Geripal experts:
If you have to share ONE TIP with your fellow Geriatricians and Gerontologists about palliative care of older adults, what would it be?
The American Academy of Hospice and Palliative Medicine is co-sponsoring a pre-conference work shop with the American Geriatrics Society during the AGS annual meeting May 12-15th 2010.
Please share your favorite geripal tip and we will compile it and share it during the workshop with all the attendees.
Comments
We are still alive and will be until we are dead. Stop treating us as if we were already in the death process.
"Let it be a dawn of flagrant gold
"With scarlet streaks flung out across the sky
"Let there be a bitter chill to hold
"The scent of burning pines when I must die."
Bonnie Parsons, GNP-BC
Manager, Center for Comprehensive Palliative Care
Ocala, Florida
Dee Wadsworth
Church Gerontologist
PHPC
Hope all goes great at the workshop (I'd be there myself if I weren't already part of the AAHCP meeting)!
Jan Walker, PA-C
Palliative Care Coordinator
VA Medical Center
Gainesville, Florida
I will answer a slightly different question, since I more represent someone who would be learning from your workshop rather than teaching it. Specifically, what would I want to learn from a Palliative Care expert to help me better care for my older patients?
My question uses as its context the new AGS Guideline on the management of chronic pain in the elderly. This guideline has a revolutionary recommendation: That after acetominophen has failed, that we view opiods as the primary traatment for chronic pain rather than NSAIDS. The implementation of this guideline would result in a large expansion of the number of older persons on opiods treatment, many of whom would be on opiods for many years.
So, I would want this type of workshop to teach me something about the management of opiod therapy in this context. Subquestions would include:
1) When should you start opiods for chronic pain in the elderly?
2) How should you initially dose these opiods, and how should you titrate your initial dose?
3) How should you monitor therapy? Should one have theraputic trials of dose reduction? When do you escalate the dose?
4) How do you manage the complications of long term opiod therapy, particularly constipation?
Many shared their favorite geriatrics tip to be shared with fellow palliators. These will be compiled and used to shape a pre-con session on geriatrics at the upcoming AAHPM/HPNA meeting in Vancouver 2011.