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#hpm
Healthcare Hashtag Twitter Transcript
   From:        Wed May 11 18:00:00 PDT 2011
   To:          Wed May 11 19:00:00 PDT 2011
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Learn more about #hpm at The Healthcare Hashtag Project




ctsinclair                     Few days left: #Hospice is trouncing Electronic health records 68 to 32% in Modern
                               Healthcare's (fake) tourney http://hpm.md/jytCpf #hpm
                               Wed May 11 18:00:20 PDT 2011




MeredithGould                  @DNRstories Ugh...feel better. Migraine headaches bite. #hpm
                               Wed May 11 18:00:21 PDT 2011




MatthewsMichele                @DNRstories sorry to hear that; Hope you feel better! You'll join us next week then?
                               #hpm
                               Wed May 11 18:00:44 PDT 2011




hollyby                        For the next hour, I'm tweeting from the #Hospice and #Palliative Medicine Tweetchat.
                               Learn how http://bit.ly/dcA3ic via @ctsinclair #hpm
                               Wed May 11 18:00:47 PDT 2011




hollyby                        Welcome to the #Hospice and #Palliative Medicine Tweetchat! Let’s get started with
                               some introductions. I'm hosting tonight. #hpm
                               Wed May 11 18:01:36 PDT 2011




aliciabloom                    time for the #hospice and #palliative medicine tweetchat! #hpm
                               Wed May 11 18:01:40 PDT 2011




MeredithGould                  <--sociologist, keen on communicating health & building community; author; writer;
                               gadfly. Also tweet as @HealthFaith #hpm
                               Wed May 11 18:02:12 PDT 2011




drpippa                        <---family doc, HPM doc, tweeting life and work from Boston. #hpm
                               Wed May 11 18:02:49 PDT 2011




ctsinclair                     Christian Sinclair, palliative MD @KCHospice, editor @Pallimed, CEO @KLXmedia,
                               fan of sports not liked in US (soccer, hockey, #F1) #hpm
                               Wed May 11 18:03:28 PDT 2011
hollyby           Hello! Holly Yang, HPM doc from @SanDiegoHospice. All tweets are my own. #hpm
                  Wed May 11 18:03:38 PDT 2011




ctsinclair        RT @MeredithGould: Hey friends, will be chatting about hospice & palliative medicine
                  for the next hr. All welcome to follow hashtag--> #hpm
                  Wed May 11 18:04:14 PDT 2011




MeredithGould     @ctsinclair Ooo! I love soccer & hockey! #hpm
                  Wed May 11 18:04:30 PDT 2011




ctsinclair        Hey @MeredithGould, @HollyBy, @Drpippa #hpm
                  Wed May 11 18:04:39 PDT 2011




drpippa           @ctsinclair @MeredithGould @HollyBy @Drpippa hey yourself! #hpm
                  Wed May 11 18:05:09 PDT 2011




ctsinclair        Might be typing slow tonight. My right thumb needs to be soaked from a pus draining
                  wound. Dumb bike. #hpm
                  Wed May 11 18:05:15 PDT 2011




aliciabloom       <-- hpm msw, lsw & clinical educator @VITASHospice in Philadelphia #hpm
                  Wed May 11 18:05:28 PDT 2011




hollyby           Welcome @SheyontheBay @aliciabloom @MeredithGould @drpippa @ctsinclair
                  @MatthewsMichele ! Great to see you! #hpm
                  Wed May 11 18:05:31 PDT 2011




hollyby           @ctsinclair Gross. Hope you feel better. #hpm
                  Wed May 11 18:05:48 PDT 2011




ctsinclair        @MedreditGould Are you going to Rochester in the fall? #hpm
                  Wed May 11 18:05:54 PDT 2011




MeredithGould     Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware
                  #hpm
                  Wed May 11 18:06:03 PDT 2011




MatthewsMichele   <--- Dir. of media and public policy comm @KLXMedia, #hpm/ #healthpolicy and
                  #socialmedia enthusiast out of DC #hpm
                  Wed May 11 18:06:12 PDT 2011




PracticalWisdom   Lisa, Speaker, Trainer, Presentation Designer, Rascal. Really glad to be with
                  wonderful, Smart #HPM Group. #HPM
                  Wed May 11 18:06:28 PDT 2011




MeredithGould     @ctsinclair Yes! You're going to make it, yes?? #hpm
                  Wed May 11 18:06:34 PDT 2011
ctsinclair        I just want to say I really like @Aliciabloom and her tweets. Everyone else's too, but
                  alicia always seems to be on when I am looking. #hpm
                  Wed May 11 18:06:34 PDT 2011




MatthewsMichele   Took the words right out of mouth! RT @hollyby: @ctsinclair Gross. Hope you feel
                  better. #hpm
                  Wed May 11 18:06:42 PDT 2011




hollyby           @DNRstories See you next week! Hope you feel better. #hpm
                  Wed May 11 18:07:09 PDT 2011




PracticalWisdom   I'll be learning and chatting with #HPM for the next hour. #HPM
                  Wed May 11 18:07:15 PDT 2011




hollyby           @PracticalWisdom Hi Lisa! #hpm
                  Wed May 11 18:07:26 PDT 2011




ctsinclair        @hollyby I forgot HPM docs usually are not fond of gross out medical stuff. My ER
                  wife on the other hand makes me quesy with stories #hpm
                  Wed May 11 18:07:35 PDT 2011




SheyontheBay      @MeredithGould @ctsinclair That's how rumors start.... #hpm
                  Wed May 11 18:07:38 PDT 2011




ePatientDave      RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness
                  Day. #FibroAware #hpm
                  Wed May 11 18:07:49 PDT 2011




PracticalWisdom   Holly Hi, looking forward to your topics tonight. Thanks!RT @hollyby:
                  @PracticalWisdom Hi Lisa! #HPM
                  Wed May 11 18:08:06 PDT 2011




MeredithGould     @ctsinclair Who doesn't like gross out medical stuff?? LOVE it! As @drsnit would
                  add: *confetti* #hpm
                  Wed May 11 18:08:38 PDT 2011




ctsinclair        @MeredithGould Will be there. Only Monday though, debating if I can stay longer.
                  (Conference BTW @Sheyonthebay) #hpm
                  Wed May 11 18:08:48 PDT 2011




PracticalWisdom   Ying/Yang=G8 RT @ctsinclair: @hollyby I forgot HPM MD usually are not fond gross
                  out med. stuff. ER wife makes me quesy with stories #HPM
                  Wed May 11 18:09:01 PDT 2011




Kaviraj2          RT @ctsinclair: RT @MeredithGould: Hey friends, will be chatting about hospice &
                  palliative medicine for the next hr. All welcome to follow hashtag--> #hpm
                  Wed May 11 18:09:04 PDT 2011




Kaviraj2          RT @ctsinclair: Christian Sinclair, palliative MD @KCHospice, editor @Pallimed,
                  CEO @KLXmedia, fan of sports not liked in US (soccer, hockey, #F1) #hpm
                  Wed May 11 18:09:08 PDT 2011
Wed May 11 18:09:08 PDT 2011




EldrcareConsult   I'll be learning and chatting with #HPM for the next hour. #HPM
                  Wed May 11 18:09:25 PDT 2011




ctsinclair        @ePatientDave You are welcome to join us in #HPM tweetchat! #hpm
                  Wed May 11 18:09:26 PDT 2011




renee_berry       Hi everyone! ---rb here, love this community, passionate about early palliative care,
                  hospice volunteerism & advance care planning #hpm
                  Wed May 11 18:09:26 PDT 2011




chemosabe         hey y'all, keeping an eye on it today, but mostly stalking... #hpm
                  Wed May 11 18:09:34 PDT 2011




Kaviraj2          RT @ctsinclair: Few days left: #Hospice is trouncing Electronic health records 68 to
                  32% in Modern Healthcare's (fake) tourney http://hpm.md/jytCpf #hpm
                  Wed May 11 18:09:44 PDT 2011




PracticalWisdom   Look who is here. Long time no chat? @ePatientDave #HPM
                  Wed May 11 18:09:50 PDT 2011




SheyontheBay      @ctsinclair @hollyby those gross ER stories shared by the parentsare great ways to
                  teach your children by osmosis, ie,STDs and condoms #hpm
                  Wed May 11 18:10:00 PDT 2011




drpippa           @renee_berry hello! has been so long! #hpm
                  Wed May 11 18:10:10 PDT 2011




hollyby           @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult Welcome! #hpm
                  Wed May 11 18:10:16 PDT 2011




PracticalWisdom   @chemosabe: So glad you R Here~from one chat to another right? #HPM
                  Wed May 11 18:10:17 PDT 2011




hollyby           Moving to Topic #1 soon… #hpm
                  Wed May 11 18:10:33 PDT 2011




MeredithGould     How cool am I? I finally get to meet -->@renee_berry in a couple of weeks! #hpm
                  Wed May 11 18:10:56 PDT 2011




chemosabe         @PracticalWisdom thanks Lisa quite right, checked out of #ivchat and here I am
                  #hpm
                  Wed May 11 18:11:01 PDT 2011




renee_berry       :) yes! happy to see you!! RT @drpippa: @renee_berry hello! has been so long! #hpm
                  Wed May 11 18:11:02 PDT 2011
EldrcareConsult   Hey there everyone....Shon from Knoxville here....serving seniors and all of
                  humanity..... #hpm
                  Wed May 11 18:11:03 PDT 2011




PracticalWisdom   @hollyby @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult G8 Crew on the
                  Ship tonight. Clear sailing ahead!! #HPM
                  Wed May 11 18:11:04 PDT 2011




MatthewsMichele   Just FYI...Lurking (mostly) is my beat tonight too. RT @chemosabe: hey yall, keeping
                  an eye on it today, but mostly stalking... #hpm
                  Wed May 11 18:11:30 PDT 2011




hollyby           @SheyontheBay @ctsinclair Somehow scare tactics don't seem to work. :) #hpm
                  Wed May 11 18:11:30 PDT 2011




jessicajohanna    Hi! Work @klxmedia. First tweetchat, may be lurking :) #hpm
                  Wed May 11 18:11:31 PDT 2011




renee_berry       yes & @jessicajohanna & matthewsmichele! RT @MeredithGould: How cool am I? I
                  finally get to meet -->@renee_berry in a couple of weeks! #hpm
                  Wed May 11 18:11:32 PDT 2011




PracticalWisdom   @EldrcareConsult Our Southern Gentleman. #HPM
                  Wed May 11 18:11:54 PDT 2011




ctsinclair        Hey @Chemosabe I always tell people about how you asked ?'s from our tweets at
                  @AAHPM conference in Feb from 1/2 way around the world #hpm
                  Wed May 11 18:11:55 PDT 2011




hollyby           Pre-T1: HPM providers (and others) think a lot about how our care impacts patients
                  and families. #hpm
                  Wed May 11 18:12:06 PDT 2011




drpippa           Welcome! RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat, may be lurking
                  :) #hpm
                  Wed May 11 18:12:19 PDT 2011




hollyby           @jessicajohanna Welcome! #hpm
                  Wed May 11 18:12:20 PDT 2011




PracticalWisdom   Welcome! How exciting. RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat,
                  may be lurking :) #HPM
                  Wed May 11 18:12:20 PDT 2011




MatthewsMichele   @jessicajohanna good to see you here!! :) WELCOME! #hpm
                  Wed May 11 18:12:26 PDT 2011




ctsinclair        @EldrcareConsult Hey Shon. I didn't realize your name was spelled so uniquely.
                  #hpm
#hpm
                  Wed May 11 18:12:26 PDT 2011




MeredithGould     RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care
                  impacts patients and families. #hpm
                  Wed May 11 18:12:34 PDT 2011




chemosabe         @ctsinclair thanks Christian, nest best thing to being there! #hpm
                  Wed May 11 18:12:43 PDT 2011




renee_berry       RT @hollyby Pre-T1: HPM providers (& others) think a lot about how our care impacts
                  patients & families #hpm
                  Wed May 11 18:12:48 PDT 2011




EldrcareConsult   @PracticalWisdom oh stop (ya'll) #hpm
                  Wed May 11 18:12:48 PDT 2011




bentleystewart    RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care
                  impacts patients and families. #hpm
                  Wed May 11 18:12:50 PDT 2011




chemosabe         anyone going to European Pallimed conference next week? #hpm
                  Wed May 11 18:13:12 PDT 2011




hollyby           T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from
                  patients would be useful to make care better? #hpm
                  Wed May 11 18:13:20 PDT 2011




hollyby           @BentleyStewart Hi there! #hpm
                  Wed May 11 18:13:36 PDT 2011




aliciabloom       @ctsinclair wow...thank you so much! i'm thrilled to have found the #hpm community.
                  love tweeting & learning!
                  Wed May 11 18:13:49 PDT 2011




MeredithGould     RT @hollyby: T1: What info from patients would be useful to make care better? #hpm
                  Wed May 11 18:13:51 PDT 2011




PracticalWisdom   If you send the Jet! I'll pitch in for Gas!RT @chemosabe: anyone going to European
                  Pallimed conference next week? #HPM
                  Wed May 11 18:13:57 PDT 2011




renee_berry       RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What
                  info from patients would be useful to make care better? #hpm
                  Wed May 11 18:14:00 PDT 2011




EldrcareConsult   @hollyby T-1 A good view of the family dynamics..... #hpm
                  Wed May 11 18:14:13 PDT 2011




Pallimed          Would love for any @Pallimed Twitter followers to join us right now in #HPM
Pallimed
                  Tweetchat. http://tweetchat.com/room/hpm #hospice
                  Wed May 11 18:14:17 PDT 2011



PracticalWisdom   1 of the best!RT @aliciabloom: @ctsinclair wow...thank you ! im thrilled to have found
                  the #hpm community. love tweeting & learning! #HPM
                  Wed May 11 18:14:40 PDT 2011




renee_berry       T1 Understanding that simply... #palliative care is comfort focused care (& that
                  hospice is not one thing, but many organizations) #hpm
                  Wed May 11 18:14:48 PDT 2011




Pallimed          RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What
                  info from pts would be useful to make care better? #hpm
                  Wed May 11 18:14:55 PDT 2011




hollyby           @chemosabe I can't go, but a poster and a presentation will be there. Look for
                  @FrankDFerris #hpm
                  Wed May 11 18:15:10 PDT 2011




MatthewsMichele   RT @EldrcareConsult: @hollyby T-1 A good view of the family dynamics..... #hpm
                  Wed May 11 18:15:51 PDT 2011




ctsinclair        It seems to me in times of stress any help is appreciated, so average care might be
                  seen as outstanding. Need critical feedback. #hpm
                  Wed May 11 18:15:51 PDT 2011




MeredithGould     T1 Families should be prepared & able to give docs/team info about how the patient
                  communicates: auditory? visual? kinesthetic? #hpm
                  Wed May 11 18:15:52 PDT 2011




chemosabe         Oh I'm not going but the director of our Pall Care Service is #hpm
                  Wed May 11 18:16:03 PDT 2011




renee_berry       T1 Listen to patient & family goals of care, before anything else #hpm
                  Wed May 11 18:16:12 PDT 2011




PracticalWisdom   T1: Respect 4 all Health Care providers. Each is an important piece to build a solid
                  foundation. PT Satisfaction can be impacted + or - #HPM
                  Wed May 11 18:16:25 PDT 2011




aliciabloom       just today, a family said that the doctors often just "come in, talk at us, & leave." they
                  were so grateful to have a dialogue & ask ? #hpm
                  Wed May 11 18:16:51 PDT 2011




hollyby           Example: I got a survey from my doc's office. Survey questions are not always helpful
                  to improve care, but what questions would be? #hpm
                  Wed May 11 18:16:58 PDT 2011




