Elsewhere in the Palliverse – reading list

This TED Talk “How Not To Be Ignorant About the World” by Dr Hans Rosling (@HansRosling – Swedish medical doctor, statistician and Professor of International Health) and his son Ola Rosling is an entertaining and eye-opening look at how our biases and intuition lead to misconceptions. (For the record, I vote like a Swede – not a chimp.)

The beautiful poem Japanese Maple by the Clive James (written while he is dying) has been all over my social media feeds this week. Here’s The Guardian‘s take on why it’s resonating with people.

Bioethicist Ezekiel Emanuel writes in the Atlantic on Why I Hope to Die at 75. And here’s a rebuttal from Alex Smith at GeriPal.

Making a case for the integration of palliative care in policies on ageing and dementia – a European perspective (EAPC Blog)

More on dementia – Ageism and death anxiety (ehospice UK)

In Australia: Call for a Royal Commission into Nursing Home Care (ABC Radio National)

And a more positive look at residential aged care: A Nursing Home Can Be a New Beginning (Adele Horin)

An interview with the Groundswell Project (Dying Wishes – Australian Ageing Agenda)

The NHS (UK) has an End of Life Guidance app! (iTunes store)

The Institute of Medicine (US) released a report entitled “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” There’s been a lot of discussion about it on palliative care social media and the mainstream media over the past week. Pallimed has a nice summary.

Terminally ill, but constantly hospitalised. (NPR)

Many Palliverse readers would be able to relate to this – The reality of nurses completing their own research (EAPC Blog)

If you haven’t already, consider signing the Montreal Declaration for palliative care (AHPCA Blog)

Also consider crowdfunding Little Stars, a movie about paediatric palliative care.

 

 

Diabetes management at the end of life

Diabetes management in palliative care is often tricky. Trying to optimise quality of life, and finding a balance between the burden of diabetes treatment (such as checking blood sugars, diabetic diet and medication side effects) and the sequelae of uncontrolled blood sugars (like unpleasant symptoms and infections) is difficult. As a patient’s weight, diet, metabolism and organ function change, the risk of hypoglycaemia (low blood sugar) increases. Adding further difficulty is that patients with chronic diabetes have often spent years being told that they need to keep strict control of their blood sugars, in order to avoid the awful long-term consequences of poorly-controlled diabetes. It can be difficult to convince patients, their families and carers blood sugar control can be relaxed in the palliative care setting. Continue reading

“Sonia’s sign” – conjunctivitis as a novel indicator of the terminal phase?

Generations of junior medical staff had internally rolled their eyes when I voiced my theory about conjunctivitis meaning that the patient would die soon, then been astounded by my prognostic skills when the patient deteriorated into the terminal phase. It was time to put my reputation where my mouth was and do a prospective audit. Did diagnosis and treatment of conjunctivitis in the inpatient palliative care setting mean that the patient had a very poor prognosis? Continue reading