#HPM Tweet Chat 5:30:12

#hpm - Healthcare Social Media Transcript
6/27/12 1:16 PM
#hpm transcript
Healthcare Social Media Transcript
From: To: Wed May 30 18:00:00 PDT 2012 Wed May 30 19:15:00 PDT 2012 change time period
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nursefriendly
#nurseup RT @hospice_mktg: We're ready! RT @ctsinclair: Getting ready for my 2nd #HPM chat in a row! Are you coming tonight? #HPM
Wed May 30 18:00:31 PDT 2012
ShahinaLakhani
Quiet Desperation http://t.co/Rsgwtfn3 #hpm #palliative care #carechat #hospice

Wed May 30 18:00:49 PDT 2012
kilani19
@ctsinclair hey Christian! It's Marwa! #hpm

Wed May 30 18:01:09 PDT 2012
aliciabloom
it's just about time for one of the best hours on twitter: #hpm chat! please take a moment to introduce yourself...
Wed May 30 18:01:10 PDT 2012
nursefriendly
@ShahinaLakhani Hi Shahina, joining us tonight? #hpm #palliative #carechat #hospice

Wed May 30 18:01:28 PDT 2012
jfclearywisc
jIm Cleary, UW Palliative care physician & Director PPSG (@painpolicy) joining #hpm chat for the next hour
Wed May 30 18:02:05 PDT 2012
http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=05-30-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1
Page 1 of 28
6/27/12 1:16 PM
emilybarryPR
Hi all! It's Emily Barry with Transcend Hospice Marketing Group (aka @hospice_mktg). Looking forward to a rich discussion! #hpm
Wed May 30 18:02:23 PDT 2012
ctsinclair
@kilani19 Hey Marwa! Great to see you here! FYI Marwa and I went to UCSD med school together and both (thankfully) discovered #HPM
Wed May 30 18:02:29 PDT 2012
nursefriendly
Hello Everyone, Andrew Lopez, from #NewJersey, Registered Nurse, have #hospice #patients every week #HPM
Wed May 30 18:03:23 PDT 2012
ctsinclair
Intro: Christian Sinclair, MD, Natl #Hospice Medical Director for Gentiva, road warrior, lapsed blogger @Pallimed (tweets are my own) #HPM
Wed May 30 18:03:32 PDT 2012
kilani19
#hpm Marwa Kilani, palliative medicine in Los Angeles area.

Wed May 30 18:03:58 PDT 2012
rfberry
Renee Berry in Menlo Park, CA, early palliative care advocate, excited to make the chat tonight! #hpm
Wed May 30 18:04:08 PDT 2012
hospiceguy
Stan Massey, Partner/Chief Branding Officer,Transcend Hospice Marketing Group. Quoted out of context in recent USA Today article #hpm
Wed May 30 18:04:16 PDT 2012
ctsinclair
Hi Andrew, Jim, Emily, Alicia and @hospiceguy #HPM

Wed May 30 18:04:28 PDT 2012
aliciabloom
MSW, LSW from Philadelphia by way of upstate NY practicing in #hpm. passionate about improving access to quality EoL care.
Wed May 30 18:04:51 PDT 2012
_lizzy_
Hi- Lizzy Miles from Columbus, OH All things thanatology - MSW,LSW, hospice volunteer, passionate advocate & researcher #hpm
Wed May 30 18:05:04 PDT 2012
ctsinclair
@rfberry Hey Renee great to see you here tonight. Feels like old times. And by old I mean 2010. ;-) #HPM
Wed May 30 18:05:08 PDT 2012
BillPfohl
Isn't there a URL that makes this chat easier? #hpm

Wed May 30 18:05:33 PDT 2012
ctsinclair
RT @BillPfohl: Isnt there a URL that makes this chat easier? "http://tweetchat.com/room/HPM" #HPM
Page 2 of 28
6/27/12 1:16 PM
Wed May 30 18:06:03 PDT 2012
_lizzy_
@BillPfohl Good to see you. I like to use http://t.co/LscETQ3M #hpm

Wed May 30 18:06:12 PDT 2012
rfberry
haha, ancient in social media :) RT @ctsinclair Hey Renee great to see you here tonight. Feels like old times. And by old I mean 2010 #hpm
Wed May 30 18:06:20 PDT 2012
BillPfohl
Thank you guys! #hpm

Wed May 30 18:06:47 PDT 2012
nursefriendly
#Tweetdeck is my personal favorite :) or #hootsuite RT @BillPfohl: Isn't there a URL that makes this chat easier? #hpm
Wed May 30 18:07:06 PDT 2012
BillPfohl
Hey @_lizzy_ missed you last week! #hpm

Wed May 30 18:08:09 PDT 2012
ctsinclair
OK getting ready for the first topic... #HPM

Wed May 30 18:08:10 PDT 2012
_lizzy_
@BillPfohl Sorry, I was at the poker table in Vegas. I was doing my part to raise death awareness with general community. ;) #hpm
Wed May 30 18:09:54 PDT 2012
ctsinclair
T1: @USAToday front page featured "Mourning 2.0" about how Americans mourn the dead in the digital age. Is this still revolutionarY? #HPM
Wed May 30 18:10:28 PDT 2012
rfberry
ready here :) RT @ctsinclair OK getting ready for the first topic... #hpm
Wed May 30 18:10:41 PDT 2012
nursefriendly
So curious on #tweetchat, if a tweet is over 140 characters, will it show up on #tweetchat like it does on regular twitter or tweetdeck #HPM
Wed May 30 18:11:05 PDT 2012
ctsinclair
Here is a link to the T1 article in USA Today: http://t.co/T1O7NoyJ on Mourning 2.0 (no need to read right now) #HPM
Wed May 30 18:11:16 PDT 2012
pamressler
Hi all,sorry to be late tonight! #hpm

Wed May 30 18:11:59 PDT 2012
NHPCO_news
#NowHiring Palliative Care and Hospice Team Physician | Hospice of the Valley: US - CA San Jose, E... http://t.co/Aoc8WqIJ #hpm #jobs
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6/27/12 1:16 PM
Wed May 30 18:12:20 PDT 2012
jfclearywisc
@ctsinclair T1. I am not sure what is the big deal. Times change. How did people mourn before there were newspaper. No Obit in NYTimes? #HPM
Wed May 30 18:12:30 PDT 2012
aliciabloom
it's natural for technology to impact the grieving process because it's certainly impacted how we live our lives #hpm
Wed May 30 18:13:24 PDT 2012
emilybarryPR
From personal experience, I have found social media to be a great help and source of support in my grief #hpm
Wed May 30 18:13:30 PDT 2012
nursefriendly
@jfclearywisc T1 The use of technology to mourn, is a natural extension of their adoption for social use. #HPM
Wed May 30 18:13:52 PDT 2012
rfberry
T1 This is a great topic, it clearly doesn't seem new to us as we've been talking about it for years, but could see relevance to public #hpm
Wed May 30 18:14:02 PDT 2012
nursefriendly
RT @aliciabloom: it's natural for technology to impact the grieving process because it's certainly impacted how we live our lives #hpm
Wed May 30 18:14:09 PDT 2012
ctsinclair
@jfclearywisc great example of an older technology that probably revolutionized communication of grief and mourning (Newpaper obit) #HPM
Wed May 30 18:14:11 PDT 2012
rfberry
great to see you Pam!! RT @pamressler: Hi all,sorry to be late tonight! #hpm

