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milhealth @aliciabloom#hpm hi all, how's everybody doing? #hchlitss (not sure which # # we'reusing...?) #healthlit

Wed Dec 14 18:02:27 PST 2011

KathyKastner #hpm Hi all. Health blogger/curator sm poster on jour pall med :) and hoper for peace andjoy

Wed Dec 14 18:02:28 PST 2011

schwartzbrown Hi everyone. Mindy, social worker from NJ here. Practicing retirement badly. #hpmWed Dec 14 18:02:45 PST 2011

KathyKastner LOLRT @schwartzbrown: Hi everyone. Mindy, social worker from NJ here. Practicingretirement badly. #hpm

Wed Dec 14 18:03:02 PST 2011

renee_berry --> hopeful more people will access palliative care earlier in the trajectory of their illness,work @gobemore, hello all! #hpm

Wed Dec 14 18:03:03 PST 2011

aliciabloom welcome @renee_berry, @jordangrumet, @MarksPhone, @schwartzbrown@kathykastne& @milhealth! glad you're all here! #hpm

Wed Dec 14 18:03:23 PST 2011

equijada Hi Earl here - medical director for VNA and hospice of So CA. Opinions are mine.Christmas shopping at the mall #hpm

Wed Dec 14 18:03:35 PST 2011

_lizzy_ Hi, I am a MSW, hospice volunteer and (hopefully) future PhD specializing in end-of-lifecommunication #hpm

Wed Dec 14 18:03:38 PST 2011

aliciabloom @milhealth we use #hpm, although feel free to tweet to the #healthlit followers, too :) #hpmWed Dec 14 18:04:09 PST 2011

milhealth @renee_berry#hchlitss#hpm I saw something good re: #Palliative care (e-mail/RSS Iread) have 2 check/hate when I can't remember :-)

Wed Dec 14 18:04:13 PST 2011

milhealth @aliciabloom#hpm cool, thanks! If you have 2 use more, takes more characters! :-)Wed Dec 14 18:04:45 PST 2011

JenMarsh2 Hi everyone, I'm Jen, therapist and educator for a hospice in CA. #hpmWed Dec 14 18:04:54 PST 2011

CarolynMcC Listening in for the first time @CarolynMcC physician and blogger for @Forbes#hpmWed Dec 14 18:05:15 PST 2011

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AnkurB_MD Hi All.., Fellow in Geri and PC-- passionate about Palliative Care #hpmWed Dec 14 18:05:33 PST 2011

aliciabloom hi @equijada and @JenMarsh2! @_lizzy_ i'm passionate about improving communicationparticularly around EoL. glad you're here! #hpm

Wed Dec 14 18:05:41 PST 2011

renee_berry @_lizzy_ nice, didn't know all that, love it! Hi Earl, Mark, LIzzy, Kathy, Jen & Mindy! #hpmWed Dec 14 18:05:57 PST 2011

aliciabloom @CarolynMcC welcome! hope you'll do more than listen! #hpmWed Dec 14 18:06:02 PST 2011

aliciabloom @AnkurB_MD glad you're here, you're in the right place! #hpmWed Dec 14 18:06:23 PST 2011

JenMarsh2 Hi all! RT @renee_berry: @_lizzy_ nice, didnt know all that, love it! Hi Earl, Mark, LIzzy,Kathy, Jen & Mindy! #hpm

Wed Dec 14 18:06:57 PST 2011

KathyKastner #hpm Oh boy! Great gang here!Wed Dec 14 18:07:20 PST 2011

aliciabloom our topics are centered around seasonally inspired themes. we'll start with hope and peacethen finish up with joy. let's get started. #hpm

Wed Dec 14 18:08:04 PST 2011

aliciabloom @KathyKastner you're actually inspiring topic 1! #hpmWed Dec 14 18:08:29 PST 2011

_lizzy_ @renee_berry@aliciabloom I tried clinical but I think I fit better w/research. Love tweetcha- thank you for hosting #hpm

Wed Dec 14 18:08:34 PST 2011

JenMarsh2 I seem to be having some technical difficulties, so please forgive any slow responses. :-)#hpm

Wed Dec 14 18:08:53 PST 2011

aliciabloom T1: @KathyKastner wrote "Hope & 'false hope': who benefits, who doesn't." Share yourthoughts about hope & it's role in serious illness #hpm

