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Videos

1. Opioid Dysmotility Dance

In this video, an anonymous GeriPal contributor wearing a local disguise (Fear the Beard!) imitates the effects of opioids and laxatives on everyone's favorite organ, the colon.



2.  Take out the trash:

What happens when you use expert communcation techniques at home including "Ask-Tell-Ask," NURSE (Naming-Understanding-Respecting-Supporting-Exploring), and the "teach back" method.




3.  GeriPal Taste Test:

Colace solution anyone?  Here is a short taste test of the very best liquid bowel meds.



4. Using VitalTalk Communication Skills at Home

After just finishing the course, we thought it would be interesting to do something similar to what Alex Smith did in his "Take Out the Trash Video" using the skills learned at the VITALtalk faculty development course.  This truly amazing course is meant to give health care professionals like us the skills needed to run communication training programs at our own home institutions. See for yourself (if you don't see the video below click here for the YouTube version)







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Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

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The Dangers of Fleet Enemas

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Survival from severe sepsis: The infection is cured but all is not well

Severe sepsis is a syndrome marked by a severe infection that results in the failure of at least one major organ system: For example, pneumonia complicated by kidney failure. It is the most common non-cardiac cause of critical illness and is associated with a high mortality rate.

But what happens to those who survive their hospitalization for severe sepsis? An important study published in JAMA from Iwashyna and colleagues provides answers and tells us all is not well. When the patient leaves the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits.

Iwashyna examined disability and cognitive outcomes among 516 survivors of severe sepsis. These subjects were Medicare enrollees who were participants in the Health and Retirement Study. The average age of patients was 77 years.

When interviewed after discharge, most survivors were left with major new deficits in their ability to live independently. …