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#hpm Healthcare Hashtag Twitter Transcript From: Wed May 25 18:00:00 PDT 2011 To: Wed May 25 19:00:00 PDT 2011 Customize transcript dates and layout Learn more about #hpm at The Healthcare Hashtag Project Kaviraj2 RT @renee_berry : hey everyone, won't be able to make #hpm tonight, hope you have a great chat! Wed May 25 18:00:19 PDT 2011 EOLnavigator We will be tweeting about hospice & palliative care topics relevant to caregivers for the next hour. #hpm Wed May 25 18:00:31 PDT 2011 jfclearywisc Jim cleary from Madison WI #hpm Wed May 25 18:00:45 PDT 2011 aliciabloom MSW, LSW focusing on #palliative care program development & increasing #hospice access through clinical education at @VITASHospice #hpm Wed May 25 18:01:43 PDT 2011 MarksPhone Mark from NYC #hpm Wed May 25 18:01:43 PDT 2011 EOLnavigator Hey there! @jfclearywisc, @Kaviraj2, @MeredithGould #hpm Wed May 25 18:01:56 PDT 2011 dockj Kevin from Wilmington NC #hpm and family med Ed. Tweets are my own opinion. Wed May 25 18:02:35 PDT 2011 EOLnavigator Hi! Glad you made it. @aliciabloom, @marksphone #hpm Wed May 25 18:02:36 PDT 2011 doctatum Paul in Columbia MO (and another day with tornados just cleared out) #hpm Wed May 25 18:03:07 PDT 2011 MarksPhone it was a real learning experience last week wanted to return and learn more #hpm
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Page 1: 2011 05 25 hpm tweetchat transcript

#hpm

Healthcare Hashtag Twitter Transcript

From: Wed May 25 18:00:00 PDT 2011

To: Wed May 25 19:00:00 PDT 2011

Customize transcript dates and layout

Learn more about #hpm at The Healthcare Hashtag Project

Kaviraj2 RT @renee_berry: hey everyone, won't be able to make #hpm tonight, hope you have

a great chat!Wed May 25 18:00:19 PDT 2011

EOLnavigator We will be tweeting about hospice & palliative care topics relevant to caregivers for

the next hour. #hpmWed May 25 18:00:31 PDT 2011

jfclearywisc Jim cleary from Madison WI #hpmWed May 25 18:00:45 PDT 2011

aliciabloom MSW, LSW focusing on #palliative care program development & increasing #hospice

access through clinical education at @VITASHospice #hpmWed May 25 18:01:43 PDT 2011

MarksPhone Mark from NYC #hpmWed May 25 18:01:43 PDT 2011

EOLnavigator Hey there! @jfclearywisc, @Kaviraj2, @MeredithGould #hpmWed May 25 18:01:56 PDT 2011

dockj Kevin from Wilmington NC #hpm and family med Ed. Tweets are my own opinion.Wed May 25 18:02:35 PDT 2011

EOLnavigator Hi! Glad you made it. @aliciabloom, @marksphone #hpmWed May 25 18:02:36 PDT 2011

doctatum Paul in Columbia MO (and another day with tornados just cleared out) #hpmWed May 25 18:03:07 PDT 2011

MarksPhone it was a real learning experience last week wanted to return and learn more #hpm

Page 2: 2011 05 25 hpm tweetchat transcript

MarksPhoneWed May 25 18:03:10 PDT 2011

EOLnavigator Hi Kevin @dockj #hpmWed May 25 18:03:13 PDT 2011

dockj Next hour tweets tagged #hpm part of palliative medicine and hospice tweetchatWed May 25 18:03:20 PDT 2011

EOLnavigator Topic 1 coming soon.... #hpmWed May 25 18:03:30 PDT 2011

EOLnavigator Glad it was! RT @MarksPhone: it was a real learning experience last week wanted to

return and learn more #hpmWed May 25 18:03:46 PDT 2011

revdoc Pam Harris, MD w/KC Hospice, ordained minister; joining HPM tweetchat; opinions

are my own #hpmWed May 25 18:03:47 PDT 2011

KathyKastner health blogger, with (it seems increasing) interest in all things #hpm (hence recent

post abt dying)http://tinyurl.com/3oqam2vWed May 25 18:03:56 PDT 2011

dockj @doctatum glad you are safe. Hope everyone there is OK. #hpmWed May 25 18:04:07 PDT 2011

EOLnavigator Hi @doctatum, @revdoc #hpmWed May 25 18:04:12 PDT 2011

EOLnavigator T1: As a caregiver, how do you define "suffering" & what influences your beliefs about

suffering? #hpmWed May 25 18:04:24 PDT 2011

PracticalWisdom HI Lisa Speaker/Trainer Myers-Briggs/Leadership/Creativity/Presentation/Adult Educ.

Morph the ho-hum into compelling. Curious/Connector #HPMWed May 25 18:04:37 PDT 2011

PracticalWisdom Yes, I forgot if you were close. Sorry for Mo folks! RT @dockj: @doctatum glad you are

safe. Hope everyone there is OK. #HPMWed May 25 18:05:22 PDT 2011

EOLnavigator @practicalwisdom Glad you made it! #hpmWed May 25 18:05:57 PDT 2011

revdoc T1 Suffering is pain/fear/sadness w/o meaning #hpmWed May 25 18:05:58 PDT 2011

jfclearywisc Are we talking clinical or family caregivers? #hpm

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jfclearywiscWed May 25 18:06:29 PDT 2011

doctatum @PracticalWisdom @dockj @doctatum Thanks. RedCross doing a good job. More

bad new in Sedalia today. #hpmWed May 25 18:06:32 PDT 2011

MarksPhone T1 Do we project what feel and believe, or as observers do we alter what we observe

or do we apply society beliefs? #hpmWed May 25 18:06:34 PDT 2011

SheyontheBay Hello all - hospice/palliative nurse NY #hpmWed May 25 18:06:43 PDT 2011

aliciabloom suffering is: anything causing distress, multifaceted (physical, emotional, spiritual)

and unique to the individual experiencing it #hpmWed May 25 18:06:46 PDT 2011

EOLnavigator Interesting. Why w/o meaning? RT @revdoc: T1 Suffering is pain/fear/sadness w/o

meaning #hpmWed May 25 18:06:49 PDT 2011

GailZahtz Trying to participate in #HPM -my first love medical chat- yet it's been hard to show-up

lately. Intro- patient, care-giver, etcWed May 25 18:07:04 PDT 2011

PracticalWisdom So Sorry. RT @doctatum: @PracticalWisdom @dockj @doctatum Thanks. RedCross

doing a good job. More bad new in Sedalia today. #HPMWed May 25 18:07:19 PDT 2011

EOLnavigator Our thoughts are with our friends affected by the tornado. Anyone here tonight? #hpmWed May 25 18:07:20 PDT 2011

PracticalWisdom RT @MarksPhone: T1 Do we project what feel and believe, or as observers do we

alter what we observe or do we apply society beliefs? #HPMWed May 25 18:07:30 PDT 2011

SheyontheBay If there's meaning, does it mean there's no suffering? #hpmWed May 25 18:07:38 PDT 2011

