth and well-being of patients and families, helping them cope in difficult moments.

📌 Illustration of two women r...
Read 4 tweets

Join me for another #neuropalliative care Tweetorial about a very broad and complicated topic: @MedTweetorials #NeuroTwitter #NeuroPal #hapc #MedEd
My goal for this 🧵 is to define key features of coma, vegetative state (VS), and minimally conscious state (MCS). And why it matters for #PalliativeCare.
This is not a Tweetorial on brain death or prognostication right after brain injury. Stay tuned for those🤓 2/17
To understand differences between disorders of consciousness (DoC) is to separate the ideas of being awake and being aware:
3/17 Image
Read 18 tweets
Let's call death as death...let them know d truth...
I just told a 32 yr old lady that her husband is dying . Breaking bad news can be tricky. There is no fixed way of doing it. What works for one may not work for the other. I hv know the couple for over 5 yrs #PalliativeCare +
S was diag with adenocarcinoma of the lung with brain mets. He was referred to me for counselling. I made him sit on a chair and spoke to him for nearly 45min. "I can't die madam, I want to live for 30 more years. I hv to see my little girl grow up" he said. Thanks to the +
Advancement in treatment modalities fr lung ca , he could survive for 4yrs ,the TKI worked very well for over 3 yrs. Then he rapidly progressed. It was sad to see him deteriorate so quickly ( cancer 😞) . I have had numerous conversations with him+
Read 9 tweets
After an intense ICU event (eg. emotional family meeting or code), especially with trainees, take time to debrief with your whole team. Pause to acknowledge & process emotions & give a safe space to have them. Don’t just go back to the grind as we do. That stacks up #unwellness.
2/ These can be & are extremely traumatic events for HCWs, & yet I see trainees, nurses, fellow colleagues going to the next patient, chart, or procedure sometimes wiping tears from their eyes. I don’t know if we built this system up that way, but it shouldn’t be.
3/ Pause to have these emotions. Take time for yourself and your team. If an unexpected code happens while you’re rounding with a team of residents, pause. Debrief it. Let your residents have those emotions. Take a break. Buy everyone coffee. Don’t just keep going on rounds.
Read 5 tweets
1/🧵 A personal story of misjudgment as a physician.
Years ago, when I was a young doctor, I had a patient in the ICU on a ventilator who was doing so poorly, day after day, that I was certain he was going to die.

I confidently told the family he was going to die.
2/ The family members all gathered and were extremely distraught. They listened and trusted me.
But I was wrong.

#PalliativeCare #EndofLife
3/ For many years to come, I received Christmas cards from this man.

It was extremely humbling.
Until I learned, this happened many other times in my life as an ICU doctor.

Sometimes I was off by just 2 weeks, sometimes 2 months, and other times by 2 years.
Read 8 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
Read 60 tweets
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 #SRFclub hat die basalsten fragen nicht beantwortet? (musste abstellen. diese inszenierungen via betroffenheit - bei #SRFarena @SandroBrotz wie bei #SRFclub @BarbaraLuethi: scheint strategie @ploxa @brenntr zu sein - ist unerträglich.)

@PresseratCH @Mark_Eisenegger @ManuelPuppis
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 @SandroBrotz @BarbaraLuethi @PresseratCH @Mark_Eisenegger @ManuelPuppis @srg_d @srginsider @SRGSSR du meinst es ernst
mir ist langweilig

ich bin sozialarbeiter
dein kind ist authist

#FranziskaSprecher hat es ausgesprochen
@BarbaraLuethi hat sie abgeklemmt
@wusi @Nightingal_news @SRF @ploxa @brenntr @SRFNews2 @SandroBrotz @BarbaraLuethi @PresseratCH @Mark_Eisenegger @ManuelPuppis @srg_d @srginsider @SRGSSR ist die dir aufgefallen, dass die kommunikationsprofifrau, welche ihren kürzlich verstorbenen mann und ihre 10-jährige tochter tränenlos eingesetzt hat, ihren account mit #SchutzfaktorM führt? #blockalsammlung #SRFclub…
Read 19 tweets
1/🧵 Why is COVID hospitalization like 2X sticks of dynamite 🧨?
A thread on the ICU portion… #PICS + #LongCOVID.
Prevent this w 3 steps:
📌Avoid #COVID by Vax & Mask
📌Avoid severe COVID by Paxlovid & Monoclonal Ab
📌👇 read here about PICS & how to reduce injury in the ICU
2/ Here’s what you must know if you get too sick & land in an ICU.

