Many patients are embalmed or cremated after death, but this isn't the only option. Embalming and cremation have a negative impact on the environment, and other, more eco-friendly, options are becoming popular.Options such as green burials, human composting, and reef balls give people options for how to handle their loved one's body after death.Do you think that accepting, and even facilitating, decomposition of a body after death helps us engage in "circle of life" coping? Or are standard fu...
Many physicians, and other clinicians, are wiped out and burned out. They may wonder if they should stay in medicine, or if there is another path that would make them happier.Yet running away from unhappiness isn't a great strategy because sometimes the unhappiness follows you to your next destination. Dr. Heather Fork is a dermatologist and physician career coach who guides physicians to a career, and life, that makes them happy. Sometimes her clients decide to remain in clinical pract...
Sometimes patients or family members express their stress with anger. And when the anger is directed your way you may get defensive or annoyed and it can put a pall on your day.Listen to this week's episode for clear guidance about what to do when your patient gets angry so that both of you leave the visit feeling calm.Coping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself is available here: www.copingcourageously.com A free guide for physicia...
Don't be afraid to talk about dying.We don't learn to talk about dying and so many people are afraid because they don't know what to say. Here are four key topics to bring up with people who have advanced illness such as progressive metastatic cancer. In patients with Alzheimer's disease or other kinds of dementia, it is important to have these conversations early in the disease course.Today we'll discuss:Fear of deathNeed for connection and closureLife review Legacy or Love projectsWhat...
Mental status changes in hospice patients are extremely common. Yet are they always due to disease progression?If a patient suddenly gets confused or sleeps all day, what should you do? Should you counsel the family that this is normal? Order testing? Assess the medication list?Family members sometimes worry that sending their loved one with advanced cancer, dementia, or other serious illness to hospice will mean that they'll just get morphine but no medical attention. Let's make sure that th...
Your patient is in terrible pain from cancer and you have the tools to relieve it. Yet they won't take the oxycontin or morphine that you prescribed. You can see that they are suffering yet you feel powerless to help. This is a common scenario and it can lead to discord between you and your patients. You may feel like saying, "Well fine then. I can't force you to help yourself..."You feel frustrated and the patient may not feel supported. Here are 30 reasons why your patient may be ...
Ketamine is in the news right now because Matthew Perry died from improper use of ketamine and his physicians just got arrested for making that possible.It is always a bit shocking when physicians get arrested for prescribing medication. It does seem like his physicians were not acting in accordance with their hippocratic oath - if that's true, shame on them.I do wonder, though, will this make clinicians less inclined to use ketamine to help reduce their patients' suffering. In addition to be...
We live in a soup of uncertainty and so do our patients and clients. Caring for patients with serious illnesses such as cancer or Alzheimers dementia can be extremely stressful because the experience is filled with uncertainty.Having a clear approach to dealing with uncertainty reduces stress and increases joy. This week we discuss 4 Dos and 4 Don'ts for dealing with uncertainty in health and in life.I'm happy that you're part of the joyful palliative care tribe!DeliaDelia Chiaramonte, M...
The LovingKindness, or Metta, meditation (not a typo - that's how it is spelled) is one of my favorite meditations. It offers kindness and healing to you, the people in your life and the world.This week I offer you a LovingKindness meditation for your own wellbeing. You'll notice that there is no intro or ending because I'd like you to hang on to this meditation to use any time you could use a boost of positive energy.Enjoy! (And then share with a friend)DeliaP.S., Can you do me a favor?...
Leave your heirs the gift of organization. Estate planning is crucial but many people put it off because they aren't sure how to proceed.Adam Zuckerman is an attorney and entrepreneur who created a company, Buried in Work, after losing his father to cancer. Adam is passionate about making estate planning and end of life preparations as easy as possible for families facing serious illness.His site covers vast topics, from having tough conversations to green burials. He even has card "gam...
