Category: End of life

The “last day” protocol

Posted by Dr. El - June 8, 2017 - Communication, End of life, McKnight's LTC News, Personal Reflections, Stress/Crisis management, Transitions in care

Here’s my latest article on McKnight’s Long-Term Care News: The “last day” protocol I waited outside the room until the rehab therapists finished talking to Jim, who’d been admitted to the nursing home the night before. I read over the basic info on his face sheet before my consult. Jim was an 87-year old widower […]

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Healthcare Proxy Resource from the Conversation Project

Posted by Dr. El - March 8, 2017 - Communication, End of life

You’ve probably already heard that it’s important to have a healthcare proxy to make healthcare decisions on your behalf if you become unable to do so. If you’re wondering who to choose as your healthcare proxy or what you’re supposed to do if someone has asked you to become their healthcare proxy, The Conversation Project […]

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Addressing the healthcare needs of “unrepresented” elders

Posted by Dr. El - September 25, 2015 - End of life

In Paula Span’s column today in the New York Times’ New Old Age column, Near the End, It’s Best to Be ‘Friended’, she discusses the increasingly common situation of elders who have no representatives assigned to make healthcare decisions on their behalf. She encourages seniors to dig deep into their social networks to find an appropriate candidate to […]

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How to Talk About Dying (Ellen Goodman, NYTimes)

Posted by Dr. El - July 2, 2015 - Communication, End of life

Here’s an important article in the New York Times Opinionator Column by Ellen Goodman, one of the founders of The Conversation Project (which I’m about to investigate further). Note her comment that she expected her mother’s doctors to tell her what to do. The families of our residents are expecting the same from us. How to Talk […]

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Dialysis: Gauging its need, and how to reduce its stress

Posted by Dr. El - April 1, 2015 - Communication, End of life, Transitions in care

Here’s my latest article on McKnight’s Long-Term Care News: Dialysis: Gauging its need, and how to reduce its stress As a psychologist observing the effects of medical interventions on the mental health of the long-term care resident, I often ask, “Is this aggressive procedure helping?” Such a well-intended question can prompt the team to reconsider […]

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6 ways to improve dealing with death in LTC

Posted by Dr. El - January 21, 2015 - End of life, Personal Reflections

Here’s my latest article on McKnight’s Long-Term Care News:  6 ways to improve dealing with death in LTC There are moments in life that engender important questions. When an individual is born, we ask, “Is it a boy or a girl?” When the person dies, we ask, “What happened?” In long-term care, we’re not around […]

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Taking Responsibility for Death, New York Times

Posted by Dr. El - April 2, 2012 - End of life, Transitions in care

I read this worthwhile article by Susan Jacoby on the March 30, 2012 Opinion Page in the New York Times.   Susan Jacoby is the author of “Never Say Die: The Myth and Marketing of the New Old Age.” I WAS standing by my 89-year-old mother’s hospital bed when she asked a doctor, “Is there […]

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Signs of Dying in Elderly

Posted by Dr. El - January 11, 2012 - Anecdotes, Communication, End of life, Transitions in care

I hadn’t been on the North wing of the nursing home in a while, and when I saw Juanita Johnson sleeping in a geri-recliner,  I turned to the nurse, aghast.  “I barely recognized her!  She’s lost so much weight!”   “I know.  It’s terrible,” the nurse replied.  “We’re having her evaluated by hospice today.” Ms. […]

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Floral Hospice: An End of Life Transitional Object

Posted by Dr. El - June 28, 2011 - Anecdotes, End of life

Nan was in the hallway, looking as thin and pale as I’d ever seen her. “Are you okay?  Do you feel well enough to meet today?” I’d heard in morning report that she’d been diagnosed with pneumonia. “No,” she croaked, and then hesitated. “I mean, yes.” She looked at me intently.  “It might be our […]

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The Death Panel

Posted by Dr. El - August 17, 2010 - Anecdotes, End of life, Transitions in care

“I never say goodbye,” Mr. O’Hara told me, “because that’s what my mother said when she left me as a child. Then she died and I never saw her again.” At 91, Mr. O’Hara was slim and getting slimmer. He began our next session as usual, discussing the procedures he was receiving from the doctors […]

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