History Lesson 📝
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.

That’s happening again 🤮
3/ We kept patients immobilized due to an overly conservative approach to fall prevention that precluded us from attempting to walk them early. We kept families away from patients, treating loved ones as visitors rather than members of the healing plan.

That’s happening again.
Read 10 tweets
Künstliche Ernährung & Flüssigkeitszufuhr hat eine enorme medizinische, gesellschaftliche & natürlich ethische Brisanz. Viele haben sich bewusst dafür entschieden & können auch über Jahre damit gut & wohl auch mehr oder weniger zufrieden leben.
Gleichzeitig bekommt diese künstl. Ernährung in vielen Momenten & v.a. auch in d. letzten Lebensphase nochmal eine ganz neue Brisanz.
Es ist ganz oft mein Eindruck, d. hier viel Fehlinformationen & auch Ängste im Raum stehen, d. einfach viel zu selten angesprochen werden.
Dies mag einerseits daran liegen, dass man nicht gern über seine Ängste spricht. Andererseits ist das Sterben & der Tod bis heute in D ein großes Tabuthema, auch wenn es wohl in den vergangenen Jahren schon ein wenig besser geworden ist.
Read 9 tweets
Increasing overmedicalisation at the end of life is denying people & their families a good death.

Towards a compassionate community model: The Lancet #ValueofDeath Commission calls for a radical rethink of care for the dying & attitudes to death. Death and dying must be rec...
How death is managed today:
• Alienates communities
• Pushes families in countries without #UHC into poverty
• Deprioritises efforts to reduce suffering, such as #PalliativeCare
• Diverts resources
• Is costly for health services
#ValueofDeath Image
Scientific advances have fuelled the belief death should be feared, avoided, defeated.

Centralising community involvement, partnerships, & better bereavement support will help rebalance societies' & medicine's relationship with death—an inevitable part of life. #ValueofDeath Image
Read 8 tweets
1/🧵 You’re dying in a hospital bed, and we grant you “THREE WISHES.” What would they be?

My dying patient is stunningly beautiful INSIDE & out. I asked what 3 wishes she had?

This video of the Birthday 🎂 party we had for her son is her BONUS Wish!

Read on for her share ❤️
Her Wish #1: Pizza, large w extra cheese. It’s been 3 years since she tasted SALT.

(again, all pics shown w their perm)
2/ Wish #2:

Expanded FAMILY visitation, which mean she enjoyed the ‘Za with all her children!

She said, “Dr. Wes, Dr. Koenig & @mad_ruk this is Priceless to me 🎁.”

Families are not a luxury. They are integral to healing (& healing can occur w/out cure).
Read 13 tweets
Today is World Hospice and Palliative Care Day!

DYK❓ Over 5⃣5⃣ million people around the 🌐 are in need of #PalliativeCare but only 12% of the global need is met.

Access to palliative care services is a human right to health 👉
When life is threatened by serious illness such as

🚨 heart failure,
🚨 cancer,
🚨 chronic lung diseases,

#PalliativeCare offers comfort & solutions to improve physical and mental well-being of patients & their loved ones.