EOLnavigator @GailZahtz Thanks for coming! #hpmWed May 25 18:07:47 PDT 2011

KathyKastner RT @aliciabloom: suffering is: anything causing distress, multifaceted (physical,

emotional, spiritual) and unique to the individual experiencing it #hpmWed May 25 18:07:51 PDT 2011

PracticalWisdom @GailZahtz: So Glad you could come. #HPMWed May 25 18:08:10 PDT 2011

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EOLnavigator @SheyontheBay Hey there! #hpmWed May 25 18:08:14 PDT 2011

GailZahtz T1- Suffering is only without meaning if we don't look for and find meaning in our pain

and challenges #HPMWed May 25 18:08:14 PDT 2011

revdoc Going through pain or other adverse situations can be brave, redemptive, or a growth

experience; w/o meaning, it is just cruel #hpmWed May 25 18:08:16 PDT 2011

GailZahtz @PracticalWisdom Thanks! I really miss you and everyone else. #HPM was my first

home. Always in my heart, even if I'm not here!Wed May 25 18:08:50 PDT 2011

aliciabloom suffering can result not only from a disease, but its treatment and the impact it has on

a person's life #hpmWed May 25 18:09:04 PDT 2011

SheyontheBay @revdoc But there'/ still suffering, yes? #hpmWed May 25 18:09:11 PDT 2011

GailZahtz @EOLnavigator Thank you for the welcome. are you moderating #HPMWed May 25 18:09:12 PDT 2011

EOLnavigator RT @aliciabloom: suffering is: anything causing distress, multifaceted & unique 2 the

individ experiencing it #hpmWed May 25 18:09:22 PDT 2011

revdoc Meaning does not erase all pain, but I think it takes things from the realm of suffering

to other experiences #hpmWed May 25 18:09:22 PDT 2011

KathyKastner RT @aliciabloom: suffering can result not only from a disease, but its treatment and

the impact it has on a person's life #hpmWed May 25 18:09:38 PDT 2011

EOLnavigator @GailZahtz Yes I am! #hpmWed May 25 18:09:53 PDT 2011

MeredithGould T1 Isn't suffering totally subjective? And don't we need to go with the definition of the

person who claims to be suffering? #hpmWed May 25 18:09:58 PDT 2011

dockj RT @aliciabloom: suffering can result not only from a disease, but its treatment and

the impact it has on a person's life #hpmWed May 25 18:10:00 PDT 2011

GailZahtz @revdoc We MUST give the pain and adversity meaning- otherwise it makes life

unbearable. #HPMWed May 25 18:10:15 PDT 2011

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KathyKastner #hpm For a family caregiver, I think suffering includes seeing/perceving loved one

'giving up.'Wed May 25 18:10:15 PDT 2011

EOLnavigator @GailZahtz Do you find it easy to know the source? #hpmWed May 25 18:10:43 PDT 2011

PracticalWisdom RT @MeredithGould: T1 Isnt suffering totally subjective? dont we need 2 go w/the

definition of the person who claims to be suffering? #HPMWed May 25 18:10:46 PDT 2011

MeredithGould @SheyontheBay My standard line is "not all suffering is redemptive." #hpmWed May 25 18:10:46 PDT 2011

aliciabloom as clinicians, we should always ask patients about the sources of their suffering so

that we can adequately address it & support them #hpmWed May 25 18:10:48 PDT 2011

SheyontheBay RT @MeredithGould: T1Isnt suffering totally subjective?dont we need to go with the

definition of the person who claims to be suffering? #hpmWed May 25 18:10:57 PDT 2011

MarksPhone @MeredithGould I agree it is the person suffering who defines it but as with all

language etc how is that communicated to the HCP? #hpmWed May 25 18:11:00 PDT 2011

EOLnavigator RT @aliciabloom: suffering can result not only from a disease, but its treatment and

the impact it has on a persons life #hpmWed May 25 18:11:24 PDT 2011

EOLnavigator RT @revdoc: Meaning does not erase all pain, but I think it takes things from the

realm of suffering to other experiences #hpmWed May 25 18:11:40 PDT 2011

GailZahtz @EOLnavigator To know the source for suffering? Some is easy- like a DX. Some

hard, like emotional impact. #HPMWed May 25 18:11:41 PDT 2011

MarksPhone @EOLnavigator agree it is multi-deminisonal and each is treated differently #hpmWed May 25 18:12:05 PDT 2011

KathyKastner RT @MeredithGould: T1 Isn't suffering totally subjective? And don't we need to go with

the definition of the person who claims to be suffering? #hpmWed May 25 18:12:19 PDT 2011

MeredithGould @MarksPhone We need to find out how the pt communicates, what language

system, nonverbal signals, etc. #hpmWed May 25 18:12:20 PDT 2011

MarksPhone RT @GailZahtz: @EOLnavigator To know the source for suffering? Some is easy- like

a DX. Some hard, like emotional impact. #HPM

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Wed May 25 18:12:27 PDT 2011

PracticalWisdom T1: My Tweets are my own. Does anybody else want to Give this information? #HPMWed May 25 18:12:29 PDT 2011

EOLnavigator RT @MeredithGould +1: Isnt suffering totally subjective? dont we need 2 go w/the

definition of the person who claims to be suffering? #hpmWed May 25 18:12:29 PDT 2011

KathyKastner RT @MeredithGould: @MarksPhone We need to find out how the pt communicates,

what language system, nonverbal signals, etc. #hpmWed May 25 18:12:46 PDT 2011

GailZahtz @PracticalWisdom Yes, tweets are my own...trust me, with the fabulous groups I

represent, each have their own very strong opinions! :) #HPMWed May 25 18:13:27 PDT 2011

dockj T2 suffering is what the patient experiences when they are in distress they cannot

cope with. Regardless of the source. #hpmWed May 25 18:13:30 PDT 2011

EOLnavigator RT @aliciabloom: as clinicians, we always ask pts about the sources of suffering so

that we can adequately address it & support them #hpmWed May 25 18:13:31 PDT 2011

KathyKastner @MeredithGould I think I need to tell you I love you (for your mind of course) #hpmWed May 25 18:13:42 PDT 2011

aliciabloom asking open ended questions ("what is distressing you?" "tell me what troubles

you?") gives patients an opportunity to speak freely #hpmWed May 25 18:13:50 PDT 2011

PracticalWisdom RT @dockj: T2 suffering is what the patient experiences when they are in distress

they cannot cope with. Regardless of the source. #HPMWed May 25 18:14:01 PDT 2011

SheyontheBay @EOLnavigator @revdoc It can take things to another realm, but if it doesn't, there's

still suffering-be it physical, spiritual... #hpmWed May 25 18:14:03 PDT 2011

GLakesCaring RT @dockj: T2 suffering is what the patient experiences when they are in distress

they cannot cope with. Regardless of the source. #hpmWed May 25 18:14:04 PDT 2011

KathyKastner RT @dockj: T2 suffering is what the patient experiences when they are in distress

they cannot cope with. Regardless of the source. #hpmWed May 25 18:14:18 PDT 2011

dockj RT @aliciabloom: asking open ended questions ("what is distressing you?" "tell me

what troubles you?") gives patients an opportunity to speak freely #hpmWed May 25 18:14:23 PDT 2011