Wed May 30 18:14:23 PDT 2012
nursefriendly
@aliciabloom T1 As geographical boundaries fade away and more meet, mingle digitally, mourning is facilitated over distances #hpm
Wed May 30 18:15:03 PDT 2012
BillPfohl
@jfclearywisc Agreed.The only concern is discovery. Finding out a family member or old friend passed in less than 140 #hpm
Wed May 30 18:15:06 PDT 2012
nursefriendly
RT @emilybarryPR: From personal experience, I have found social media to be a great help and source of support in my grief #hpm
Wed May 30 18:15:14 PDT 2012
hospiceguy
Saw related video on website.Tasteful example of man using Facebook to celebrate and grieve wife. Useful tool in digital age. #hpm
Wed May 30 18:15:19 PDT 2012
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6/27/12 1:16 PM
ctsinclair
T1b: Does online expressions of mourning validate social media beyond the common superficial notion that SM might actually isolate us? #HPM
Wed May 30 18:15:19 PDT 2012
_lizzy_
@ctsinclair T1 I don't think it's revolutionary yet we're still anecdotal...research has not fully caught up 2 journalism. #hpm
Wed May 30 18:15:25 PDT 2012
pamressler
@rfberry Thanks Renee! #hpm

Wed May 30 18:15:31 PDT 2012
ctsinclair
RT @nursefriendly: T1 As geographical boundaries fade away and more meet, mingle digitally, mourning is facilitated over distances #HPM
Wed May 30 18:15:59 PDT 2012
nursefriendly
RT @BillPfohl: @jfclearywisc Agreed.The only concern is discovery. Finding out a family member or old friend passed in less than 140 #hpm
Wed May 30 18:16:03 PDT 2012
rfberry
@ctsinclair I think online expressions of mourning are a great example of how social media can absolutely be meaningful #hpm
Wed May 30 18:16:25 PDT 2012
ctsinclair
@_lizzy_ good point, journalism can be very ephemeral. Just surprised to see it get so much press like it is new #HPM
Wed May 30 18:16:45 PDT 2012
jfclearywisc
@ctsinclair T1 When a mentor died, I was amazed to find that family had to pay for NYTimes obit! SoMe is generally free! #hpm
Wed May 30 18:16:52 PDT 2012
nursefriendly
@BillPfohl In the past, in person or by phone at least would be the customary way to notify. Nowadays, Facebook or a tweet the norm? #hpm
Wed May 30 18:17:05 PDT 2012
pamressler
RT @rfberry: @ctsinclair I think online expressions of mourning are a great example of how social media can absolutely be meaningful #hpm
Wed May 30 18:17:30 PDT 2012
aliciabloom
@ctsinclair i think on-line expressions of mourning & the community response it allows suggests technology is the opposite of isolating #hpm
Wed May 30 18:17:40 PDT 2012
_lizzy_
T1 I still believe that a Facebook note does not replace a card in the mail...and yet you might get more support than ever online #hpm
Wed May 30 18:17:40 PDT 2012
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6/27/12 1:16 PM
ctsinclair
@jfclearywisc I guess I never thought about having to pay for a NYT obit, figured it was more of an honor bestowed. #HPM
Wed May 30 18:17:51 PDT 2012
ctsinclair
RT @rfberry: @ctsinclair I think online expressions of mourning are a great example of how social media can absolutely be meaningful #HPM
Wed May 30 18:18:01 PDT 2012
nursefriendly
@hospiceguy T1 Has anyone read about #Facebook Accounts being "digitized" & "printed" into hard cover after one passes? #hpm
Wed May 30 18:18:09 PDT 2012
ctsinclair
RT @_lizzy_: T1 A Facebook note does not replace a card in the mail...and yet you might get more support than ever online #HPM
Wed May 30 18:18:23 PDT 2012
pamressler
@jfclearywisc Many smaller newspapers also charge for obits #hpm

Wed May 30 18:18:28 PDT 2012
BillPfohl
@nursefriendly I don't think its the norm...but it can be very impersonal #hpm
Wed May 30 18:18:42 PDT 2012
_lizzy_
@ctsinclair Well by that point, journalism is still trying to convince people that hospice and palliative care are beneficial #hpm
Wed May 30 18:18:45 PDT 2012
rfberry
@jfclearywisc I think that's embarrassing @NYTimes, not sure what else to say on that one! #hpm
Wed May 30 18:18:49 PDT 2012
ctsinclair
@_lizzy_ Yeah, i have shied away from mass birthday greetings on Facebook or any short note of condolence #HPM
Wed May 30 18:19:09 PDT 2012
aliciabloom
RT @_lizzy_: still believe Facebook note does not replace a card in the mail...and yet you might get more support than ever online #hpm
Wed May 30 18:19:16 PDT 2012
BillPfohl
@_lizzy_ You have stock in Hallmark?LOL #hpm

Wed May 30 18:19:16 PDT 2012
nursefriendly
@ctsinclair T1b Don't need to consider mourning to address isolation. For #patients needing support, it brings together. #HPM
Wed May 30 18:19:18 PDT 2012
aliciabloom
obituary publication is a major money maker for newspapers #hpm
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6/27/12 1:16 PM
Wed May 30 18:19:47 PDT 2012
hospiceguy
SoMe is helpful for immediate response and support. Facebook has the range to celebrate a life through photos, video, text, links. #hpm
Wed May 30 18:19:51 PDT 2012
_lizzy_
@BillPfohl I should, come to think of it. I'm old fashioned, I guess. Many people say my cards are the only ones they get #hpm
Wed May 30 18:20:08 PDT 2012
nursefriendly
@ctsinclair T1b On #grief & #mourning specifically, it is another accepted form of #socialmedia activity becoming mainstream #HPM
Wed May 30 18:20:10 PDT 2012
ctsinclair
@nursefriendly yes being online can lead to the support one may never find in person. #HPM
Wed May 30 18:20:30 PDT 2012
rfberry
holding on to whatever they can get I guess. (won't last) RT @aliciabloom obituary publication is a major money maker for newspapers #hpm
Wed May 30 18:20:40 PDT 2012
emilybarryPR
RT @hospiceguy: SoMe is helpful for immediate response and support. Facebook has the range to celebrate a life through photos, video #hpm
Wed May 30 18:20:41 PDT 2012
ctsinclair
@hospiceguy It is impressive to see the creative abilities when people publish tributes online. #HPM
Wed May 30 18:21:14 PDT 2012
nursefriendly
@ctsinclair T1b Perfect example: When #Facebook #banned #BabyGrayson pictures posted by his mother to memorialize memory #HPM
Wed May 30 18:21:17 PDT 2012
kilani19
@_lizzy_ agreed! We do grievance cards routinely instead of email, etc #hpm

Wed May 30 18:21:20 PDT 2012
jfclearywisc
@rfberry Away from $ Is there a difference from reading of a death in the paper or online? I know when I am at obit page, Not so online #hpm
Wed May 30 18:21:34 PDT 2012
aliciabloom
@rfberry i guess so. it just seems so exploitative. #hpm

Wed May 30 18:21:35 PDT 2012
BillPfohl
Online messages can also be wonderful. Imagine finding out so many people thought about your loved one... #hpm
Wed May 30 18:21:47 PDT 2012
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6/27/12 1:16 PM
ctsinclair
@_lizzy_ @BillPfohl A personal card (not a bunch of signatures) can mean so much. #HPM
Wed May 30 18:21:59 PDT 2012
nursefriendly
I'd take exception to it personally. RT @BillPfohl: @nursefriendly I don't think its the norm...but it can be very impersonal #hpm
Wed May 30 18:22:03 PDT 2012
ctsinclair
All this talk of writing letters reminds me I have to get some research published about letters of condolence in the ICU. #HPM
Wed May 30 18:22:30 PDT 2012
kilani19
@aliciabloom I would think so since people are dying everyday and usually no holding back on expense! #hpm
Wed May 30 18:22:40 PDT 2012
emilybarryPR
@BillPfohl I agree. Online messages are an immediate expression of support from people near and far. #hpm
Wed May 30 18:22:54 PDT 2012
aliciabloom
interesting to think about a facebook page can become a living, interactive memorial for someone after they've died. #hpm
Wed May 30 18:22:59 PDT 2012
nursefriendly
@ctsinclair T1b How many other #facebook users and beyond came together to support that mother in her grief (and/or to protest censor) #HPM
Wed May 30 18:23:03 PDT 2012
ctsinclair
@BillPfohl Apparently some parents have had to get their children's facebook accounts locked when they have been defaced after death #HPM
Wed May 30 18:23:16 PDT 2012
nursefriendly
RT @rfberry: @ctsinclair I think online expressions of mourning are a great example of how social media can absolutely be meaningful #hpm
Wed May 30 18:23:30 PDT 2012
rfberry
@ctsinclair interesting! ... subscribe. #hpm

