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Healthcare Social Media TranscriptFrom: Wed Jan 18 18:00:00 PST 2012

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CompAndChoices It's time for #hpm tweetchat! Join us! #hpmWed Jan 18 18:00:45 PST 2012

rfberry RT@CompAndChoices: Its time for #hpm tweetchat! Join us! #hpmWed Jan 18 18:01:40 PST 2012

nursefriendly RT @KathyKastner: Thank you all for fab convo. Passion, compassion, motivation alwaysinspiring. Over to #hpm while listening to Nancy Finn. #S4PM

Wed Jan 18 18:02:06 PST 2012

SheyontheBay Hello all, I'm RN, CHPN in NY- advocating for advance care planning #hpmWed Jan 18 18:03:17 PST 2012

rfberry --> Rene Berry here, healthcare background, hospice volunteer, ED Navigation, GeriatricOutpatient Services, currently @goBeMoRe love: #hpmWed Jan 18 18:03:25 PST 2012

CompAndChoices T1 coming up in just a moment.... #hpmWed Jan 18 18:03:36 PST 2012

KathyKastner Hot off #S4PM - where I honest to goodness tried to talk about #hpm :)

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Wed Jan 18 18:04:06 PST 2012

JenMarsh2 Hi all, Jen here - therapist and community educator for a hospice in California #hpmWed Jan 18 18:04:15 PST 2012

CompAndChoices @rfberry Yay! welcome! So glad to "see" you. :) #hpmWed Jan 18 18:04:23 PST 2012

CompAndChoices @SheyontheBay Hey there! How's your week going? #hpmWed Jan 18 18:04:38 PST 2012

rfberry cool! RT @KathyKastner: Hot off #S4PM - where I honest to goodness tried to talk about#hpm :) #hpm

Wed Jan 18 18:04:46 PST 2012

NatriceR RT @KathyKastner: Thank you all for fab convo. Passion, compassion, motivation alwaysinspiring. Over to #hpm while listening to Nancy Finn. #S4PM

Wed Jan 18 18:04:50 PST 2012

KathyKastner #hpm Oh yes I'm health blogger and launching beta of Best Endings: app for e-o-ldecisions.

Wed Jan 18 18:04:53 PST 2012

CompAndChoices @KathyKastner thanks so much for the great #s4pm chat. Glad to see you made it heretoo. Busy day for you! #hpm

Wed Jan 18 18:05:01 PST 2012

CompAndChoices @JenMarsh2 Welcome! Glad you're here. :) #hpmWed Jan 18 18:05:17 PST 2012

SheyontheBay @CompAndChoices Dreamy! I have a 3mo old granddaughter! #hpmWed Jan 18 18:05:49 PST 2012

KathyKastner @CompAndChoices busy, yes, but not to busy for my fav convo!! #hpm (ps thanks forcoming to S4PM :)

Wed Jan 18 18:06:06 PST 2012

JenMarsh2 Happy to see everyone here! RT @CompAndChoices: @JenMarsh2 Welcome! Gladyoure here. :) #hpmWed Jan 18 18:06:09 PST 2012

SheyontheBay @KathyKastner REALLY wanna hear about that! #hpmWed Jan 18 18:06:12 PST 2012

CompAndChoices T1: What is the best way to encourage individuals to have end-of-life conversations withtheir doc & family? #hpm

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Wed Jan 18 18:06:26 PST 2012

CompAndChoices Oh wow! Congrats! RT @SheyontheBay: @CompAndChoices Dreamy! I have a 3mo oldgranddaughter! #hpm

Wed Jan 18 18:06:47 PST 2012

_lizzy_ Hi all. I'm a researcher, social worker, hospice volunteer and all around hospice enthusias

#hpmWed Jan 18 18:07:17 PST 2012

CompAndChoices T1: This is something our org struggles with all the time. So much fear of death. Peoplefear even the conversation. #hpm

Wed Jan 18 18:07:43 PST 2012

KathyKastner Terrific. I'll put out a link to it as soon as it's launched ! RT @SheyontheBay:@KathyKastner REALLY wanna hear about that! #hpm

Wed Jan 18 18:07:54 PST 2012

CompAndChoices @_lizzy_ Welcome! Glad you could join us. :) #hpmWed Jan 18 18:08:03 PST 2012

SheyontheBay T1 ReaCh them when they're NOT in crisis....church meetings, PTAs, etc. make it fun: "itain't gonna kill u to talk about it. Havetools #hpm

Wed Jan 18 18:08:28 PST 2012

KathyKastner @_lizzy_ Hi Lizzy! My fav thanatologist #hpmWed Jan 18 18:08:36 PST 2012

SheyontheBay @KathyKastner Thank you! #hpmWed Jan 18 18:08:40 PST 2012

JenMarsh2 @SheyontheBay Yes - the best time to have the conversation is before you have to haveto conversation #hpm

Wed Jan 18 18:09:20 PST 2012

ShyDi47 Good evening everyone Diana from freezing Canada. #HpmWed Jan 18 18:09:22 PST 2012

_lizzy_ @KathyKastner you crack me up. It's your new favorite word, isn't it? #hpmWed Jan 18 18:09:28 PST 2012

SheyontheBay health fairs, too #hpmWed Jan 18 18:09:48 PST 2012

CompAndChoices @SheyontheBay T1: Any thoughts on the best way to get those tools in the hands of theunwilling? LOL #hpm

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Wed Jan 18 18:09:49 PST 2012

rfberry RT @KathyKastner: @_lizzy_ Hi Lizzy! My fav thanatologist #hpmWed Jan 18 18:10:20 PST 2012

CompAndChoices @ShyDi47 Wish I had some spiked hot chocolate to tweet your way. :) #hpmWed Jan 18 18:10:21 PST 2012