MatthewsMichele   agree! T1 Families should be prepared & able to give docs/team info about how the
                  patient communicates via @MeredithGould #hpm
                  Wed May 11 18:17:23 PDT 2011
hollyby           RT @ctsinclair: ... in times of stress any help is appreciated, so avg care might be
                  seen as outstanding. Need critical feedback. #hpm
                  Wed May 11 18:17:26 PDT 2011




MeredithGould     T1 Thought the question was what should families provide for providers? Did I get
                  this wrong? #hpm
                  Wed May 11 18:17:27 PDT 2011




renee_berry       RT @hollyby: Example: I got a survey from my doc's office. Survey questions are not
                  always helpful to improve care, but what questions would be? #hpm
                  Wed May 11 18:17:32 PDT 2011




hollyby           @MeredithGould You are spot on. #hpm
                  Wed May 11 18:17:50 PDT 2011




ctsinclair        T1: hearing 'you are all angels' frequently can lead to poor self-analysis of skills,
                  might be a weakness of feedback to #hospice staff #hpm
                  Wed May 11 18:17:51 PDT 2011




hillaryboucher    @PracticalWisdom what is #hpm ?
                  Wed May 11 18:17:56 PDT 2011




EldrcareConsult   @renee_berry That is a great point....LISTEN #hpm
                  Wed May 11 18:18:11 PDT 2011




PracticalWisdom   @hollyby: Holly are the questions open ended or not. Need Specific Feedback in
                  order to Feed Forward. #HPM
                  Wed May 11 18:18:13 PDT 2011




renee_berry       @hollyby @ctsinclair that is such a crucial aspect to understand, #hospice CEO's
                  please see this comment... #hpm
                  Wed May 11 18:18:24 PDT 2011




renee_berry       RT @hollyby: RT @ctsinclair: ... in times of stress any help is appreciated, so avg
                  care might be seen as outstanding. Need critical feedback. #hpm
                  Wed May 11 18:18:30 PDT 2011




ctsinclair        @hollyby I find many surveys about medical care have to deal with the
                  delivery/mechanics, not necessarily deliver/humanity #hpm
                  Wed May 11 18:18:38 PDT 2011




drpippa           T1 - I want to hear whether they understand/agree with/are comfortable with the plan
                  of care. particularly in crisis. #hpm
                  Wed May 11 18:18:49 PDT 2011




MeredithGould     T1 Families should be prepared & able to provide info about the patient's spiritual
                  perspective, religious practices, faith & beliefs #hpm
                  Wed May 11 18:18:50 PDT 2011




PracticalWisdom   @hillaryboucher Hospice and Palliative Medicine. Great group. Good to see you.
                  #HPM
Wed May 11 18:19:01 PDT 2011




chemosabe         T1 reponsiveness of staff 2 admit requirements. availablitiy of allied health staff. time
                  to spend with client & family non-clinically #hpm
                  Wed May 11 18:19:19 PDT 2011




renee_berry       agree RT @EldrcareConsult @renee_berry That is a great point....LISTEN #hpm
                  Wed May 11 18:19:38 PDT 2011




MeredithGould     T1 Let docs/teams know if there are estranged family members who might be
                  brought back into conversation/relationship at this point. #hpm
                  Wed May 11 18:19:45 PDT 2011




jessicajohanna    @aliciabloom it's rare. though today my doctor asked me about my job, hobbies and
                  love life #hpm
                  Wed May 11 18:19:54 PDT 2011




bgood64           RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness
                  Day. #FibroAware #hpm
                  Wed May 11 18:19:58 PDT 2011




LVADone           RT @ctsinclair: It seems to me in times of stress any help is appreciated, so average
                  care might be seen as outstanding. Need critical feedback. #hpm
                  Wed May 11 18:20:02 PDT 2011




ctsinclair        On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high
                  emotional stress, not b/c of poor skills #hpm
                  Wed May 11 18:20:17 PDT 2011




renee_berry       @drpippa that is so important, so many families I think are not prepared to simply
                  say what they think or are feeling #hpm
                  Wed May 11 18:20:21 PDT 2011




renee_berry       RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable
                  with the plan of care. particularly in crisis. #hpm
                  Wed May 11 18:20:27 PDT 2011




EldrcareConsult   RT @MeredithGould: estranged family members who might be brought back into
                  conversation/relationship at this point. EXACTLY! #hpm
                  Wed May 11 18:20:43 PDT 2011




drpippa           I also want to hear about the patient/family before the illness. Helps with
                  goals/plans/preserving dignity and humanity. #hpm
                  Wed May 11 18:20:59 PDT 2011




Pallimed          RT @MeredithGould: T1 Let teams know if estranged family members who might be
                  brought back into conversation/relationship #hpm
                  Wed May 11 18:21:03 PDT 2011




MatthewsMichele   t-1. patient general temperament, mood, the way they prefer to communicate...things
                  that are intuitive to family members... #hpm
                  Wed May 11 18:21:12 PDT 2011
hollyby           RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by
                  pts/families b/c of high stress, not b/c of poor skills #hpm
                  Wed May 11 18:21:13 PDT 2011




PracticalWisdom   Might be in Shock RT @renee_berry: @drpippa so many families I think R not
                  prepared e simply say what they think or are feeling #HPM
                  Wed May 11 18:21:25 PDT 2011




SheyontheBay      RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable
                  with the plan of care. particularly in crisis. #hpm
                  Wed May 11 18:21:41 PDT 2011




ctsinclair        @MeredithGould This is such a touchy area. I often will ask about other family who
                  cannot be present. Can be a touchy area. #hpm
                  Wed May 11 18:21:43 PDT 2011




ctsinclair        @MeredithGould Sorry my record player skipped. My record player skipped! ;-) #hpm
                  Wed May 11 18:22:08 PDT 2011




MeredithGould     @ctsinclair Very very touchy area, which is why chaplains should be involved & on the
                  team. #hpm
                  Wed May 11 18:22:13 PDT 2011




EldrcareConsult   RT @PracticalWisdom: Might be in Shock Good point Lisa..... #hpm
                  Wed May 11 18:22:23 PDT 2011




MeredithGould     @ctsinclair s'ok s'ok #hpm
                  Wed May 11 18:22:24 PDT 2011




Pallimed          RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable
                  with the plan of care. particularly in crisis. #hpm
                  Wed May 11 18:22:29 PDT 2011




jessicajohanna    RT @drpippa: I also want to hear about the patient/family before the illness. Helps
                  with goals/plans/preserving dignity and humanity. #hpm
                  Wed May 11 18:22:39 PDT 2011




aliciabloom       the patient/family narrative before & throughout illness is helpful-- builds rapport,
                  provides insight into values. #hpm
                  Wed May 11 18:22:44 PDT 2011




PracticalWisdom   @hollyby @ctsinclair: When people really feel they are listened to the scores many
                  times go up. Think Social Workers/Clergy can help #HPM
                  Wed May 11 18:22:49 PDT 2011




PracticalWisdom   RT @aliciabloom: the patient/family narrative before & throughout illness is helpful--
                  builds rapport, provides insight into values. #HPM
                  Wed May 11 18:23:03 PDT 2011




MeredithGould     RT @drpippa: I also want to hear about the patient/family before the illness. Helps
MeredithGould
                  with goals/plans/preserving dignity and humanity. #hpm
                  Wed May 11 18:23:07 PDT 2011



drpippa           RT @aliciabloom: the patient/family narrative before & throughout illness is helpful--
                  builds rapport, provides insight into values. #hpm
                  Wed May 11 18:23:09 PDT 2011




hollyby           Wonderful! Getting two things from this 1) quality improvement help from pts, 2)
                  questions to ask pts to ensure complete picture. #hpm
                  Wed May 11 18:23:10 PDT 2011




LVADone           “@HPHHospice: Nursing encompasses an art, a humanistic orientation, a feeling for
                  the value of the individual... http://t.co/tUdDd49” #hpm
                  Wed May 11 18:23:11 PDT 2011




EldrcareConsult   @ctsinclair Its very touchy...hardest conversation I have to have with my
                  families....who to/who not to include in the decisions #hpm
                  Wed May 11 18:23:19 PDT 2011




ctsinclair        Interesting that many medical providers choose to survey AFTER care is delivered.
                  Not always during. #hpm
                  Wed May 11 18:23:25 PDT 2011




MatthewsMichele   @ctsinclair @MeredithGould Very touchy! Caused my fam to close ranks & not open
                  up as much to docs when our matriarch was ill #hpm
                  Wed May 11 18:23:29 PDT 2011




hollyby           RT @ctsinclair: Interesting that many medical providers choose to survey AFTER
                  care is delivered. Not always during. #hpm
                  Wed May 11 18:23:43 PDT 2011




renee_berry       RT @drpippa: I also want to hear about the patient/family before the illness. Helps
                  with goals/plans/preserving dignity and humanity. #hpm
                  Wed May 11 18:23:45 PDT 2011




MatthewsMichele   RT @ctsinclair: Interesting that many medical providers choose to survey AFTER
                  care is delivered. Not always during. #hpm
                  Wed May 11 18:23:46 PDT 2011




SheyontheBay      often pts/family have difficulty HEARing in crisis, understand also difficult to articulate
                  values and goals without gentle guidance #hpm
                  Wed May 11 18:23:46 PDT 2011




PracticalWisdom   RT @jessicajohanna: RT @drpippa: want 2 hear re: patient/family b4 illness. Helps
                  with goals/plans/preserving dignity and humanity. #HPM
                  Wed May 11 18:23:49 PDT 2011




LVADone           RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by
                  pts/families b/c of high emotional stress, not b/c of poor skills #hpm
                  Wed May 11 18:24:00 PDT 2011




renee_berry       RT @aliciabloom: the patient/family narrative before & throughout illness is helpful--
                  builds rapport, provides insight into values. #hpm
builds rapport, provides insight into values. #hpm
                  Wed May 11 18:24:01 PDT 2011




MatthewsMichele   @ctsinclair seems counter intuitive doesnt it? #hpm
                  Wed May 11 18:24:16 PDT 2011




ctsinclair        @MatthewsMichele @MeredithGould Yes i have seen the discussion of 'estranged
                  family' alienate communication ability #hpm
                  Wed May 11 18:24:20 PDT 2011




chemosabe         @ctsinclair we do during care...but my client base is not post terminal event! #hpm
                  Wed May 11 18:24:24 PDT 2011




MeredithGould     Touchy subjects: all the more reason to Have the Talk! #hpm
                  Wed May 11 18:24:29 PDT 2011




PracticalWisdom   RT @SheyontheBay: often pts/family have dif. HEARing crisis, understand also
                  difficult to articulate values/goals without gentle guid #HPM
                  Wed May 11 18:24:37 PDT 2011




drpippa           RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! #hpm
                  Wed May 11 18:24:52 PDT 2011




EldrcareConsult   RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! Yep!
                  #hpm
                  Wed May 11 18:24:57 PDT 2011




ctsinclair        @MatthewsMichele Patients and families don't take lessons on how to communicate
                  best. Many HC profs dont either though... #hpm
                  Wed May 11 18:25:00 PDT 2011




MatthewsMichele   YES! RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk!
                  #hpm
                  Wed May 11 18:25:02 PDT 2011




renee_berry       always yes on advance care planning! RT @MeredithGould: Touchy subjects: all the
                  more reason to #HaveTheaTalk! #hpm
                  Wed May 11 18:25:13 PDT 2011




PracticalWisdom   @ctsinclair @MatthewsMichele @MeredithGould Families are complex and now
                  often live many miles away #HPM
                  Wed May 11 18:25:17 PDT 2011




aliciabloom       "@ctsinclair: Interesting that many medical providers choose to survey AFTER care is
                  delivered. Not always during." puzzling, really. #hpm
                  Wed May 11 18:25:19 PDT 2011




MeredithGould     @ctsinclair @MatthewsMichele Ok, so do NOT say: "Who does your loved one
                  despise who should nevertheless be here?" #hpm
                  Wed May 11 18:25:34 PDT 2011




                  @hollyby I had plans to lurk but your T1 has drawn me in! #hpm
@hollyby I had plans to lurk but your T1 has drawn me in! #hpm
                  Wed May 11 18:25:38 PDT 2011
MatthewsMichele

mojonimbus        RT @aliciabloom: "@ctsinclair: Interesting that many medical providers choose to
                  survey AFTER care is delivered. Not always during." puzzling, really. #hpm
                  Wed May 11 18:25:44 PDT 2011




ctsinclair        Clarify last statement,not to say that patients and families should improve or change
                  their comm styles, just that we need to adjust #hpm
                  Wed May 11 18:25:48 PDT 2011




hollyby           We are going to get started with Topic #2 soon… #hpm
                  Wed May 11 18:26:07 PDT 2011




renee_berry       hahaha! great!!!! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has
                  drawn me in! #hpm
                  Wed May 11 18:26:11 PDT 2011




ctsinclair        RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in!
                  "Like a vaudville lasso....invisible but powerful." #hpm
                  Wed May 11 18:26:27 PDT 2011




PracticalWisdom   T1: It's been my experience that most organization need better survey tools. Filling in
                  the bubbles is not Valuable feedback #HPM
                  Wed May 11 18:26:31 PDT 2011




hollyby           Agree! RT @PracticalWisdom: T1: ... most organization need better survey tools.
                  Filling in the bubbles is not Valuable feedback #hpm
                  Wed May 11 18:27:00 PDT 2011




hollyby           Hooray! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn
                  me in! #hpm
                  Wed May 11 18:27:10 PDT 2011




PracticalWisdom   T1: Feedback would be great through the entire process. Are families debriefed by
                  Pall care teams afterward? #HPM
                  Wed May 11 18:27:18 PDT 2011




EldrcareConsult   RT @PracticalWisdom: Families are complex and now often live many miles away
                  When the end is near they come out of the woodwork #hpm
                  Wed May 11 18:27:21 PDT 2011




MatthewsMichele   @ctsinclair so true! #hpm
                  Wed May 11 18:27:27 PDT 2011




MeredithGould     @ctsinclair Really...simply knowing how everyone best communicates is big, i.e.,
                  don't yak endlessly at someone who prefers reading #hpm
                  Wed May 11 18:27:37 PDT 2011




MeredithGould     @MatthewsMichele Yeah, I always mean to lurk and get totally sucked in by this great
                  group & convo! #hpm
                  Wed May 11 18:28:06 PDT 2011
hollyby           Topic #2: How does a life-threatening diagnosis change the management of chronic
                  disease? For the patient? For the doc/team? #hpm
                  Wed May 11 18:28:09 PDT 2011




LVADone           RT @PracticalWisdom: @ctsinclair @MatthewsMichele @MeredithGould Families
                  are complex and now often live many miles away #HPM
                  Wed May 11 18:28:16 PDT 2011




Pallimed          RT @PracticalWisdom: T1:my experience that most orgs need better survey tools.
                  Filling in the bubbles does not = Valuable feedback #hpm
                  Wed May 11 18:28:31 PDT 2011




renee_berry       RT @hollyby: Topic #2: How does a life-threatening diagnosis change the
                  management of chronic disease? For the patient? For the doc/team? #hpm
                  Wed May 11 18:28:36 PDT 2011