Wed May 30 18:23:35 PDT 2012
rfberry
RT @ctsinclair: @hospiceguy It is impressive to see the creative abilities when people publish tributes online. #hpm
Wed May 30 18:23:56 PDT 2012
pamressler
RT @aliciabloom: interesting to think about a facebook page can become a living, interactive memorial for someone after theyve died. #hpm
Wed May 30 18:24:19 PDT 2012
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6/27/12 1:16 PM
ctsinclair
We will be moving on to topic 2...hint it has to do with nutrition... #HPM

Wed May 30 18:24:40 PDT 2012
chemosabe
T1b Experience down under was that an fb memorial page was digitally defaced and generally defiled. further distressed family! #hpm
Wed May 30 18:25:16 PDT 2012
pamressler
T1 Especially when adolescents die, Facebook is an amazing way for friends to connect and grieve in a way that feels familiar. #hpm
Wed May 30 18:26:05 PDT 2012
kilani19
@chemosabe thats terrible! #hpm

Wed May 30 18:26:10 PDT 2012
nursefriendly
Rare diseases, geographically isolated :) RT @ctsinclair: yes being online can lead to the support one may never find in person. #HPM
Wed May 30 18:26:12 PDT 2012
ctsinclair
@chemosabe that is pretty sad to hear. #HPM

Wed May 30 18:26:12 PDT 2012
aliciabloom
@kilani19 wonder if it's generational? i think as facebook becomes more integrated in daily life/communication, may feel more "normal" #hpm
Wed May 30 18:26:16 PDT 2012
_lizzy_
My Uncle Don was a reporter. When he died the journalists wrote amazing online tributes. Here's just one: http://t.co/9yIw01Lp #hpm
Wed May 30 18:26:20 PDT 2012
KathyKastner
#hpm Hi all...dipping in: today learnd via twitter that Doug Gosling @dyingdigitally blog died. I bet Blog'll be used for commemeration.
Wed May 30 18:26:21 PDT 2012
nursefriendly
RT @ctsinclair: @hospiceguy It is impressive to see the creative abilities when people publish tributes online. #HPM
Wed May 30 18:26:26 PDT 2012
BillPfohl
Recently one of our popular Hospice nurses died unexpectedly...one of his patients wrote the most moving blogs about that I ever read. #hpm
Wed May 30 18:26:30 PDT 2012
kilani19
@pamressler agreed. #hpm

Wed May 30 18:26:44 PDT 2012
rfberry
@chemosabe disappointing, hasn't been my experience, I wonder if they could transition from profile to page for better management #hpm
Wed May 30 18:26:49 PDT 2012
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6/27/12 1:16 PM
chemosabe
@kilani19 @ctsinclair yep down right disgusting! #hpm

Wed May 30 18:26:55 PDT 2012
nursefriendly
RT @BillPfohl: Online messages can also be wonderful. Imagine finding out so many people thought about your loved one... #hpm
Wed May 30 18:26:57 PDT 2012
bobstolz1970
Wed May 30 18:27:02 PDT 2012
nursefriendly
RT @aliciabloom: interesting to think about a facebook page can become a living, interactive memorial for someone after they've died. #hpm
Wed May 30 18:27:30 PDT 2012
ctsinclair
Topic 2: A recent study showed tube feeds increase risk of new wounds & do not help heal wounds in patients with impaired thinking... #HPM
Wed May 30 18:27:35 PDT 2012
jfclearywisc
MT @_lizzy_: My Uncle Don was a reporter. When he died the journalists wrote amazing online tributes. http://t.co/wWzIFAmX #hpm
Wed May 30 18:27:47 PDT 2012
aliciabloom
RT @ctsinclair: We will be moving on to topic 2...hint it has to do with nutrition... #hpm

Wed May 30 18:27:50 PDT 2012
_lizzy_
MT @nursefriendly @BillPfohl: Online messages can also be wonderful. Imagine finding out so many people thought about your loved one... #hpm
Wed May 30 18:27:55 PDT 2012
nursefriendly
RT @kilani19: #hpm I hear many negatives from folks though regarding deaths noted on Facebook - such as "I can't believe it was announced that way..."
Wed May 30 18:28:05 PDT 2012
chemosabe
@rfberry think it may have been the sitch - online bullying or personal violence death from memory. #hpm
Wed May 30 18:28:07 PDT 2012
rfberry
Wed May 30 18:28:09 PDT 2012
ctsinclair
Topic 2 (cont): since this is so contrary to common wisdom re: tube feeds(TF) how do we educate professionals and the public? #HPM
Wed May 30 18:28:17 PDT 2012
http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=05-30-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1
Page 10 of 28
6/27/12 1:16 PM
MDelaCalzada
Listening to one of our International Physician Fellows from Tanzania about #palliative care in his country #hpm http://t.co/9d5PDDvb
Wed May 30 18:28:43 PDT 2012
pamressler
I'm sorry..he taught us all so much MT @KathyKastner: Doug Gosling @dyingdigitally blog died I bet Blogll be used for commemeration. #hpm
Wed May 30 18:29:06 PDT 2012
nursefriendly
RT @KathyKastner: #hpm Hi all...dipping in: today learnd via twitter that Doug Gosling @dyingdigitally blog died. I bet Blog'll be used for commemeration.
Wed May 30 18:29:09 PDT 2012
aliciabloom
just gave a lecture "The Role of Artificial Nutrition & Hydration at End of Life" and it spurred very interesting discussion #hpm
Wed May 30 18:29:14 PDT 2012
ctsinclair
Link to Topic 2 summary on Tube Feeds and Wounds: http://t.co/H3vBoFNx #HPM

Wed May 30 18:29:15 PDT 2012
chemosabe
that has happened down here more than once. Maybe it is a gen Y aussie culture thing? #hpm
Wed May 30 18:29:22 PDT 2012
rfberry
@chemosabe interesting, as much as we've thought about it & people have written about it, online platforms still need to plan more #hpm
Wed May 30 18:29:43 PDT 2012
rfberry
RT @ctsinclair Link to Topic 2 summary on Tube Feeds and Wounds: http://t.co/PVBxqlKb #hpm
Wed May 30 18:29:55 PDT 2012
aliciabloom
need to educate public & clinicians: tube feeds = artificial nutrition = medical intervention. need to weigh benefit vs. burden #hpm
Wed May 30 18:30:25 PDT 2012
KathyKastner
TY RT @rfberry: RT @ctsinclair Link to Topic 2 summary on Tube Feeds and Wounds: http://t.co/iwzn9MRr #hpm
Wed May 30 18:30:29 PDT 2012
nursefriendly
@ctsinclair T2 I would question the need for the tube feeding to start with, and the mobility of the patient. #HPM
Wed May 30 18:31:01 PDT 2012
_lizzy_
T2: @ctsinclair As a SW, I don't think I'm the best to inform patient, but I can notify MD if/when p/f appears to misunderstand risks #hpm
Wed May 30 18:31:01 PDT 2012
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jfclearywisc
@ctsinclair: INteresting results. A choosing wisely topic. RT Link to Topic 2 summary on Tube Feeds and Wounds: http://t.co/B8q5hcGk #HPM
Wed May 30 18:31:25 PDT 2012
rfberry
agree "clinicians & families should ask more questions about whether feeding tubes are appropriate treatments" http://t.co/PVBxqlKb #hpm
Wed May 30 18:31:33 PDT 2012
ctsinclair
Background: Many docs and nurses tell families: "put in a feeding tube and it will help nutrition thereby preventing wounds" #HPM
Wed May 30 18:32:09 PDT 2012
nursefriendly
@ctsinclair T2 How did the study suggest that the tube feeding played a role in new wounds forming? Doesn't make sense to me. #HPM
Wed May 30 18:32:10 PDT 2012
KathyKastner
@rfberry IMHO, we real people don't know enough abt FT's to ask: don't we equate food w love/caring? #hpm
Wed May 30 18:32:22 PDT 2012
hospiceguy
Need to educate public on being specific in Advance Directives. #hpm