_lizzy_ T1 In my experience, both parties seem to be waiting for the other to start theconversation. #hpm

Wed Jan 18 18:10:42 PST 2012

SheyontheBay @CompAndChoices Yes, give them out FREE at venue! #hpmWed Jan 18 18:10:43 PST 2012

AnkurB_MD Hi All, Geri and Palliative Care fellow/academic doc at Univ Cinci. Strong advocate for PC- joining HPM chat for the next hour... #hpm

Wed Jan 18 18:10:52 PST 2012

KathyKastner Yes it is!! RT @_lizzy_: @KathyKastner you crack me up. It's your new favorite word, isn'tit? #hpm

Wed Jan 18 18:11:03 PST 2012

rfberry RT @CompAndChoices: T1: What is the best way to encourage individuals to have end-of-life conversations with their doc & family? #hpm

Wed Jan 18 18:11:12 PST 2012

SheyontheBay @ShyDi47 If only.... #hpmWed Jan 18 18:11:16 PST 2012

JenMarsh2 RT @_lizzy_: T1 In my experience, both parties seem to be waiting for the other to startthe conversation. #hpm

Wed Jan 18 18:11:21 PST 2012

colleen_young hi. #hpm. Can I join in?Wed Jan 18 18:11:37 PST 2012

ShyDi47 @CompAndChoices I have found with end of life they can be restless @ have anxiety#HpmWed Jan 18 18:11:42 PST 2012

KathyKastner I'd add tequlia to that RT @CompAndChoices: @ShyDi47 Wish I had some spiked hotchocolate to tweet your way. :) #hpm

Wed Jan 18 18:11:42 PST 2012

@AnkurB_MD Welcome. We're talking now about how to get fearful folks to have those

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CompAndChoices key end-of-life conversations. #hpmWed Jan 18 18:11:59 PST 2012

NatriceR RT @KathyKastner: #hpm Oh yes I'm health blogger and launching beta of Best Endings:app for e-o-l decisions.

Wed Jan 18 18:12:04 PST 2012

ShyDi47 @rfberry have a meeting with everyone that everything is in place advance directives, will@ p/a. #Hpm

Wed Jan 18 18:12:39 PST 2012

rfberry RT @CompAndChoices: @colleen_young Absolutely. Welcome! #hpmWed Jan 18 18:12:51 PST 2012

KathyKastner And the Canadian contingent grows RT @colleen_young: hi. #hpm. Can I join in?Wed Jan 18 18:12:53 PST 2012

rfberry RT @ShyDi47: @rfberry have a meeting with everyone that everything is in place advancdirectives, will @ p/a. #Hpm

Wed Jan 18 18:13:25 PST 2012

CompAndChoices Canucks in the house tonight! #hpmWed Jan 18 18:13:43 PST 2012

SheyontheBay @rfberry My tag line: say it, write it, say it again #hpmWed Jan 18 18:14:01 PST 2012

ShyDi47 @CompAndChoices silence works @ being sensitive to their internal feelings #HpmWed Jan 18 18:14:08 PST 2012

CompAndChoices T1: We do provide free tools--but I'm always surprised how many people are afraid of evethe free stuff. #hpm

Wed Jan 18 18:14:27 PST 2012

rfberry T1 When people don't want to talk about it, it's really hard on family. It's really helpful whenclinicians can initiate the convo #hpm

Wed Jan 18 18:14:33 PST 2012

rfberry RT @SheyontheBay: @rfberry My tag line: say it, write it, say it again #hpmWed Jan 18 18:14:39 PST 2012

ShahinaLakhani I believe when we stop portraying death as defeat and change terms like DNR to AND"allow Natural death" perceptions will change #hpm

Wed Jan 18 18:14:44 PST 2012

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_lizzy_ T1 I try to suggest that it's easier to talk about 'in theory' than in the middle of a crisis.#hpm

Wed Jan 18 18:15:07 PST 2012

ShyDi47 @rfberry having a family conference more less #HpmWed Jan 18 18:15:14 PST 2012

CompAndChoices So much wisdom here on #eol conversations. Brilliant. #hpmWed Jan 18 18:15:23 PST 2012

JenMarsh2 RT @CompAndChoices: T1: We do provide free tools--but Im always surprised how manypeople are afraid of even the free stuff. #hpm

Wed Jan 18 18:15:32 PST 2012

ShahinaLakhani RT @CompAndChoices: So much wisdom here on #eol conversations. Brilliant. #hpmWed Jan 18 18:16:03 PST 2012

ShyDi47 @ShahinaLakhani death is part of life @ it should be a very peaceful @ happy eventsurrounded by loved ones #Hpm

Wed Jan 18 18:16:14 PST 2012

KathyKastner #hpm I gotta say, working on Best Endings app, I get to take all kinds of opportunities totalk - often start w how CPR on TV ain't reality

Wed Jan 18 18:16:24 PST 2012

CompAndChoices MT @ShahinaLakhani When we stop portraying death as defeat & change terms like DNRto "allow Natural death" perceptions will change #hpm

Wed Jan 18 18:16:55 PST 2012

CompAndChoices @KathyKastner Really looking forward to seeing that app. Very excited about it for you.#hpm

Wed Jan 18 18:17:16 PST 2012

rfberry @ShyDi47 I agree with that personally, but I think we need to be careful of pushing ourpreferences & telling someone what "should" be #hpm

Wed Jan 18 18:17:21 PST 2012

ShyDi47 Closure very important in EOL @ any unresolved family issues #HpmWed Jan 18 18:17:31 PST 2012

KathyKastner :)RT @CompAndChoices: @KathyKastner Really looking forward to seeing that app. Veryexcited about it for you. #hpm