Page 7: 2011 05 25 hpm tweetchat transcript

EOLnavigator RT @KathyKastner: @MeredithGould I think I need to tell you I love you (for your mind

of course) #hpmWed May 25 18:14:30 PDT 2011

MeredithGould Is there a T2? #hpmWed May 25 18:14:35 PDT 2011

GailZahtz T2 IMO opinion we need to add in people's cultural perspective to the event and the

relative suffering and communication of it. #HPMWed May 25 18:14:41 PDT 2011

PracticalWisdom RT @aliciabloom: asking open ended (?)'s ("what is distressing U?" "tell me what

troubles U?") gives patients an oppor. 2 speak freely #HPMWed May 25 18:14:44 PDT 2011

MeredithGould @KathyKastner So does that mean you do NOT love my hair, too? #hpmWed May 25 18:15:00 PDT 2011

EOLnavigator Suffering always spurs me to action as a clinician. #hpmWed May 25 18:15:16 PDT 2011

dockj Sorry mine was a miss answer. LoL should be T 1. #hpmWed May 25 18:15:19 PDT 2011

MarksPhone some patients want to put on a good face for the HCP show they are succeeding in tx

and making progress while outside HC they hurt #hpmWed May 25 18:15:20 PDT 2011

KathyKastner I covet your hair. RT @MeredithGould: @KathyKastner So does that mean you do

NOT love my hair, too? #hpmWed May 25 18:15:29 PDT 2011

dockj RT @EOLnavigator: Suffering always spurs me to action as a clinician. #hpmWed May 25 18:15:43 PDT 2011

EOLnavigator @MeredithGould No T2 yet....still on T1 #hpmWed May 25 18:15:54 PDT 2011

PracticalWisdom Yup, Not Blond. RT @KathyKastner: I covet your hair. RT @MeredithGould:

@KathyKastner So does that mean you do NOT love my hair, too? #HPMWed May 25 18:16:09 PDT 2011

GailZahtz @dockj T2 I don't think that suffering is distress that someone can't cope with. I think

that you may be coping- but it's hard! #HPMWed May 25 18:16:13 PDT 2011

MeredithGould @EOLnavigator Ok, thanks. #hpmWed May 25 18:16:21 PDT 2011

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EOLnavigator Do you think culture or religion influences suffering? #hpmWed May 25 18:16:36 PDT 2011

MeredithGould BTW, @bentleystewart has a great post at http://healthfaith.com today re:

communicatng w/pts. #hpmWed May 25 18:16:59 PDT 2011

GailZahtz @MarksPhone In my experience, both hcp's and outsiders WANT us to be strong,

stoic, "brave" and that minimizes the reality of the pain #HPMWed May 25 18:17:16 PDT 2011

SheyontheBay @EOLnavigator Yes #hpmWed May 25 18:17:27 PDT 2011

KathyKastner A big yessrree bob to that RT @EOLnavigator: Do you think culture or religion

influences suffering? #hpmWed May 25 18:17:31 PDT 2011

revdoc I think culture and religion can teach us patterns of coping, give us resources to

stand up under adversity #hpmWed May 25 18:17:55 PDT 2011

EOLnavigator RT @dockj: T2 suffering is what the patient experiences when they are in distress

they cannot cope with. Regardless of the source. #hpmWed May 25 18:18:01 PDT 2011

KathyKastner Nice! RT @revdoc: I think culture and religion can teach us patterns of coping, give us

resources to stand up under adversity #hpmWed May 25 18:18:16 PDT 2011

aliciabloom "@EOLnavigator: Do u think culture/religion influences suffering?" yes. patient

perception & values are impacted by culture & religion #hpmWed May 25 18:18:36 PDT 2011

hollyby Hello all! At Upaya this week, so only lurking tonight! Have a great chat! #hpmWed May 25 18:18:41 PDT 2011

GailZahtz @dockj What is coping? In the face of tragedy- it's just getting up and dong the next

right thing. May not be pretty or clean... #HPMWed May 25 18:18:50 PDT 2011

SusanCadell I was very pleased to present research about caregiving parents in peds #palliative

care today @sickkids via @OTNtelemedicine #hpm #growthWed May 25 18:19:00 PDT 2011

MeredithGould Culture shapes the ways suffering is perceived and expressed, sure. #hpmWed May 25 18:19:03 PDT 2011

EOLnavigator @hollyby Thanks for coming! #hpmWed May 25 18:19:04 PDT 2011

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revdoc Unfortunately, culture and religion can also provide NEGATIVE examples of coping

#hpmWed May 25 18:19:23 PDT 2011

jfclearywisc I actually find the question "are you suffering?" to be very powerful and revealing. Or to

ask it of family #hpmWed May 25 18:19:45 PDT 2011

GailZahtz @aliciabloom @EOLnavigator Yes, definitely said earlier, culture, religions, belief

system completely impact what and how we suffer #HPMWed May 25 18:19:47 PDT 2011

dockj Culture/ religion give us constructs to help us decode suffering in the context of

society, but it is still and individual experience. #hpmWed May 25 18:20:02 PDT 2011

PracticalWisdom Hey Meredith,“I’m hoping for a miracle soon. Quote in Blog

RT@MeredithGould.@bentleystewart has a great post at http://healthfaith.com #HPMWed May 25 18:20:14 PDT 2011

EOLnavigator RT @GailZahtz +1What is coping? In the face of tragedy- its just getting up & doing

the next right thing. May not be pretty or clean... #hpmWed May 25 18:20:28 PDT 2011

EOLnavigator Topic 2 coming in a jiffy..... #hpmWed May 25 18:20:41 PDT 2011

GailZahtz The book on the Hunan and their experience with medicine in the U.S. is a beautiful

example of the impact of culture on getting care. #HPMWed May 25 18:20:41 PDT 2011

MarksPhone America is death phobic this is the over arching driver of this discussion we do not

accept it therefore we dont want to mitigate it #hpmWed May 25 18:20:47 PDT 2011

MeredithGould RT @dockj: Culture/ religion give us constructs to help us decode suffering in the

context of society, #hpmWed May 25 18:21:00 PDT 2011

jfclearywisc "What do you mean by a miracle?" #hpmWed May 25 18:21:12 PDT 2011

EOLnavigator RT @jfclearywisc: I actually find the question "are you suffering?" to be very powerful

and revealing. Or to ask it of family #hpmWed May 25 18:21:20 PDT 2011

doctatum I think it reframes things for the family in conflctRT @jfclearywisc: the question "are

you suffering?" = very powerful and revealing. #hpmWed May 25 18:21:29 PDT 2011

culture and religion can be protective factors & sources of strength, but they can also

Page 10: 2011 05 25 hpm tweetchat transcript

aliciabloom

culture and religion can be protective factors & sources of strength, but they can also

create unique challenges and barriers #hpmWed May 25 18:21:38 PDT 2011

KathyKastner #hpm Religion caused my best pal great suffering when she felt baby's death was

god's punishmentWed May 25 18:21:46 PDT 2011

EOLnavigator T2: How does your perspective on suffering affect how you care for someone who is

terminally ill? #hpmWed May 25 18:21:53 PDT 2011

revdoc @EOLnavigator @GailZahtz Up and dressed is a fine goal if that is the only place you

can be at the time #hpmWed May 25 18:22:08 PDT 2011

dockj RT @MarksPhone: America is death phobic this is the over arching driver of this

discussion we do not accept it therefore we dont want to mitigate it #hpmWed May 25 18:22:32 PDT 2011