Wed May 30 18:32:28 PDT 2012
ctsinclair
T2: to me this brings up the question of true informed consent. Are clinicians really taught to teach risks and benefits? #HPM
Wed May 30 18:32:50 PDT 2012
nursefriendly
@ctsinclair T2 Most #patients with #decubitus #ulcers or #bedsores are not very mobile to start with, #mobility more an issue. #HPM
Wed May 30 18:33:09 PDT 2012
chemosabe
T2 is living longer with parenteral feeding a confounder v no feed? #hpm

Wed May 30 18:33:13 PDT 2012
rfberry
@ctsinclair ahh, the question of the day! #hpm

Wed May 30 18:33:49 PDT 2012
rfberry
@KathyKastner agree, but I think clinicians don't know enough about the risks and benefits well enough to explain them completely #hpm
Wed May 30 18:34:23 PDT 2012
jfclearywisc
MT @ctsinclair: T2: this brings up the question of true informed consent. Are clinicians really taught to teach risks and benefits? #HPM
Wed May 30 18:34:24 PDT 2012
KathyKastner
I want to include on best-endings. com . Suggesstions? RT @hospiceguy: Need to educate public on being specific in Advance Directives. #hpm
Wed May 30 18:34:30 PDT 2012
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ctsinclair
I thought about making a website just to help with informed consent on TF, but someone already bought http://t.co/F3mEfhpj #HPM
Wed May 30 18:34:32 PDT 2012
chemosabe
T2 are u not using the language of pressure injury up there v PU and Bedsores? #hpm
Wed May 30 18:34:33 PDT 2012
equijada
@chemosabe I think so. #hpm

Wed May 30 18:34:36 PDT 2012
kilani19
@ctsinclair yeah, would be more effective to educate physicians on this since they are so quick to advocate for its insertion! #hpm
Wed May 30 18:34:43 PDT 2012
aliciabloom
@ctsinclair clinicians seem to focus on risks & benefits of the procedure itself as opposed to it's impact on the patient's life #hpm
Wed May 30 18:34:54 PDT 2012
emilybarryPR
Absolutely! With "specific" being key word RT @hospiceguy: Need to educate public on being specific in Advance Directives. #hpm
Wed May 30 18:34:56 PDT 2012
hospiceguy
@ctsinclair Great point. Reflects the recent discussion on discouraging certain medical tests when risk outweights reward. #hpm
Wed May 30 18:34:59 PDT 2012
rfberry
@KathyKastner (I should add, many clinicians, not all) #hpm

Wed May 30 18:35:26 PDT 2012
ctsinclair
@rfberry @KathyKastner In an effort to make risks/benefits easy to understand to families, clinicians sometimes take shortcuts? #HPM
Wed May 30 18:35:32 PDT 2012
nursefriendly
@ctsinclair T2 If you've got a tube feeding, you're likely not moving on your own, dependent on being turned, not eating on your own. #HPM
Wed May 30 18:35:45 PDT 2012
pamressler
RT @aliciabloom: @ctsinclair clinicians seem to focus on risks/benefits of the procedure itself as opposed 2 its impact on the pt life #hpm
Wed May 30 18:36:08 PDT 2012
ctsinclair
This study is ground breaking but may take years/decades to percolate through medical culture as most new studies do. Role for SM? #HPM
Wed May 30 18:36:09 PDT 2012
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6/27/12 1:16 PM
_lizzy_
T2 Tubes are also the result of pt/family fearing that the patient will "starve to death" because they can no longer swallow. #hpm
Wed May 30 18:36:13 PDT 2012
rfberry
@ctsinclair maybe, I think sometimes they're just trying to do plain English, but missing many important points in explaining reality #hpm
Wed May 30 18:36:38 PDT 2012
nursefriendly
@ctsinclair T2 Is the point of the Tube Feeding to give better nutrition to help heal, or to get the patient food into them period? #HPM
Wed May 30 18:36:46 PDT 2012
ctsinclair
@nursefriendly One of the prime risk factors this study showed. People who got careful hand feeding did better, less restraints #HPM
Wed May 30 18:36:50 PDT 2012
chemosabe
@ctsinclair couldn't agree more #hpm

Wed May 30 18:36:51 PDT 2012
emilybarryPR
Important to educate patients and families on the benefits and risks of interventional methods. Empowers pts to make informed decisions #hpm
Wed May 30 18:36:57 PDT 2012
chemosabe
@_lizzy_ but comfort is the thing that needs to be highlighted in that conversation. #hpm
Wed May 30 18:37:31 PDT 2012
rfberry
@_lizzy_ very common/normal fear, understandable, such an opportunity for clinicians to clarify what is normal @ that stage of illness #hpm
Wed May 30 18:37:47 PDT 2012
nursefriendly
@ctsinclair T2 If they were able to be hand fed in the first place, why did they need the tube feedings? #HPM
Wed May 30 18:37:58 PDT 2012
DeathwDignity
No doubt, #VT ready for #DeathwithDignity law. #VTleg should listen to voters--72% support this! http://t.co/04ydgp6H #hpm #eol #dwdvt
Wed May 30 18:38:01 PDT 2012
aliciabloom
critically important for pts/families, clinicians to understand decreased appetite+PO intake normal part of advancing disease process #hpm
Wed May 30 18:38:10 PDT 2012
ctsinclair
@nursefriendly increasing calories, protein doesn't always lead to improvement, especially if your body is in a catabolic state #HPM
Wed May 30 18:38:20 PDT 2012
chemosabe
Amen MT @emilybarryPR: Important 2 educate pts & families on benefits & risks of intervention. Empowers pts 2 make informed decisions #hpm
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Wed May 30 18:38:45 PDT 2012
_lizzy_
@chemosabe Could not agree more, but with the decision to not insert tube, families have feeling of guilt for not doing enough. #hpm
Wed May 30 18:39:13 PDT 2012
jfclearywisc
MT @ctsinclair: @nursefriendly increasing calories, protein doesn't always lead to improvement, especially if body is catabolic #HPM
Wed May 30 18:39:17 PDT 2012
ctsinclair
FYI: Catabolic (Gk kata = dwnwrd + ballein = to throw) set of metabolic pathways to break down molecules into smaller units/release NRG #HPM
Wed May 30 18:39:30 PDT 2012
BillPfohl
Yes Doctor here's my Advance Directives, its 127 pages long and it covers every possible concern...(How much can you ask of a patient) #hpm
Wed May 30 18:39:31 PDT 2012
nursefriendly
@ctsinclair T2 In my neck of the woods, #tubefeedings are given when #patients start aspirating, or losing weight when they won't eat #HPM
Wed May 30 18:39:42 PDT 2012
KathyKastner
#hpm I'm having fascinating time workshopping best-endings. com with real peeps. So little knowledg event what questions to ask
Wed May 30 18:40:14 PDT 2012
_lizzy_
@rfberry T2 The key is to find the right talking points so that it sinks in. What to say is easy...HOW to say is harder. #hpm
Wed May 30 18:40:26 PDT 2012
Kathy_Brandt
@rfberry today's New Old Age blog in NYT - invoke the h-word, hospice, to make sure comfort care and prevent tube feedings. #hpm
Wed May 30 18:40:34 PDT 2012
nursefriendly
@ctsinclair T2 When they start losing weight, we may offer peg tube with bolus feedings if they eat 50% or less of meals. #HPM
Wed May 30 18:40:41 PDT 2012
chemosabe
@_lizzy_ allowing a loved one to pass "quicker" with less discomfort should be considered to be doing more than "enough"? #hpm
Wed May 30 18:40:43 PDT 2012
ctsinclair
@BillPfohl Great point - the balance between simple and flexible advance directives and precise and complex ones is tough. Answer: DPOA #HPM
Wed May 30 18:40:43 PDT 2012
jfclearywisc
@nursefriendly But no evidence that #tubefeedings reduce aspiration in#patients who can't swallow #HPM
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Wed May 30 18:40:47 PDT 2012
aliciabloom
@nursefriendly @ctsinclair tube feedings do not necessarily decrease aspiration risk nor make patients gain weight #hpm
Wed May 30 18:41:02 PDT 2012
ctsinclair
RT @_lizzy_: @rfberry T2 The key is to find the right talking points so that it sinks in. What to say is easy...HOW to say is harder. #HPM
Wed May 30 18:41:11 PDT 2012
KathyKastner
Fab! RT @Kathy_Brandt: @rfberry New Old Age blog in NYT - invoke the h-word, hospice, to make sure comfort care /prevent tube feedings. #hpm
Wed May 30 18:41:21 PDT 2012
ctsinclair
Getting ready to move to Topic 3... #HPM