Wed Jan 18 18:17:36 PST 2012

rfberry RT @SheyontheBay: It's about the teachable moments, Advance care planning = inadvance of crisis...not when hospice referral is made #hpm

Wed Jan 18 18:17:54 PST 2012

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CompAndChoices @SheyontheBay Hopefully we can guide docs to take a more proactive role in that, too.#hpm

Wed Jan 18 18:17:59 PST 2012

ShahinaLakhani Ppl mirror the attitude of the media and clinicians. Ads on national TV will play animportant role in changing perspective #hpm

Wed Jan 18 18:18:20 PST 2012

ShyDi47 @_lizzy_ yes that is where social workers can intervene #HpmWed Jan 18 18:18:27 PST 2012

CompAndChoices Next topic coming shortly, fyi. #hpmWed Jan 18 18:19:02 PST 2012

KathyKastner Nicely put RT @SheyontheBay: @KathyKastner Yes, and when I teach adults, importantto remember anxiety down = learning up. #hpm

Wed Jan 18 18:19:05 PST 2012

ThankTank RT @SheyontheBay: @KathyKastner Thank you! #hpmhttp://t.co/pSKbnCm3Wed Jan 18 18:19:13 PST 2012

rfberry @KathyKastner agree, the massive difference in medical TV shows & reality with CPR isso important for education #hpm

Wed Jan 18 18:19:44 PST 2012

KathyKastner RT @SheyontheBay: It's about the teachable moments, Advance care planning = inadvance of crisis...not when hospice referral is made #hpm

Wed Jan 18 18:20:02 PST 2012

_lizzy_ also need to overcome myths and false beliefs about ADs - it's not about choosing to die,it's about choosing how you die. #hpm

Wed Jan 18 18:20:03 PST 2012

SheyontheBay got to know/ read the "audience." #hpmWed Jan 18 18:20:13 PST 2012

AnkurB_MD @CompAndChoices I have noticed - Getting rid of "Our Own Fears" re EOL discussions i

the first most imp step! #hpmWed Jan 18 18:20:34 PST 2012

KathyKastner RT @_lizzy_: also need to overcome myths and false beliefs about ADs - it's not aboutchoosing to die, it's about choosing how you die. #hpm

Wed Jan 18 18:20:35 PST 2012

KathyKastner AmenRT @AnkurB_MD: @CompAndChoices I have noticed - Getting rid of "Our Own

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Fears" re EOL discussions is the first most imp step! #hpm

Wed Jan 18 18:20:58 PST 2012

ShyDi47 Pain Management, Spiritual, psycho-social, focus on the pt @ family this is what E0L is alabout #Hpm

Wed Jan 18 18:21:00 PST 2012

ShahinaLakhani Yes! RT @shydi47: @ShahinaLakhani death is part of life @ it should be a very peaceful

@ happy event surrounded by loved ones #HpmWed Jan 18 18:21:12 PST 2012

SheyontheBay Community outreach education is not family meeting at hospice referral. What's the goal?#hpm

Wed Jan 18 18:21:22 PST 2012

_lizzy_ For the archives...NPR article about Wisconsin success with advanced directiveshttp://t.co/tw4teGCP#hpm

Wed Jan 18 18:21:26 PST 2012

rfberry RT @AnkurB_MD: @CompAndChoices I have noticed - Getting rid of "Our Own Fears" reEOL discussions is the first most imp step! #hpm

Wed Jan 18 18:22:00 PST 2012

CompAndChoices T2: A blog post called "How Doctors Die" recently went viral. Nutshell: docs want less #eotreatment, have ADs, etc. Thoughts? #hpm

Wed Jan 18 18:22:06 PST 2012

rfberry RT @_lizzy_: For the archives...NPR article about Wisconsin success with advanceddirectives http://t.co/ZBNVTgpi#hpm

Wed Jan 18 18:22:13 PST 2012

colleen_young Nice RT @_lizzy_: For the archives...NPR article about Wisconsin success with advanceddirectives http://t.co/3C13mell#hpm

Wed Jan 18 18:22:28 PST 2012

KathyKastner Reallly RT @_lizzy_: Another myth to overcome: It's important to let patients know thatthey can change their mind later #hpm

Wed Jan 18 18:22:31 PST 2012

CompAndChoices T2: here's the post, for reference: http://t.co/NLb90vF6#hpmWed Jan 18 18:22:37 PST 2012

ShahinaLakhani RT @AnkurB_MD: @CompAndChoices I have noticed - Getting rid of "Our Own Fears" reEOL discussions is the first most imp step! #hpm

Wed Jan 18 18:22:39 PST 2012

ShyDi47 Norms of Practise: assessment, info sharing, decision making, care planning, caredelivery, confirmation. #Hpm

Wed Jan 18 18:22:53 PST 2012

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CompAndChoices RT @AnkurB_MD: @CompAndChoices I have noticed - Getting rid of "Our Own Fears" reEOL discussions is the first most imp step! #hpm

Wed Jan 18 18:23:10 PST 2012

AnkurB_MD MT @rfberry: T1 When people dont want to tlk about EOL its really hard on family. Itsreally helpful when clinicians can initiate convo #hpm

Wed Jan 18 18:23:14 PST 2012

SheyontheBay @colleen_young And they will bring the Respecting Choices to your venue #hpmWed Jan 18 18:23:29 PST 2012

NatriceR RT @SheyontheBay: It's about the teachable moments, Advance care planning = inadvance of crisis...not when hospice referral is made #hpm

Wed Jan 18 18:23:46 PST 2012

KathyKastner #hpm and then there's plain talking at the end of life http://t.co/1xK3F3zu gr8 approachIMOWed Jan 18 18:24:07 PST 2012

ShyDi47 @AnkurB_MD they can be helpful as well part of the multi disciplinary team #HpmWed Jan 18 18:24:08 PST 2012

CompAndChoices T2: It fascinates me that the people who really understand #eol care want less treatment.#hpm

Wed Jan 18 18:24:16 PST 2012

colleen_young Wow RT @SheyontheBay: @colleen_young And they will bring the Respecting Choices tyour venue #hpmWed Jan 18 18:24:41 PST 2012

CompAndChoices T2: these docs obviously have the inside scoop that a lot of other folks don't have. Or so iseems. #hpm

Wed Jan 18 18:25:09 PST 2012

nursefriendly RT @CompAndChoices: Tonight at 9PM Eastern, 6PM Pacific: #hpm tweetchat: Did youknow that doctors die differently from most of the rest of us? Discuss with us!