PracticalWisdom   @EldrcareConsult: Hopefully come for good reasons. Have seen when was a clergy
                  Family Member the Good, Bad and ugly reasons! #HPM
                  Wed May 11 18:28:37 PDT 2011




MatthewsMichele   RT @MeredithGould: @ctsinclair Simply knowing how everyone communicates is
                  big, i.e., dont yak endlessly at someone who prefers reading #hpm
                  Wed May 11 18:28:38 PDT 2011




hollyby           @PracticalWisdom Not always, and not always well, but that goes for most of
                  medical care I think #hpm
                  Wed May 11 18:28:51 PDT 2011




mojonimbus        #HPM I think concurrent Feedback could prevent misunderstanding and sone patient
                  hostility toward health care workers, better care for all
                  Wed May 11 18:28:59 PDT 2011




MatthewsMichele   RT @hollyby: T2: How does a life-threatening diagnosis change the management of
                  chronic disease? For the patient? For the doc/team? #hpm
                  Wed May 11 18:29:08 PDT 2011




aliciabloom       if we just ask patients & families if they feel heard & have any
                  questions/concerns/fears, it can open up the lines of communication. #hpm
                  Wed May 11 18:29:14 PDT 2011




MeredithGould     T2 Think it would depend on the chronic disease? #hpm
                  Wed May 11 18:29:20 PDT 2011




EldrcareConsult   RT @PracticalWisdom: Hopefully come for good reasons. Have seen when was a
                  clergy Family Member the Good, Bad and ugly reasons! Me 2! #hpm
                  Wed May 11 18:29:25 PDT 2011




ctsinclair        T2: may free of some of the medical limitations to control the chronic disease as in
                  the case of cholesterol or diabetes meds #hpm
                  Wed May 11 18:29:51 PDT 2011
drpippa           You assume it does - often it doesn't - that is the problem. How does life-threatening
                  dx change the mgmt of chronic dis? For the team? #hpm
                  Wed May 11 18:29:57 PDT 2011



hollyby           Example: A diabetic person with new advanced cancer diagnosis. #hpm
                  Wed May 11 18:30:09 PDT 2011




RossJeanette      Hi all joining late t2 goals for chronic illnesses such as Diabetes & high cholesterol
                  dont need to be tight #HPM
                  Wed May 11 18:30:14 PDT 2011




PracticalWisdom   RT @mojonimbus:#HPM think concurrent Feedback could prev.
                  misunderstanding/sone pt hostility 2ward health care folks, better care 4 all #HPM
                  Wed May 11 18:30:34 PDT 2011




hollyby           True! RT @drpippa: You assume it does - often it doesnt - that is the problem. #hpm
                  Wed May 11 18:30:47 PDT 2011




MeredithGould     Won't change it at all if the chronic disease is basically unmanageable/untreatable to
                  begin with (e.g., #fibro) #hpm
                  Wed May 11 18:30:52 PDT 2011




ctsinclair        T2: 1 of most intriguing discussions: how to safely minimize burdensome treatments
                  for preventing long term complications of disease #hpm
                  Wed May 11 18:30:57 PDT 2011




MatthewsMichele   RT @aliciabloom: if we just ask patients & families if they feel heard & have any
                  questions/concerns/fears, it can open up the lines of communication. #hpm
                  Wed May 11 18:30:57 PDT 2011




hollyby           @mojonimbus Thanks for joining us! #hpm
                  Wed May 11 18:31:01 PDT 2011




aliciabloom       it should be about the benefits vs burdens of on-going management of the chronic
                  condition. #hpm
                  Wed May 11 18:31:11 PDT 2011




MeredithGould     RT @aliciabloom: it should be about the benefits vs burdens of on-going
                  management of the chronic condition. #hpm
                  Wed May 11 18:31:24 PDT 2011




PracticalWisdom   RT @drpippa: You assume it does often it doesnt that's the problem. How does life-
                  threatening dx change mgmt chronic dis? 4 team? #HPM
                  Wed May 11 18:31:28 PDT 2011




hollyby           RT @aliciabloom: it should be about the benefits vs burdens of on-going
                  management of the chronic condition. #hpm
                  Wed May 11 18:31:30 PDT 2011




ctsinclair        RT @mojonimbus: concurrent Feedback could prevent misunderstanding, some
                  hostility toward health care workers-> better care for all #hpm
                  Wed May 11 18:31:46 PDT 2011
Wed May 11 18:31:46 PDT 2011




hollyby           @RossJeanette Welcome Jeanette! Glad you could make it! #hpm
                  Wed May 11 18:31:50 PDT 2011




PracticalWisdom   @ctsinclair; Like Feeding Tube Issue? #HPM
                  Wed May 11 18:32:02 PDT 2011




RossJeanette      T2 I like to put patients in the everything you want to eat diet as opposed to the
                  diabetic renal cardiac... Diet it's about QOL #HPM
                  Wed May 11 18:32:04 PDT 2011




drpippa           must tread lightly - often can be traumatic to patients to stop doing the things we have
                  spent so much time telling them to do #hpm
                  Wed May 11 18:32:25 PDT 2011




MeredithGould     @RossJeanette Gee, may I be on that diet now??? #HPM
                  Wed May 11 18:32:31 PDT 2011




renee_berry       RT @aliciabloom: it should be about the benefits vs burdens of on-going
                  management of the chronic condition. #hpm
                  Wed May 11 18:32:45 PDT 2011




chemosabe         T2 shouldn't the focus be the clients decisions about there death and dying and
                  therefore symptom management that complies with this? #hpm
                  Wed May 11 18:32:58 PDT 2011




ctsinclair        Hi @RossJeanette Hello @mojonimbus glad to meet you! #hpm
                  Wed May 11 18:32:59 PDT 2011




PracticalWisdom   Practical Wis.RT @RossJeanette:T2 I like 2 put pt's everything U want 2 eat diet as
                  opposed 2 diabetic renal cardiac Diet its about QOL #HPM
                  Wed May 11 18:33:12 PDT 2011




drpippa           absolutely! RT @renee_berry: RT @aliciabloom: it should be about the benefits vs
                  burdens of on-going mgmt of the chronic condition. #hpm
                  Wed May 11 18:33:16 PDT 2011




renee_berry       @aliciabloom for that particular person, & not necessarily how the family perceives
                  benefits vs burdens #hpm
                  Wed May 11 18:33:19 PDT 2011




MeredithGould     I'd like to be told to eat massive amounts of high quality dark chocolate & bags of
                  Cheez Doodles. Oh wait, this isn't about me? #hpm
                  Wed May 11 18:33:28 PDT 2011




ctsinclair        @PracticalWisdom Yes even feeding tube goals can be readdressed, are we aiming
                  for long term nutrion goals or short term pleaure #hpm
                  Wed May 11 18:33:45 PDT 2011




MatthewsMichele   RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the
MatthewsMichele   RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the
                  things we have spent so much time telling them to do #hpm
                  Wed May 11 18:33:46 PDT 2011




PracticalWisdom   RT @chemosabe: T2 shouldnt focus b clients dec. re:t their death and dying and
                  therefore symptom management that complies with this? #HPM
                  Wed May 11 18:33:53 PDT 2011




renee_berry       RT @RossJeanette: T2 I like to put patients in the everything you want to eat diet as
                  opposed to the diabetic renal cardiac... Diet it's about QOL #HPM
                  Wed May 11 18:33:58 PDT 2011




ctsinclair        @MeredithGould Oh its all about you! Autonomy rules in American Health Care
                  System. #hpm
                  Wed May 11 18:34:15 PDT 2011




hollyby           Goals of care are always important. RT @chemosabe: T2 shouldnt the focus be the
                  clients decisions... #hpm
                  Wed May 11 18:34:51 PDT 2011




ctsinclair        RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the
                  things we have spent so much time telling them to do #hpm
                  Wed May 11 18:34:56 PDT 2011




EldrcareConsult   BRB guys...work calls! #hpm
                  Wed May 11 18:35:19 PDT 2011




aliciabloom       @renee_berry excellent point! although, patients often make treatment decisions for
                  their families. #hpm
                  Wed May 11 18:35:29 PDT 2011




renee_berry       really?! I hope it does, not sure though.. RT @ctsinclair @MeredithGould Oh its all
                  about you! Autonomy rules in US Health Care System #hpm
                  Wed May 11 18:35:32 PDT 2011




hollyby           @drpippa Agree that there is a huge emotional component of changing
                  management of long-standing illness #hpm
                  Wed May 11 18:36:08 PDT 2011




MeredithGould     @renee_berry I think he's goofing on me. How unusual, right? #hpm
                  Wed May 11 18:36:10 PDT 2011




SheyontheBay      @RossJeanette We call that the diet of the dying. I remember a dying chocoholic,
                  couldnt eat - we swabbed Hershey syrup on her lips #hpm
                  Wed May 11 18:36:25 PDT 2011




PracticalWisdom   Bat Phone must have Rang! Batman to the Rescue! Dedicated to his Clients RT
                  @EldrcareConsult: BRB guys...work calls! #HPM
                  Wed May 11 18:36:36 PDT 2011




RossJeanette      Agree with @drpippa be careful with readdressing goals and being perceived as
                  "doing nothing" #HPM
                  Wed May 11 18:36:59 PDT 2011
Wed May 11 18:36:59 PDT 2011




ctsinclair        @renee_berry In many ways Autonomy can trump other key ethical principles of
                  beneficence, Nonmaleficence and fairness. #hpm
                  Wed May 11 18:37:08 PDT 2011




Pallimed          RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the
                  things we have spent so much time telling them to do #hpm
                  Wed May 11 18:37:18 PDT 2011




MeredithGould     @SheyontheBay Now THAT is compassionate care. Absolutely! But Hershey's? Not
                  Godiva? #hpm
                  Wed May 11 18:37:21 PDT 2011




renee_berry       RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical
                  principles of beneficence, Nonmaleficence and fairness. #hpm
                  Wed May 11 18:37:35 PDT 2011




chemosabe         T2 don't know about mx up there, but, separation of client on physician for chronic
                  illness mx down here v diff. attachment issues #hpm
                  Wed May 11 18:37:37 PDT 2011




PracticalWisdom   Loving RT @SheyontheBay: @RossJeanette Diet of the dying.Remember a dying
                  chocoholic, couldnt eat we swabbed Hershey syrup on lips #HPM
                  Wed May 11 18:38:02 PDT 2011




LVADone           RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical
                  principles of beneficence, Nonmaleficence and fairness. #hpm
                  Wed May 11 18:38:10 PDT 2011




EldrcareConsult   @PracticalWisdom Its not the Bat Phone I mind, but these flashing strobe lights kill
                  me! #hpm I may be a while..................
                  Wed May 11 18:38:12 PDT 2011




RossJeanette      @SheyontheBay I'll have to remember thatchocolaye syrup swab good idea #HPM
                  Wed May 11 18:38:13 PDT 2011




SheyontheBay      @MeredithGould @SheyontheBay Does Godiva make syrup? Too risky to melt chips
                  #hpm
                  Wed May 11 18:38:17 PDT 2011




mojonimbus        #hpm nice to meet you all too
                  Wed May 11 18:38:17 PDT 2011




drpippa           RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical
                  principles of beneficence, Nonmaleficence and fairness. #hpm
                  Wed May 11 18:38:32 PDT 2011




MeredithGould     @SheyontheBay I believe Ghiradelli (sp?) makes syrup. #hpm
                  Wed May 11 18:38:58 PDT 2011




ctsinclair        It is interesting many HC professionals feel autonomy overrides often, whereas
ctsinclair        It is interesting many HC professionals feel autonomy overrides often, whereas

                  patients often note feeling powerless cc @renee_berry #hpm
                  Wed May 11 18:38:58 PDT 2011



PracticalWisdom   @EldrcareConsult: It's the piercing Alarm Sound that gets me! #HPM
                  Wed May 11 18:39:04 PDT 2011




renee_berry       @ctsinclair agree though think OFTEN the case- autonomy is not possible w/o
                  informed medical decision making... which I think is often #hpm
                  Wed May 11 18:39:13 PDT 2011




hollyby           @chemosabe Can you say more? #hpm
                  Wed May 11 18:39:26 PDT 2011




renee_berry       RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides
                  often, whereas patients often note feeling powerless cc @renee_berry #hpm
                  Wed May 11 18:39:29 PDT 2011




MeredithGould     @renee_berry @ctsinclair Or patients can't even conceive of Autonomy? #hpm
                  Wed May 11 18:39:56 PDT 2011




PracticalWisdom   RT @ctsinclair: nteresting HC profess. feel autonomy overrides often, whereas
                  patients often note feeling powerless cc @renee_berry #HPM
                  Wed May 11 18:40:00 PDT 2011




MatthewsMichele   RT @renee_berry: @ctsinclair agree though think OFTEN the case- autonomy is not
                  possible w/o informed medical decision making... which I think is often #hpm
                  Wed May 11 18:40:04 PDT 2011




thinkalot         RT @PracticalWisdom: Practical Wis.RT @RossJeanette:T2 I like 2 put pt's
                  everything U want 2 eat diet as opposed 2 diabetic renal cardiac Diet its about QOL
                  #HPM
                  Wed May 11 18:40:38 PDT 2011




ctsinclair        RT @MeredithGould: @renee_berry @ctsinclair Or patients cant even conceive of
                  Autonomy? "foreign concept?" #hpm
                  Wed May 11 18:40:46 PDT 2011




chemosabe         @hollyby attachment to treating team, difficult to trust new hpm team to mx dz
                  appropriately. particular if goal of care now comfort #hpm
                  Wed May 11 18:40:51 PDT 2011




renee_berry       yes, how can they w/o clear information RT @MeredithGould @renee_berry
                  @ctsinclair Or patients cant even conceive of Autonomy? #hpm
                  Wed May 11 18:41:15 PDT 2011




aliciabloom       @ctsinclair HC providers often respect autonomy when pts make decisions they
                  think are right. otherwise, they order psych consults. #hpm
                  Wed May 11 18:41:39 PDT 2011




MatthewsMichele   @MeredithGould @renee_berry @ctsinclair Good point! I'd guess pts often don't
                  think they are in the drivers seat of their #healthcare. #hpm
                  Wed May 11 18:41:44 PDT 2011
Wed May 11 18:41:44 PDT 2011




drpippa           great point. RT @chemosabe: attachment to treating team, diff to trust new hpm
                  team. particularly if goal of care now comfort #hpm
                  Wed May 11 18:41:57 PDT 2011




PracticalWisdom   RT @chemosabe: @hollyby attachment 2 treating team, difficult 2 trust new hpm
                  team 2 mx dz approp.. partic if goal of care now comfort #HPM
                  Wed May 11 18:41:59 PDT 2011




EOLnavigator      Hey there. 20 mins is better than 0 mins #hpm
                  Wed May 11 18:42:01 PDT 2011




ctsinclair        @chemosabe Agree with you. Have had patients say they went for more chemo in
                  part because they like the staff, same with dialysis. #hpm
                  Wed May 11 18:42:06 PDT 2011




hollyby           @chemosabe:Thx... so they actually switch care teams. That could be challenging.
                  #hpm
                  Wed May 11 18:42:07 PDT 2011




LVADone           RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides
                  often, whereas patients often note feeling powerless cc @renee_berry #hpm
                  Wed May 11 18:42:10 PDT 2011




ctsinclair        RT @EOLnavigator: Hey there. 20 mins is better than 0 mins "Glad you are here
                  before the buzzer!" #hpm
                  Wed May 11 18:42:29 PDT 2011




renee_berry       RT @MatthewsMichele: @MeredithGould @renee_berry @ctsinclair Good point! I'd
                  guess pts often don't think they are in the drivers seat of their #healthcare. #hpm
                  Wed May 11 18:42:31 PDT 2011