Wed May 30 18:41:24 PDT 2012
emilybarryPR
@Kathy_Brandt That was a great article about the magic of the "h" word #hpm
Wed May 30 18:41:34 PDT 2012
_lizzy_
@chemosabe Hey, I am totally with you...I just think it's harder to get families to that point. Takes time and the right words. #hpm
Wed May 30 18:41:45 PDT 2012
nursefriendly
@jfclearywisc Oh? How about a dysphagic CVA patient that cannot eat normally? How will you feed them? #tubefeedings #patients #HPM
Wed May 30 18:41:48 PDT 2012
Kathy_Brandt
The power of #hospice discussed in NY Times New Old Age blog. http://t.co/EKElRNbk #RT via @NHPCO_news #hpm
Wed May 30 18:42:13 PDT 2012
aliciabloom
important to talk with patients/families about goals & support them in understanding what interventions are helpful to achieve goals #hpm
Wed May 30 18:42:19 PDT 2012
pamressler
T2 Important to realize that some MDs and RNs have not witnessed natural death, and thus difficult for them to advise families. #hpm
Wed May 30 18:42:25 PDT 2012
rfberry
@Kathy_Brandt the h word, the p word or both :) #hpm (either way goals of care need to be central... always)
Wed May 30 18:42:35 PDT 2012
KathyKastner
+1 RT @emilybarryPR: @Kathy_Brandt That was a great article about the magic of the "h" word http://t.co/ItKCeupF #hpm
Wed May 30 18:42:40 PDT 2012
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_lizzy_
@KathyKastner LOVED that article today about the 'h' word #hpm
Wed May 30 18:42:41 PDT 2012
chemosabe
@_lizzy_ yep, sorry I had communicating in print, looks like attack, when not intended. #hpm
Wed May 30 18:42:54 PDT 2012
ctsinclair
Topic 3: Kids,teens and young adults have some free time this summer, what volunteer/job opportunities can you find them in #HPM
Wed May 30 18:43:03 PDT 2012
nursefriendly
@jfclearywisc Aspiration is a risk also of #tubefeedings. It is much less of a risk in patient who #aspirates by mouth feedings #HPM
Wed May 30 18:43:06 PDT 2012
KathyKastner
@_lizzy_ Hi Lizzy!! #hpm

Wed May 30 18:43:12 PDT 2012
emilybarryPR
Yes! RT @rfberry: @Kathy_Brandt the h word, the p word or both :) #hpm (either way goals of care need to be central... always) #hpm
Wed May 30 18:43:24 PDT 2012
nursefriendly
@aliciabloom T2 Have many strictly NPO patients who have no other option for receiving nutrition. #hpm
Wed May 30 18:43:56 PDT 2012
jfclearywisc
@nursefriendly Strokes r one of major challenges face w palliative Care consults. Previously. tube, nursing home, died. NOt my problem #HPM
Wed May 30 18:43:58 PDT 2012
aliciabloom
RT @pamressler: Important to realize that some MDs & RNs have not witnessed natural death, thus difficult for them to advise families #hpm
Wed May 30 18:44:03 PDT 2012
chemosabe
@nursefriendly unless reflux or over feeding. #hpm

Wed May 30 18:44:30 PDT 2012
_lizzy_
@chemosabe no worries! I'm highly empathic so I do represent the family POV often @KathyKastner Hello there! #hpm
Wed May 30 18:44:37 PDT 2012
KnowYourWishes
Hi #hpm. Sorry I'm late!

Wed May 30 18:44:59 PDT 2012
nursefriendly
That is why we check for residuals isn't it? Keep HOB elevated? RT @chemosabe: @nursefriendly unless reflux or over feeding. #hpm
Wed May 30 18:45:02 PDT 2012
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aliciabloom
@nursefriendly and depending upon where they are in their disease process will impact if artificial nutrition is beneficial or a burden #hpm
Wed May 30 18:45:16 PDT 2012
jfclearywisc
@nursefriendly Now our neurologists consult #palliative care. Discuss goals, wishes, ADs, risks, benefits. Informed consent #HPM
Wed May 30 18:45:16 PDT 2012
nursefriendly
Technical yes. RT @KathyKastner: @rfberry IMHO, we real people don't know enough abt FT's to ask: don't we equate food w love/caring? #hpm
Wed May 30 18:45:24 PDT 2012
chemosabe
@nursefriendly in a perfect world! #hpm

Wed May 30 18:45:50 PDT 2012
nursefriendly
@aliciabloom To not feed is to sign a death warrant isnt it? #hpm

Wed May 30 18:45:57 PDT 2012
aliciabloom
awesome! RT @jfclearywisc: Now our neurologists consult #palliative care. Discuss goals, wishes, ADs, risks, benefits. Informed consent #hpm
Wed May 30 18:46:12 PDT 2012
_lizzy_
@ctsinclair Do hospitals still have candy stripers? #hpm

Wed May 30 18:46:32 PDT 2012
aliciabloom
NO! not necessarily RT @nursefriendly: @aliciabloom To not feed is to sign a death warrant isnt it? #hpm
Wed May 30 18:46:48 PDT 2012
ctsinclair
RT @jfclearywisc: Now our neurologists consult #palliative care. Discuss goals, wishes, ADs, risks, benefits. Informed consent "NICE!" #HPM
Wed May 30 18:46:49 PDT 2012
rfberry
I would say not at all RT @nursefriendly @aliciabloom To not feed is to sign a death warrant isnt it? #hpm
Wed May 30 18:46:56 PDT 2012
rhgerard
NEJM | Home: Palliation for Dying Undocumented Immigrants: touching account on ethics and the right care #hpm #hospice http://t.co/o5SZPkop
Wed May 30 18:47:00 PDT 2012
nursefriendly
@aliciabloom They don't increase risks of developing ulcers by themselves, lots of other precipitating factors #hpm
Wed May 30 18:47:11 PDT 2012
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ctsinclair
@_lizzy_ I think it is a lot harder to be a hospital volunteer these days. #HPM

Wed May 30 18:47:12 PDT 2012
KnowYourWishes
Agree agree! RT @aliciabloom: NO! not necessarily RT @nursefriendly: @aliciabloom To not feed is to sign a death warrant isnt it? #hpm
Wed May 30 18:47:19 PDT 2012
kilani19
T3 I would have them volunteer on cases that have kids in their age group or at a hospital w/ a palliative team #hpm
Wed May 30 18:47:46 PDT 2012
rfberry
T3 Contact your local hospice and volunteer! You can do administrative volunteering if you're not ready to be at the bedside! #hpm
Wed May 30 18:47:48 PDT 2012
ctsinclair
@nursefriendly You can usually always feed by hand carefully and with love and person to person connection and touch. #HPM
Wed May 30 18:47:53 PDT 2012
aliciabloom
@KnowYourWishes hello there! #hpm

