Tag: pain management

EOLPodcast

Ep. 354 The Hospice Journey: A Step-by-Step Guide with Barbara Karnes RN

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Learn about the basics of hospice care, when to consider it, how to talk about it with others, and what to expect during the dying process.

My guest Barbara Karnes RN is an internationally recognized author, speaker, thought leader and expert on end of life care. She is the author of the “little blue hospice book” Gone From My Sight: The Dying Experience, which has sold over 30 million copies worldwide in 12 different languages. Today Barbara shares her insights and stories about the hospice journey for patients and their families and walks us through each step of the process. Learn more about her work at her website:

www.bkbooks.com

Get her books here

Watch on YouTube

Listen here:

This episode includes:

  • When is it time to consider hospice
  • Why hospice care is a special type of medical care
  • How to find a good hospice
  • What it takes to care for a loved one at home
  • What hospice does and doesn’t provide for families
  • How to talk to a loved one about hospice
  • What to expect as death draws near
  • How hospice provides comfort and pain management

Links mentioned in this episode:

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If you enjoy this content please share it with others and consider leaving a review on iTunes. Thanks again to all supporters on my page at Patreon.com/eolu, especially to Jan Wessel for increasing your pledge! Also thank you to Thilda Zorn for your Paypal donation and Bob Hoffman for buying me a coffee! Your contributions make all the difference.

EOLPodcast

Ep. 347 The Global Palliative Care Movement with Katherine Pettus

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Learn about the status of palliative care in developing nations around the world and how IAHPC is working to increase global access.

My guest Katherine Pettus is the Senior Advocacy Director for The International Association for Hospice and Palliative Care. In this role she meets with delegates at the United Nations to increase the understanding of palliative care and to advocate for improved availability of opioids for patients needing pain relief. She is the author of Global Palliative Care: Reports from the Peripheries, which describes her visits to communities around the world to witness firsthand their utilization of palliative care. Learn more about the work of IAHPC at the website:

www.hospicecare.com

Read the transcript

Watch on YouTube

Get the book

Listen here:

This episode includes:

  • Why 80% of the world’s population has no access to morphine
  • How Hospice Africa Uganda is utilizing powdered morphine for pain relief and also allows nurses to prescribe it in the field
  • Why palliative care teams are good at “sideways thinking” to solve problems that arrive in the moment
  • How caregiving is a crisis everywhere in the world right now (except Costa Rica that provides support for family caregivers)
  • Why the extended family is becoming a myth in developing nations
  • What is the “health poverty trap” and how lack of access to palliative care contributes to it
  • How the Western model of medicalized death is spreading to developing nations
  • Expanding palliative care helps medical systems and medical providers as well
  • How a “palliative care peace corps” could transform society
  • How COVID has affected the global palliative care movement

Palliative Care transforms everyone who participates in it.” 

Katherine Pettus in Global Palliative Care: Reports from the Peripheries

Links mentioned in this episode:

If you enjoy this content please share it with others and consider leaving a review on iTunes. Thanks again to all supporters on my page at Patreon.com/eolu! Your contributions make all the difference.

EOLPodcast

Ep. 251 Insights Into the Experience of Dying with Jennie Dear

kwyattmd

Learn about current research into the experience of dying as a physical, emotional and spiritual process.

My guest Jennie Dear, who has been a journalist, English professor and hospice volunteer, was curious about the question “what does it feel like to die?” so she conducted her own research project. After interviewing doctors, nurses, psychologists, and other experts about the passage between diagnosis and death, she wrote a book (What Does it Feel Like to Die?) to share the hopeful insights she gained. She discusses what she learned from that project and what most people don’t know and need to know about the dying process. Learn more about her work at the website:

www.jenniedear.com

Listen here:

This episode includes:

  • Why and how Jennie wrote this book
  • How knowing about the physical process of dying can help people prepare better for the end of life
  • Why some dying patients’ pain is not alleviated
    • Fear of opioid abuse
    • Other untreated symptoms
    • Mental/emotional suffering of the dying process
  • Neuroscience experiments with patients in a vegetative state show patients are more aware than they appear to be
  • How do we know that “hearing is the last sense to go” for a dying patient
  • The 4 trajectories of dying (according to Dr. Joanne Lynn) and why it’s helpful to understand them
    • Sudden death
    • Terminal illness
    • Chronic illness
    • Frailty
  • Most common reasons for choosing medical aid in dying:
    • Fear of pain
    • Not wanting to be a burden to family
    • Not wanting to prolong the dying process