MatthewsMichele   Definitely! You made it...glad you're here! RT @EOLnavigator: Hey there. 20 mins is
                  better than 0 mins #hpm
                  Wed May 11 18:43:02 PDT 2011




HerHealthySelf    RT @PracticalWisdom: Loving RT @SheyontheBay: @RossJeanette Diet of the
                  dying.Remember a dying chocoholic, couldnt eat we swabbed Hershey syrup on lips
                  #HPM
                  Wed May 11 18:43:14 PDT 2011




PracticalWisdom   Remarkable. RT @ctsinclair: @chemosabe Agree Have had pt's say they went 4#
                  chemo because they like the staff, same with dialysis. #HPM
                  Wed May 11 18:43:24 PDT 2011




ctsinclair        @aliciabloom RE: Disagree with the doc = psych consult. See this less with good
                  integration of a palliative care team. #hpm
                  Wed May 11 18:43:37 PDT 2011




MeredithGould     How could patients possibly think they have any control/say? The entire system is set
                  up to disabuse them of that notion. #hpm
                  Wed May 11 18:43:38 PDT 2011
Wed May 11 18:43:38 PDT 2011




aliciabloom       @ctsinclair @chemosabe agreed. they don't want to "disappoint" their physician &
                  care team. #hpm
                  Wed May 11 18:43:43 PDT 2011




chemosabe         @hollyby yep we tried models we called shared care where pt still sees both teams.
                  can be just as difficult to mx as hand over #hpm
                  Wed May 11 18:44:19 PDT 2011




LVADone           RT @aliciabloom: @ctsinclair HC providers often respect autonomy when pts make
                  decisions they think are right. otherwise, they order psych consults. #hpm
                  Wed May 11 18:44:20 PDT 2011




hollyby           True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych consult. See
                  this less with good integration of palliative care. #hpm
                  Wed May 11 18:44:26 PDT 2011




renee_berry       RT @MeredithGould: How could patients possibly think they have any control/say?
                  The entire system is set up to disabuse them of that notion. #hpm
                  Wed May 11 18:44:44 PDT 2011




PracticalWisdom   @aliciabloom @ctsinclair @chemosabe: Sounds like some Boundary Issues or
                  some other challenging dynamics at play. #HPM
                  Wed May 11 18:45:08 PDT 2011




hollyby           Moving on to Topic #3 soon… ready to jump frames a bit? #hpm
                  Wed May 11 18:45:22 PDT 2011




aliciabloom       good point. RT @ctsinclair: RE: Disagree with the doc = psych consult. See this less
                  with good integration of a palliative care team. #hpm
                  Wed May 11 18:45:38 PDT 2011




lugstew           At hbo screening of dying in Oregon. #hpm #hospice
                  Wed May 11 18:45:51 PDT 2011




EOLnavigator      This is why open access is a better idea for hospice care RT @hollyby:
                  @chemosabe:..switch care teams......challenging. #hpm
                  Wed May 11 18:45:52 PDT 2011




renee_berry       patients deserve to know RT @aliciabloom @ctsinclair @chemosabe agreed. they
                  dont want to "disappoint" their physician & care team #hpm
                  Wed May 11 18:45:59 PDT 2011




PracticalWisdom   RT @chemosabe: @hollyby we tried models we called shared care where pt still
                  sees both teams. can be just difficult 2 mx as hand over #HPM
                  Wed May 11 18:46:16 PDT 2011




EOLnavigator      Clinicians don't know how to discuss options. RT @MeredithGould: The entire
                  system is set up to disabuse them of that notion. #hpm
                  Wed May 11 18:46:44 PDT 2011




hollyby           T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any
hollyby           T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any
                  experience with them? http://bitly.com/lEjzfQ #hpm
                  Wed May 11 18:46:50 PDT 2011



PracticalWisdom   RT @renee_berry: pts' deserve 2 know RT @aliciabloom @ctsinclair @chemosabe
                  agreed. they dont want 2 disappoint" physician & care team #HPM
                  Wed May 11 18:46:58 PDT 2011




ctsinclair        @MeredithGould spend some time rounding with your local doc and you will see the
                  amount of deference to patient wishes #hpm
                  Wed May 11 18:47:03 PDT 2011




LVADone           RT @hollyby: True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych
                  consult. See this less with good integration of palliative care. #hpm
                  Wed May 11 18:47:28 PDT 2011




apjonas           RT @MeredithGould: T1 Families should be prepared & able to provide info about
                  the patient's spiritual perspective, religious practices, faith & beliefs #hpm
                  Wed May 11 18:47:39 PDT 2011




MeredithGould     @ctsinclair May that be so! #hpm
                  Wed May 11 18:47:56 PDT 2011




ctsinclair        T3: Threshold Choirs? Interesting name. Makes me think of Memorex...like you are
                  testing a threshold of hearing. #hpm
                  Wed May 11 18:47:57 PDT 2011




renee_berry       RT @ctsinclair: @MeredithGould spend some time rounding with your local doc and
                  you will see the amount of deference to patient wishes #hpm
                  Wed May 11 18:47:58 PDT 2011




drpippa           yes! truly extraordinary. music can help in ways that I can not. RT @hollyby: T3: I
                  recently learned about threshold choirs #hpm
                  Wed May 11 18:48:01 PDT 2011




MeredithGould     RT @hollyby: T3: Learned about threshold choirs, volunteers who sing for the dying.
                  Any experience with them? http://bitly.com/lEjzfQ #hpm
                  Wed May 11 18:48:17 PDT 2011




RossJeanette      T3 one of the hospice agencies has a harp player. She apparently plays tunes that
                  calm patients. #HPM
                  Wed May 11 18:48:20 PDT 2011




PracticalWisdom   @apjonas @MeredithGould: G8 Points I'd also include understanding of culture.
                  #HPM
                  Wed May 11 18:48:28 PDT 2011




renee_berry       RT @drpippa: yes! truly extraordinary. music can help in ways that I can not. RT
                  @hollyby: T3: I recently learned about threshold choirs #hpm
                  Wed May 11 18:48:31 PDT 2011




ctsinclair        @MeredithGould And you will also see some steamrolling of patient preferences and
                  dignity. Sadly. #hpm
dignity. Sadly. #hpm
                  Wed May 11 18:48:49 PDT 2011




aliciabloom       autonomy requires informed consent for which effective communication with patients
                  & families is essential. #hpm
                  Wed May 11 18:48:56 PDT 2011




MeredithGould     T3 Sounds wonderful. So many ways to ease transition. One pt I was with wanted to
                  hold a kitty again before he died. #hpm
                  Wed May 11 18:49:04 PDT 2011




PracticalWisdom   Know harp not choir RT @RossJeanette: T3 one of the hospice agencies has a harp
                  player. She apparently plays tunes that calm patients. #HPM
                  Wed May 11 18:49:10 PDT 2011




MatthewsMichele   @renee_berry @MeredithGould lets face it: takes lots of tenacity to get over 'doc
                  knows best' mentality to inform your own #healthcare #hpm
                  Wed May 11 18:49:19 PDT 2011




ctsinclair        Any #MBTC or #MusicTherapy people want to come comment on Threshold Choirs?
                  #hpm
                  Wed May 11 18:49:27 PDT 2011




SheyontheBay      T3 I ve worked at a hospital where both a chaplain and a hospice nurse sang -
                  sooooo soothing #hpm
                  Wed May 11 18:49:32 PDT 2011




apjonas           RT @MeredithGould: T1 Let docs/teams know if there are estranged family members
                  who might be brought back into conversation/relationship at this point. #hpm
                  Wed May 11 18:49:42 PDT 2011




PracticalWisdom   T3: Our church has ladies who knit Prayer Shawls for very sick or dying. #HPM
                  Wed May 11 18:49:47 PDT 2011




MeredithGould     @ctsinclair Which is why I liked serving as a patient advocate, especially in hospice
                  situations. #hpm
                  Wed May 11 18:49:52 PDT 2011




ctsinclair        Any #MTBC or #MusicTherapy people want to come comment on Threshold Choirs?
                  (fixed hashtag) #hpm
                  Wed May 11 18:50:03 PDT 2011




renee_berry       absolutely @MatthewsMichele @renee_berry @MeredithGould #hpm
                  Wed May 11 18:50:05 PDT 2011




renee_berry       RT @MatthewsMichele: @renee_berry @MeredithGould lets face it: takes lots of
                  tenacity to get over 'doc knows best' mentality to inform your own #healthcare #hpm
                  Wed May 11 18:50:12 PDT 2011




aliciabloom       @ a hospital where i do #palliative care consults there are music therapists and
                  "musicians on-call." our #hospice unit has a harpist. #hpm
                  Wed May 11 18:50:16 PDT 2011
SheyontheBay      T3 Calvary's music therapy does flute work for dyspnea #hpm
                  Wed May 11 18:50:19 PDT 2011




MatthewsMichele   T3 havent heard about it, what has been the response from patients and families?
                  #hpm
                  Wed May 11 18:50:43 PDT 2011




hollyby           @MeredithGould One of the most powerful moments I had was with a pt who ignored
                  me and just held his cat, who came to the hospital #hpm
                  Wed May 11 18:50:50 PDT 2011




chemosabe         @SheyontheBay does it work... what is the science? #hpm
                  Wed May 11 18:51:05 PDT 2011




drpippa           could have so much discussion on music - I have patients who are unresponsive to
                  everyone/everything except music therapist. #hpm
                  Wed May 11 18:51:12 PDT 2011




hollyby           @MatthewsMichele Haven't hear the threshold choir here in San Diego yet. Hope to
                  see them soon. #hpm
                  Wed May 11 18:51:31 PDT 2011




EOLnavigator      T3. Need to embrace what is appropriate for the patient / family. Seen alot of things
                  on an AIDS unit far off my Irish Cath mindset. #hpm
                  Wed May 11 18:51:35 PDT 2011




ctsinclair        RT @drpippa: I have patients who are unresponsive to everyone/everything except
                  music therapist. #MTBC #hpm
                  Wed May 11 18:52:05 PDT 2011




MeredithGould     I'd so love to be part of that kind of choir. What a blessing to sing in that context. #hpm
                  Wed May 11 18:52:15 PDT 2011




renee_berry       RT @hollyby: T3: I recently learned about threshold choirs, volunteers who sing for
                  the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm
                  Wed May 11 18:52:28 PDT 2011




MatthewsMichele   RT @ctsinclair: RT @drpippa: I have patients who are unresponsive to
                  everyone/everything except music therapist. #MTBC #hpm
                  Wed May 11 18:52:33 PDT 2011




EOLnavigator      We had a "llama" request....had to settle for a goat. RT @MeredithGould: T3 One pt I
                  was with wanted to hold a kitty again. #hpm
                  Wed May 11 18:52:38 PDT 2011




PracticalWisdom   T3: Again be aware of the Pt's preference. Some might want Lenard Skynard vs. A
                  choir. #HPM
                  Wed May 11 18:52:52 PDT 2011




MeredithGould     @EOLnavigator Oh my! #hpm
                  Wed May 11 18:52:57 PDT 2011
hollyby           @MeredithGould There are many groups forming across the US. Anyone know of
                  community group that are doing this internationally? #hpm
                  Wed May 11 18:53:07 PDT 2011




ctsinclair        Just looked on Wikipedia for the disambiguation page for Threshold - lots of different
                  connections. Esp Pain Threshold. #hpm
                  Wed May 11 18:53:36 PDT 2011




MeredithGould     @hollyby I should check that out. (Like I have the energy.) Loved having opportunities
                  to sing at funerals. #hpm
                  Wed May 11 18:54:15 PDT 2011




drpippa           for sure! have heard some rousing tunes! RT @PracticalWisdom: T3: Some might
                  want Lenard Skynard vs. A choir. #hpm
                  Wed May 11 18:54:18 PDT 2011




ctsinclair        I wish I had a singing voice that could work in a small group like a Threshold Choir.
                  Sounds like a rewarding experience. #hpm
                  Wed May 11 18:54:26 PDT 2011




hollyby           They would have to have a wide repertoire :) RT @PracticalWisdom: T3: ... Some
                  might want Lenard Skynard vs. A choir. #hpm
                  Wed May 11 18:54:28 PDT 2011




ctsinclair        RT @hollyby: There are many Threshold Choirs forming across the US. Anyone know
                  of community group internationally? #hpm
                  Wed May 11 18:54:56 PDT 2011




katfulton         @renee_berry @ctsinclair I have a #MusicTherapy friend who runs a threshold choir
                  in Flagstaff! #hpm
                  Wed May 11 18:55:04 PDT 2011




EOLnavigator      Staff wouldn't mind Lenard Skynard either! RT @PracticalWisdom: T3: Some might
                  want Lenard Skynard vs. A choir. #hpm
                  Wed May 11 18:55:10 PDT 2011




MatthewsMichele   @MeredithGould ditto! if only i were blessed with good vocals! Singing is def not my
                  ministry! #hpm
                  Wed May 11 18:55:23 PDT 2011




aliciabloom       hearing is often the sense that stays w/ patients the longest. music can be soothing
                  & powerful way to communicate with a patient @ EOL #hpm
                  Wed May 11 18:55:37 PDT 2011




MeredithGould     @ctsinclair Always felt better after choir rehearsal and singing for worship, even if I
                  felt like crap going in. #HPM
                  Wed May 11 18:56:08 PDT 2011




renee_berry       @ctsinclair when I started as a #hospice volunteer, they asked what do you do to
                  deStress, I said sing in the car..but I have no voice #hpm
                  Wed May 11 18:56:16 PDT 2011
SheyontheBay      @chemosabe @SheyontheBay dont know the science behind it - it sure seems to
                  work! I bet Andy at Calvary could tell you #hpm
                  Wed May 11 18:56:17 PDT 2011




RachelleNorman    @ctsinclair I'm just catching the tail end of this chat, but I can say that I've actually
                  never heard of Threshold Choirs. #googlingnow #hpm
                  Wed May 11 18:56:17 PDT 2011




MeredithGould     @MatthewsMichele I miss it a lot. #hpm
                  Wed May 11 18:56:26 PDT 2011




ctsinclair        @PracticalWisdom You could always make your own 'Last Playlist' via Life Before
                  Death http://hpm.md/lN2fKH #hpm
                  Wed May 11 18:56:26 PDT 2011




renee_berry       RT @ctsinclair: I wish I had a singing voice that could work in a small group like a
                  Threshold Choir. Sounds like a rewarding experience. #hpm
                  Wed May 11 18:56:29 PDT 2011




apjonas           @aliciabloom Hearing stays longer than touch? #HPM
                  Wed May 11 18:56:33 PDT 2011




katfulton         Just arrived at #hpm. Thx for the invite, @ctsinclair =) I'm a board-certified
                  #MusicTherapy -ist. Loving this discussion so far!
                  Wed May 11 18:56:44 PDT 2011




LVADone           :-) “@hollyby: They would have to have a wide repertoire :) RT @PracticalWisdom: T3:
                  ... Some might want Lenard Skynard vs. A choir. #hpm”
                  Wed May 11 18:56:51 PDT 2011




drpippa           RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be
                  soothing, powerful way to communicate with a patient #hpm
                  Wed May 11 18:56:54 PDT 2011