Wed May 30 18:47:53 PDT 2012
KathyKastner
@KnowYourWishes Hey LJ - fantastic blog posts/excerpts wtg! #hpm

Wed May 30 18:48:17 PDT 2012
rfberry
T3 There's nothing more rewarding than being a hospice volunteer, they carry the true heart & mission of the hospice movement #hpm
Wed May 30 18:48:19 PDT 2012
BillPfohl
T3 volunteer help is needed in development. many non profit hospices have been hurt by poor economy. we need creative ways to find $$$ #hpm
Wed May 30 18:48:24 PDT 2012
ctsinclair
RT @rfberry: T3 Contact local hospice and volunteer! You can do administrative volunteering if youre not ready to be at the bedside! #HPM
Wed May 30 18:48:40 PDT 2012
chemosabe
@nursefriendly yep like a suggested earlier the "artificial" extension of life, give greater opportunity over time to develop PI. #hpm
Wed May 30 18:48:42 PDT 2012
aliciabloom
RT @ctsinclair: You can usually always feed by hand carefully and with love and person to person connection and touch. #hpm
Wed May 30 18:48:42 PDT 2012
KnowYourWishes
T3: Perhaps pet hospices would be good for kids. Or hospices that bring animals to the visit hospice patients #hpm
Wed May 30 18:48:51 PDT 2012
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nursefriendly
@aliciabloom How long will any patient live without nutrition? #hpm
Wed May 30 18:49:14 PDT 2012
KathyKastner
RT @aliciabloom: RT @ctsinclair: You can usually always feed by hand carefully and with love and person to person connection and touch. #hpm
Wed May 30 18:49:15 PDT 2012
KnowYourWishes
Thx Kathy! :) Lots been happening! :) RT @KathyKastner: @KnowYourWishes Hey LJ fantastic blog posts/excerpts wtg! #hpm
Wed May 30 18:49:17 PDT 2012
aliciabloom
RT @rfberry: There's nothing more rewarding than being a hospice volunteer, they carry the true heart & mission of the hospice movement #hpm
Wed May 30 18:49:31 PDT 2012
ctsinclair
Hospice volunteers opportunities are numerous and can be patient care related (more training usually) or administrative, developmental #HPM
Wed May 30 18:49:34 PDT 2012
KnowYourWishes
@aliciabloom Hey there chica! #hpm

Wed May 30 18:49:38 PDT 2012
chemosabe
T3 special needs summer camps. #hpm

Wed May 30 18:49:43 PDT 2012
_lizzy_
T3 http://t.co/Rj7hjD9o is great website for permanent or one-off volunteer opportunities. One time I was a pretend rioter for police! #hpm
Wed May 30 18:49:44 PDT 2012
rfberry
T3 Young adults can make wonderful volunteers, I think it's really important for hospices not to overlook the many things they can do! #hpm
Wed May 30 18:50:06 PDT 2012
jfclearywisc
@ctsinclair T3; Get kids to volunteer with older neighbours. Establish relationships with older folks. Talk to them. Hear stories #HPM
Wed May 30 18:50:16 PDT 2012
ctsinclair
@BillPfohl Great point about teens and young adults helping in development. Great to harness the enthusiasm. #HPM
Wed May 30 18:50:19 PDT 2012
nursefriendly
@aliciabloom Lets use the example of a patient with multiple episodes of aspiration pneumonia, tube feed or sign waver to let aspirate? #hpm
Wed May 30 18:50:28 PDT 2012
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KathyKastner
@rfberry Isn't volunteering how you fell in love with #hpm

Wed May 30 18:50:43 PDT 2012
aliciabloom
@nursefriendly patient w/advanced illness, approaching EoL- not much survival benefit w/ artificial nutrition. more symptom burden. #hpm
Wed May 30 18:51:05 PDT 2012
rfberry
T3 My passion for #hospice started as a VOL (introduced in high school) & more extensively in college, the experience changed my life #hpm
Wed May 30 18:51:12 PDT 2012
chemosabe
T3 check out http://t.co/DfwCpE0A #hpm

Wed May 30 18:51:17 PDT 2012
rfberry
that's right! RT @KathyKastner @rfberry Isnt volunteering how you fell in love with #hpm
Wed May 30 18:51:26 PDT 2012
nursefriendly
@rfberry If they won't eat on their own due to dementia, and you don't artificially feed, how long can they last? #hpm
Wed May 30 18:51:29 PDT 2012
pamressler
T3: Perhaps some hospices and organizations would welcome help from volunteers in social media development? #hpm
Wed May 30 18:51:39 PDT 2012
chemosabe
@nursefriendly by hand feeding them! #hpm

Wed May 30 18:52:15 PDT 2012
KnowYourWishes
T3: Perhaps pet hospices would be good for kids. Also, hospices that bring animals to patients also would be good experience for kids #hpm
Wed May 30 18:52:15 PDT 2012
ctsinclair
We need more teens to volunteer in #Hospice so we can create a few more @rfberry clones #HPM
Wed May 30 18:52:29 PDT 2012
KathyKastner
+100RT @ctsinclair: We need more teens to volunteer in #Hospice so we can create a few more @rfberry clones #HPM
Wed May 30 18:52:49 PDT 2012
chemosabe
@nursefriendly if there is no problem with swallow, do not believe that parenteral feed is the correct answer. #hpm
Wed May 30 18:52:59 PDT 2012
nursefriendly
@ctsinclair Role of SM would be to help educate the public, #patients #caregivers on benefits/pitfalls of #artificial #nutrition #HPM
Wed May 30 18:53:17 PDT 2012
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_lizzy_
RT @ctsinclair: We need more teens to volunteer in #Hospice so we can create a few more @rfberry clones #hpm
Wed May 30 18:53:19 PDT 2012
ctsinclair
@pamressler might need to be careful if those volunteers dont stick around or properly teach staff about socmed #HPM
Wed May 30 18:53:26 PDT 2012
pamressler
+++ RT @ctsinclair: We need more teens to volunteer in #Hospice so we can create a few more @rfberry clones #hpm
Wed May 30 18:53:32 PDT 2012
nursefriendly
RT @ctsinclair: @nursefriendly You can usually always feed by hand carefully and with love and person to person connection and touch. #HPM
Wed May 30 18:53:36 PDT 2012
hospiceguy
@pamressler Great idea! Teens can teach a lot about social media skills. #hpm
Wed May 30 18:53:49 PDT 2012
rfberry
@jfclearywisc my greatgrandpa was in Itally, my mom had us visit local nursing homes w/the hope that someone would visit him there #hpm
Wed May 30 18:53:54 PDT 2012
chemosabe
T3 I worked a couple of camps up there, and some of those young people r still in my tweetstream, fb, etc. Brilliant, caring young uns #hpm
Wed May 30 18:53:55 PDT 2012
ctsinclair
@KnowYourWishes good one! teens for pet hospice support! Mom, I wanna be a palliative vet! #HPM
Wed May 30 18:53:57 PDT 2012
nursefriendly
@ctsinclair T2 We have speech/swallow evaluations weekly that advise patients to be kept NPO. Feeding orally not an option. #HPM
Wed May 30 18:54:29 PDT 2012
KnowYourWishes
@ctsinclair hehe. Thx. Seriously, I think animals and hospice go hand and hand. Perfect way to involve kids! #hpm
Wed May 30 18:54:41 PDT 2012
jfclearywisc
!! RT @rfberry: my greatgrandpa was in Itally, my mom had us visit local nursing homes w/the hope that someone would visit him there #hpm
Wed May 30 18:54:51 PDT 2012
aliciabloom
that would be great! RT @ctsinclair: We need more teens to volunteer in #Hospice so we can create a few more @rfberry clones #hpm
Wed May 30 18:54:51 PDT 2012
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ctsinclair
I am working to get my kids (6 yo) a volunteer position with me at the nursing home near our house and their school. #HPM
Wed May 30 18:54:54 PDT 2012
rfberry
@pamressler @ctsinclair #blushing, thank you.. AND... #hpm