Wed Dec 14 18:09:04 PST 2011

KathyKastner ?! RT @aliciabloom: @KathyKastner you're actually inspiring topic 1! #hpmWed Dec 14 18:09:05 PST 2011

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renee_berry RT @aliciabloom: T1: @KathyKastner wrote "Hope & 'false hope': who benefits, whodoesn't." Share your thoughts about hope & it's role in serious illness #hpm

Wed Dec 14 18:09:51 PST 2011

aliciabloom @_lizzy_ clinical & research are like peanut butter & jelly. can't have one without the other#hpm

Wed Dec 14 18:10:02 PST 2011

KathyKastner #hpm T1 @aliciabloom Yay!Wed Dec 14 18:10:13 PST 2011

JenMarsh2 @aliciabloom@KathyKastner Wow....that's a big one to start! #hpmWed Dec 14 18:10:41 PST 2011

renee_berry T1 I think hope is always important, it's just crucial to know each person defines hope intheir own way & even that changes over time #hpm

Wed Dec 14 18:10:50 PST 2011

renee_berry T1 There is more to hope than curative treatments #hpmWed Dec 14 18:11:02 PST 2011

aliciabloom just in case anyone missed it...here is the link to @KathyKastner's JPM blog post:http://t.co/iaJ2A9KY.#hpm

Wed Dec 14 18:11:25 PST 2011

_lizzy_ RT @aliciabloom: clinical & research are like peanut butter & jelly. cant have one withoutthe other. #hpm

Wed Dec 14 18:11:31 PST 2011

crgonzalez I made it! Hi everyone. Carmen Gonzalez, clinical trial patient recruitment strategist #HPMWed Dec 14 18:11:33 PST 2011

JenMarsh2 Agreed RT @renee_berry: T1 There is more to hope than curative treatments #hpmWed Dec 14 18:11:49 PST 2011

jordangrumet T1: Hope is that whether one lives or dies they will do it with grace. #hpmWed Dec 14 18:12:15 PST 2011

equijada t1: I think the role is to find hope, however defined by pt/family, and catalyze it. #hpmWed Dec 14 18:12:16 PST 2011

KathyKastner TY! RT @aliciabloom: just in case anyone missed it...here is the link to @KathyKastner'sJPM blog post: http://t.co/kBzl0d0d.#hpm

Wed Dec 14 18:12:16 PST 2011

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aliciabloom @crgonzalez welcome! #hpmWed Dec 14 18:12:28 PST 2011

MarksPhone Is hope intrinsic in the person or do HCP help to bring it forward in the person with illness?#hpm

Wed Dec 14 18:12:30 PST 2011

JenMarsh2 I second @renee_berry - hope is subjective and can't be projected onto another #hpmWed Dec 14 18:12:52 PST 2011

colleen_young Hi all. Sorry I'm late. We had a brief blackout. Did it reach your neighbourhood@KathyKastner? #hpm

Wed Dec 14 18:13:00 PST 2011

MeredithGould RT @equijada: t1: I think the role is to find hope, however defined by pt/family, andcatalyze it. #hpm

Wed Dec 14 18:13:04 PST 2011

KathyKastner #hpm What happens when carer has different different ideas about what should be hopedfor ?

Wed Dec 14 18:13:06 PST 2011

aliciabloom RT @MarksPhone: Is hope intrinsic in the person or do HCP help to bring it forward in theperson with illness?

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JenMarsh2 Hope can be a myriad of things, depending on stages of illness, values and beliefs #hpmWed Dec 14 18:13:52 PST 2011

KathyKastner @colleen_young No blackout here. T1 based on my jpm blog : hope and false hope #hpmWed Dec 14 18:13:59 PST 2011

renee_berry @JenMarsh2 but the clinician may project their lack of ability to be creative in finding morehope than another clinical trial to offer #hpm

Wed Dec 14 18:14:17 PST 2011

MarksPhone Can we open those hope receptors in patients? #hpmWed Dec 14 18:14:22 PST 2011

crgonzalez RT @JenMarsh2: Hope can be a myriad of things, depending on stages of illness, valuesand beliefs #HPM

Wed Dec 14 18:14:22 PST 2011

renee_berry RT @equijada: t1: I think the role is to find hope, however defined by pt/family, andcatalyze it. #hpm

