Sunday, January 30, 2011

Evidence-based health care

With all the evidence-based care the CMAJ publishes (at US$20, as a matter of fact). Peer-reviewed, researched articles that make a difference. As a teacher, I made it a point to read articles on a regular basis. I attended conferences, workshops, and ensured that I read or heard all the evidence. We do more research in both education and the field of healthcare, than in many parts of the world. We ignore more of it, as well.

 We know that great social services work includes empathy, whether we be educators or healthcare professionals or volunteers. We understand that when a patient cannot understand our words, they understand our affect. When I would visit my father, his tumour had wreaked havoc with his communication skills. Sometimes it was expressive language, sometimes it was receptive language
It means the type of bedside care that a patient deserves. It isn't always more treatment, more tests, more pain. Many of us fear the pain of dying, rather than the dying itself. It can be done with dignity with a wise and caring support person. This is why I volunteer with Dignity House Hospice.

To learn the empathic response is not difficult.
It isn't the physician who tells us that facing your pain lets you know you are alive.
It isn't the physician that complains to the hospice volunteer sitting bedside that 'she just won't die', about the client in a coma on the bed.
It isn't the physician who spends time in diagnosis, and a few moments to state, "Yes, bad news. You have cancer," and leaves the room.
It isn't the physician who marched into a client's room, where I was bedside giving respite to the daughter, and said to me, "She just won't die!" about the woman in a coma between us.

The empathic doctor recognizes your pain, emotional and physical. They present a treatment plan, choices, option for care. They give you resources to assist you in making informed decisions about your care: side effect from treatment, longevity with or timelines without treatment. They recognize that you are a human being with dignity and humanity.

Empathic responses in clinical practice: Intuition or tuition?
January 24, 2011
Many physicians find it difficult to respond to the emotions their patients express, report Buckman and colleagues. Yet an empathic response can improve patient satisfaction and adherence to treatment as well as result in fewer malpractice complaints. (CMAJ, Buckman et al. CMAJ.2011; 0: cmaj.090113v1-cmaj.09011)

More People Choosing Hospice at Life's End

With focus on comfort, people often feel more in control, with less distress

By Dennis Thompson
HealthDay Reporter
FRIDAY, Jan. 28 (HealthDay News) -- People facing a fatal illness often find their fears and pain exacerbated by lack of control -- with doctors poking and prodding and treating and testing even as the end grows near.

A person's hospice team develops a care plan that helps control pain and symptoms. The team also will:
  • Help the patient and family members deal with the emotional and spiritual aspects of dying.
  • Equip the patient's home with needed medical supplies and equipment.
  • Coach family members on caring for the person.
  • Provide quick-response care on an around-the-clock basis when pain or symptoms flare up.
  • Make bereavement care available to the patient's surviving family and friends.

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