Wed Jan 18 18:25:15 PST 2012

colleen_young Truly fascinating. RT @CompAndChoices: T2: It fascinates me that the people who reallyunderstand #eol care want less treatment. #hpm

Wed Jan 18 18:25:18 PST 2012

nursefriendly @CompAndChoices#hpm Hello Everyone, my daughter was in need of someone to readto her :) I'm back now.

Wed Jan 18 18:25:50 PST 2012

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ShyDi47 The process of providing care is followed by certain steps to be met during a therapeuticrelationship. #Hpm

Wed Jan 18 18:26:09 PST 2012

rfberry T2 I think clinicians see #eol decisions as straightforward but sometimes forget mostpeople are less exposed to health/law language #hpm

Wed Jan 18 18:26:16 PST 2012

CompAndChoices @nursefriendly Hey there! So glad you could join us. And yeah, reading to kidsDEFINITELY trumps Twitter. :) #hpm

Wed Jan 18 18:26:38 PST 2012

SheyontheBay Bet most clinicians who've seen futile care die differently #hpmWed Jan 18 18:26:43 PST 2012

NatriceR RT @CompAndChoices: Tonight at 9PM Eastern, 6PM Pacific: #hpm tweetchat: Did youknow that doctors die differently from most of the rest of us? Discuss with us!

Wed Jan 18 18:27:08 PST 2012

rfberry @CompAndChoices I think it's interesting that they tend to want less (aggressive)treatment :) #hpm

Wed Jan 18 18:27:10 PST 2012

CompAndChoices T2: the disparity between what docs want and what non-docs want/receive seems prettyprofound to me. More info=less treatment? #hpm

Wed Jan 18 18:27:32 PST 2012

JenMarsh2 RT @rfberry: T2 I think clinicians see #eol decisions as straightforward but forget most

people are less exposed to health/law language #hpmWed Jan 18 18:27:33 PST 2012

SheyontheBay MT@rfberry:think clinicians see #eol decisions as straightforward, sometimes forget mostppl are less exposed to health/law language #hpm

Wed Jan 18 18:27:46 PST 2012

CompAndChoices @rfberry Yes yes...of course you're right. I'm trying to stay in 140 characters. Maybe toomuch brevity. :) #hpm

Wed Jan 18 18:28:04 PST 2012

nursefriendly RT @CompAndChoices: Alright..must get ready for #hpm tweetchat! Come on over ifyou'd like to carry on more conversation. #s4pm

Wed Jan 18 18:28:24 PST 2012

nursefriendly RT @CompAndChoices: It's time for #hpm tweetchat! Join us! #hpmWed Jan 18 18:28:44 PST 2012

ShyDi47 We can all learn from each other when it comes to caring for our PTS or loved ones. #Hpm

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Wed Jan 18 18:28:48 PST 2012

_lizzy_ Let's not forget the human aspect to the doctor/patient relationship. It's hard to give theREAL truth of prognosis #hpm

Wed Jan 18 18:29:00 PST 2012

nursefriendly RT @CompAndChoices: T1 coming up in just a moment.... #hpmWed Jan 18 18:29:21 PST 2012

visitingnurse RT @SheyontheBay: Its about the teachable moments, Advance care planning = inadvance of crisis...not when hospice referral is made #hpm

Wed Jan 18 18:29:27 PST 2012

AnkurB_MD Good thought!MT @rfberry:T2 I think clinicians see #eol decisions as strghtfwd but forgetmost people r less exposed to health/law lang #hpm

Wed Jan 18 18:29:36 PST 2012

JenMarsh2 @_lizzy_ I just read an article about a website that plans to "formulate" prognosis for drs#hpmWed Jan 18 18:29:53 PST 2012

rfberry more info=more informed decision making MT @CompAndChoices T2 disparity betweenwhat docs want & what non-docs want is profound to me #hpm

Wed Jan 18 18:29:53 PST 2012

rfberry @CompAndChoices I'm actually embarrassingly/obsessively picky about futiletreatment/aggressive treatment language #hpm

Wed Jan 18 18:30:28 PST 2012

ShyDi47 @_lizzy_ agree @ that is what I mentioned that is part of the therapeutic relationshipwhich is very important #Hpm

Wed Jan 18 18:30:34 PST 2012

pamressler Hi all...just checking in briefly tonight...sorry. #hpmWed Jan 18 18:30:40 PST 2012

ShahinaLakhani @rfberry a lot of patients also buy into doctors' attitude of pursuing all RX. often unrealistiRx is performed on well insured pts #hpm

Wed Jan 18 18:30:42 PST 2012

produceconsume RT @rfberry: RT @_lizzy_: For the archives...NPR article about Wisconsin success withadvanced directives http://t.co/ZBNVTgpi#hpm

Wed Jan 18 18:31:22 PST 2012

nursefriendly RT @CompAndChoices: @KathyKastner thanks so much for the great #s4pm chat. Gladto see you made it here too. Busy day for you! #hpm