Wed Dec 14 18:14:31 PST 2011

apjonas Hi all, Pat Jonas, MD, Holsitic Family Physician in Ohio #hpmWed Dec 14 18:14:37 PST 2011

colleen_young @KathyKastner Your short blog on hope in the Journal of Palliative Med and ensuingcomments was extremely powerful. #hpm

Wed Dec 14 18:14:51 PST 2011

equijada I tend you sue the word "hope" in my clinical interview often #hpmWed Dec 14 18:15:08 PST 2011

equijada err use #hpmWed Dec 14 18:15:14 PST 2011

renee_berry I think it's possible, often missed opportunities RT @MarksPhone: Can we open thosehope receptors in patients? #hpm

Wed Dec 14 18:15:14 PST 2011

milhealth @renee_berry#hpm isn't on topic but didn't want 2 forget: Muscular Dystrophy#Patienthealthhttp://t.co/DTLaIqsC

Wed Dec 14 18:15:16 PST 2011

KathyKastner #hpm one of the comments on blog was: patients don't want to disappoint docs by seeminto give up hope (!)

Wed Dec 14 18:15:24 PST 2011

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jordangrumet t1: HCP cultivate hope by easing fears and allowing it to flourish and grow. #hpmWed Dec 14 18:15:25 PST 2011

JenMarsh2 @renee_berry Yes and sometimes clinicians have a completely different sense of whathope "should" look like #hpm

Wed Dec 14 18:15:27 PST 2011

KathyKastner RT @JenMarsh2: @renee_berry Yes and sometimes clinicians have a completely differensense of what hope "should" look like #hpm

Wed Dec 14 18:15:34 PST 2011

aliciabloom welcome to the folks who have just joined us! we're talking about hope in serious illness:http://t.co/iaJ2A9KY#hpm

Wed Dec 14 18:15:48 PST 2011

MeredithGould T1 When "hopes" collide? Probably important to find out how different participants aredefining hope. #hpm

Wed Dec 14 18:15:49 PST 2011

MarksPhone And further what role does hope play in outcomes has it been studied, can it be associatedwith epatients #hpm

Wed Dec 14 18:15:52 PST 2011

renee_berry @AliciaBloom, as a social worker do you often deal with conversations in helping familiesredefine their connection to hope? #hpm

Wed Dec 14 18:15:54 PST 2011

JenMarsh2 RT @equijada: t1: I think the role is to find hope, however defined by pt/family, andcatalyze it. #hpmWed Dec 14 18:16:02 PST 2011

KathyKastner RT @MeredithGould: T1 When "hopes" collide? Probably important to find out howdifferent participants are defining hope. #hpm

Wed Dec 14 18:16:13 PST 2011

JenMarsh2 RT @KathyKastner: #hpm one of the comments on blog was: patients dont want todisappoint docs by seeming to give up hope (!) #hpm

Wed Dec 14 18:16:14 PST 2011

equijada "How are you hoping we can help", "what do you hope will happen", "what are you hopingfor" etc... #hpm

Wed Dec 14 18:16:25 PST 2011

crgonzalez @MeredithGould Exactly. I think the tipping point varies among people when acceptancecan take hold #HPM

Wed Dec 14 18:16:41 PST 2011

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MeredithGould T1 What one person defines as "giving up hope," another might define as being "realistic."#hpm

Wed Dec 14 18:16:49 PST 2011

colleen_young @renee_berry redefine their connection to hope and/or re-focus on where to put hope or owhat. #hpm

Wed Dec 14 18:17:04 PST 2011

KathyKastner Ah RT @MeredithGould: Good to hear from you T1 What one person defines as "giving uphope," another might define as being "realistic." #hpm

Wed Dec 14 18:17:18 PST 2011

aliciabloom Hope is something people hold tightly to-- instead of losing it, we have to reframe it. #hpmWed Dec 14 18:17:29 PST 2011

JenMarsh2 @KathyKastner AHHHH!! The "giving up hope" idea!! Makes hospice people cringe :-)#hpm

Wed Dec 14 18:17:34 PST 2011

MeredithGould @KathyKastner I've been MIA for a while...that getting married thing & book writing thing!#hpm

Wed Dec 14 18:17:44 PST 2011

colleen_young @MeredithGould I think realism would play a role in where to focus hope. #hpmWed Dec 14 18:17:52 PST 2011