MatthewsMichele   Wish I had a singing voice that could work in a small group like a Threshold Choir.
                  Sounds like a rewarding exp. via @ ctsinclair. #hpm
                  Wed May 11 18:56:57 PDT 2011




JordanEM          @RachelleNorman @ctsinclair Me either. More info please on Threshold choir #hpm
                  Wed May 11 18:57:18 PDT 2011




EOLnavigator      All kinds of music does it for me too! RIP Bob Marley. RT @MeredithGould:
                  @ctsinclair #hpm
                  Wed May 11 18:57:28 PDT 2011




katfulton         True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music
                  can be soothing, powerful way to communicate with a pt #hpm
                  Wed May 11 18:57:35 PDT 2011




MeredithGould     @apjonas @aliciabloom That's my question, too. I'd think both hearing & touch last
                  equally long. #hpm
equally long. #hpm
                  Wed May 11 18:57:42 PDT 2011




PracticalWisdom   RT @drpippa: RT @aliciabloom: hearing often sense stays w/ patients longest.
                  music can b soothing, powerful way 2 communicate w/ PT #HPM
                  Wed May 11 18:57:54 PDT 2011




aliciabloom       @apjonas hard to know for sure, but have seen patients completely comatose have
                  increase in respiratory rate when a loved one speaks. #hpm
                  Wed May 11 18:58:00 PDT 2011




SheyontheBay      My daughter's 1 st complete sentence was "no sing mama" She STILL says it (she's
                  33) #hpm
                  Wed May 11 18:58:06 PDT 2011




MatthewsMichele   RT @PracticalWisdom: RT @drpippa: RT @aliciabloom: hearing often sense stays
                  w/ patients longest. music can b soothing, powerful way 2 communicate w/ PT #HPM
                  Wed May 11 18:58:22 PDT 2011




PracticalWisdom   T3: Asked a PT who was actively dying about music preference. She looked me in the
                  eye and said we will not discuss this! #HPM
                  Wed May 11 18:58:40 PDT 2011




ctsinclair        @renee_berry Hopefully you have not had to sing too much lately! ;-) #hpm
                  Wed May 11 18:58:43 PDT 2011




hollyby           Ok all! Thanks so much for the wonderful conversation! Last thoughts? FYIs? Twitter
                  hugs? #hpm
                  Wed May 11 18:58:46 PDT 2011




MatthewsMichele   LOL! RT @SheyontheBay: My daughters 1 st complete sentence was "no sing
                  mama" She STILL says it (shes 33) #hpm
                  Wed May 11 18:58:47 PDT 2011




aliciabloom       @renee_berry i love to belt it out in the car, too...but i know it sounds terrible! #hpm
                  Wed May 11 18:58:51 PDT 2011




PracticalWisdom   RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She
                  STILL says it (shes 33) #HPM
                  Wed May 11 18:58:53 PDT 2011




ctsinclair        RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She
                  STILL says it (shes 33) "Sounds like my kids" #hpm
                  Wed May 11 18:59:07 PDT 2011




renee_berry       T3 My first hospice patient used to sing a song so loud that doors would be
                  slammed shut when I would visit & he would sing for me :) #hpm
                  Wed May 11 18:59:12 PDT 2011




RachelleNorman    Wow, Threshold Choir looks like a beautiful ministry. As @PracticalWisdom said, the
                  repertoire might be a bit narrow to meet all needs. #hpm
                  Wed May 11 18:59:16 PDT 2011
Pallimed          Make sure to check out Palliative Care Grand Rounds (it's back!) with @Daitpcg at
                  Palliative Care Success http://hpm.md/lxIYWv #hpm
                  Wed May 11 18:59:17 PDT 2011



drpippa           great tweetchat this evening! Many thanks @hollyby! now lets all go sing together.
                  have a great night all. #hpm
                  Wed May 11 18:59:32 PDT 2011




aliciabloom       @hollyby high fives & fist bumps for a great #hospice & #palliative medicine tweet
                  chat! #hpm
                  Wed May 11 18:59:44 PDT 2011




MatthewsMichele   RT @drpippa: great tweetchat this evening! Many thanks @hollyby! now lets all go
                  sing together. have a great night all. #hpm
                  Wed May 11 18:59:58 PDT 2011




RachelleNorman    True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music
                  can be soothing, powerful way to communicate with a pt #hpm
                  Wed May 11 18:59:59 PDT 2011

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2011 05 11 hpm tweetchat transcript