More info 👉…
#PalliativeCare helps relieve suffering and improve quality of life for patients and families dealing with serious illnesses through

✅ practical help
✅ medicines
✅ spiritual and emotional support

More info 👉
Read 12 tweets
To wrap up the final day of #21OPCC, here are ten key quotes that give an overview of topics discussed today.
“Cultural aspect of what death and dying mean. Other countries do that so much better than what we do in Australia.” - Prof Patsy Yates #21OPCC @pastyymates
"Aged care facilities want to provide great care - if funded appropriately, we can do that better, capacity can be built." - Peter Jenkin #21OPCC
Read 12 tweets
@PatsyYates and @didarmody in conversation at #21OPCC. #socialjustice is a major take away from this #palliativecare conference.
Importance of appreciating all unique contexts - homelessness, paediatric care, care of older people. Legal aspects of #palliativecare #21OPCC
International panel very strong on not "othering" - we can all learn from each other in a global community. COVID-19 has made that even clearer. Yes!! Well done international panel team. You rock :) @OdetteSpruyt @ntizimira @kpettus @APHPCN Dr Ghauri, Dr Malama #21OPCC
Read 9 tweets
Looking forward to following this podcast! Thanks @SammyWinemaker @HSeowPhD #21OPCC
Ways to be prepared and hopeful facing serious illness. Walk 2 roads - hope for the best and prepare for the rest! Zoom out - understand the big picture. Know your style - find someone who meshes well with you. @HSeowPhD @SammyWinemaker #21OPCC
#palliativecare is not about planning for death, it's about planning for the future. We are more death-avoiding than death-denying. #21OPCC @HSeowPhD
Read 11 tweets
This morning’s plenary is given by Dr Hsien Seow @HSeowPhD, the recipient of the Ian Maddocks Guest Lecture, given to the best submission by an author under the age of 40 who is engaged in the study or delivery of #palliativecare #21OPCC
@meera_agar @Pall_Care_Aus chair provides history of Ian Maddocks Guest Lecture. Emritus Prof Maddocks was integral in establishing @Pall_Care_Aus #21OPCC
Dr Seow @HSeowPhD is the Canada Research Chair in #PalliativeCare #21OPCC
As part of his research, he created the Waiting Room Revolution PodCast @WaitingRoomRev
Read 31 tweets
Another full day of interesting and insightful discussions about #palliativecare at #21OPCC. Following are ten key quotes for an overview of the second full day of presentations.
"When the doctor has time to sit and listen, this has a huge impact on the patient" - Dr Diana Ferreira @diana_mbhf - great insight from the patients' perspective as a cancer patient #21OPCC
"Death is not linear" - Dr Katrin Gerber @NAgeingRI #21OPCC
Read 11 tweets
Last plenaries for the day about to begin - I'll be tweeting from this one- What is needed for better outcomes for breakthrough cancer pain? #21OPCC
Session chaired by Prof Gregory Crawford from Uni of Adelaide, Prof Andrew Davies from Trinity College, Dublin, Emeritus Prof Maree Smith from Uni of Qld, @diana_mbhf a #palliativecare researcher & cancer patient, & Dr Jessica Lee from Concord Centre for Palliative Care #21OPCC
Prof Andrew Davies - longstanding interest in breakthrough pain, disappointing thing is we still seem to have a problem in terms of diagnosing the problem, assessing it, and providing adequate medications #21OPCC
Read 14 tweets
I will now be tweeting from the ''Collaboration and Integration session, chaired by Camilla Rowland #21OPCC
First presenter in this session is Judy Hollingworth talking about 'Palliative care practitioners and community advocates collaborate in a disadvantaged rural region' #21OPCC
After a lovely acknowledgement to country, Judy begins her story about collaboration and causation #21OPCC
Read 76 tweets
Chaired by Dr Will Cairns OAM, introduces some of the early discussions about #palliativecare - identified key issues - continuity of care, caring for new patients with new conditions, caring for #COVID19 patients and also #palliativecare colleagues #21OPCC
Communication and international collaboration vital for management of #palliativecare during pandemic #21OPCC
Vital for #palliativecare providers to document their experiences of #COVID19 #21OPCC
Read 48 tweets

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