We've all had challenging patient or client interactions. It can be hard to know how to handle them and it can make us feel lousy or even derail our day.You want to be an empathetic physician, nurse, therapist, PA or other clinician but how do you balance empathy with boundaries when a patient or family is angry or mean?This week join me to reflect on the 8 steps to managing a challenging patient interaction. Let me know what I missed! Join us on Facebook in the Integrative Palliative Medicin...
Dr. Gary Sprouse is the Less Stress Doc. He is a family physician with expertise in stress management and he's the author of Highway to Your Happy Place: A Roadmap to Less Stress.This week Dr. Sprouse shares tools and insights to help you manage stress, banish guilt and regret, and live a happier life. You can find more information about Dr. Sprouse at www.thelessstressdoc.comCoping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself is avail...
Caring for a loved one who is aging or ill is hard. It is especially hard if you've had a challenging relationship with them. If you had a difficult childhood and now find yourself caring for a parent with cancer, a stroke, or Alzheimer's dementia, you may be experiencing extreme stress and overwhelm.Ask yourself these 3 questions and ponder these 3 truths to make a hard time less stressful.Thanks for listening,Delia Chiaramonte, MDwww.integrativepalliative.comCoping Courageously: A Heart-Cen...
Chiropractic care is widely misunderstood by the medical community. In this interesting interview, chiropractor Brian Morrison clues us in to how we got here and the ways in which chiropractic education and clinical care have changed for the better in recent years.Dr. Morrison discusses who benefits most from chiropractic care, and which patients should not be referred.Here's to an expanded clinical toolbox.Delia Chiaramonte, MDwww.integrativepalliative.comCoping Courageously: A Heart-Centere...
Our internal judge has us judging ourselves, other people, and our circumstances. This makes practicing palliative care (and any patient care) harder and generates stress for us that we certainly don't need.This week you'll learn strategies for noticing your own judge and practical techniques for calming it, so you can enjoy your practice more, have less burnout, and be a happier person.Try it out and let me know how it goes!I'm glad you're here,DeliaDelia Chiaramonte, MDwww.integrativepallia...
Dr Gordon is a world-recognized authority and pioneer in mind-body medicine, and he is the founder and executive director of The Center for Mind-Body Medicine in Washington, DC.He is a Harvard educated psychiatrist and a clinical professor at Georgetown Medical School. He was chair of the White House Commission on Complementary and Alternative Medicine Policy, and he has a recent book called Transforming Trauma: The Path to Hope and Healing.Dr. Gordon has created and implemented extraordinary...
Moral distress and moral injury are common in healthcare, yet few physicians, nurses or other clinicians talk about it on a regular basis.Stuffing the shame, guilt, anger and other powerful emotions that can accompany moral injury can lead to clinician burnout, compassion fatigue, depression or even suicide. And it can also result in excellent, empathetic clinicians leaving healthcare,Let's talk about it!DeliaDelia Chiaramonte, MDwww.integrativepalliative.comCoping Courageously: A Heart-Cente...
The term self-care has a bad rap lately. It can seem like healthcare organizations use terms like "self-care" and "resilience" to make their doctors, nurses, and other healthcare practitioners work harder and harder. They offer free yoga, while piling on more and more work!There is truth to this scenario, yet pushing away the concepts of self-care is not the solution.This week we cover 4 myths of clinician self-care. This episode is appropriate if you are a physician, nurse, nurse practitione...
Many clinicians, especially physicians, don't learn in school what to do when a patient is crying. When we don't know what to do we feel uncomfortable, and no one likes to feel uncomfortable.I've seen many physicians sit in the presence of a crying patient, continue to work on their computer, or awkwardly shift in their seat. This gives the patient the message that their tears and feelings aren't welcome.This week we talk about what to do when your patient starts crying.I'm glad you're here,D...
Is Joyful Palliative Care possible? Palliative care clinicians are often kind and highly empathetic people, but uncontrolled caring can lead to compassion fatigue or even burnout.Yet approaching the care of seriously ill people with an intentional approach can indeed make palliative care joyful.Here are the steps:1. More tools to relieve your patients' suffering (integrative symptom management)2. Develop your healing presence3. Know yourself4. Become a heart-centered leader5. Fill your cupI'm...