Wed May 30 18:55:03 PDT 2012
rfberry
my main & constant statement will be... Young People Can & Will Be Interested & Impact -> #hpm
Wed May 30 18:55:12 PDT 2012
ctsinclair
Let's wrap it up and be with our families and friends, get some sleep or exercise, so leave us with a great thought! #HPM
Wed May 30 18:55:37 PDT 2012
KnowYourWishes
T3: Also, pet therapy dogs and companion animals in nursing homes. Doesn't have to be hospice related #hpm
Wed May 30 18:55:41 PDT 2012
pamressler
Agreed! RT @rfberry: my main & constant statement will be... Young People Can & Will Be Interested & Impact --> #hpm
Wed May 30 18:56:01 PDT 2012
ctsinclair
RT @kilani19: T3 I would have them volunteer on cases that have kids in their age group or at a hospital w/ a palliative team #hpm
Wed May 30 18:56:02 PDT 2012
rfberry
Demand Palliative Care. #hpm

Wed May 30 18:56:25 PDT 2012
aliciabloom
love! RT @rfberry: my greatgrandpa was in Italy, my mom had us visit local nursing homes w/the hope that someone would visit him there #hpm
Wed May 30 18:56:28 PDT 2012
nursefriendly
In NPO patients, at high risk for aspiration pneumonia? RT @chemosabe: @nursefriendly by hand feeding them! #hpm
Wed May 30 18:56:51 PDT 2012
KnowYourWishes
My final thought: I want to snuggle with an animal as I'm dying :) #hpm

Wed May 30 18:56:53 PDT 2012
chemosabe
Not original but "be the change you wish to see in the world" - Ghandi (I'm embarrassed to say I THINK) #hpm
Wed May 30 18:56:54 PDT 2012
KathyKastner
#hpm last thot is a brag: embarking on Best Endings video project: 3 minutes of a whack o
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people talking abt e-o-l thots.

Wed May 30 18:57:03 PDT 2012
_lizzy_
Wanted to let everyone know that my Death Cafe event got funded so I will be making a go at raising death awareness in the community! #hpm
Wed May 30 18:57:10 PDT 2012
KathyKastner
@_lizzy_ W00t: Death Cafe funding Awriiight! #hpm

Wed May 30 18:57:34 PDT 2012
BillPfohl
Have the young record patients stories. They can learn so much history and what a great tribute ... posting someones memories #hpm
Wed May 30 18:57:42 PDT 2012
nursefriendly
@_lizzy_ T2 Emotions play a large part in the decision to insert, or not insert a feeding tube #hpm
Wed May 30 18:57:47 PDT 2012
jfclearywisc
RT @_lizzy_: my Death Cafe event got funded so I will be making a go at raising death awareness in the community! #hpm
Wed May 30 18:57:51 PDT 2012
chemosabe
@nursefriendly ? here then is are we talking acute care or pall care, as per the chat. if the later, ?qol, maybe time 2 let go! #hpm
Wed May 30 18:58:10 PDT 2012
BillPfohl
@_lizzy_ Congrats! #hpm

Wed May 30 18:58:12 PDT 2012
ctsinclair
RT @KnowYourWishes: My final thought: I want to snuggle with an animal as Im dying :) #HPM

Wed May 30 18:58:12 PDT 2012
hospiceguy
This was my first TweetChat with the group. Thoroughly enjoyed the dialog. Fastest hour of my day! Thanks to all. #hpm
Wed May 30 18:58:27 PDT 2012
KnowYourWishes
@_lizzy_ Congrats!!! #DeathCafe Love it! #hpm

Wed May 30 18:58:28 PDT 2012
ctsinclair
@_lizzy_ Death Cafe link please #HPM

Wed May 30 18:58:28 PDT 2012
hughstephens
RT @rfberry: Demand Palliative Care. #hpm

Wed May 30 18:58:40 PDT 2012
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pamressler
RT @BillPfohl: Have young record patients stories They can learn so much history and what a great tribute, posting someones memories #hpm
Wed May 30 18:58:47 PDT 2012
KathyKastner
#hpm no, wait I have an even better brag Best Endings got funding too @_lizzy_ - a collab in our future?
Wed May 30 18:59:10 PDT 2012
_lizzy_
My program http://t.co/ktys2XhP but also http://t.co/tTOjqh5G (England) #hpm

Wed May 30 18:59:11 PDT 2012
nursefriendly
Final Thought: Are Feeding Tubes inserted for the #patients comfort? or for ours? #HPM
Wed May 30 18:59:14 PDT 2012
KnowYourWishes
Reflective writing benefits all ages! MT @BillPfohl: record patients stories They can learn so much history and what a great tribute #hpm
Wed May 30 18:59:24 PDT 2012
_lizzy_
@KnowYourWishes @BillPfohl Thanks! @KathyKastner Of course! #hpm

Wed May 30 19:00:07 PDT 2012
chemosabe
@nursefriendly BRILLIANT final point Andrew. That would have been my next post in our banter. #hpm
Wed May 30 19:00:17 PDT 2012
KnowYourWishes
@KathyKastner @_lizzy_ Congrats to you both!!! http://t.co/Cu3VEQLX would love to post links!!! Email me with info! #hpm
Wed May 30 19:00:23 PDT 2012
aliciabloom
@hospiceguy hope you'll join us regularly! we're here every Wednesday at 9pm EST #hpm
Wed May 30 19:00:28 PDT 2012
nursefriendly
@ctsinclair #Thankyou for hosting : #HPM

Wed May 30 19:00:41 PDT 2012
chemosabe
@hughstephens hello Hugh, fancy seeing you here. lol #hpm

Wed May 30 19:00:50 PDT 2012
KathyKastner
RT @nursefriendly: @ctsinclair #Thankyou for hosting : #HPM

Wed May 30 19:00:50 PDT 2012
BillPfohl
I have a major complaint...this chat is too short. #hpm

Wed May 30 19:01:03 PDT 2012
aliciabloom
yay @_lizzy_! #hpm
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Wed May 30 19:01:14 PDT 2012
_lizzy_
@KnowYourWishes I'm so grateful to Jon Underwood with @deathcafe (England) for allowing me to follow his lead #hpm
Wed May 30 19:01:18 PDT 2012
KnowYourWishes
@aliciabloom @hospiceguy I second that! :) #hpm

Wed May 30 19:01:22 PDT 2012
pamressler
I am looking forward to teaching the first blended learning course on Palliative and EOL Issues at Tufts in June/July...more awareness! #hpm
Wed May 30 19:01:38 PDT 2012
emilybarryPR
@ctsinclair Thanks for hosting. What a great discussion! Night all! #hpm
Wed May 30 19:02:02 PDT 2012
aliciabloom
so awesome, @pamressler! #hpm

Wed May 30 19:02:08 PDT 2012
BillPfohl
Good night from the almost east coast... #hpm

Wed May 30 19:02:39 PDT 2012
aliciabloom
a big thank you to @ctsinclair for hosting tonight-- great discussion! #hpm
Wed May 30 19:02:40 PDT 2012
rfberry
@pamressler this is such an amazing program, a huge step in #meded & public awareness about --> #hpm
Wed May 30 19:02:42 PDT 2012
KathyKastner
RT @rfberry: @pamressler this is such an amazing program, a huge step in #meded & public awareness about --> #hpm
Wed May 30 19:02:51 PDT 2012
pamressler
Thanks for hosting @ctsinclair! #hpm