  • 1. #hpm Healthcare Hashtag Twitter Transcript From: Wed May 11 18:00:00 PDT 2011 To: Wed May 11 19:00:00 PDT 2011 Customize transcript dates and layout Learn more about #hpm at The Healthcare Hashtag Project ctsinclair Few days left: #Hospice is trouncing Electronic health records 68 to 32% in Modern Healthcare's (fake) tourney http://hpm.md/jytCpf #hpm Wed May 11 18:00:20 PDT 2011 MeredithGould @DNRstories Ugh...feel better. Migraine headaches bite. #hpm Wed May 11 18:00:21 PDT 2011 MatthewsMichele @DNRstories sorry to hear that; Hope you feel better! You'll join us next week then? #hpm Wed May 11 18:00:44 PDT 2011 hollyby For the next hour, I'm tweeting from the #Hospice and #Palliative Medicine Tweetchat. Learn how http://bit.ly/dcA3ic via @ctsinclair #hpm Wed May 11 18:00:47 PDT 2011 hollyby Welcome to the #Hospice and #Palliative Medicine Tweetchat! Let’s get started with some introductions. I'm hosting tonight. #hpm Wed May 11 18:01:36 PDT 2011 aliciabloom time for the #hospice and #palliative medicine tweetchat! #hpm Wed May 11 18:01:40 PDT 2011 MeredithGould <--sociologist, keen on communicating health & building community; author; writer; gadfly. Also tweet as @HealthFaith #hpm Wed May 11 18:02:12 PDT 2011 drpippa <---family doc, HPM doc, tweeting life and work from Boston. #hpm Wed May 11 18:02:49 PDT 2011 ctsinclair Christian Sinclair, palliative MD @KCHospice, editor @Pallimed, CEO @KLXmedia, fan of sports not liked in US (soccer, hockey, #F1) #hpm Wed May 11 18:03:28 PDT 2011
  • 2. hollyby Hello! Holly Yang, HPM doc from @SanDiegoHospice. All tweets are my own. #hpm Wed May 11 18:03:38 PDT 2011 ctsinclair RT @MeredithGould: Hey friends, will be chatting about hospice & palliative medicine for the next hr. All welcome to follow hashtag--> #hpm Wed May 11 18:04:14 PDT 2011 MeredithGould @ctsinclair Ooo! I love soccer & hockey! #hpm Wed May 11 18:04:30 PDT 2011 ctsinclair Hey @MeredithGould, @HollyBy, @Drpippa #hpm Wed May 11 18:04:39 PDT 2011 drpippa @ctsinclair @MeredithGould @HollyBy @Drpippa hey yourself! #hpm Wed May 11 18:05:09 PDT 2011 ctsinclair Might be typing slow tonight. My right thumb needs to be soaked from a pus draining wound. Dumb bike. #hpm Wed May 11 18:05:15 PDT 2011 aliciabloom <-- hpm msw, lsw & clinical educator @VITASHospice in Philadelphia #hpm Wed May 11 18:05:28 PDT 2011 hollyby Welcome @SheyontheBay @aliciabloom @MeredithGould @drpippa @ctsinclair @MatthewsMichele ! Great to see you! #hpm Wed May 11 18:05:31 PDT 2011 hollyby @ctsinclair Gross. Hope you feel better. #hpm Wed May 11 18:05:48 PDT 2011 ctsinclair @MedreditGould Are you going to Rochester in the fall? #hpm Wed May 11 18:05:54 PDT 2011 MeredithGould Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:06:03 PDT 2011 MatthewsMichele <--- Dir. of media and public policy comm @KLXMedia, #hpm/ #healthpolicy and #socialmedia enthusiast out of DC #hpm Wed May 11 18:06:12 PDT 2011 PracticalWisdom Lisa, Speaker, Trainer, Presentation Designer, Rascal. Really glad to be with wonderful, Smart #HPM Group. #HPM Wed May 11 18:06:28 PDT 2011 MeredithGould @ctsinclair Yes! You're going to make it, yes?? #hpm Wed May 11 18:06:34 PDT 2011
  • 3. ctsinclair I just want to say I really like @Aliciabloom and her tweets. Everyone else's too, but alicia always seems to be on when I am looking. #hpm Wed May 11 18:06:34 PDT 2011 MatthewsMichele Took the words right out of mouth! RT @hollyby: @ctsinclair Gross. Hope you feel better. #hpm Wed May 11 18:06:42 PDT 2011 hollyby @DNRstories See you next week! Hope you feel better. #hpm Wed May 11 18:07:09 PDT 2011 PracticalWisdom I'll be learning and chatting with #HPM for the next hour. #HPM Wed May 11 18:07:15 PDT 2011 hollyby @PracticalWisdom Hi Lisa! #hpm Wed May 11 18:07:26 PDT 2011 ctsinclair @hollyby I forgot HPM docs usually are not fond of gross out medical stuff. My ER wife on the other hand makes me quesy with stories #hpm Wed May 11 18:07:35 PDT 2011 SheyontheBay @MeredithGould @ctsinclair That's how rumors start.... #hpm Wed May 11 18:07:38 PDT 2011 ePatientDave RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:07:49 PDT 2011 PracticalWisdom Holly Hi, looking forward to your topics tonight. Thanks!RT @hollyby: @PracticalWisdom Hi Lisa! #HPM Wed May 11 18:08:06 PDT 2011 MeredithGould @ctsinclair Who doesn't like gross out medical stuff?? LOVE it! As @drsnit would add: *confetti* #hpm Wed May 11 18:08:38 PDT 2011 ctsinclair @MeredithGould Will be there. Only Monday though, debating if I can stay longer. (Conference BTW @Sheyonthebay) #hpm Wed May 11 18:08:48 PDT 2011 PracticalWisdom Ying/Yang=G8 RT @ctsinclair: @hollyby I forgot HPM MD usually are not fond gross out med. stuff. ER wife makes me quesy with stories #HPM Wed May 11 18:09:01 PDT 2011 Kaviraj2 RT @ctsinclair: RT @MeredithGould: Hey friends, will be chatting about hospice & palliative medicine for the next hr. All welcome to follow hashtag--> #hpm Wed May 11 18:09:04 PDT 2011 Kaviraj2 RT @ctsinclair: Christian Sinclair, palliative MD @KCHospice, editor @Pallimed, CEO @KLXmedia, fan of sports not liked in US (soccer, hockey, #F1) #hpm Wed May 11 18:09:08 PDT 2011
  • 4. Wed May 11 18:09:08 PDT 2011 EldrcareConsult I'll be learning and chatting with #HPM for the next hour. #HPM Wed May 11 18:09:25 PDT 2011 ctsinclair @ePatientDave You are welcome to join us in #HPM tweetchat! #hpm Wed May 11 18:09:26 PDT 2011 renee_berry Hi everyone! ---rb here, love this community, passionate about early palliative care, hospice volunteerism & advance care planning #hpm Wed May 11 18:09:26 PDT 2011 chemosabe hey y'all, keeping an eye on it today, but mostly stalking... #hpm Wed May 11 18:09:34 PDT 2011 Kaviraj2 RT @ctsinclair: Few days left: #Hospice is trouncing Electronic health records 68 to 32% in Modern Healthcare's (fake) tourney http://hpm.md/jytCpf #hpm Wed May 11 18:09:44 PDT 2011 PracticalWisdom Look who is here. Long time no chat? @ePatientDave #HPM Wed May 11 18:09:50 PDT 2011 SheyontheBay @ctsinclair @hollyby those gross ER stories shared by the parentsare great ways to teach your children by osmosis, ie,STDs and condoms #hpm Wed May 11 18:10:00 PDT 2011 drpippa @renee_berry hello! has been so long! #hpm Wed May 11 18:10:10 PDT 2011 hollyby @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult Welcome! #hpm Wed May 11 18:10:16 PDT 2011 PracticalWisdom @chemosabe: So glad you R Here~from one chat to another right? #HPM Wed May 11 18:10:17 PDT 2011 hollyby Moving to Topic #1 soon… #hpm Wed May 11 18:10:33 PDT 2011 MeredithGould How cool am I? I finally get to meet -->@renee_berry in a couple of weeks! #hpm Wed May 11 18:10:56 PDT 2011 chemosabe @PracticalWisdom thanks Lisa quite right, checked out of #ivchat and here I am #hpm Wed May 11 18:11:01 PDT 2011 renee_berry :) yes! happy to see you!! RT @drpippa: @renee_berry hello! has been so long! #hpm Wed May 11 18:11:02 PDT 2011
  • 5. EldrcareConsult Hey there everyone....Shon from Knoxville here....serving seniors and all of humanity..... #hpm Wed May 11 18:11:03 PDT 2011 PracticalWisdom @hollyby @Kaviraj2 @renee_berry @chemosabe @EldrcareConsult G8 Crew on the Ship tonight. Clear sailing ahead!! #HPM Wed May 11 18:11:04 PDT 2011 MatthewsMichele Just FYI...Lurking (mostly) is my beat tonight too. RT @chemosabe: hey yall, keeping an eye on it today, but mostly stalking... #hpm Wed May 11 18:11:30 PDT 2011 hollyby @SheyontheBay @ctsinclair Somehow scare tactics don't seem to work. :) #hpm Wed May 11 18:11:30 PDT 2011 jessicajohanna Hi! Work @klxmedia. First tweetchat, may be lurking :) #hpm Wed May 11 18:11:31 PDT 2011 renee_berry yes & @jessicajohanna & matthewsmichele! RT @MeredithGould: How cool am I? I finally get to meet -->@renee_berry in a couple of weeks! #hpm Wed May 11 18:11:32 PDT 2011 PracticalWisdom @EldrcareConsult Our Southern Gentleman. #HPM Wed May 11 18:11:54 PDT 2011 ctsinclair Hey @Chemosabe I always tell people about how you asked ?'s from our tweets at @AAHPM conference in Feb from 1/2 way around the world #hpm Wed May 11 18:11:55 PDT 2011 hollyby Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:06 PDT 2011 drpippa Welcome! RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat, may be lurking :) #hpm Wed May 11 18:12:19 PDT 2011 hollyby @jessicajohanna Welcome! #hpm Wed May 11 18:12:20 PDT 2011 PracticalWisdom Welcome! How exciting. RT @jessicajohanna: Hi! Work @klxmedia. First tweetchat, may be lurking :) #HPM Wed May 11 18:12:20 PDT 2011 MatthewsMichele @jessicajohanna good to see you here!! :) WELCOME! #hpm Wed May 11 18:12:26 PDT 2011 ctsinclair @EldrcareConsult Hey Shon. I didn't realize your name was spelled so uniquely. #hpm
  • 6. #hpm Wed May 11 18:12:26 PDT 2011 MeredithGould RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:34 PDT 2011 chemosabe @ctsinclair thanks Christian, nest best thing to being there! #hpm Wed May 11 18:12:43 PDT 2011 renee_berry RT @hollyby Pre-T1: HPM providers (& others) think a lot about how our care impacts patients & families #hpm Wed May 11 18:12:48 PDT 2011 EldrcareConsult @PracticalWisdom oh stop (ya'll) #hpm Wed May 11 18:12:48 PDT 2011 bentleystewart RT @hollyby: Pre-T1: HPM providers (and others) think a lot about how our care impacts patients and families. #hpm Wed May 11 18:12:50 PDT 2011 chemosabe anyone going to European Pallimed conference next week? #hpm Wed May 11 18:13:12 PDT 2011 hollyby T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from patients would be useful to make care better? #hpm Wed May 11 18:13:20 PDT 2011 hollyby @BentleyStewart Hi there! #hpm Wed May 11 18:13:36 PDT 2011 aliciabloom @ctsinclair wow...thank you so much! i'm thrilled to have found the #hpm community. love tweeting & learning! Wed May 11 18:13:49 PDT 2011 MeredithGould RT @hollyby: T1: What info from patients would be useful to make care better? #hpm Wed May 11 18:13:51 PDT 2011 PracticalWisdom If you send the Jet! I'll pitch in for Gas!RT @chemosabe: anyone going to European Pallimed conference next week? #HPM Wed May 11 18:13:57 PDT 2011 renee_berry RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from patients would be useful to make care better? #hpm Wed May 11 18:14:00 PDT 2011 EldrcareConsult @hollyby T-1 A good view of the family dynamics..... #hpm Wed May 11 18:14:13 PDT 2011 Pallimed Would love for any @Pallimed Twitter followers to join us right now in #HPM
  • 7. Pallimed Tweetchat. http://tweetchat.com/room/hpm #hospice Wed May 11 18:14:17 PDT 2011 PracticalWisdom 1 of the best!RT @aliciabloom: @ctsinclair wow...thank you ! im thrilled to have found the #hpm community. love tweeting & learning! #HPM Wed May 11 18:14:40 PDT 2011 renee_berry T1 Understanding that simply... #palliative care is comfort focused care (& that hospice is not one thing, but many organizations) #hpm Wed May 11 18:14:48 PDT 2011 Pallimed RT @hollyby: T1: I’ve been thinking abt patient/family feedback to docs/teams. What info from pts would be useful to make care better? #hpm Wed May 11 18:14:55 PDT 2011 hollyby @chemosabe I can't go, but a poster and a presentation will be there. Look for @FrankDFerris #hpm Wed May 11 18:15:10 PDT 2011 MatthewsMichele RT @EldrcareConsult: @hollyby T-1 A good view of the family dynamics..... #hpm Wed May 11 18:15:51 PDT 2011 ctsinclair It seems to me in times of stress any help is appreciated, so average care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:15:51 PDT 2011 MeredithGould T1 Families should be prepared & able to give docs/team info about how the patient communicates: auditory? visual? kinesthetic? #hpm Wed May 11 18:15:52 PDT 2011 chemosabe Oh I'm not going but the director of our Pall Care Service is #hpm Wed May 11 18:16:03 PDT 2011 renee_berry T1 Listen to patient & family goals of care, before anything else #hpm Wed May 11 18:16:12 PDT 2011 PracticalWisdom T1: Respect 4 all Health Care providers. Each is an important piece to build a solid foundation. PT Satisfaction can be impacted + or - #HPM Wed May 11 18:16:25 PDT 2011 aliciabloom just today, a family said that the doctors often just "come in, talk at us, & leave." they were so grateful to have a dialogue & ask ? #hpm Wed May 11 18:16:51 PDT 2011 hollyby Example: I got a survey from my doc's office. Survey questions are not always helpful to improve care, but what questions would be? #hpm Wed May 11 18:16:58 PDT 2011 MatthewsMichele agree! T1 Families should be prepared & able to give docs/team info about how the patient communicates via @MeredithGould #hpm Wed May 11 18:17:23 PDT 2011
  • 8. hollyby RT @ctsinclair: ... in times of stress any help is appreciated, so avg care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:17:26 PDT 2011 MeredithGould T1 Thought the question was what should families provide for providers? Did I get this wrong? #hpm Wed May 11 18:17:27 PDT 2011 renee_berry RT @hollyby: Example: I got a survey from my doc's office. Survey questions are not always helpful to improve care, but what questions would be? #hpm Wed May 11 18:17:32 PDT 2011 hollyby @MeredithGould You are spot on. #hpm Wed May 11 18:17:50 PDT 2011 ctsinclair T1: hearing 'you are all angels' frequently can lead to poor self-analysis of skills, might be a weakness of feedback to #hospice staff #hpm Wed May 11 18:17:51 PDT 2011 hillaryboucher @PracticalWisdom what is #hpm ? Wed May 11 18:17:56 PDT 2011 EldrcareConsult @renee_berry That is a great point....LISTEN #hpm Wed May 11 18:18:11 PDT 2011 PracticalWisdom @hollyby: Holly are the questions open ended or not. Need Specific Feedback in order to Feed Forward. #HPM Wed May 11 18:18:13 PDT 2011 renee_berry @hollyby @ctsinclair that is such a crucial aspect to understand, #hospice CEO's please see this comment... #hpm Wed May 11 18:18:24 PDT 2011 renee_berry RT @hollyby: RT @ctsinclair: ... in times of stress any help is appreciated, so avg care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:18:30 PDT 2011 ctsinclair @hollyby I find many surveys about medical care have to deal with the delivery/mechanics, not necessarily deliver/humanity #hpm Wed May 11 18:18:38 PDT 2011 drpippa T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:18:49 PDT 2011 MeredithGould T1 Families should be prepared & able to provide info about the patient's spiritual perspective, religious practices, faith & beliefs #hpm Wed May 11 18:18:50 PDT 2011 PracticalWisdom @hillaryboucher Hospice and Palliative Medicine. Great group. Good to see you. #HPM
  • 9. Wed May 11 18:19:01 PDT 2011 chemosabe T1 reponsiveness of staff 2 admit requirements. availablitiy of allied health staff. time to spend with client & family non-clinically #hpm Wed May 11 18:19:19 PDT 2011 renee_berry agree RT @EldrcareConsult @renee_berry That is a great point....LISTEN #hpm Wed May 11 18:19:38 PDT 2011 MeredithGould T1 Let docs/teams know if there are estranged family members who might be brought back into conversation/relationship at this point. #hpm Wed May 11 18:19:45 PDT 2011 jessicajohanna @aliciabloom it's rare. though today my doctor asked me about my job, hobbies and love life #hpm Wed May 11 18:19:54 PDT 2011 bgood64 RT @MeredithGould: Slipping in a mention that tomorrow is Fibromyalgia Awareness Day. #FibroAware #hpm Wed May 11 18:19:58 PDT 2011 LVADone RT @ctsinclair: It seems to me in times of stress any help is appreciated, so average care might be seen as outstanding. Need critical feedback. #hpm Wed May 11 18:20:02 PDT 2011 ctsinclair On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high emotional stress, not b/c of poor skills #hpm Wed May 11 18:20:17 PDT 2011 renee_berry @drpippa that is so important, so many families I think are not prepared to simply say what they think or are feeling #hpm Wed May 11 18:20:21 PDT 2011 renee_berry RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:20:27 PDT 2011 EldrcareConsult RT @MeredithGould: estranged family members who might be brought back into conversation/relationship at this point. EXACTLY! #hpm Wed May 11 18:20:43 PDT 2011 drpippa I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:20:59 PDT 2011 Pallimed RT @MeredithGould: T1 Let teams know if estranged family members who might be brought back into conversation/relationship #hpm Wed May 11 18:21:03 PDT 2011 MatthewsMichele t-1. patient general temperament, mood, the way they prefer to communicate...things that are intuitive to family members... #hpm Wed May 11 18:21:12 PDT 2011
  • 10. hollyby RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high stress, not b/c of poor skills #hpm Wed May 11 18:21:13 PDT 2011 PracticalWisdom Might be in Shock RT @renee_berry: @drpippa so many families I think R not prepared e simply say what they think or are feeling #HPM Wed May 11 18:21:25 PDT 2011 SheyontheBay RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:21:41 PDT 2011 ctsinclair @MeredithGould This is such a touchy area. I often will ask about other family who cannot be present. Can be a touchy area. #hpm Wed May 11 18:21:43 PDT 2011 ctsinclair @MeredithGould Sorry my record player skipped. My record player skipped! ;-) #hpm Wed May 11 18:22:08 PDT 2011 MeredithGould @ctsinclair Very very touchy area, which is why chaplains should be involved & on the team. #hpm Wed May 11 18:22:13 PDT 2011 EldrcareConsult RT @PracticalWisdom: Might be in Shock Good point Lisa..... #hpm Wed May 11 18:22:23 PDT 2011 MeredithGould @ctsinclair s'ok s'ok #hpm Wed May 11 18:22:24 PDT 2011 Pallimed RT @drpippa: T1 - I want to hear whether they understand/agree with/are comfortable with the plan of care. particularly in crisis. #hpm Wed May 11 18:22:29 PDT 2011 jessicajohanna RT @drpippa: I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:22:39 PDT 2011 aliciabloom the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm Wed May 11 18:22:44 PDT 2011 PracticalWisdom @hollyby @ctsinclair: When people really feel they are listened to the scores many times go up. Think Social Workers/Clergy can help #HPM Wed May 11 18:22:49 PDT 2011 PracticalWisdom RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #HPM Wed May 11 18:23:03 PDT 2011 MeredithGould RT @drpippa: I also want to hear about the patient/family before the illness. Helps
