In palliative and hospice care, our work often hinges on recognizing subtle cognitive changes before they escalate into crises. When most people—clinicians included—think about dementia, they think about memory loss and confusion. While these are hallmark features, they are not always the earliest signs of cognitive decline. One
Agitation is a frequent and distressing symptom in individuals with advanced dementia. It may manifest as restlessness, verbal outbursts, pacing, aggression, or resistance to care. For patients in hospice or palliative care settings, these behaviors can pose significant challenges for caregivers, impact the dignity of the patient, and strain the
As palliative care professionals, we’re trained to focus on comfort, dignity, and whole-person care—especially in the face of progressive neurologic illness. But recent findings from researchers at Caltech challenge long-held assumptions about where diseases like Parkinson’s truly begin—and offer new insight into how gut
In the complex landscape of symptom management in palliative and hospice care, nausea and vomiting are frequent and distressing symptoms that demand careful clinical attention. Among the arsenal of antiemetic medications, ondansetron (Zofran) is often recognized for its effectiveness in specific settings such as chemotherapy-induced nausea and postoperative emesis.
In hospice and palliative care, healthcare providers offer not only clinical support but also emotional, spiritual, and physical comfort to patients facing serious, life-limiting illnesses. This compassionate work often involves physically demanding tasks such as repositioning bedbound patients, transferring those with limited mobility, and spending prolonged hours at the
For years, popular advice about preventing dementia has centered on the idea that brain games—crossword puzzles, Sudoku, language apps—can preserve cognition and slow decline. But what if this advice is not only misguided, but actively harmful? What if it offers patients and families false reassurance, while the root
For centuries, pneumonia has been described as “the old man’s friend,” a term first attributed to the renowned physician Sir William Osler. While modern medicine has rightly moved beyond the romanticization of illness, the core sentiment behind this expression still resonates in hospice and palliative care: pneumonia, when it
In the evolving landscape of metabolic disorders, the term “Type 3 Diabetes” has emerged as a provocative and multifaceted label—one that resonates in two vastly different yet clinically relevant contexts. While not officially recognized by the American Diabetes Association, “Type 3 Diabetes” is used informally to describe both Alzheimer’
Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide. While their short-term efficacy in managing acid-related disorders is well established, their long-term use—especially in older adults and hospice patients—raises important concerns about safety, necessity, and alignment with patient-centered goals of care.
In an era where genetic testing is accessible to nearly anyone with an internet connection, palliative care clinicians are increasingly encountering patients—and family members—who are anxious about their APOE4 status. Popular genetic platforms like 23andMe often alert users to their APOE4 allele status, sparking fears that a diagnosis
As the population ages and chronic disease burdens deepen, palliative care and hospice teams are increasingly faced with the intersecting trajectories of metabolic and neurodegenerative disease. Among the most clinically significant—and often overlooked—intersections is the strong association between Type 2 diabetes and Alzheimer's disease. Understanding this
Helping Families Navigate the Complex Terrain of Dementia with Compassion and Clarity “How long do we have?” It’s the question every family asks when dementia becomes part of their reality—and it’s one of the most challenging to answer. For years, many of us in hospice and palliative
In the world of palliative care, providers frequently navigate the complexities of neurocognitive decline. Subtle shifts in memory, behavior, and function often raise the question: is this dementia, delirium, or simply the “normal aging brain”? Among the many tools available, the Clock Drawing Test (CDT) remains one of the most
Palliative medicine, once seen as a niche field, has now become an essential component of healthcare, focusing on providing relief from the symptoms, pain, and stress of serious illnesses. As the global population ages and the burden of chronic diseases continues to rise, palliative care has gained prominence, emphasizing holistic,
In the nuanced world of post-cardiac care, one key metric often serves as the bridge between clinical recovery and functional reintegration: the Metabolic Equivalent of Task (MET). This standardized measure of energy expenditure empowers healthcare providers to assess the intensity of physical activities, customize rehabilitation protocols, and predict patient
Opioids remain the cornerstone of symptom relief in hospice and palliative care, especially for pain and dyspnea. However, navigating reported "allergies" to opioids—particularly morphine and codeine—can pose significant challenges. In an already complex clinical landscape, these allergy labels can lead to under-treatment of distressing symptoms,
As palliative care continues to evolve with an emphasis on quality of life, comfort, and symptom control, the incorporation of precision medicine tools like pharmacogenomics (PGx) offers promising benefits. Pharmacogenomics, the study of how a patient’s genetic makeup influences their response to medications, can serve as a powerful ally
In palliative medicine, attention to genitourinary symptoms is often overshadowed by more pressing issues such as pain, dyspnea, or existential distress. Yet lower urinary tract dysfunction—particularly the confusing coexistence of overactive bladder (OAB) symptoms and urinary retention—is both common and under-recognized, especially in older adults with complex
March is Kidney Awareness Month, a time often focused on prevention, early detection, and life-sustaining treatments like dialysis. These conversations are important—and incomplete. Missing too often is space for an equally valid, deeply human decision: the decision to stop dialysis. For many people living with advanced kidney disease,
March is Kidney Awareness Month, a time often focused on prevention, early detection, and life-sustaining treatments like dialysis. These conversations are important—and incomplete. Missing too often is space for an equally valid, deeply human decision: the decision to stop dialysis. For many people living with advanced kidney disease,
We spend a great deal of time helping patients in maintaining stability—physically, emotionally, and socially. For individuals living with dementia, stability is more than a comfort; it is a lifeline. Disrupting it—especially through relocation—can carry significant clinical and emotional risks. Whether moving from home to a facility,
In palliative and hospice medicine, opioids remain the cornerstone of pain and symptom management. Morphine, codeine, hydromorphone, oxycodone, and other agents provide profound relief from pain, dyspnea, and certain distressing symptoms at the end of life. Yet, many patients arrive with their medical record littered with “opioid allergy” labels. These
As the hospice community deepens its commitment to equity and trauma-informed care, clinicians are increasingly caring for individuals who have experienced incarceration. These patients bring with them a lifetime of medical, psychological, and existential burdens shaped not only by disease, but by the enduring imprint of trauma, stigma, and
Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases that track controlled substance prescribing and dispensing. While they were originally designed as a tool to combat the opioid epidemic, PDMPs are now an expected part of safe, compliant medical practice in nearly every setting—including palliative care and hospice.