Wed May 30 19:02:51 PDT 2012
_lizzy_
@pamressler LOVE that you are contributing more formal education on EOL #hpm
Wed May 30 19:02:57 PDT 2012
nursefriendly
@chemosabe Talking #Palliative care, for many families initially the thought of loved ones not getting fed is unthinkable #hpm
Wed May 30 19:02:57 PDT 2012
produceconsume
RT @douggosling: Ideas from odd places. See blog post House at http:s//dyingdigitally.com #HPM #Hospice #Palliative #EOLchat
Wed May 30 19:02:58 PDT 2012
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produceconsume
RT @douggosling: Spreading the word about palliative care. See new blog post "Getting Political" at http://t.co/TEUemRsm #HPM #Palliativ ...
Wed May 30 19:03:05 PDT 2012
ctsinclair
Good night everyone, thanks for coming out each and every week! #HPM
Wed May 30 19:03:15 PDT 2012
KnowYourWishes
RT @aliciabloom: a big thank you to @ctsinclair for hosting tonight-- great discussion! #hpm
Wed May 30 19:03:31 PDT 2012
aliciabloom
"Feeding Tubes in Patients with Severe Dementia" http://t.co/BPktPsXN <- 10 years old, but great summary #hpm
Wed May 30 19:03:36 PDT 2012
KathyKastner
@pamressler extremely late hey to you.. and thanks for weiging in on doug gosling. What a hero that man is #hpm
Wed May 30 19:03:37 PDT 2012
aliciabloom
RT @ctsinclair: Good night everyone, thanks for coming out each and every week! #hpm
Wed May 30 19:03:51 PDT 2012
rfberry
Interested in a fascinating #meded class on #hpm? http://t.co/83is8L1B #hcsm

Wed May 30 19:03:58 PDT 2012
nursefriendly
Change yes, but do not disappear. @aliciabloom: @nursefriendly @SteveBednarski @rfberry #hpm
Wed May 30 19:04:03 PDT 2012
chemosabe
@nursefriendly yes of course, we need to help them get to that point where it could be acceptable. NGT pref in this case than PEG #hpm
Wed May 30 19:04:04 PDT 2012
kilani19
@ctsinclair thanks Christian! #hpm

Wed May 30 19:04:11 PDT 2012
rfberry
Thanks for hosting CT! RT @ctsinclair Good night everyone, thanks for coming out each and every week! #hpm
Wed May 30 19:04:39 PDT 2012
chemosabe
cheers y'all and yes thanks @ctsinclair #hpm

Wed May 30 19:04:46 PDT 2012
pamressler
Thanks! RT @rfberry: Interested in a fascinating #meded class on #hpm? http://t.co/JQkssB58 #hcsm #hpm
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6/27/12 1:16 PM
Wed May 30 19:05:11 PDT 2012
aliciabloom
@nursefriendly does not mean that a PEG tube is the answer. #hpm
Wed May 30 19:05:14 PDT 2012
KnowYourWishes
I was invitd 2 join Prof Education Workgroup at C-TAC and it's AMAZING. If u don't know abt @CTACorg, check it out http://t.co/HjnbaaBT #hpm
Wed May 30 19:05:39 PDT 2012
pamressler
@KathyKastner Hi Kathy -- yes Doug inspired many with his candor and grace in living and in dying #hpm
Wed May 30 19:06:03 PDT 2012
colleen_young
#hpm Sorry to have missed the chat tonight, but I had to stick with the superfast #hcsmca tonight.
Wed May 30 19:06:18 PDT 2012
colleen_young
#hpm T3: Did you know that @VirtualHospice has some great resources for volunteers and volunteer coordination? http://t.co/1lmAZaey
Wed May 30 19:06:26 PDT 2012
nursefriendly
Nope, but that was the topic of the discussion. RT @aliciabloom: @nursefriendly does not mean that a PEG tube is the answer. #hpm
Wed May 30 19:06:42 PDT 2012
nursefriendly
If they are that close to passing, then they would not get a feeding tube regardless. #hpm @SteveBednarski @aliciabloom @rfberry
Wed May 30 19:08:10 PDT 2012
pamressler
@_lizzy_ Thanks, Lizzy -- I am looking forward to combining onsite and online learning in a higher ed course on Palliative and EOL #hpm
Wed May 30 19:08:13 PDT 2012
nursefriendly
@aliciabloom Important for clinicians to know weight loss is a quality assurance metric,medicare reimbursements of non hospice patients #hpm
Wed May 30 19:10:29 PDT 2012
pamressler
@_lizzy_ Congrats on your funding! #hpm

Wed May 30 19:12:43 PDT 2012
Page 28 of 28

#HPM Tweet Chat 5:30:12

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#hpm - Healthcare Social Media Transcript

Quiet Desperation http://t.co/Rsgwtfn3 #hpm #palliative care #carechat #hospice

@ctsinclair hey Christian! It's Marwa! #hpm

@ShahinaLakhani Hi Shahina, joining us tonight? #hpm #palliative #carechat #hospice

#hpm - Healthcare Social Media Transcript

#hpm Marwa Kilani, palliative medicine in Los Angeles area.

Hi Andrew, Jim, Emily, Alicia and @hospiceguy #HPM

Isn't there a URL that makes this chat easier? #hpm

#hpm - Healthcare Social Media Transcript

Wed May 30 18:06:03 PDT 2012

@BillPfohl Good to see you. I like to use http://t.co/LscETQ3M #hpm

Thank you guys! #hpm

Hey @_lizzy_ missed you last week! #hpm

OK getting ready for the first topic... #HPM

Hi all,sorry to be late tonight! #hpm

#hpm - Healthcare Social Media Transcript

Wed May 30 18:12:20 PDT 2012

great to see you Pam!! RT @pamressler: Hi all,sorry to be late tonight! #hpm

#hpm - Healthcare Social Media Transcript

@rfberry Thanks Renee! #hpm

#hpm - Healthcare Social Media Transcript

@jfclearywisc Many smaller newspapers also charge for obits #hpm

@_lizzy_ You have stock in Hallmark?LOL #hpm

obituary publication is a major money maker for newspapers #hpm

#hpm - Healthcare Social Media Transcript

Wed May 30 18:19:47 PDT 2012

@_lizzy_ agreed! We do grievance cards routinely instead of email, etc #hpm

@rfberry i guess so. it just seems so exploitative. #hpm

#hpm - Healthcare Social Media Transcript

@ctsinclair interesting! ... subscribe. #hpm

#hpm - Healthcare Social Media Transcript

We will be moving on to topic 2...hint it has to do with nutrition... #HPM

@chemosabe thats terrible! #hpm

@chemosabe that is pretty sad to hear. #HPM

@pamressler agreed. #hpm

#hpm - Healthcare Social Media Transcript

@kilani19 @ctsinclair yep down right disgusting! #hpm

RT @ctsinclair: We will be moving on to topic 2...hint it has to do with nutrition... #hpm

#hpm - Healthcare Social Media Transcript

Link to Topic 2 summary on Tube Feeds and Wounds: http://t.co/H3vBoFNx #HPM

#hpm - Healthcare Social Media Transcript

Need to educate public on being specific in Advance Directives. #hpm

T2 is living longer with parenteral feeding a confounder v no feed? #hpm

@ctsinclair ahh, the question of the day! #hpm

#hpm - Healthcare Social Media Transcript

@chemosabe I think so. #hpm

@KathyKastner (I should add, many clinicians, not all) #hpm

#hpm - Healthcare Social Media Transcript

@ctsinclair couldn't agree more #hpm

#hpm - Healthcare Social Media Transcript

Wed May 30 18:38:45 PDT 2012

#hpm - Healthcare Social Media Transcript

Wed May 30 18:40:47 PDT 2012

Getting ready to move to Topic 3... #HPM

#hpm - Healthcare Social Media Transcript

@_lizzy_ Hi Lizzy!! #hpm

@nursefriendly unless reflux or over feeding. #hpm

Hi #hpm. Sorry I'm late!

#hpm - Healthcare Social Media Transcript

@nursefriendly in a perfect world! #hpm

@aliciabloom To not feed is to sign a death warrant isnt it? #hpm

@ctsinclair Do hospitals still have candy stripers? #hpm

#hpm - Healthcare Social Media Transcript