Plan palliative care options well in advance

This is the fifth in a series of articles about palliative care.

Palliative care can help improve your quality of life and ability to function when a serious medical condition and/or the treatments you are getting for it have resulted in symptoms that significantly disrupt your life.

Three common sites at which to get such care are the hospital, a nursing home (nursing or skilled nursing facility), and your own home. This column provides some comments about the last two from two board-certified palliative care practitioners.

Getting a referral for a palliative care specialist

This is the fourth in a series of articles about palliative care.

Palliative care can help improve your quality of life if you have a serious - often chronic - illness. Last week's column explained how to organize your thoughts and feelings to explain what you are looking for from palliative care. But how do you even find and get a referral to a palliative care specialist (who may be a doctor, nurse practitioner, or social worker focusing on palliative care)?

Identify what you need from palliative care

This is the third in a series of articles about palliative care.

You've heard that there's a branch of medicine, palliative care, that can help improve your quality of life if you have a serious - often chronic - illness. But what exactly do you ask for?

What does palliative care consist of?

This is the second in a series of articles about palliative care.

Palliative (PAL-yuh-tiv) care focuses on reducing pain and suffering and increasing quality of life in people with serious illnesses, regardless of the expected course of their disease or how long they are expected to live. It can also help their families.

Palliative care: It's not just for people in hospice

This is the first in a series of articles about palliative care.

What could "palliative" care possibly be? Isn't a "pall" a shroud or gloomy atmosphere - as in "cast a pall over?" Yes, but get ready for a completely different idea. Care that is palliative (PAL-yuh-tiv) is designed to cloak or cover - in other words, make recede into the background - the pain or suffering or stress felt by people who have serious medical conditions, and also to ease the distress felt by their loved ones.

If dementia is suspected, consult a neuropsychologist

You have made a convincing case to your father's doctor that your father just isn't thinking as clearly as he used to. The doctor has concluded that your father is not depressed, and tests have ruled out other common problems such as infection and various metabolic disorders. You want to ask for some kind of test of mental functioning, and you don't want it to be just a five-minute test that you suspect your father, who was at the top of his class in graduate school many decades ago, will pass with flying colors.

Test of mental status may overlook some declines

"Oh, I can do a test right now. You don't need a referral, and we'll have the results right away," your mother's doctor says when you ask if it makes sense to have your mother see a specialist for testing because you have observed some lapses in her thinking.

Take action if loved one returns from hospital confused

Your father was doing okay before he went into the hospital, as far as you could tell. Then he fell off a ladder trying to fix a gutter. Miraculously, after an anxiety-inducing round of treatments including surgery and a few weeks in a rehabilitation facility, he comes home. He can't stop grinning as he sits in his favorite chair in the living room. You cook him his favorite meal.

Strategy for preventing delirium in hospitalized loved ones

Last week's column offered action steps you can take to combat delirium in hospitalized loved ones. Today's column takes a step back and offers more comprehensive strategies you can use to address this deadly complication.

First, take it seriously. When I was an executive for a big corporation in the healthcare industry, one way that my colleagues would signal that they were describing a critical issue that they wanted other executives to pay attention to was to say, "I'm serious as a heart attack."

How to help loved ones avoid delirium in the hospital

Last week's column described delirium, a temporary problem common in hospital patients that can result in long-term - and even permanent - damage, often meaning that people who lived independently before they went into the hospital never do so again after they get out.

What action steps can you take to help prevent or stop delirium in people you care about?

1. Remember that they are medically fragile; ensure that you and anything you bring into their room (such as your hands or their eyeglasses) has been appropriately cleaned.


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