DrSnit #hpm oh hai! Been watching hockey. Now I'm here!!! How goes cats? Xx missed you!Wed May 25 18:22:35 PDT 2011

GailZahtz @MeredithGould @dockj @revdoc The real question isn't does culture/religion work-

how does it work for the individual patient and family #HPMWed May 25 18:22:43 PDT 2011

DoctorFisher @jfclearywisc Or even better "In what way are you suffering?" gives patient the open

door to talk #hpmWed May 25 18:22:45 PDT 2011

PracticalWisdom Sigh, how terrible.RT @KathyKastner: #hpm Religion caused my best pal great

suffering when she felt babys death was gods punishment #HPMWed May 25 18:22:51 PDT 2011

EOLnavigator @aliciabloom Irish Catholic (my background) always equate suffering with payment

for sins! #hpmWed May 25 18:22:52 PDT 2011

GLakesCaring RT @EOLnavigator: T2: How does your perspective on suffering affect how you care

for someone who is terminally ill? #hpmWed May 25 18:22:53 PDT 2011

EOLnavigator @DrSnit Hai there to you too! #hpmWed May 25 18:23:12 PDT 2011

PracticalWisdom So Glad you are Here. Like Superman but GirlRT @DrSnit: #hpm oh hai! Been

watching hockey. Now Im here!!! How goes cats? Xx missed you! #HPMWed May 25 18:23:20 PDT 2011

MarksPhone T2 my vision or the caregivers vision will effect the patient if the patient allows it and

then the battle of wills begins #hpmWed May 25 18:23:24 PDT 2011

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SheyontheBay RT @GailZahtz: The real question isnt does culture/religion work-how does it work for

the individual patient and family #hpmWed May 25 18:23:27 PDT 2011

MeredithGould T2 Takes a lot of consciousness to not project/superimpose one's own stuff onto

patients & caregivers. #hpmWed May 25 18:23:47 PDT 2011

GailZahtz @revdoc @EOLnavigator Succeeding 51% of the time- especially during trauma- is

100% success. #HPMWed May 25 18:23:55 PDT 2011

DoctorFisher Hi just arrived #hpmWed May 25 18:24:00 PDT 2011

EOLnavigator RT @doctorfisher: @jfclearywisc Or even better "In what way are you suffering?" gives

patient the open door to talk #hpmWed May 25 18:24:05 PDT 2011

KathyKastner RT @MeredithGould: T2 Takes a lot of consciousness to not project/superimpose

one's own stuff onto patients & caregivers. #hpmWed May 25 18:24:16 PDT 2011

aliciabloom @EOLnavigator i'm part italian catholic and part eastern european jew-- i hear you!

#hpmWed May 25 18:24:20 PDT 2011

revdoc @GailZahtz @revdoc @EOLnavigator Amen, sister! #hpmWed May 25 18:24:30 PDT 2011

EOLnavigator @PracticalWisdom @KathyKastner So sorry! That happens alot. Makes you suffer

too. #hpmWed May 25 18:24:44 PDT 2011

MeredithGould @aliciabloom We should talk! #hpmWed May 25 18:24:51 PDT 2011

DoctorFisher @MeredithGould agree, try not to project, yet my patients find it comforting when I

share what gives me hope #hpmWed May 25 18:25:05 PDT 2011

PracticalWisdom Welcome, so glad you come tonight. RT @doctorfisher: Hi just arrived #HPMWed May 25 18:25:12 PDT 2011

SheyontheBay @EOLnavigator @aliciabloom i heard suffering bought time off in purgatory, now

there's no more purgatory->what to do withmy suffering? #hpmWed May 25 18:25:20 PDT 2011

KathyKastner Basta. Oy. RT @aliciabloom: @EOLnavigator i'm part italian catholic and part eastern

european jew-- i hear you! #hpm

Page 12: 2011 05 25 hpm tweetchat transcript

european jew-- i hear you! #hpmWed May 25 18:25:32 PDT 2011

revdoc T2 risk that caregivers push pt to find meaning pt is not ready to investigate;

caregivers are successful if pt finds "closure" #hpmWed May 25 18:25:46 PDT 2011

MeredithGould @doctorfisher Right and that's not projecting, that's sharing! #hpmWed May 25 18:25:51 PDT 2011

DrSnit Belief in punishment or Suffering certainly changes both caregiver & patient EOL /

illness experiences. #hpmWed May 25 18:26:01 PDT 2011

GailZahtz Also, neither the outsider nor the person "suffering" knows which even will cause the

most pain. We need to be gentle in judgment. #HPMWed May 25 18:26:09 PDT 2011

EOLnavigator @doctorfisher Thanks for making it! #hpmWed May 25 18:26:12 PDT 2011

doctorfisher @PracticalWisdom thanks it's always great to 'be' here #hpmWed May 25 18:26:30 PDT 2011

EOLnavigator RT @doctorfisher: @MeredithGould agree, try not to project, yet my patients find it

comforting when I share what gives me hope #hpmWed May 25 18:26:36 PDT 2011

MeredithGould @aliciabloom Oy vey, Maria...as my mother would say. #hpmWed May 25 18:26:51 PDT 2011

aliciabloom @MeredithGould love it! #hpmWed May 25 18:27:14 PDT 2011

EOLnavigator I find, when I can identify with pt.'s suffering & they realize we have common

understanding, their suffering decreases. #hpmWed May 25 18:27:15 PDT 2011

RossJeanette Hi all I'm joining in late. I'll lurk u til I can figure out what we are talking about #HPMWed May 25 18:27:37 PDT 2011

doctorfisher @MeredithGould yes and I think sharing my own views makes me more 'human' plus

if we disagree, it's on the table #hpmWed May 25 18:27:38 PDT 2011

EOLnavigator Hope is definitely an important part of relief from suffering. #hpmWed May 25 18:27:56 PDT 2011

DrSnit @MeredithGould yes. Also to not be offended or annoyed by seemingly outlandish

beliefs. Oy. "what did you do to make god mad?" #hpm

Page 13: 2011 05 25 hpm tweetchat transcript

beliefs. Oy. "what did you do to make god mad?" #hpmWed May 25 18:28:04 PDT 2011

doctorfisher RT @EOLnavigator: I find, when I can identify with pt.'s suffering & they realize we

have common understanding, their suffering decreases. #hpmWed May 25 18:28:07 PDT 2011

EOLnavigator @RossJeanette Glad you made it! #hpmWed May 25 18:28:13 PDT 2011

GailZahtz @EOLnavigator I think the key with connecting and identifying with other's suffering is

validating their own perceptions of it. #HPMWed May 25 18:28:18 PDT 2011

MeredithGould @RossJeanette We're talking about suffering. LOL. #hpmWed May 25 18:28:21 PDT 2011

dockj I think the concept of total pain which accounts for all sources of suffering is a useful

construct. #hpmWed May 25 18:28:29 PDT 2011

aliciabloom what we perceive as suffering should be left outside the patient's room, so that we

can fully understand their unique suffering #hpmWed May 25 18:28:29 PDT 2011

DoctorFisher RT @EOLnavigator: Hope is definitely an important part of relief from suffering. #hpmWed May 25 18:28:34 PDT 2011