Links mentioned in this episode:

  • Course: Racism in Death Care – Confronting Bias, Ignorance and Prejudice taught by Joel Anthony and Anita Grant
  • Get Jennie’s book here: What Does it Feel Like to Die?
  • Get Karen’s book here: 7 Lessons for Living from the Dying
  • Dr. Joanne Lynn discusses 3 Trajectories of Death – video
  • The Five Trajectories pdf by Jennifer Moore Ballentine
  • Jennie’s YouTube video
  • Join the team at Patreon.com/eolu and get access to the EOLU mug: “Mind if we talk about death?” (only Patrons can purchase it). PLUS get our new bonuses: the monthly EOL News Update, movie reviews from 2 Doctors and a Movie, and automatic access to A Year of Reading Dangerously!

If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on my page at Patreon.com/eolu, especially my newest Patron: Heather Capuano. Your contributions make all the difference!

End of Life, EOLPodcast

Ep. 222 The Benefits of Medical Hypnosis at the End of Life with Roger Moore

kwyattmd

Learn how hypnosis can help dying patients, their loved ones, and their medical providers find greater ease and less stress as they cope with the end of life.

podcastMoore

My guest Roger Moore is a medical hypnotherapist who frequently works with patients at the end of life and their caregivers. He’ll discuss how he utilizes hypnosis to help ease symptoms for his patients and share tools that all of us can use to deal with stress. Learn more about Roger’s work at his website:

www.hypnosishealthinfo.com

Download “Orange Blossom” mp3 here

Listen here:

 

This episode includes:

  • What is “medical hypnosis”
  • What happens in a typical session of hypnosis
  • The “wiggle” technique for returning to the present moment
  • How hypnosis benefits both patient and caregiver
  • How hypnosis helps with the fear of death and dying
  • The “flow through” technique to prevent taking on the suffering of the patient
  • How self-hypnosis tools can help healthcare providers deal with stress, grief and guilt
  • Hypnosis as a tool for learning mindfulness
  • When is the best time to recommend hypnosis as an end-of-life tool
  • Hypnosis can help patients reduce their need for pain medication
  • “Orange Blossom” recording for stress relief

Links mentioned in this episode:

If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on my page at Patreon.com/eolu, especially my newest Patrons: Gail Clemson, and Kathy Bates; your contributions make all the difference!

End of Life, EOLPodcast, Hospice

Ep. 162 Part 1: The Palliative Care Team Physician with Colin Scibetta MD

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PodcastPallScibetta

 

 

ProvidencescibettaThis episode is the first of a 4-part series that introduces you to the members of a palliative care team. Today Dr. Colin Scibetta discusses his role as the physician on the team and how palliative care differs from hospice care. In future episodes you’ll hear from the team nurse, social worker and chaplain.

 

ANNOUNCEMENTS:

grenade-1285671_640As this episode airs I am enjoying a trip through Spain, including cycling in the Andalucia region! I’ll be back home in a few weeks to report on the trip. Follow me on Instagram to see my photos at kwyattmd or this link: https://www.instagram.com/kwyattmd/

 

FEATURE PRESENTATION:

This interview will cover:

  • What palliative care consists of
  • The difference between palliative care and hospice
  • The benefits of palliative care for patients
  • How the whole-person approach of palliative medicine also benefits care providers
  • Why Providence Institute for Human Caring (et al) was awarded the Circle of Life Award from the American Hospital Association

 

Colin Scibetta MD is a fellowship-trained palliative medicine physician who complete his undergrad in neuroscience and biology at Wesleyan University. He then moved to Ecuador where he worked on a health initiative for indigenous communities impacted by oil development. Dr. Scibetta did his undergraduate medical training at the University of California, San Francisco School of Medicine, where he also completed an internal medicine residency and a fellowship in hospice and palliative medicine.