Wed Jan 18 18:31:32 PST 2012

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CompAndChoices T2: I've read that African American communities want more #eol treatment than average.Less informed? #hpm

Wed Jan 18 18:31:32 PST 2012

SheyontheBay @rfberry I am too, don't like "futile" clinicians get it, pt/families withdraw when they hear it#hpm

Wed Jan 18 18:31:48 PST 2012

nursefriendly RT @CompAndChoices: T1: What is the best way to encourage individuals to have end-of-life conversations with their doc & family? #hpm

Wed Jan 18 18:31:49 PST 2012

CompAndChoices @pamressler Glad you can be here, even if it's short. :) #hpmWed Jan 18 18:31:52 PST 2012

JenMarsh2 @_lizzy_ I agree. Would be interesting to see what the formula would be #hpm

Wed Jan 18 18:32:12 PST 2012

_lizzy_ @JenMarsh2 old article but it really stuck with me http://t.co/adIA3HrT#hpmWed Jan 18 18:32:24 PST 2012

nursefriendly @CompAndChoices#hpm T1 Start the discussion early. Normalize the conversation, worto remove, eliminate the #stigma of #dying

Wed Jan 18 18:32:36 PST 2012

CompAndChoices @rfberry As you should be. I should be too. Sometimes brain goes faster than fingers. :)

#hpmWed Jan 18 18:32:52 PST 2012

JenMarsh2 @CompAndChoices I think cultural preferences play a huge part in accessing and utilizingeol services #hpm

Wed Jan 18 18:32:54 PST 2012

SheyontheBay @CompAndChoices suggested more distrustful of health industry #hpmWed Jan 18 18:33:05 PST 2012

JenMarsh2@_lizzy_ Thank you! #hpm

Wed Jan 18 18:33:05 PST 2012

CompAndChoices @_lizzy_ LOVE Jane Brody. She in so insightful and informative. #hpmWed Jan 18 18:33:34 PST 2012

visitingnurse RT @ShahinaLakhani: RT @ShyDi47: Pain Management, Spiritual, psycho-social, focuson the pt @ family this is what E0L is all about #hpm

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Wed Jan 18 18:33:50 PST 2012

SheyontheBay MT@nursefriendly: #hpm T1 Start the discussion early. Normalize the conversation, workto remove, eliminate the #stigma of dying #hpm

Wed Jan 18 18:33:59 PST 2012

rfberry @ShahinaLakhani I'm not sure about 'unrealistic' treatment, some people may wantaggressive treatment for as long as they can have it #hpm

Wed Jan 18 18:33:59 PST 2012

CompAndChoices @JenMarsh2 Yes. I agree. I think it's more than just being informed. The cultural thing ishuge. #hpm

Wed Jan 18 18:34:05 PST 2012

pamressler Yes, research supports this MT @JenMarsh2: @CompAndChoices cultural preferencesplay a huge part in accessing + utilizing eol services #hpm

Wed Jan 18 18:34:32 PST 2012

JenMarsh2 Absolutely RT @CompAndChoices: @JenMarsh2 Yes. I agree. I think its more than justbeing informed. The cultural thing is huge. #hpm

Wed Jan 18 18:34:42 PST 2012

rfberry I understand though, it is more common for aggressive treatment to be provided as optionvs('stopping treatment' ->language pet peeve) #hpm

Wed Jan 18 18:35:21 PST 2012

CompAndChoices @JenMarsh2 Have spent some time with friends in this community--mistrust of medicine a real issue here. #hpm

Wed Jan 18 18:35:35 PST 2012

Kammy_CS RT @CompAndChoices: T1: What is the best way to encourage individuals to have end-of-life conversations with their doc & family? #hpm

Wed Jan 18 18:35:41 PST 2012

ShyDi47 Culture has a big part in EOL @ respecting their culture @ how they want their loved oneto die, etc. #Hpm

Wed Jan 18 18:35:43 PST 2012

KathyKastner RT @ShyDi47: Culture has a big part in EOL @ respecting their culture @ how they wanttheir loved one to die, etc. #Hpm

Wed Jan 18 18:35:54 PST 2012

JenMarsh2 @rfberry :-) I have that language pet peeve too! #hpmWed Jan 18 18:36:07 PST 2012

visitingnurse @nursefriendly start with advance care planning--user-friendly document like Five WishesGet them thinking about wishes not lost hope #hpm

Wed Jan 18 18:36:07 PST 2012

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CompAndChoices T2: Wonder if docs in Afr. Amer. community could play bigger role in #eol conversations?Or if it's clergy? #hpm

Wed Jan 18 18:36:24 PST 2012

nursefriendly @CompAndChoices#hpm T1 Ask your #parents, how their parents, siblings died. Make itacceptable to discuss at the #kitchentable

Wed Jan 18 18:36:33 PST 2012

ShyDi47 @rfberry seen treatment stop when they r very, very, close to death I had to do it manytimes #Hpm

Wed Jan 18 18:36:37 PST 2012

rfberry @ShahinaLakhani I'm not exactly getting to what I mean, struggling with 140 I guess, sorr#hpm

Wed Jan 18 18:36:48 PST 2012

nursefriendly @CompAndChoices#hpm When going with the #elderly to #doctors appointments, ask

the #doctor about @#livingwills#advancedirectivesWed Jan 18 18:37:15 PST 2012

CompAndChoices @rfberry Sometimes 140 just isn't enough. Happens to me all the time. (sigh) #hpmWed Jan 18 18:37:36 PST 2012

ShahinaLakhani @rfberry I meant RX that has potential of more harm than good. Often ppl undergo RX &end up with shorter life than without RX #hpm