  • 11. MeredithGould with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:23:07 PDT 2011 drpippa RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm Wed May 11 18:23:09 PDT 2011 hollyby Wonderful! Getting two things from this 1) quality improvement help from pts, 2) questions to ask pts to ensure complete picture. #hpm Wed May 11 18:23:10 PDT 2011 LVADone “@HPHHospice: Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual... http://t.co/tUdDd49” #hpm Wed May 11 18:23:11 PDT 2011 EldrcareConsult @ctsinclair Its very touchy...hardest conversation I have to have with my families....who to/who not to include in the decisions #hpm Wed May 11 18:23:19 PDT 2011 ctsinclair Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:25 PDT 2011 MatthewsMichele @ctsinclair @MeredithGould Very touchy! Caused my fam to close ranks & not open up as much to docs when our matriarch was ill #hpm Wed May 11 18:23:29 PDT 2011 hollyby RT @ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:43 PDT 2011 renee_berry RT @drpippa: I also want to hear about the patient/family before the illness. Helps with goals/plans/preserving dignity and humanity. #hpm Wed May 11 18:23:45 PDT 2011 MatthewsMichele RT @ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during. #hpm Wed May 11 18:23:46 PDT 2011 SheyontheBay often pts/family have difficulty HEARing in crisis, understand also difficult to articulate values and goals without gentle guidance #hpm Wed May 11 18:23:46 PDT 2011 PracticalWisdom RT @jessicajohanna: RT @drpippa: want 2 hear re: patient/family b4 illness. Helps with goals/plans/preserving dignity and humanity. #HPM Wed May 11 18:23:49 PDT 2011 LVADone RT @ctsinclair: On the flipside, HPM staff can often be criticized heavily by pts/families b/c of high emotional stress, not b/c of poor skills #hpm Wed May 11 18:24:00 PDT 2011 renee_berry RT @aliciabloom: the patient/family narrative before & throughout illness is helpful-- builds rapport, provides insight into values. #hpm
  • 12. builds rapport, provides insight into values. #hpm Wed May 11 18:24:01 PDT 2011 MatthewsMichele @ctsinclair seems counter intuitive doesnt it? #hpm Wed May 11 18:24:16 PDT 2011 ctsinclair @MatthewsMichele @MeredithGould Yes i have seen the discussion of 'estranged family' alienate communication ability #hpm Wed May 11 18:24:20 PDT 2011 chemosabe @ctsinclair we do during care...but my client base is not post terminal event! #hpm Wed May 11 18:24:24 PDT 2011 MeredithGould Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:24:29 PDT 2011 PracticalWisdom RT @SheyontheBay: often pts/family have dif. HEARing crisis, understand also difficult to articulate values/goals without gentle guid #HPM Wed May 11 18:24:37 PDT 2011 drpippa RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:24:52 PDT 2011 EldrcareConsult RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! Yep! #hpm Wed May 11 18:24:57 PDT 2011 ctsinclair @MatthewsMichele Patients and families don't take lessons on how to communicate best. Many HC profs dont either though... #hpm Wed May 11 18:25:00 PDT 2011 MatthewsMichele YES! RT @MeredithGould: Touchy subjects: all the more reason to Have the Talk! #hpm Wed May 11 18:25:02 PDT 2011 renee_berry always yes on advance care planning! RT @MeredithGould: Touchy subjects: all the more reason to #HaveTheaTalk! #hpm Wed May 11 18:25:13 PDT 2011 PracticalWisdom @ctsinclair @MatthewsMichele @MeredithGould Families are complex and now often live many miles away #HPM Wed May 11 18:25:17 PDT 2011 aliciabloom "@ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during." puzzling, really. #hpm Wed May 11 18:25:19 PDT 2011 MeredithGould @ctsinclair @MatthewsMichele Ok, so do NOT say: "Who does your loved one despise who should nevertheless be here?" #hpm Wed May 11 18:25:34 PDT 2011 @hollyby I had plans to lurk but your T1 has drawn me in! #hpm
  • 13. @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:25:38 PDT 2011 MatthewsMichele mojonimbus RT @aliciabloom: "@ctsinclair: Interesting that many medical providers choose to survey AFTER care is delivered. Not always during." puzzling, really. #hpm Wed May 11 18:25:44 PDT 2011 ctsinclair Clarify last statement,not to say that patients and families should improve or change their comm styles, just that we need to adjust #hpm Wed May 11 18:25:48 PDT 2011 hollyby We are going to get started with Topic #2 soon… #hpm Wed May 11 18:26:07 PDT 2011 renee_berry hahaha! great!!!! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:26:11 PDT 2011 ctsinclair RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! "Like a vaudville lasso....invisible but powerful." #hpm Wed May 11 18:26:27 PDT 2011 PracticalWisdom T1: It's been my experience that most organization need better survey tools. Filling in the bubbles is not Valuable feedback #HPM Wed May 11 18:26:31 PDT 2011 hollyby Agree! RT @PracticalWisdom: T1: ... most organization need better survey tools. Filling in the bubbles is not Valuable feedback #hpm Wed May 11 18:27:00 PDT 2011 hollyby Hooray! RT @MatthewsMichele: @hollyby I had plans to lurk but your T1 has drawn me in! #hpm Wed May 11 18:27:10 PDT 2011 PracticalWisdom T1: Feedback would be great through the entire process. Are families debriefed by Pall care teams afterward? #HPM Wed May 11 18:27:18 PDT 2011 EldrcareConsult RT @PracticalWisdom: Families are complex and now often live many miles away When the end is near they come out of the woodwork #hpm Wed May 11 18:27:21 PDT 2011 MatthewsMichele @ctsinclair so true! #hpm Wed May 11 18:27:27 PDT 2011 MeredithGould @ctsinclair Really...simply knowing how everyone best communicates is big, i.e., don't yak endlessly at someone who prefers reading #hpm Wed May 11 18:27:37 PDT 2011 MeredithGould @MatthewsMichele Yeah, I always mean to lurk and get totally sucked in by this great group & convo! #hpm Wed May 11 18:28:06 PDT 2011
  • 14. hollyby Topic #2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:28:09 PDT 2011 LVADone RT @PracticalWisdom: @ctsinclair @MatthewsMichele @MeredithGould Families are complex and now often live many miles away #HPM Wed May 11 18:28:16 PDT 2011 Pallimed RT @PracticalWisdom: T1:my experience that most orgs need better survey tools. Filling in the bubbles does not = Valuable feedback #hpm Wed May 11 18:28:31 PDT 2011 renee_berry RT @hollyby: Topic #2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:28:36 PDT 2011 PracticalWisdom @EldrcareConsult: Hopefully come for good reasons. Have seen when was a clergy Family Member the Good, Bad and ugly reasons! #HPM Wed May 11 18:28:37 PDT 2011 MatthewsMichele RT @MeredithGould: @ctsinclair Simply knowing how everyone communicates is big, i.e., dont yak endlessly at someone who prefers reading #hpm Wed May 11 18:28:38 PDT 2011 hollyby @PracticalWisdom Not always, and not always well, but that goes for most of medical care I think #hpm Wed May 11 18:28:51 PDT 2011 mojonimbus #HPM I think concurrent Feedback could prevent misunderstanding and sone patient hostility toward health care workers, better care for all Wed May 11 18:28:59 PDT 2011 MatthewsMichele RT @hollyby: T2: How does a life-threatening diagnosis change the management of chronic disease? For the patient? For the doc/team? #hpm Wed May 11 18:29:08 PDT 2011 aliciabloom if we just ask patients & families if they feel heard & have any questions/concerns/fears, it can open up the lines of communication. #hpm Wed May 11 18:29:14 PDT 2011 MeredithGould T2 Think it would depend on the chronic disease? #hpm Wed May 11 18:29:20 PDT 2011 EldrcareConsult RT @PracticalWisdom: Hopefully come for good reasons. Have seen when was a clergy Family Member the Good, Bad and ugly reasons! Me 2! #hpm Wed May 11 18:29:25 PDT 2011 ctsinclair T2: may free of some of the medical limitations to control the chronic disease as in the case of cholesterol or diabetes meds #hpm Wed May 11 18:29:51 PDT 2011
  • 15. drpippa You assume it does - often it doesn't - that is the problem. How does life-threatening dx change the mgmt of chronic dis? For the team? #hpm Wed May 11 18:29:57 PDT 2011 hollyby Example: A diabetic person with new advanced cancer diagnosis. #hpm Wed May 11 18:30:09 PDT 2011 RossJeanette Hi all joining late t2 goals for chronic illnesses such as Diabetes & high cholesterol dont need to be tight #HPM Wed May 11 18:30:14 PDT 2011 PracticalWisdom RT @mojonimbus:#HPM think concurrent Feedback could prev. misunderstanding/sone pt hostility 2ward health care folks, better care 4 all #HPM Wed May 11 18:30:34 PDT 2011 hollyby True! RT @drpippa: You assume it does - often it doesnt - that is the problem. #hpm Wed May 11 18:30:47 PDT 2011 MeredithGould Won't change it at all if the chronic disease is basically unmanageable/untreatable to begin with (e.g., #fibro) #hpm Wed May 11 18:30:52 PDT 2011 ctsinclair T2: 1 of most intriguing discussions: how to safely minimize burdensome treatments for preventing long term complications of disease #hpm Wed May 11 18:30:57 PDT 2011 MatthewsMichele RT @aliciabloom: if we just ask patients & families if they feel heard & have any questions/concerns/fears, it can open up the lines of communication. #hpm Wed May 11 18:30:57 PDT 2011 hollyby @mojonimbus Thanks for joining us! #hpm Wed May 11 18:31:01 PDT 2011 aliciabloom it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:11 PDT 2011 MeredithGould RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:24 PDT 2011 PracticalWisdom RT @drpippa: You assume it does often it doesnt that's the problem. How does life- threatening dx change mgmt chronic dis? 4 team? #HPM Wed May 11 18:31:28 PDT 2011 hollyby RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:31:30 PDT 2011 ctsinclair RT @mojonimbus: concurrent Feedback could prevent misunderstanding, some hostility toward health care workers-> better care for all #hpm Wed May 11 18:31:46 PDT 2011
  • 16. Wed May 11 18:31:46 PDT 2011 hollyby @RossJeanette Welcome Jeanette! Glad you could make it! #hpm Wed May 11 18:31:50 PDT 2011 PracticalWisdom @ctsinclair; Like Feeding Tube Issue? #HPM Wed May 11 18:32:02 PDT 2011 RossJeanette T2 I like to put patients in the everything you want to eat diet as opposed to the diabetic renal cardiac... Diet it's about QOL #HPM Wed May 11 18:32:04 PDT 2011 drpippa must tread lightly - often can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:32:25 PDT 2011 MeredithGould @RossJeanette Gee, may I be on that diet now??? #HPM Wed May 11 18:32:31 PDT 2011 renee_berry RT @aliciabloom: it should be about the benefits vs burdens of on-going management of the chronic condition. #hpm Wed May 11 18:32:45 PDT 2011 chemosabe T2 shouldn't the focus be the clients decisions about there death and dying and therefore symptom management that complies with this? #hpm Wed May 11 18:32:58 PDT 2011 ctsinclair Hi @RossJeanette Hello @mojonimbus glad to meet you! #hpm Wed May 11 18:32:59 PDT 2011 PracticalWisdom Practical Wis.RT @RossJeanette:T2 I like 2 put pt's everything U want 2 eat diet as opposed 2 diabetic renal cardiac Diet its about QOL #HPM Wed May 11 18:33:12 PDT 2011 drpippa absolutely! RT @renee_berry: RT @aliciabloom: it should be about the benefits vs burdens of on-going mgmt of the chronic condition. #hpm Wed May 11 18:33:16 PDT 2011 renee_berry @aliciabloom for that particular person, & not necessarily how the family perceives benefits vs burdens #hpm Wed May 11 18:33:19 PDT 2011 MeredithGould I'd like to be told to eat massive amounts of high quality dark chocolate & bags of Cheez Doodles. Oh wait, this isn't about me? #hpm Wed May 11 18:33:28 PDT 2011 ctsinclair @PracticalWisdom Yes even feeding tube goals can be readdressed, are we aiming for long term nutrion goals or short term pleaure #hpm Wed May 11 18:33:45 PDT 2011 MatthewsMichele RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the
  • 17. MatthewsMichele RT @drpippa: must tread lightly - often can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:33:46 PDT 2011 PracticalWisdom RT @chemosabe: T2 shouldnt focus b clients dec. re:t their death and dying and therefore symptom management that complies with this? #HPM Wed May 11 18:33:53 PDT 2011 renee_berry RT @RossJeanette: T2 I like to put patients in the everything you want to eat diet as opposed to the diabetic renal cardiac... Diet it's about QOL #HPM Wed May 11 18:33:58 PDT 2011 ctsinclair @MeredithGould Oh its all about you! Autonomy rules in American Health Care System. #hpm Wed May 11 18:34:15 PDT 2011 hollyby Goals of care are always important. RT @chemosabe: T2 shouldnt the focus be the clients decisions... #hpm Wed May 11 18:34:51 PDT 2011 ctsinclair RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:34:56 PDT 2011 EldrcareConsult BRB guys...work calls! #hpm Wed May 11 18:35:19 PDT 2011 aliciabloom @renee_berry excellent point! although, patients often make treatment decisions for their families. #hpm Wed May 11 18:35:29 PDT 2011 renee_berry really?! I hope it does, not sure though.. RT @ctsinclair @MeredithGould Oh its all about you! Autonomy rules in US Health Care System #hpm Wed May 11 18:35:32 PDT 2011 hollyby @drpippa Agree that there is a huge emotional component of changing management of long-standing illness #hpm Wed May 11 18:36:08 PDT 2011 MeredithGould @renee_berry I think he's goofing on me. How unusual, right? #hpm Wed May 11 18:36:10 PDT 2011 SheyontheBay @RossJeanette We call that the diet of the dying. I remember a dying chocoholic, couldnt eat - we swabbed Hershey syrup on her lips #hpm Wed May 11 18:36:25 PDT 2011 PracticalWisdom Bat Phone must have Rang! Batman to the Rescue! Dedicated to his Clients RT @EldrcareConsult: BRB guys...work calls! #HPM Wed May 11 18:36:36 PDT 2011 RossJeanette Agree with @drpippa be careful with readdressing goals and being perceived as "doing nothing" #HPM Wed May 11 18:36:59 PDT 2011
  • 18. Wed May 11 18:36:59 PDT 2011 ctsinclair @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:37:08 PDT 2011 Pallimed RT @drpippa: must tread lightly - can be traumatic to patients to stop doing the things we have spent so much time telling them to do #hpm Wed May 11 18:37:18 PDT 2011 MeredithGould @SheyontheBay Now THAT is compassionate care. Absolutely! But Hershey's? Not Godiva? #hpm Wed May 11 18:37:21 PDT 2011 renee_berry RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:37:35 PDT 2011 chemosabe T2 don't know about mx up there, but, separation of client on physician for chronic illness mx down here v diff. attachment issues #hpm Wed May 11 18:37:37 PDT 2011 PracticalWisdom Loving RT @SheyontheBay: @RossJeanette Diet of the dying.Remember a dying chocoholic, couldnt eat we swabbed Hershey syrup on lips #HPM Wed May 11 18:38:02 PDT 2011 LVADone RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:38:10 PDT 2011 EldrcareConsult @PracticalWisdom Its not the Bat Phone I mind, but these flashing strobe lights kill me! #hpm I may be a while.................. Wed May 11 18:38:12 PDT 2011 RossJeanette @SheyontheBay I'll have to remember thatchocolaye syrup swab good idea #HPM Wed May 11 18:38:13 PDT 2011 SheyontheBay @MeredithGould @SheyontheBay Does Godiva make syrup? Too risky to melt chips #hpm Wed May 11 18:38:17 PDT 2011 mojonimbus #hpm nice to meet you all too Wed May 11 18:38:17 PDT 2011 drpippa RT @ctsinclair: @renee_berry In many ways Autonomy can trump other key ethical principles of beneficence, Nonmaleficence and fairness. #hpm Wed May 11 18:38:32 PDT 2011 MeredithGould @SheyontheBay I believe Ghiradelli (sp?) makes syrup. #hpm Wed May 11 18:38:58 PDT 2011 ctsinclair It is interesting many HC professionals feel autonomy overrides often, whereas
  • 19. ctsinclair It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:38:58 PDT 2011 PracticalWisdom @EldrcareConsult: It's the piercing Alarm Sound that gets me! #HPM Wed May 11 18:39:04 PDT 2011 renee_berry @ctsinclair agree though think OFTEN the case- autonomy is not possible w/o informed medical decision making... which I think is often #hpm Wed May 11 18:39:13 PDT 2011 hollyby @chemosabe Can you say more? #hpm Wed May 11 18:39:26 PDT 2011 renee_berry RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:39:29 PDT 2011 MeredithGould @renee_berry @ctsinclair Or patients can't even conceive of Autonomy? #hpm Wed May 11 18:39:56 PDT 2011 PracticalWisdom RT @ctsinclair: nteresting HC profess. feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #HPM Wed May 11 18:40:00 PDT 2011 MatthewsMichele RT @renee_berry: @ctsinclair agree though think OFTEN the case- autonomy is not possible w/o informed medical decision making... which I think is often #hpm Wed May 11 18:40:04 PDT 2011 thinkalot RT @PracticalWisdom: Practical Wis.RT @RossJeanette:T2 I like 2 put pt's everything U want 2 eat diet as opposed 2 diabetic renal cardiac Diet its about QOL #HPM Wed May 11 18:40:38 PDT 2011 ctsinclair RT @MeredithGould: @renee_berry @ctsinclair Or patients cant even conceive of Autonomy? "foreign concept?" #hpm Wed May 11 18:40:46 PDT 2011 chemosabe @hollyby attachment to treating team, difficult to trust new hpm team to mx dz appropriately. particular if goal of care now comfort #hpm Wed May 11 18:40:51 PDT 2011 renee_berry yes, how can they w/o clear information RT @MeredithGould @renee_berry @ctsinclair Or patients cant even conceive of Autonomy? #hpm Wed May 11 18:41:15 PDT 2011 aliciabloom @ctsinclair HC providers often respect autonomy when pts make decisions they think are right. otherwise, they order psych consults. #hpm Wed May 11 18:41:39 PDT 2011 MatthewsMichele @MeredithGould @renee_berry @ctsinclair Good point! I'd guess pts often don't think they are in the drivers seat of their #healthcare. #hpm Wed May 11 18:41:44 PDT 2011