Remember to tune in next week for Part 2 of this palliative care series! If you enjoy this content be sure to share it with others who might find it helpful and consider leaving a review on iTunes. 

Until next time …

Face Your Fear          BE Ready           Love Your Life

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End of Life, EOLPodcast, Hospice

Ep. 148 Lessons Learned from Dame Cicely Saunders: Founder of the First Modern Hospice

kwyattmd

Learn about the life of Cicely Saunders and what we can discover from her quest to change the way that people died.

 

PodcastSaunders

cicelysaundersyoungIn this episode, recorded just after the celebration of what would have been Cicely Saunder’s 100th birthday, I talk about how she became interested in caring for the dying, what inspired her to create St. Christopher’s Hospice, and what we can learn from her determination to improve care at the end of life.

Read more about the life and work of Dame Cicely Saunders at:

cicelysaundersinternational.org.

ANNOUNCEMENTS:

downloads_wordmark_white_on_coralThanks as always to my devoted supporters at Patreon.com/eolu who make small contributions each month to keep this podcast and the End-of-Life University Interview Series on the air. I’m so grateful for your financial, emotional and spiritual support!

If you’d like to join A Year of Reading Dangerously, our online reading group for 2018, there’s still time! Check out the reading list here and start reading along with 1,000 other people around the globe!

FEATURE PRESENTATION:

Cicely Saunders first began working with dying patients when she was training to be a nurse in the early 1940’s in London. She went on to become an Almoner (medical social worker) and a volunteer nurse at a hospice for the dying poor where she recognized the great need for better pain management and comfort care at the end of life.

When she was told that the medical system would not be interested in her ideas because she wasn’t a physician she accepted the challenge and went to medical school. One revolutionary contribution to end-of-life care was her concept of “Total Pain,” which included emotional and spiritual pain as well as physical.

As a doctor Cicely received a research grant where she studied pain management and wrote many articles. She took “before and after” photos of each patient so that she could show the transformation that occurred when pain was alleviated. Eventually her dream of creating a hospital dedicated to care of the dying was fulfilled when St. Christopher’s Hospice opened 10 years later.

From her story we can take much inspiration for today’s ongoing struggle to improve care at the end of life:

  • Follow your heart – Cicely stayed true to her heart and passion throughout her career as she dedicated herself to care of the dying, even when others discouraged her.
  • Be willing to change course to achieve your dream – Cicely was unable to pursue her original dream of being a nurse after a back injury and shifted to medical social work as a way of continuing her work with dying patients.
  • Be persistent – Cicely’s determination to do whatever it took to bring her dream to fruition led her to become a doctor.
  • Patience is essential – Cicely had to wait for many years to see her dream of a hospice become a reality: first while she studied to be a doctor, then did several years of research, and finally raised the funds to build St. Christopher’s. Change rarely happens overnight so stay the course!
  • Be credible before you can be incredible – Cicely demonstrated this throughout her career as she diligently worked through her own education and her research to gain credibility in the eyes of the medical system she was trying to change
  • The importance of teamwork – Cicely found likeminded individuals in her community and in the U.S. to sustain her inspiration and her enthusiasm for her goal. We can accomplish more as a team than as individuals.
  • Flexible models are necessary for optimum care – Cicely resisted standardizing her model of hospice care and instead chose to help others create their own unique solutions for the needs of their communities.
  • Have a big vision but humble expectations – Cicely sought to change care of the dying across the world with her vision of hospice but was content to make a difference to just one patient at at time.

“If one man from a poor village in India dies without pain because of what I have done, it will all have been worthwhile.” – Dame Cicely Saunders

Today we would be advised to remember her Total Pain concept as we struggle to deal with an opioid crisis in the U.S. Neglecting the contribution of emotional and spiritual pain to physical pain has led to over-reliance on drugs as the answer to suffering.

cicelyhospice1

Happy Birthday Dame Cicely Saunders!

Thank you for inspiring us to carry on your big vision of helping every person find comfort, peace and love at the end of life.