EOLnavigator @rossjeanette "Suffering" #hpmWed May 25 18:28:37 PDT 2011

MeredithGould RT @dockj: I think the concept of total pain which accounts for all sources of suffering

is a useful construct. #hpmWed May 25 18:29:07 PDT 2011

dockj Physical/family dysfunction / relationships/ religious/ cultural. #hpmWed May 25 18:29:15 PDT 2011

doctorfisher RT @GailZahtz: @EOLnavigator I think the key with connecting and identifying with

other's suffering is validating their own perceptions of it. #HPMWed May 25 18:29:21 PDT 2011

EOLnavigator RT @DrSnit: @MeredithGould yes. Also 2 not be offended or annoyed by outlandish

beliefs. Oy. "what did you do 2 make god mad?" #hpmWed May 25 18:29:24 PDT 2011

MeredithGould @dockj Total pain as in physical, mental and spiritual, right? #hpmWed May 25 18:29:25 PDT 2011

MeredithGould And, gee, what the heck...also total pain as in familial?1? #hpm

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MeredithGould And, gee, what the heck...also total pain as in familial?1? #hpmWed May 25 18:30:20 PDT 2011

dockj Any or all can be the biggest source of suffering at any one time #hpmWed May 25 18:30:22 PDT 2011

KathyKastner #hpm I know this is a serious discussion, but 2nite I'm suffering cuz I have piles of

reading for QA committee meeting in the am.Wed May 25 18:30:27 PDT 2011

EOLnavigator RT @DrSnit: Belief in punishment or Suffering certainly changes both caregiver &

patient EOL / illness experiences. #hpmWed May 25 18:30:32 PDT 2011

aliciabloom hope is important, but often hope = cure, which isn't always reality. sometimes we

need to help patients/families reframe hope. #hpmWed May 25 18:30:43 PDT 2011

revdoc Should we question pts about distress we see in them even if they do not report they

are suffering? #hpmWed May 25 18:30:54 PDT 2011

GailZahtz No offense, but making fun of other people's belief's (which may seem silly or

destructive to you) is the exact opposite of support #HPMWed May 25 18:31:04 PDT 2011

PracticalWisdom MD told Wife/Patient Don't ask a (?) right now if U don't want truth. Arc of Life & Love,

Unbent by Treatment http://nyti.ms/kJ7Sr2 #HPMWed May 25 18:31:10 PDT 2011

doctorfisher RT @aliciabloom: hope is important, but often hope = cure, which isn't always reality.

sometimes we need to help patients/families reframe hope. #hpmWed May 25 18:31:20 PDT 2011

EOLnavigator @aliciabloom Do you think that you have to have suffered yourself to understand

someone else's suffering? #hpmWed May 25 18:31:23 PDT 2011

GailZahtz @revdoc Absolutely, may people suffer the most in silence, and won't discuss or heal

if not directly asked. #HPMWed May 25 18:31:54 PDT 2011

PracticalWisdom RT @GailZahtz: Making fun of other peoples beliefs (which may seem silly or

destructive to you) is the exact opposite of support #HPMWed May 25 18:31:57 PDT 2011

SheyontheBay @aliciabloom often to facilitate change in what they are hoping for...a peaceful

passing, instead of cure #hpmWed May 25 18:31:59 PDT 2011

KathyKastner RT @SheyontheBay: @aliciabloom often to facilitate change in what they are hoping

for...a peaceful passing, instead of cure #hpmWed May 25 18:32:17 PDT 2011

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MeredithGould @EOLnavigator Great question. Probably everyone suffers but some have denial so

thick they don't cop to it. #hpmWed May 25 18:32:21 PDT 2011

GailZahtz @PracticalWisdom Thanks Lisa! #HPMWed May 25 18:32:41 PDT 2011

MarksPhone I wonder, do HCP have the wear with all to identify all the issues surrounding the

patient and family and navigate a path? #hpmWed May 25 18:32:53 PDT 2011

DoctorFisher @aliciabloom Yes, I never let my patients "give up hope", I help them shift their hope

to realistic goals #hpmWed May 25 18:32:55 PDT 2011

GailZahtz @DoctorFisher For some reason, we haven't crossed paths. Nice to meet you, and

get to know you, and hope to meet again :) #HPMWed May 25 18:33:10 PDT 2011

KathyKastner Yep. My hubRT @MeredithGould: @EOLnavigator Great Q. Probably everyone suffers

but some have denial so thick they don't cop to it. #hpmWed May 25 18:33:17 PDT 2011

RossJeanette The physical suffering may be "easier" to identify. #HPMWed May 25 18:33:26 PDT 2011

EOLnavigator Sometimes they don't know RT @revdoc: Should we question pts about distress we

C in them even if they do not report they are suffering? #hpmWed May 25 18:33:28 PDT 2011

GailZahtz @DoctorFisher @aliciabloom Is there an appropriate time and place when a patient

is entitled to give up hope? Question, not sure. #HPMWed May 25 18:33:47 PDT 2011

KathyKastner How wonderful of you RT @DoctorFisher: @aliciabloom I never let my pts "give up

hope", I help them shift their hope 2 realistic goals #hpmWed May 25 18:34:00 PDT 2011

aliciabloom @EOLnavigator think suffering is something we all experience in life, regardless of

the source. it's part of being human. #hpmWed May 25 18:34:09 PDT 2011

DoctorFisher @GailZahtz You as well! #hpmWed May 25 18:34:10 PDT 2011

EldrcareConsult Hey guys so sorry i am late! #hpmWed May 25 18:34:10 PDT 2011

revdoc @EOLnavigator @revdoc But is that my deciding the pt is suffering? #hpmWed May 25 18:34:25 PDT 2011

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EOLnavigator @EldrcareConsult Hey there! We are talking about suffering #hpmWed May 25 18:34:39 PDT 2011

EOLnavigator RT @doctorfisher: @aliciabloom Yes, I never let my patients "give up hope", I help

them shift their hope to realistic goals #hpmWed May 25 18:35:04 PDT 2011

MeredithGould Great post about hope and communicating w/pts: http://bit.ly/lHaS1l #hpmWed May 25 18:35:04 PDT 2011

KathyKastner Good Q. RT @revdoc: @EOLnavigator @revdoc But is that my deciding the pt is

suffering? #hpmWed May 25 18:35:06 PDT 2011

EOLnavigator RT @RossJeanette: The physical suffering may be "easier" to identify. #hpmWed May 25 18:35:10 PDT 2011

DrSnit @GailZahtz have you ever watched a mother ask her daughter what she did to anger

god? It is hard to deal with their needs fully #hpmWed May 25 18:35:35 PDT 2011

MeredithGould RT @DrSnit: Belief in punishment or Suffering certainly changes both caregiver &

patient EOL / illness experiences. #hpmWed May 25 18:35:40 PDT 2011

EOLnavigator RT @KathyKastner RT @MeredithGould Probably everyone suffers but some have

denial so thick they dont cop to it. #hpmWed May 25 18:35:44 PDT 2011

PracticalWisdom Great To See You. RT @EldrcareConsult: Hey guys so sorry i am late! #HPMWed May 25 18:35:59 PDT 2011

aliciabloom @GailZahtz- i agree with @DoctorFisher in that we have to help people find hope &

meaning all the time, even if it means reframing it. #hpmWed May 25 18:36:13 PDT 2011

doctorfisher @GailZahtz sure, we need to let patients grieve loss. But I don't want to leave them

hopeless so must offer some form of help #hpmWed May 25 18:36:47 PDT 2011

whole_patients RT @MeredithGould: Great post about hope and communicating w/pts:

http://bit.ly/lHaS1l #hpmWed May 25 18:36:53 PDT 2011

KathyKastner Is it only #hpm-ers who are trained to re-frame?Wed May 25 18:36:58 PDT 2011