  • 20. Wed May 11 18:41:44 PDT 2011 drpippa great point. RT @chemosabe: attachment to treating team, diff to trust new hpm team. particularly if goal of care now comfort #hpm Wed May 11 18:41:57 PDT 2011 PracticalWisdom RT @chemosabe: @hollyby attachment 2 treating team, difficult 2 trust new hpm team 2 mx dz approp.. partic if goal of care now comfort #HPM Wed May 11 18:41:59 PDT 2011 EOLnavigator Hey there. 20 mins is better than 0 mins #hpm Wed May 11 18:42:01 PDT 2011 ctsinclair @chemosabe Agree with you. Have had patients say they went for more chemo in part because they like the staff, same with dialysis. #hpm Wed May 11 18:42:06 PDT 2011 hollyby @chemosabe:Thx... so they actually switch care teams. That could be challenging. #hpm Wed May 11 18:42:07 PDT 2011 LVADone RT @ctsinclair: It is interesting many HC professionals feel autonomy overrides often, whereas patients often note feeling powerless cc @renee_berry #hpm Wed May 11 18:42:10 PDT 2011 ctsinclair RT @EOLnavigator: Hey there. 20 mins is better than 0 mins "Glad you are here before the buzzer!" #hpm Wed May 11 18:42:29 PDT 2011 renee_berry RT @MatthewsMichele: @MeredithGould @renee_berry @ctsinclair Good point! I'd guess pts often don't think they are in the drivers seat of their #healthcare. #hpm Wed May 11 18:42:31 PDT 2011 MatthewsMichele Definitely! You made it...glad you're here! RT @EOLnavigator: Hey there. 20 mins is better than 0 mins #hpm Wed May 11 18:43:02 PDT 2011 HerHealthySelf RT @PracticalWisdom: Loving RT @SheyontheBay: @RossJeanette Diet of the dying.Remember a dying chocoholic, couldnt eat we swabbed Hershey syrup on lips #HPM Wed May 11 18:43:14 PDT 2011 PracticalWisdom Remarkable. RT @ctsinclair: @chemosabe Agree Have had pt's say they went 4# chemo because they like the staff, same with dialysis. #HPM Wed May 11 18:43:24 PDT 2011 ctsinclair @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of a palliative care team. #hpm Wed May 11 18:43:37 PDT 2011 MeredithGould How could patients possibly think they have any control/say? The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:43:38 PDT 2011
  • 21. Wed May 11 18:43:38 PDT 2011 aliciabloom @ctsinclair @chemosabe agreed. they don't want to "disappoint" their physician & care team. #hpm Wed May 11 18:43:43 PDT 2011 chemosabe @hollyby yep we tried models we called shared care where pt still sees both teams. can be just as difficult to mx as hand over #hpm Wed May 11 18:44:19 PDT 2011 LVADone RT @aliciabloom: @ctsinclair HC providers often respect autonomy when pts make decisions they think are right. otherwise, they order psych consults. #hpm Wed May 11 18:44:20 PDT 2011 hollyby True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of palliative care. #hpm Wed May 11 18:44:26 PDT 2011 renee_berry RT @MeredithGould: How could patients possibly think they have any control/say? The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:44:44 PDT 2011 PracticalWisdom @aliciabloom @ctsinclair @chemosabe: Sounds like some Boundary Issues or some other challenging dynamics at play. #HPM Wed May 11 18:45:08 PDT 2011 hollyby Moving on to Topic #3 soon… ready to jump frames a bit? #hpm Wed May 11 18:45:22 PDT 2011 aliciabloom good point. RT @ctsinclair: RE: Disagree with the doc = psych consult. See this less with good integration of a palliative care team. #hpm Wed May 11 18:45:38 PDT 2011 lugstew At hbo screening of dying in Oregon. #hpm #hospice Wed May 11 18:45:51 PDT 2011 EOLnavigator This is why open access is a better idea for hospice care RT @hollyby: @chemosabe:..switch care teams......challenging. #hpm Wed May 11 18:45:52 PDT 2011 renee_berry patients deserve to know RT @aliciabloom @ctsinclair @chemosabe agreed. they dont want to "disappoint" their physician & care team #hpm Wed May 11 18:45:59 PDT 2011 PracticalWisdom RT @chemosabe: @hollyby we tried models we called shared care where pt still sees both teams. can be just difficult 2 mx as hand over #HPM Wed May 11 18:46:16 PDT 2011 EOLnavigator Clinicians don't know how to discuss options. RT @MeredithGould: The entire system is set up to disabuse them of that notion. #hpm Wed May 11 18:46:44 PDT 2011 hollyby T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any
  • 22. hollyby T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:46:50 PDT 2011 PracticalWisdom RT @renee_berry: pts' deserve 2 know RT @aliciabloom @ctsinclair @chemosabe agreed. they dont want 2 disappoint" physician & care team #HPM Wed May 11 18:46:58 PDT 2011 ctsinclair @MeredithGould spend some time rounding with your local doc and you will see the amount of deference to patient wishes #hpm Wed May 11 18:47:03 PDT 2011 LVADone RT @hollyby: True. RT @ctsinclair: @aliciabloom RE: Disagree with the doc = psych consult. See this less with good integration of palliative care. #hpm Wed May 11 18:47:28 PDT 2011 apjonas RT @MeredithGould: T1 Families should be prepared & able to provide info about the patient's spiritual perspective, religious practices, faith & beliefs #hpm Wed May 11 18:47:39 PDT 2011 MeredithGould @ctsinclair May that be so! #hpm Wed May 11 18:47:56 PDT 2011 ctsinclair T3: Threshold Choirs? Interesting name. Makes me think of Memorex...like you are testing a threshold of hearing. #hpm Wed May 11 18:47:57 PDT 2011 renee_berry RT @ctsinclair: @MeredithGould spend some time rounding with your local doc and you will see the amount of deference to patient wishes #hpm Wed May 11 18:47:58 PDT 2011 drpippa yes! truly extraordinary. music can help in ways that I can not. RT @hollyby: T3: I recently learned about threshold choirs #hpm Wed May 11 18:48:01 PDT 2011 MeredithGould RT @hollyby: T3: Learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:48:17 PDT 2011 RossJeanette T3 one of the hospice agencies has a harp player. She apparently plays tunes that calm patients. #HPM Wed May 11 18:48:20 PDT 2011 PracticalWisdom @apjonas @MeredithGould: G8 Points I'd also include understanding of culture. #HPM Wed May 11 18:48:28 PDT 2011 renee_berry RT @drpippa: yes! truly extraordinary. music can help in ways that I can not. RT @hollyby: T3: I recently learned about threshold choirs #hpm Wed May 11 18:48:31 PDT 2011 ctsinclair @MeredithGould And you will also see some steamrolling of patient preferences and dignity. Sadly. #hpm
  • 23. dignity. Sadly. #hpm Wed May 11 18:48:49 PDT 2011 aliciabloom autonomy requires informed consent for which effective communication with patients & families is essential. #hpm Wed May 11 18:48:56 PDT 2011 MeredithGould T3 Sounds wonderful. So many ways to ease transition. One pt I was with wanted to hold a kitty again before he died. #hpm Wed May 11 18:49:04 PDT 2011 PracticalWisdom Know harp not choir RT @RossJeanette: T3 one of the hospice agencies has a harp player. She apparently plays tunes that calm patients. #HPM Wed May 11 18:49:10 PDT 2011 MatthewsMichele @renee_berry @MeredithGould lets face it: takes lots of tenacity to get over 'doc knows best' mentality to inform your own #healthcare #hpm Wed May 11 18:49:19 PDT 2011 ctsinclair Any #MBTC or #MusicTherapy people want to come comment on Threshold Choirs? #hpm Wed May 11 18:49:27 PDT 2011 SheyontheBay T3 I ve worked at a hospital where both a chaplain and a hospice nurse sang - sooooo soothing #hpm Wed May 11 18:49:32 PDT 2011 apjonas RT @MeredithGould: T1 Let docs/teams know if there are estranged family members who might be brought back into conversation/relationship at this point. #hpm Wed May 11 18:49:42 PDT 2011 PracticalWisdom T3: Our church has ladies who knit Prayer Shawls for very sick or dying. #HPM Wed May 11 18:49:47 PDT 2011 MeredithGould @ctsinclair Which is why I liked serving as a patient advocate, especially in hospice situations. #hpm Wed May 11 18:49:52 PDT 2011 ctsinclair Any #MTBC or #MusicTherapy people want to come comment on Threshold Choirs? (fixed hashtag) #hpm Wed May 11 18:50:03 PDT 2011 renee_berry absolutely @MatthewsMichele @renee_berry @MeredithGould #hpm Wed May 11 18:50:05 PDT 2011 renee_berry RT @MatthewsMichele: @renee_berry @MeredithGould lets face it: takes lots of tenacity to get over 'doc knows best' mentality to inform your own #healthcare #hpm Wed May 11 18:50:12 PDT 2011 aliciabloom @ a hospital where i do #palliative care consults there are music therapists and "musicians on-call." our #hospice unit has a harpist. #hpm Wed May 11 18:50:16 PDT 2011
  • 24. SheyontheBay T3 Calvary's music therapy does flute work for dyspnea #hpm Wed May 11 18:50:19 PDT 2011 MatthewsMichele T3 havent heard about it, what has been the response from patients and families? #hpm Wed May 11 18:50:43 PDT 2011 hollyby @MeredithGould One of the most powerful moments I had was with a pt who ignored me and just held his cat, who came to the hospital #hpm Wed May 11 18:50:50 PDT 2011 chemosabe @SheyontheBay does it work... what is the science? #hpm Wed May 11 18:51:05 PDT 2011 drpippa could have so much discussion on music - I have patients who are unresponsive to everyone/everything except music therapist. #hpm Wed May 11 18:51:12 PDT 2011 hollyby @MatthewsMichele Haven't hear the threshold choir here in San Diego yet. Hope to see them soon. #hpm Wed May 11 18:51:31 PDT 2011 EOLnavigator T3. Need to embrace what is appropriate for the patient / family. Seen alot of things on an AIDS unit far off my Irish Cath mindset. #hpm Wed May 11 18:51:35 PDT 2011 ctsinclair RT @drpippa: I have patients who are unresponsive to everyone/everything except music therapist. #MTBC #hpm Wed May 11 18:52:05 PDT 2011 MeredithGould I'd so love to be part of that kind of choir. What a blessing to sing in that context. #hpm Wed May 11 18:52:15 PDT 2011 renee_berry RT @hollyby: T3: I recently learned about threshold choirs, volunteers who sing for the dying. Any experience with them? http://bitly.com/lEjzfQ #hpm Wed May 11 18:52:28 PDT 2011 MatthewsMichele RT @ctsinclair: RT @drpippa: I have patients who are unresponsive to everyone/everything except music therapist. #MTBC #hpm Wed May 11 18:52:33 PDT 2011 EOLnavigator We had a "llama" request....had to settle for a goat. RT @MeredithGould: T3 One pt I was with wanted to hold a kitty again. #hpm Wed May 11 18:52:38 PDT 2011 PracticalWisdom T3: Again be aware of the Pt's preference. Some might want Lenard Skynard vs. A choir. #HPM Wed May 11 18:52:52 PDT 2011 MeredithGould @EOLnavigator Oh my! #hpm Wed May 11 18:52:57 PDT 2011
  • 25. hollyby @MeredithGould There are many groups forming across the US. Anyone know of community group that are doing this internationally? #hpm Wed May 11 18:53:07 PDT 2011 ctsinclair Just looked on Wikipedia for the disambiguation page for Threshold - lots of different connections. Esp Pain Threshold. #hpm Wed May 11 18:53:36 PDT 2011 MeredithGould @hollyby I should check that out. (Like I have the energy.) Loved having opportunities to sing at funerals. #hpm Wed May 11 18:54:15 PDT 2011 drpippa for sure! have heard some rousing tunes! RT @PracticalWisdom: T3: Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:54:18 PDT 2011 ctsinclair I wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding experience. #hpm Wed May 11 18:54:26 PDT 2011 hollyby They would have to have a wide repertoire :) RT @PracticalWisdom: T3: ... Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:54:28 PDT 2011 ctsinclair RT @hollyby: There are many Threshold Choirs forming across the US. Anyone know of community group internationally? #hpm Wed May 11 18:54:56 PDT 2011 katfulton @renee_berry @ctsinclair I have a #MusicTherapy friend who runs a threshold choir in Flagstaff! #hpm Wed May 11 18:55:04 PDT 2011 EOLnavigator Staff wouldn't mind Lenard Skynard either! RT @PracticalWisdom: T3: Some might want Lenard Skynard vs. A choir. #hpm Wed May 11 18:55:10 PDT 2011 MatthewsMichele @MeredithGould ditto! if only i were blessed with good vocals! Singing is def not my ministry! #hpm Wed May 11 18:55:23 PDT 2011 aliciabloom hearing is often the sense that stays w/ patients the longest. music can be soothing & powerful way to communicate with a patient @ EOL #hpm Wed May 11 18:55:37 PDT 2011 MeredithGould @ctsinclair Always felt better after choir rehearsal and singing for worship, even if I felt like crap going in. #HPM Wed May 11 18:56:08 PDT 2011 renee_berry @ctsinclair when I started as a #hospice volunteer, they asked what do you do to deStress, I said sing in the car..but I have no voice #hpm Wed May 11 18:56:16 PDT 2011
  • 26. SheyontheBay @chemosabe @SheyontheBay dont know the science behind it - it sure seems to work! I bet Andy at Calvary could tell you #hpm Wed May 11 18:56:17 PDT 2011 RachelleNorman @ctsinclair I'm just catching the tail end of this chat, but I can say that I've actually never heard of Threshold Choirs. #googlingnow #hpm Wed May 11 18:56:17 PDT 2011 MeredithGould @MatthewsMichele I miss it a lot. #hpm Wed May 11 18:56:26 PDT 2011 ctsinclair @PracticalWisdom You could always make your own 'Last Playlist' via Life Before Death http://hpm.md/lN2fKH #hpm Wed May 11 18:56:26 PDT 2011 renee_berry RT @ctsinclair: I wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding experience. #hpm Wed May 11 18:56:29 PDT 2011 apjonas @aliciabloom Hearing stays longer than touch? #HPM Wed May 11 18:56:33 PDT 2011 katfulton Just arrived at #hpm. Thx for the invite, @ctsinclair =) I'm a board-certified #MusicTherapy -ist. Loving this discussion so far! Wed May 11 18:56:44 PDT 2011 LVADone :-) “@hollyby: They would have to have a wide repertoire :) RT @PracticalWisdom: T3: ... Some might want Lenard Skynard vs. A choir. #hpm” Wed May 11 18:56:51 PDT 2011 drpippa RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a patient #hpm Wed May 11 18:56:54 PDT 2011 MatthewsMichele Wish I had a singing voice that could work in a small group like a Threshold Choir. Sounds like a rewarding exp. via @ ctsinclair. #hpm Wed May 11 18:56:57 PDT 2011 JordanEM @RachelleNorman @ctsinclair Me either. More info please on Threshold choir #hpm Wed May 11 18:57:18 PDT 2011 EOLnavigator All kinds of music does it for me too! RIP Bob Marley. RT @MeredithGould: @ctsinclair #hpm Wed May 11 18:57:28 PDT 2011 katfulton True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a pt #hpm Wed May 11 18:57:35 PDT 2011 MeredithGould @apjonas @aliciabloom That's my question, too. I'd think both hearing & touch last equally long. #hpm
  • 27. equally long. #hpm Wed May 11 18:57:42 PDT 2011 PracticalWisdom RT @drpippa: RT @aliciabloom: hearing often sense stays w/ patients longest. music can b soothing, powerful way 2 communicate w/ PT #HPM Wed May 11 18:57:54 PDT 2011 aliciabloom @apjonas hard to know for sure, but have seen patients completely comatose have increase in respiratory rate when a loved one speaks. #hpm Wed May 11 18:58:00 PDT 2011 SheyontheBay My daughter's 1 st complete sentence was "no sing mama" She STILL says it (she's 33) #hpm Wed May 11 18:58:06 PDT 2011 MatthewsMichele RT @PracticalWisdom: RT @drpippa: RT @aliciabloom: hearing often sense stays w/ patients longest. music can b soothing, powerful way 2 communicate w/ PT #HPM Wed May 11 18:58:22 PDT 2011 PracticalWisdom T3: Asked a PT who was actively dying about music preference. She looked me in the eye and said we will not discuss this! #HPM Wed May 11 18:58:40 PDT 2011 ctsinclair @renee_berry Hopefully you have not had to sing too much lately! ;-) #hpm Wed May 11 18:58:43 PDT 2011 hollyby Ok all! Thanks so much for the wonderful conversation! Last thoughts? FYIs? Twitter hugs? #hpm Wed May 11 18:58:46 PDT 2011 MatthewsMichele LOL! RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) #hpm Wed May 11 18:58:47 PDT 2011 aliciabloom @renee_berry i love to belt it out in the car, too...but i know it sounds terrible! #hpm Wed May 11 18:58:51 PDT 2011 PracticalWisdom RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) #HPM Wed May 11 18:58:53 PDT 2011 ctsinclair RT @SheyontheBay: My daughters 1 st complete sentence was "no sing mama" She STILL says it (shes 33) "Sounds like my kids" #hpm Wed May 11 18:59:07 PDT 2011 renee_berry T3 My first hospice patient used to sing a song so loud that doors would be slammed shut when I would visit & he would sing for me :) #hpm Wed May 11 18:59:12 PDT 2011 RachelleNorman Wow, Threshold Choir looks like a beautiful ministry. As @PracticalWisdom said, the repertoire might be a bit narrow to meet all needs. #hpm Wed May 11 18:59:16 PDT 2011
  • 28. Pallimed Make sure to check out Palliative Care Grand Rounds (it's back!) with @Daitpcg at Palliative Care Success http://hpm.md/lxIYWv #hpm Wed May 11 18:59:17 PDT 2011 drpippa great tweetchat this evening! Many thanks @hollyby! now lets all go sing together. have a great night all. #hpm Wed May 11 18:59:32 PDT 2011 aliciabloom @hollyby high fives & fist bumps for a great #hospice & #palliative medicine tweet chat! #hpm Wed May 11 18:59:44 PDT 2011 MatthewsMichele RT @drpippa: great tweetchat this evening! Many thanks @hollyby! now lets all go sing together. have a great night all. #hpm Wed May 11 18:59:58 PDT 2011 RachelleNorman True! RT @aliciabloom: hearing often sense that stays w/ patients longest. music can be soothing, powerful way to communicate with a pt #hpm Wed May 11 18:59:59 PDT 2011