Tune in every Monday for a new episode! If you enjoy this content please share with others and consider leaving a review on iTunes. Until next week:

Face Your Fear           BE Ready             Love Your Life

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End of Life, EOLPodcast, Hospice

Ep. 104 Alternative Remedies for Pain

kwyattmd

Learn about 10 alternative remedies that are helpful for chronic or terminal pain.

PodcastPain

In this episode I’ll share some insights about pain management from a recent blog I wrote in response to the opioid crisis in the U.S. I’ll cover 10 alternative remedies for pain that can be used alone or in conjunction with pain medication. Read the companion blog here (includes links to sources.)

ANNOUNCEMENTS:

If you missed “An Evening with Ira Byock MD” you can still sign up to listen to the replay. Just click here to submit your email address and you’ll receive the link to listen.

Patreonbecome2xThanks to all of my supporters on Patreon.com/eolu who generously contribute every month to help keep this podcast and the End-of-Life University Interview Series on the air! If you’d like to become a Patron for just $1 or $2 per month go to Patreon.com/eolu and join the fun! You’ll receive access to our monthly Hospice Happy Hour Q&A session, the Top 10 Interviews from EOLU, I’ll also promote your website, business, organization, book, etc. related to the end of life on this podcast.

In personal news, I’m busy preparing for my trip to Italy where I’ll be traveling for a month and writing a new book about grief. You can check out my travel plans on my Pinterest board and follow my journey on Instagram and Facebook.

FEATURED PRESENTATION:

The current opioid crisis in the U.S. has reached epidemic proportions and prescription drug-related deaths now outnumber traffic fatalities and gun deaths. This crisis has been  partly fueled by the pressure placed on physicians two decades ago to do a better job of treating pain. Since that time the trend has been for doctors to hand out prescriptions for powerful and addictive opioids for relatively moderate pain when those drugs should be reserved for intractable pain from serious or terminal illness.

As a response to this epidemic I discuss 10 alternative therapies which can help with pain management that can be used alone or in combination with medications. These remedies can decrease the need for drugs and will help improve wellbeing and decrease stress as well:

  1. Laughter
  2. Music
  3. Exercise and stretching
  4. Massage
  5. Guided imagery
  6. Coloring
  7. Deep breathing
  8. Loving relationships and sexual intimacy
  9. Prayer and meditation
  10. Emotional Freedom Techniques (E.F.T.)

I’ll discuss each alternative along with the science that supports its use. Hopefully we can learn to manage pain in ways that support overall health of the whole person.

Tune in next week for another episode! Until then …

Face Your Fear.                    BE Ready.                        Love Your Life.

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End of Life, EOLPodcast

Ep. 27 February End of the Month Update on the End-of-Life with Dr. Karen Wyatt

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In this February Update on End-of-Life Issues, Dr. Wyatt will discuss:

  • Medical schools put more emphasis on pain management education to help reduce over-prescribing of opioid medications, misuse of these drugs and subsequent OD’s, which have doubled in the past decade.
  • Dementia rates appear to be falling in the U.S. according to a recent report in NEJM due to the level of education and improved heart health of the senior population.
  • Prison hospices face a challenge in meeting the needs of dying patients for pain medications due to risks of misuse of meds within the prison walls.
  •  Johns Hopkins study published in JAMA shows impact of stress on family caregivers. New website caretransitions.org has tools and resources for caregivers and also to train “care transitions coaches” who can educate community members on the skills needed to become an effective caregiver. Hopefully this will alleviate some caregiver stress and increase the number of available caregivers.
  • Talk about the newly-released book “When Breath Becomes Air” by 36 y.o. neurosurgeon Paul Kalanithi who wrote the book while dying of cancer.
  • Emergency care nurse instituted “The Pause” at a UVa hospital after a death in the ER to show respect and acknowledge the loss of life. Trend is spreading to other hospitals.
  • Similarly a photo circulated on Facebook showing doctors in China bowing to an 11 y.o. boy who asked that, after his death from a brain tumor, his organs be donated to save the lives of others. The medical staff bowed 3 times to honor his bravery and selflessness. Beautiful!
  • Article about homeless people dying on the streets and the need for options to care for those without suitable homes available as they are dying. Discussed the “social model hospice” option. See Episode 23 from February 1st for more info about the social model hospice.