EOLnavigator Never! Hope to die well. RT @GailZahtz: @DoctorFisher @aliciabloom Is there an

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EOLnavigator Never! Hope to die well. RT @GailZahtz: @DoctorFisher @aliciabloom Is there an

appropriate time & place when a pt can give up hope? #hpmWed May 25 18:36:59 PDT 2011

GailZahtz @DrSnit I've been told that either in this life or a former life I did something that I'm

doing "teshuvah" for. (need to go to a 2nd..) #HPMWed May 25 18:37:12 PDT 2011

MarksPhone http://bit.ly/jt92nj Jimmie Holland the Human Side of Cancer #hpmWed May 25 18:37:15 PDT 2011

MeredithGould RT @KathyKastner: Is it only #hpm-ers who are trained to re-frame?<--my guess is

yesWed May 25 18:37:23 PDT 2011

EOLnavigator Ur only frame of reference tho RT @KathyKastner: Good Q. RT @revdoc:

@EOLnavigator @revdoc But is that my deciding the pt is suffering? #hpmWed May 25 18:38:05 PDT 2011

GailZahtz @DrSnit On one hand, very hard to hear, process, benefit. On another, my personal

belief system from where it comes, helps me cope. #HPMWed May 25 18:38:17 PDT 2011

EOLnavigator Topic 3 is almost upon us.... #hpmWed May 25 18:38:19 PDT 2011

revdoc @MeredithGould @KathyKastner Reframing not a big part of my medical education...

#hpmWed May 25 18:38:24 PDT 2011

jfclearywisc Said it b4; Tulsky (Hope or Hubris, JPM) Hope=trust. However bad, things will work

out. #hpmWed May 25 18:38:32 PDT 2011

DoctorFisher @KathyKastner I was trained to re-frame during #geriatrics fellowship #hpmWed May 25 18:38:42 PDT 2011

EOLnavigator Different topic...we've suffered enough! #hpmWed May 25 18:38:59 PDT 2011

MeredithGould @revdoc Because it's too "soft" and not "science," right? #hpmWed May 25 18:39:01 PDT 2011

MeredithGould @EOLnavigator LOLOL...good one #hpmWed May 25 18:39:09 PDT 2011

GailZahtz @DrSnit I want to strangle people who say "it's all for the best" or "we're not given

more than we can handle" others benefit from that #HPMWed May 25 18:39:19 PDT 2011

revdoc @MeredithGould @revdoc Yep #hpm

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revdoc @MeredithGould @revdoc Yep #hpm

Wed May 25 18:39:30 PDT 2011

KathyKastner I have pondered hope and false hope http://tinyurl.com/3yzvexh #hpmWed May 25 18:39:35 PDT 2011

KathyKastner Ha! RT @EOLnavigator: Different topic...we've suffered enough! #hpmWed May 25 18:39:57 PDT 2011

PracticalWisdom RT @KathyKastner: Ha! RT @EOLnavigator: Different topic...weve suffered enough!

#HPMWed May 25 18:40:25 PDT 2011

aliciabloom i often feel like #hospice & #palliative care is as much an art as it is a science #hpmWed May 25 18:40:30 PDT 2011

EOLnavigator T3: When you search for information about end of life care online, what kind of

information are you looking for & do you find it? #hpmWed May 25 18:40:48 PDT 2011

DrSnit @GailZahtz not the same as watching it as a provider but you get it from an advocacy

perspective. #hpmWed May 25 18:40:54 PDT 2011

KathyKastner Hope and aging.Gr8 combo RT @DoctorFisher: @KathyKastner I was trained to re-

frame during #geriatrics fellowship #hpmWed May 25 18:41:06 PDT 2011

GailZahtz @aliciabloom @DoctorFisher @EOLnavigator Studies show that outcomes of same

surgeries affected by hope. #HPMWed May 25 18:41:07 PDT 2011

PracticalWisdom Great Truth 2 That. Thank you! RT @aliciabloom: i often feel like #hospice &

#palliative care is as much an art as it is a science #HPMWed May 25 18:41:11 PDT 2011

revdoc @aliciabloom Absolutely! #hpmWed May 25 18:41:12 PDT 2011

dockj RT @aliciabloom: i often feel like #hospice & #palliative care is as much an art as it

is a science #hpmWed May 25 18:41:19 PDT 2011

DrSnit RT @EOLnavigator: T3: When you search for information about end of life care

online, what kind of information are you looking for & do you find it? #hpmWed May 25 18:41:25 PDT 2011

MarksPhone Finding it is one thing, wanting to know what it says is another there is a gap in

acquiring this knowledge to the problem at hand #hpmWed May 25 18:42:00 PDT 2011

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Wed May 25 18:42:00 PDT 2011

revdoc T3 More research is being done, but too much old literature was anecdotal; I'm

looking for best practices #hpmWed May 25 18:42:14 PDT 2011

EOLnavigator It makes me feel defeated when I hear that. RT @GailZahtz: @DrSnit #hpmWed May 25 18:42:21 PDT 2011

dockj RT @EOLnavigator: T3: When you search for information about end of life care

online, what kind of information are you looking for & do you find it? #hpmWed May 25 18:42:22 PDT 2011

DebErupts RT @aliciabloom I often feel like #hospice & #palliative care is as much an art as it is

a science #hpm | AbsolutelyWed May 25 18:42:34 PDT 2011

MeredithGould @MarksPhone Brilliant...wanted to RT but it was too long. :-( #hpmWed May 25 18:42:39 PDT 2011

dockj RT @revdoc: T3 More research is being done, but too much old literature was

anecdotal; I'm looking for best practices #hpmWed May 25 18:42:42 PDT 2011

EOLnavigator RT @PracticalWisdom: Great Truth 2 That. RT @aliciabloom: i often feel like

#hospice & #palliative care is as much art as it is science #hpmWed May 25 18:43:00 PDT 2011

GLakesCaring RT @EOLnavigator: T3: When you search for info about end of life care online, what

kind of info are you looking for & do you find it? #hpmWed May 25 18:43:13 PDT 2011

EOLnavigator RT @dockj: RT @revdoc: T3 More research is being done, but too much old literature

was anecdotal; Im looking for best practices #hpmWed May 25 18:43:28 PDT 2011

dockj I spend more time hard searching NLM for #hpm questions than any other clinical

questions I have.Wed May 25 18:43:50 PDT 2011

GailZahtz @DrSnit @EOLnavigator The juggle is for pt, caregiver, provider, family, allowing

some kind of freedom of perspective allowing dignity #HPMWed May 25 18:44:02 PDT 2011

PracticalWisdom RT @MarksPhone: Finding it is 1thing, wanting 2 know what it says is another. A gap

in acquiring this knowledge to the problem at hand #HPMWed May 25 18:44:17 PDT 2011

EOLnavigator Best practices in EOL care is pandora's box IMO! #hpmWed May 25 18:44:28 PDT 2011

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dockj RT @EOLnavigator: Best practices in EOL care is pandora's box IMO! #hpmWed May 25 18:45:26 PDT 2011

PracticalWisdom @MarksPhone: Sincerely think/Feel you are one of the sharpest Crayons in the Box.

