Thursday, February 14, 2013

Palliative diagnosis essential in US, in Canada: Patient Trajectory

: When should a physician obtain a  care consult?  

Patient Trajectory
He lasted months,
with only Ensure,
weighing 60 lbs.
PSWs twice per day,
for 10 hours total.

Many are watching KevinMD vigilantly. Many Healthcare advocates, who jump on an issue, confuse individual issues, personal stories, with trends and this truly obfuscates Canadian healthcare.

We have to ber in mind that KevinMD is writing from a US perspective.
In order to qualify for specialized care, in order to get your money back through healthcare insurance companies in the US, you must be officially declared palliative.

chronic morbidities
In Ontario, the trend has been to give valuable information on patient trajectory. That question, that most ask, 'How long do I have, Doctor?' is often unanswerable. With better overall treatments, better nutrition, more awareness, patients are living longer with chronic morbidities.

In Canada, we must monitor patient symptoms, disease asessements, do pain assessments, and make good decisions, such as whether to put in a feeding tube, which may not be a good decision.
We must provide research-based tests, not nurses who pop in and ask a client, "Are you in pain?" Our stoic seniors deny it.
pain assessments
Patient Trajectory
We must ask more about patient trajectory. For those with identifiable conditions, dementias, COPD, MS, MD, or like my late Dad's brain tumour, these conditions are predictable in terms of symptoms and physical conditions, and the PPS, with good testing, monitoring of conditions, and excellent nursing and case management. Most of us, in our advance care directive, wish for quality of life, not quantity, once we have said our peace, spoken to loved ones, and, perhaps, done a Life Review.

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