Wed Jan 18 18:37:46 PST 2012

ShyDi47 Bringing closure to EOL is important. The main focus should be on the pt @ making surethey r comfortable. #HpmWed Jan 18 18:38:02 PST 2012

visitingnurse @CompAndChoices Good point. Clergy is definitely key, especially in areas where thereare access barriers to care. #hpm

Wed Jan 18 18:38:08 PST 2012

JenMarsh2 RT @CompAndChoices: @rfberry Sometimes 140 just isnt enough. Happens to me all thetime. (sigh) #hpm

Wed Jan 18 18:38:08 PST 2012

nursefriendly @CompAndChoices#hpm T1 Ease into the conversations about #endoflife#eolchat, dotalk about them, not just at #funerals

Wed Jan 18 18:38:09 PST 2012

rfberry @ShyDi47 why "stop treatment" I would hope for a change in goals of care &implementation of #hospice treatment #hpm

Wed Jan 18 18:38:11 PST 2012

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SheyontheBay MT@nursefriendly: T1 Ask your #parents, how their parents, siblings died. Make itacceptable to discuss at #kitchentable

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Wed Jan 18 18:40:51 PST 2012

ShyDi47 When the PTS PPS is 10 percent death is close. Pt was comfortable @ free from pain.#Hpm

Wed Jan 18 18:41:02 PST 2012

DeathwDignity RT @_lizzy_: I want to point out that on hospice doesn't necessarily mean ADs arespecified (unfortunately) #hpmWed Jan 18 18:41:27 PST 2012

CompAndChoices T3: A new Facebook app called "If I die" allows users to leave a last message before theirdeath. Good idea? Weird? Would you use it? #hpm

Wed Jan 18 18:41:52 PST 2012

SheyontheBay @ShyDi47:I stopped the pain meds @ of died 2 hrs later he was comfortable,nothing elsemattered

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Wed Jan 18 18:43:18 PST 2012

JenMarsh2 Ditto RT @rfberry@CompAndChoices I think it's awesome, however I was kind of turnedoff by the app's video & the tone of the intro #hpm

Wed Jan 18 18:43:40 PST 2012

CompAndChoices @rfberry I guess I haven't seen the video. What's the thrust? #hpmWed Jan 18 18:43:46 PST 2012

JenMarsh2 RT @CompAndChoices T3: incidentally, every article I've seen on this app refers to it as"morbid". #hpm

Wed Jan 18 18:44:02 PST 2012

visitingnurse @CompAndChoices Fascinating. How frequently would you post that. Each post could beyour last. #hpm

Wed Jan 18 18:44:35 PST 2012

CompAndChoices @_lizzy_ that's a great policy. Don't let things to unsaid. Love it. #hpmWed Jan 18 18:44:41 PST 2012

nursefriendly @SheyontheBay T1 #hpm About the only time people talk about #dying is when ithappens. #crisis situations, not great for discussing

Wed Jan 18 18:44:52 PST 2012

SheyontheBay @_lizzy_ Me too (FB gimmick) YouTube monitors msgs of those intneding suicide,initiates emergent intervention #hpm

Wed Jan 18 18:45:08 PST 2012

ShahinaLakhani @nursefriendly yes, if gandparents lived at home& home care subsidized rather than justnsg homes, our conversation would be different #HPMWed Jan 18 18:45:30 PST 2012

JenMarsh2 T3 I can see why they did it from a business standpoint, I just wish they had someone onboard with a chat like this #hpm

Wed Jan 18 18:45:34 PST 2012

visitingnurse t3: Haven't seen the ap, but have had two friends die. Pages are still up (families didn'tknow pw), and friends post memorial thoughts #hpm

Wed Jan 18 18:45:45 PST 2012

CompAndChoices @visitingnurse I think it only kicks in after there's verification that the app owner is dead.There's some kind of verification. #hpm

Wed Jan 18 18:45:46 PST 2012

rfberry http://t.co/znMkvFJH RT @CompAndChoices@rfberry I guess I havent seen the video.Whats the thrust? #hpm

Wed Jan 18 18:45:55 PST 2012

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DeathwDignity T3: think it has potential to help transition Facebook profile to your chosen person if youdie suddenly. #hpm

Wed Jan 18 18:46:04 PST 2012

rfberry RT @CompAndChoices: @_lizzy_ thats a great policy. Dont let things to unsaid. Love it.#hpm

Wed Jan 18 18:46:30 PST 2012

SheyontheBay @nursefriendly Agree. Why I like doing community outreach in addition to clinical practice#hpm

Wed Jan 18 18:46:35 PST 2012

_lizzy_ @SheyontheBay had not heard that youtube had that - pretty neat if it saves lives #hpmWed Jan 18 18:46:36 PST 2012

SupportForHome RT @nursefriendly: @CompAndChoices#hpm When going with the #elderly to #doctorsappointments, ask the #doctor about @#livingwills...