#HPMWed May 25 18:45:37 PDT 2011

MarksPhone the real issue is getting the seeking of a this knowledge to want to apply it. In a death

phobic society we want to survial DFS etc #hpmWed May 25 18:45:38 PDT 2011

GailZahtz We should be allowed to rage, or find irrational comfort, or even to control our hope if

that empowers us, yes? #HPM @EOLnavigator @DrSnitWed May 25 18:45:41 PDT 2011

revdoc @EOLnavigator We can use good information to help find most effective, least toxic,

cost-effective regimens though #hpmWed May 25 18:45:42 PDT 2011

DoctorFisher T3 sometimes my search is less about info and more about finding people with

similar mission (like you fine people) #hpmWed May 25 18:45:47 PDT 2011

DrSnit There is too much separation between provider, patient, caregiver and "what next" in

palliative and hospice care right now. #hpmWed May 25 18:45:47 PDT 2011

MeredithGould RT @DrSnit: There is too much separation between provider, patient, caregiver and

"what next" in palliative and hospice care right now. #hpmWed May 25 18:45:56 PDT 2011

KathyKastner Aren't best practices 'situational' in eol care?RT @EOLnavigator: Best practices in

EOL care is pandora's box IMO! #hpmWed May 25 18:46:04 PDT 2011

EOLnavigator I've noticed that alot of healthcare sites really shy away from EOL care topics #hpmWed May 25 18:46:09 PDT 2011

aliciabloom political discourse about end of life care is frustrating ("death panels" "rationing").

fosters fear & creates barriers for patients #hpmWed May 25 18:46:12 PDT 2011

GailZahtz Agree! MT @DrSnit: Too much separation between provider, patient, caregiver and

"what next" in palliative and hospice care right now. #hpmWed May 25 18:46:21 PDT 2011

PracticalWisdom RT @doctorfisher: T3 sometimes my search is less about info and more about

finding people with similar mission (like you fine people) #HPMWed May 25 18:46:28 PDT 2011

dockj The problems with research in #hpm that good outcomes = bad outcomes for most

medical research.

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Wed May 25 18:46:38 PDT 2011

KathyKastner RT @GailZahtz: We should be allowed to rage, or find irrational comfort, or even to

control our hope if that empowers us, yes? #HPM @EOL ...Wed May 25 18:46:54 PDT 2011

MarksPhone The edu issue at hand is changing the learners desire to uptake knowledge and

apply, we dont know what the learners need to know #hpmWed May 25 18:46:59 PDT 2011

EOLnavigator RT @revdoc: @EOLnavigator We can use good information to help find most

effective, least toxic, cost-effective regimens though #hpmWed May 25 18:47:02 PDT 2011

GLakesCaring T3: Trick is to find info that doesn't "scare" people away from using HPM. #hpmWed May 25 18:47:05 PDT 2011

doctatum could you say more?RT @DrSnit: too much separation between provider, patient,

caregiver and "what next" in palliative and hospice care #hpmWed May 25 18:47:18 PDT 2011

GailZahtz IMO Palliative physicians, caregivers and providers are the most COURAGEOUS

because they can't cure. #HPMWed May 25 18:47:29 PDT 2011

MeredithGould RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most

COURAGEOUS because they can't cure. #HPMWed May 25 18:47:46 PDT 2011

dockj Even in the best of circumstances, there has to be subjectivity in most EOL research.

#hpmWed May 25 18:48:03 PDT 2011

EOLnavigator TY. RT @doctorfisher: T3 sometimes my search is less about info & more about

finding people with similar mission (like you fine people) #hpmWed May 25 18:48:05 PDT 2011

KathyKastner How about this http://tinyurl.com/4uphd7c @GLakesCaring: T3: Trick is to find info

that doesn't "scare" people away from using HPM. #hpmWed May 25 18:48:07 PDT 2011

PracticalWisdom T3: @doctorfisher Do you tell other MD's about finding people with similar mission? I

think so few really understand the beneifts #HPMWed May 25 18:48:12 PDT 2011

EOLnavigator Precisely! RT @KathyKastner: Arent best practices situational in eol care? Best

practices in EOL care is pandoras box IMO! #hpmWed May 25 18:48:44 PDT 2011

aliciabloom RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most

COURAGEOUS because they cant cure. #hpmWed May 25 18:48:45 PDT 2011

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DrSnit Yes! RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most

COURAGEOUS because they can't cure. #HPMWed May 25 18:48:47 PDT 2011

MeredithGould @dockj There's subjectivity in all research -- we just pretend there isn't. #hpmWed May 25 18:49:03 PDT 2011

MarksPhone @GLakesCaring That's the point what do learners want I believe a need assessment

to understand caregivers and patients is critical #hpmWed May 25 18:49:04 PDT 2011

PracticalWisdom RT @DrSnit: Yes! RT @GailZahtz: IMO Palliative physicians, caregivers and providers

are the most COURAGEOUS because they cant cure. #HPMWed May 25 18:49:20 PDT 2011

KathyKastner And practice, too, no? RT @dockj: Even in the best of circumstances, there has to be

subjectivity in most EOL research. #hpmWed May 25 18:49:24 PDT 2011

EOLnavigator @MarksPhone That's why I asked the Q. I see alot of what we think people want to

know! #hpmWed May 25 18:49:32 PDT 2011

GailZahtz T3: Especially in palliative information, it needs to have many formats and messages

so that people can access it within their way. #HPMWed May 25 18:49:58 PDT 2011

EOLnavigator RT @GLakesCaring: T3: Trick is to find info that doesnt "scare" people away from

using HPM. #hpmWed May 25 18:49:59 PDT 2011

revdoc I don't know about the rest of you...my treatment plans are ALWAYS the best! ;) #hpmWed May 25 18:50:09 PDT 2011

SheyontheBay RT @KathyKastner: Arent best practices situational in eol care? Best practices in

EOL care is pandoras box IMO! #hpmWed May 25 18:50:21 PDT 2011

dockj @KathyKastner yes. #hpmWed May 25 18:50:31 PDT 2011

PracticalWisdom Could you clarify RT @EOLnavigator: @MarksPhone Thats why I asked the Q. I see

alot of what we think people want to know! #HPMWed May 25 18:50:37 PDT 2011

MarksPhone EOL research should be paired with a study of knowledge translation How can what

we learn in EOL be up took (LOL) better #hpmWed May 25 18:50:49 PDT 2011

EOLnavigator @GailZahtz The value is in the relief of suffering & improvement in QOL without cure.

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EOLnavigator @GailZahtz The value is in the relief of suffering & improvement in QOL without cure.

