Skip to main content

GeriPal Hits 2 Million Pageviews


The Places Where GeriPal is Read

Last week GeriPal hit 2 million pageviews.  We celebrated quietly when the counter showed a whole line of 0's, but I thought it would be worth creating a list of the top 25 most read posts to commemorate the occasion.  Enjoy!
  1. The Dangers of Fleet Enemas
  2. Length of Stay in Nursing Homes at the End of Life
  3. End Stage Dementia: A Terminal Disease Needing Palliative Care 
  4. What to give Uncle Ernie, Grandma Mabel and Great Aunt Rose? 
  5. Dying without Dialysis 
  6. Beers Criteria Contest: Submit the Craziest Medication Combinations 
  7. When Surrogates Override the DNR: A Terrific Geriatrics and Palliative Care Teaching Video 
  8. MMSE and Copyrights Part II: Is the MMSE Derivative of Some Other Work? 
  9. Atul Gawande New Yorker Article "Letting Go" 
  10. Coffee Is Bad For You. Coffee is Good For You. Why Am I So Confused? 
  11. Survival from severe sepsis: The infection is cured but all is not well 
  12. Why is Forest Laboratories discontinuing Namenda? 
  13. TAVR: Life-prolonging and palliative or risky and costly?
  14. A New Treatment For Atrial Fibrillation in the Elderly?: The (IR)relevance of Clincial Resarch to Geriatric Populations 
  15. Death of the Gerontological Nurse Practitioner: Part 1 of 2 
  16. Loneliness 
  17. Watchful Waiting or Surgery for Prostate Cancer? 
  18. “Elders?” “Older Adults?” “Seniors?” Language Matters 
  19. A Call for Hospice Reform: Nurse Practitioners Lead the Way 
  20. A Study of Dignity Therapy on Distress and the End-of-Life Experience 
  21. 3 Issues of Hospice 
  22. How do you explain hospice? 
  23. Being Accused of Murder 
  24. Inappropriate Medications in the Hospice Setting
  25. Copyrights and Copylefts in Medicine: The Case of the Wayward MMSE

by: Eric Widera (@ewidera)


Comments

Congratulations on 2 million views! Eric and Alex, you have done a fantastic job of getting really interesting topics out to a wide audience. Honestly looking back at those top 25 posts is a testament to the good medical journalism you have done.

Popular posts from this blog

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Opening the Black Box of LTACs: Podcast with Anil Makam

What happens in Long Term Acute Care Hospitals, or LTACs (pronounced L-tacs)?  I've never been in one.  I've sent patients to them - usually patients with long ICU stays, chronically critically ill, with a gastric feeding tube and a trach for ventilator support.  For those patients, the goals (usually as articulated by the family) are based on a hope for recovery of function and a return home.

And yet we learn some surprising things from Anil Makam, Assistant Professor of Medicine at UCSF.  In his JAGS study of about 14,000 patients admitted to LTACHs, the average patient spent two thirds of his or her remaining life in an institutional settings (including hospitals, LTACs and skilled nursing facilities).  One third died in an LTAC, never returning home.

So you would think with this population of older people with serious illness and a shorter prognosis than many cancers, we would have robust geriatrics and palliative care in LTACs?  Right? Wrong.

3% were seen by a geriatrici…

Length of Stay in Nursing Homes at the End of Life

One out of every four of us will die while residing in a nursing home. For most of us, that stay in a nursing home will be brief, although this may depend upon social and demographic variables like our gender, net worth, and marital status. These are the conclusions of an important new study published in JAGS by Kelly and colleagues (many of whom are geripal contributors, including Alex Smith and Ken Covinsky).

The study authors used data from the Health and Retirement Study (HRS) to describe the lengths of stay of older adults who resided in nursing homes at the end of life. What they found was that out of the 8,433 study participants who died between 1992 and 2006, 27.3% of resided in a nursing home prior to their death. Most of these patients (70%) actually died in the nursing home without being transferred to another setting like a hospital.

 The length of stay data were striking:

the median length of stay in a nursing home before death was 5 months the average length of stay was l…