Wed Jan 18 18:46:38 PST 2012

CompAndChoices T3: I love the idea of people being able to leave thoughts after they've died. I wonder if itwill ever NOT be considered "morbid"? #hpm

Wed Jan 18 18:46:51 PST 2012

rfberry RT @JenMarsh2: RT @CompAndChoices T3: incidentally, every article I've seen on thisapp refers to it as "morbid". #hpm

Wed Jan 18 18:46:52 PST 2012

JenMarsh2 @CompAndChoices@visitingnurse It looks like you have to choose who you trust to verifwith Facebook (multiple people) #hpm

Wed Jan 18 18:46:54 PST 2012

rfberry RT @JenMarsh2: T3 I can see why they did it from a business standpoint, I just wish theyhad someone on board with a chat like this #hpm

Wed Jan 18 18:47:00 PST 2012

nursefriendly RT @JenMarsh2: RT @_lizzy_: T1 In my experience, both parties seem to be waiting forthe other to start the conversation. #hpm

Wed Jan 18 18:47:37 PST 2012

_lizzy_ @CompAndChoices I have noticed a trend with dying patients starting blogs. I plan tostudy it #hpm

Wed Jan 18 18:47:50 PST 2012

nursefriendly @JenMarsh2#hpm T1 Sounds very familiar, like when a #patient is going bad, and no onwants to address code status

Wed Jan 18 18:48:16 PST 2012

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rfberry @CompAndChoices It may be that I tweet about hospice every week, but I don't find itmorbid at all :) #hpm

Wed Jan 18 18:48:16 PST 2012

CompAndChoices RT @DeathwDignity: T3: think it has potential to help transition Facebook profile to yourchosen person if you die suddenly. #hpm

Wed Jan 18 18:48:18 PST 2012

SheyontheBay As the world changes along with technology and SM, some tools of grief work likely will aswell, ie., memorial pages #hpm

Wed Jan 18 18:48:27 PST 2012

rfberry @_lizzy_ talk to @PamRessler she's done research on it #hpmWed Jan 18 18:48:47 PST 2012

rfberry awesome RT @_lizzy_: @CompAndChoices I have noticed a trend with dying patientsstarting blogs. I plan to study it #hpm

Wed Jan 18 18:49:03 PST 2012

nursefriendly @JenMarsh2#hpm T1 Code Status - Like pulling teeth to get #comfortcare#DNR#Hospice consults #eolchat#nursefriendly

Wed Jan 18 18:49:13 PST 2012

CompAndChoices @rfberry LOL...well, you're an above average kind of woman. :) #hpmWed Jan 18 18:49:15 PST 2012

ShahinaLakhani simplest n most difficult solution is 2 revisit how we invest in the care of elderly n sickadvocate n subsidize hm care=easier EOLC #hpm

Wed Jan 18 18:49:15 PST 2012

ShyDi47 We r in the baby boom generation r u prepared 2 look after your parents? #HpmWed Jan 18 18:49:16 PST 2012

SheyontheBay @rfberry :-D #hpmWed Jan 18 18:49:21 PST 2012

JenMarsh2 Me too RT @CompAndChoices@_lizzy_ Oh....that's cool. I'd love to follow your progresswith that. #hpm

Wed Jan 18 18:49:27 PST 2012

CompAndChoices RT @SheyontheBay: As the world changes along with technology and SM, some tools ofgrief work likely will as well, ie., memorial pages #hpm

Wed Jan 18 18:49:33 PST 2012

nursefriendly RT @CompAndChoices: @AnkurB_MD Welcome. We're talking now about how to getfearful folks to have those key end-of-life conversations. #hpm

Wed Jan 18 18:49:41 PST 2012

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_lizzy_ @rfberry Thanks, I will get in touch with her #hpmWed Jan 18 18:49:46 PST 2012

pamressler Would love to chat with you @_lizzy_RT@rfberry: @_lizzy_ talk to @PamRessler shesdone research on it #hpm

Wed Jan 18 18:49:50 PST 2012

nursefriendly :) RT @CompAndChoices: @nursefriendly Hey there! So glad you could join us. Andyeah, reading to kids DEFINITELY trumps Twitter. :) #hpm

Wed Jan 18 18:50:09 PST 2012

ShahinaLakhani its a passion! RT @rfberry: @CompAndChoices It may be that I tweet about hospice everweek, but I don't find it morbid at all :) #hpm

Wed Jan 18 18:50:28 PST 2012

rfberry ha if only, more like overtweeter hospice obsessed :) RT @CompAndChoices: @rfberryLOL...well, youre an above average kind of woman #hpm

Wed Jan 18 18:50:32 PST 2012

CompAndChoices T3: I would like to leave a message. But I'm bossy. I think my afterlife message wouldreflect my bossiness. LOL #hpm

Wed Jan 18 18:50:37 PST 2012

nursefriendly @visitingnurse#hpm Yes, need to introduce them totWed Jan 18 18:50:43 PST 2012

pamressler @_lizzy_ Great! #hpmWed Jan 18 18:50:44 PST 2012

rfberry I kept Pam on the phone for an hour questioning away, it was #awesome :) RT @_lizzy_:@rfberry Thanks, I will get in touch with her #hpm

Wed Jan 18 18:51:01 PST 2012

nursefriendly @visitingnurse#hpm Need to introduce them to #FiveWishes#LivingWills#Advancedirectives early in the name, not later.

Wed Jan 18 18:51:22 PST 2012

SheyontheBay MT @nursefriendlyT1 Code Status - Like pulling teeth to get #comfortcare#DNR#Hospicconsults #eolchat#nursefriendly

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Wed Jan 18 18:52:39 PST 2012

CompAndChoices T3: Would you use an app that would let you leave a message after your death? #hpmWed Jan 18 18:52:44 PST 2012

rfberry RT @CompAndChoices: T3: I would like to leave a message. But I'm bossy. I think myafterlife message would reflect my bossiness. LOL #hpm

Wed Jan 18 18:52:48 PST 2012

pamressler Loved it! RT @rfberry: I kept Pam on the phone for an hour questioning away, it was#awesome :) #hpm

Wed Jan 18 18:53:25 PST 2012

nursefriendly @ShahinaLakhani#HPM How insurance pays for #endoflife care plays a pivotal role forsure. Most would prefer #dying at home

Wed Jan 18 18:53:38 PST 2012

rfberryYES! RT @CompAndChoices T3 Would you use an app that would let you leave amessage after your death? #hpm