#hpm

Wed May 25 18:50:53 PDT 2011

TAFORU RT @DrSnit: There is too much separation between provider, patient, caregiver and

"what next" in palliative and hospice care right now. #hpmWed May 25 18:51:02 PDT 2011

MeredithGould Re: research methods & subjectivity, read @SusannahFox post: http://bit.ly/jHrnH4

#HPMWed May 25 18:51:13 PDT 2011

Tanrita24 RT @DrSnit: There is too much separation between provider, patient, caregiver and

"what next" in palliative and hospice care right now. #hpmWed May 25 18:51:36 PDT 2011

DrSnit p value of what? RT @MeredithGould: @dockj There's subjectivity in all research --

we just pretend there isn't. #hpmWed May 25 18:51:46 PDT 2011

MeredithGould @colleen_young Was just recommending folks at the #HPM chapt read that article.

#hcsmca #hcsmeuWed May 25 18:51:53 PDT 2011

SheyontheBay VERY cautious about sites I choose 4 research. Like with most "disease-specific"

sites, can b fraught with misinformation #hpmWed May 25 18:52:18 PDT 2011

KathyKastner Truth be told..RT @MeredithGould: @dockj There's subjectivity in all research -- we

just pretend there isn't. #hpmWed May 25 18:52:27 PDT 2011

doctorfisher T3 lots of 'subjective' research in social sciences and even #psych, can #hpm learn

from them?Wed May 25 18:53:02 PDT 2011

GailZahtz Palliate: to ease (as a disease) without curing. Webster's Dictionary. I've always loved

that. TO EASE- our goal. #HPMWed May 25 18:53:11 PDT 2011

EOLnavigator @PracticalWisdom @marksphone The edu issue is that we dont know what the

learners need to know.asked Q to C if the info found is good #hpmWed May 25 18:53:39 PDT 2011

AliveHospice A must-read for #nurses, especially those who work in #pediatrics: http://bit.ly/iCdJC2

#hpmWed May 25 18:54:04 PDT 2011

SheyontheBay @GailZahtz And dis-ease = not at ease #hpmWed May 25 18:54:23 PDT 2011

doctorfisher @GailZahtz I like that- we take the 'dis' out of 'disease'! #hpmWed May 25 18:54:32 PDT 2011

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EOLnavigator Agree & it's scary! RT @MeredithGould: @dockj Theres subjectivity in all research --

we just pretend there isnt. #hpmWed May 25 18:54:38 PDT 2011

dockj RT @doctorfisher: T3 lots of 'subjective' research in social sciences and even

#psych, can #hpm learn from them?Wed May 25 18:54:51 PDT 2011

MeredithGould @DoctorFisher Subjective research, aka, qualitative research used to be essential

sociology & anthropology #hpmWed May 25 18:54:54 PDT 2011

EOLnavigator I can tell! RT @revdoc: I dont know about the rest of you...my treatment plans are

ALWAYS the best! ;) #hpmWed May 25 18:55:24 PDT 2011

GailZahtz @DoctorFisher @SheyontheBay Yes, we're easing the pain for others, we aren't

taking it away, can't cure it, shouldn't minimize it. #HPMWed May 25 18:55:31 PDT 2011

MarksPhone Knowledge translation is the scientific study of methods for closing the knowledge-

to-practice gap what is gap for pateints and HCP? #hpmWed May 25 18:55:55 PDT 2011

MeredithGould Factoid about me: exquisitely well trained in qualitative methods! Can do &

understand quantitative stuff but not under its thrall #hpmWed May 25 18:56:20 PDT 2011

SheyontheBay @MeredithGould @DoctorFisher Cant really do controlled studies in EOL care. Not

ethical! #hpmWed May 25 18:56:35 PDT 2011

rebeccatrocki RT @MeredithGould: Factoid about me: exquisitely well trained in qualitative

methods! Can do & understand quantitative stuff but not under its thrall #hpmWed May 25 18:56:44 PDT 2011

GailZahtz @MarksPhone Gap for patients on HCP? That 10 point "pain scale" Funny, yet true!

#HPMWed May 25 18:56:46 PDT 2011

EOLnavigator Thank you all for sharing your thoughts. Any final words of wisdom? #hpmWed May 25 18:56:52 PDT 2011

MeredithGould @SheyontheBay @DoctorFisher Even if you could, why would you? Makes NO sense

given the research questions. #hpmWed May 25 18:57:14 PDT 2011

revdoc @MarksPhone What do I have? What are my options? What are risks/benefits? Best

and worst case? #hpmWed May 25 18:57:14 PDT 2011

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MarksPhone @EOLnavigator we can apply priciples of adult to identify problems to be solved

#hpmWed May 25 18:57:19 PDT 2011

GailZahtz Final thoughts- validate others' pain and suffering, support them how they need, ease

and comfort how individually works. #HPMWed May 25 18:57:51 PDT 2011

KathyKastner #hpm we (non hcp) need to know more about dying as well as eol options (hence my

post, she said encouragingly)http://tinyurl.com/26k4kpmWed May 25 18:58:40 PDT 2011

GailZahtz Rockin' Thanks to "classic" and new people from #HPM. Congratz and thanks

@EOLnavigator for doing a great job moderating! Love to all :)Wed May 25 18:58:40 PDT 2011

PracticalWisdom @EOLnavigator @marksphone and I R Adult Educators. We believe in the

importance of a Need Assessment & Androgogy. It's in our Blood. #HPMWed May 25 18:58:45 PDT 2011

revdoc "How are you suffering?" is a very powerful tool #hpmWed May 25 18:58:52 PDT 2011

EOLnavigator RT @MarksPhone: @EOLnavigator we can apply priciples of adult to identify

problems to be solved #hpmWed May 25 18:58:58 PDT 2011

Lux_Seeker RT @KimberlySMoore: Musical Analgesia: Using Music for #Pain http://bit.ly/kFvLSZ

#musictherapy #hpm #cancerWed May 25 18:59:04 PDT 2011

pamojamo RT @AliveHospice: A must-read for #nurses, especially those who work in

#pediatrics: http://bit.ly/iCdJC2 #hpmWed May 25 18:59:07 PDT 2011

KathyKastner RT @EOLnavigator: RT @MarksPhone: @EOLnavigator we can apply priciples of

adult to identify problems to be solved #hpmWed May 25 18:59:15 PDT 2011

DrSnit You cats rock my socks! Thanks for all the amazing insight tonight! Great moderating!

#HPMWed May 25 18:59:16 PDT 2011

EOLnavigator RT @GailZahtz: Final thoughts- validate others pain and suffering, support them how

they need, ease and comfort how individually works. #hpmWed May 25 18:59:16 PDT 2011

MeredithGould Final thoughts: Listen carefully with care & caring. Be present. Don't get hung up on

the so-called science of care delivery. #hpmWed May 25 18:59:25 PDT 2011

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KathyKastner RT @MeredithGould: Final thoughts: Listen carefully with care & caring. Be present.

Don't get hung up on the so-called science of care delivery. #hpmWed May 25 18:59:37 PDT 2011

EOLnavigator RT @KathyKastner: #hpm we (non hcp) need to know more about dying as well as

eol options (hence my post) http://tinyurl.com/26k4kpm #hpmWed May 25 18:59:38 PDT 2011

MarksPhone Obviously I am not being clear here this is not about the obvious but the issues that

impede patients family & HPC from knowledge #hpmWed May 25 18:59:38 PDT 2011