Wed Jan 18 18:53:47 PST 2012

CompAndChoices I'd be careful about using #FiveWishes for an advance directive. State approved ADs getthe job done and are free. #hpm

Wed Jan 18 18:53:54 PST 2012

visitingnurse T3: Just watched the ap video--creepy marketing--they need to create an FB ap thatencourages end of life planning--let that go viral. #hpm

Wed Jan 18 18:54:19 PST 2012

ShahinaLakhani RT @nursefriendly: @ShahinaLakhani#HPM How insurance pays for #endoflife careplays a pivotal role for sure. Most would prefer #dying at home

Wed Jan 18 18:54:26 PST 2012

nursefriendly It isn't hard to start the convo :( RT @SheyontheBay: Agree. Why I like doing communityoutreach in addition to clinical practice #hpm

Wed Jan 18 18:54:30 PST 2012

lfettig @CompAndChoices t3: "sorry I didn't get around to telling you and that you didn't ask. Toolate now." #hpm

Wed Jan 18 18:54:31 PST 2012

DeathwDignity RT @CompAndChoices: I'd be careful about using #FiveWishes for an advance directive.State approved ADs get the job done and are free. #hpm

Wed Jan 18 18:54:39 PST 2012

ShyDi47 I definitely would be uncomfortable leaving a message after I died what if u r not in aposition to do that or simply can't. #Hpm

Wed Jan 18 18:54:54 PST 2012

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rfberry T3 I just wish I was a designer & could make one myself so I could implement all of myinsane picky tidbits about eol language :) #hpm

Wed Jan 18 18:55:05 PST 2012

SheyontheBay @CompAndChoices After I'm Gone Message? Like the videos hospice volunteers help ptmake? #hpm

Wed Jan 18 18:55:09 PST 2012

CompAndChoices @rfberry That video for "If I Die" is kinda crazy. I get why they went there on tone, trying tostay lighthearted. But it's too silly. #hpm

Wed Jan 18 18:55:11 PST 2012

CompAndChoices @SheyontheBay More like the Facebook app, but the same principle. #hpmWed Jan 18 18:55:49 PST 2012

visitingnurse T3: would be better to tell friends what's in your heart for them now rather than from thebeyond of cyberspace. #hpm

Wed Jan 18 18:55:52 PST 2012

ShyDi47 Dying at home is the best thing we have an excellent program here in Canada by VON.#Hpm

Wed Jan 18 18:55:58 PST 2012

aliciabloom @rfberry hospice & palliative care provide "aggressive" treatment, too-- aggressivesymptom management. take back the word! #hpm

Wed Jan 18 18:56:10 PST 2012

DeathwDignity Oh, a @nhdd opportunity! @visitingnurse T3: they need to create an FB ap thatencourages end of life planning--let that go viral. #hpmWed Jan 18 18:56:20 PST 2012

CompAndChoices YES MT @visitingnurse: T3: they need to create an FB ap that encourages end of lifeplanning--let that go viral. #hpm

Wed Jan 18 18:56:39 PST 2012

nursefriendly RT @KathyKastner: #hpm and then there's plain talking at the end of lifehttp://t.co/1xK3F3zu gr8 approach IMO

Wed Jan 18 18:56:53 PST 2012

rfberry @aliciabloom wooooot! #hpmWed Jan 18 18:56:54 PST 2012

CompAndChoices RT @visitingnurse: T3: would be better to tell friends whats in your heart for them nowrather than from the beyond of cyberspace. #hpm

Wed Jan 18 18:57:02 PST 2012

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visitingnurse @aliciabloom I like that "aggressive symptom management". I may need to borrow that insome materials. #hpm

Wed Jan 18 18:57:13 PST 2012

nursefriendly People can decide :) RT @CompAndChoices: T2: It fascinates me that the people whoreally understand #eol care want less treatment. #hpm

Wed Jan 18 18:57:24 PST 2012

AnkurB_MD @CompAndChoices I guess the Right Q could be:"What would be the best way to give Uclosure at EOL? Mess. via FB App or something else.. #hpm

Wed Jan 18 18:57:34 PST 2012

CompAndChoices @DeathwDignity Look at you...always thinking of good ways to leverage. You're amazing:) #hpm

Wed Jan 18 18:57:39 PST 2012

SheyontheBay Yes, hospice videos are for what the pt wants to convey. maybe family difficulties made ithard to speak. Tell family hx too #hpm

Wed Jan 18 18:57:41 PST 2012

ShyDi47 @ShahinaLakhani letting the pt did @ home in the comfort of their own home @ their ownsurrounding is the best death one can ask for #Hpm

Wed Jan 18 18:57:42 PST 2012

visitingnurse @nursefriendly problem with talking at EOL is that probably there wasn't goodcommunication before the end was near. #hpm

Wed Jan 18 18:58:14 PST 2012

CompAndChoices @AnkurB_MD Love that. "What would be the best way to give U closure at EOL? " #hpmWed Jan 18 18:58:20 PST 2012

nursefriendly #eol#hpm T2 If we give them the information, let them make the choice of what they do,do not want at #endoflife, better quality.

Wed Jan 18 18:58:31 PST 2012

ShahinaLakhani would luv to kno more! RT @shydi47: Dying at home is the best thing we have anexcellent program here in Canada by VON. #Hpm

Wed Jan 18 18:58:37 PST 2012

SheyontheBay Five Wishes helps start the conversation, substantiate AD #hpmWed Jan 18 18:58:55 PST 2012

CompAndChoices Hey tweeps: our time is almost up. Any last thoughts? #hpmWed Jan 18 18:59:29 PST 2012

visitingnurse RT @SheyontheBay: Five Wishes helps start the conversation, substantiate AD #hpmWed Jan 18 18:59:42 PST 2012