MarksPhone @JenMarsh2#hpm good point to reframe itWed Dec 14 18:17:52 PST 2011

_lizzy_ T1 After identifying discrepancies in hopes, aiding the family/patient to talk aboutdifferences would be ideal #hpm

Wed Dec 14 18:17:55 PST 2011

renee_berry From Cure to Quality of Life: The Shifting Meaning of Hope at the End of Lifehttp://t.co/fdpxnJtk#hpm (Can I quote an entire article) :)

Wed Dec 14 18:18:07 PST 2011

AnkurB_MD T1: Hope is the very essence of survival... its the light at the end of the tunnel..our role is tokeep it alive within our patients! #hpm

Wed Dec 14 18:18:11 PST 2011

_lizzy_ RT @aliciabloom: Hope is something people hold tightly to-- instead of losing it, we have treframe it. #hpm

Wed Dec 14 18:18:14 PST 2011

KathyKastner #hpm hope isn't always a solitary emotion, lots of diffrent hopers to manageWed Dec 14 18:18:28 PST 2011

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MeredithGould @colleen_young But even "reality" varies among people and shifts over time. #hpmWed Dec 14 18:18:33 PST 2011

milhealth @renee_berry#hpm as long as U cite it.... ;-)Wed Dec 14 18:18:35 PST 2011

renee_berry RT @MeredithGould: T1 What one person defines as "giving up hope," another mightdefine as being "realistic." #hpm

Wed Dec 14 18:18:41 PST 2011

MeredithGould @renee_berry Wow, you've stopped waving! #hpmWed Dec 14 18:19:00 PST 2011

milhealth RT @MeredithGould: T1 What one person defines as "giving up hope," another mightdefine as being "realistic." #hpm/good point.

Wed Dec 14 18:19:07 PST 2011

MarksPhone But hope alone is not enough it needs to be tied to action and behavior not just hoping toget better. #hpm

Wed Dec 14 18:19:11 PST 2011

KathyKastner RT @aliciabloom: Hope is something people hold tightly to-- instead of losing it, we have treframe it. #hpm

Wed Dec 14 18:19:13 PST 2011

JenMarsh2 @MarksPhone Absolutely! #hpmWed Dec 14 18:19:21 PST 2011

aliciabloom Hope is an emotion, a focal point, a goal. It's many different things to people. Ask: "what doyou hope for?" #hpm

Wed Dec 14 18:19:31 PST 2011

KathyKastner +1 !!RT @aliciabloom: Hope is an emotion, a focal point, a goal. It's many different things tpeople. Ask: "what do you hope for?" #hpm

Wed Dec 14 18:19:53 PST 2011

MeredithGould@MarksPhone My big hope is always to manage illness more gracefully & with more

humor. Getting better is not exactly an option. #hpmWed Dec 14 18:19:59 PST 2011

aliciabloom RT @MarksPhone: But hope alone is not enough it needs to be tied to action and behavionot just hoping to get better.

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semblance of control #HPM

Wed Dec 14 18:20:13 PST 2011

jordangrumet RT @aliciabloom: Hope is an emotion, a focal point, a goal. It's many different things topeople. Ask: "what do you hope for?" #hpm

Wed Dec 14 18:20:15 PST 2011

KathyKastner I took note, too. Figuring hand got tired RT @MeredithGould: @renee_berry Wow, you'vestopped waving! #hpmWed Dec 14 18:20:44 PST 2011

schwartzbrown How is hope different from optimism or pessimism? #hpmWed Dec 14 18:20:48 PST 2011

GodtheHealerDev What does #hpm stand for?Wed Dec 14 18:20:48 PST 2011

renee_berry @AnkurB_MD agree this is important for #hpm, do you think sometimes people let theirown ideas fog straightforward communication?Wed Dec 14 18:20:48 PST 2011

renee_berry RT @AnkurB_MD: T1: Hope is the very essence of survival... its the light at the end of thetunnel..our role is to keep it alive within our patients! #hpm

Wed Dec 14 18:20:53 PST 2011

KathyKastner RT @renee_berry: @AnkurB_MD agree this is important for #hpm, do you think sometimepeople let their own ideas fog straightforward comm ...

Wed Dec 14 18:21:03 PST 2011

hollyby Great crowd tonight! Hi there! Arriving late. Holly Yang, doc with @SanDiegoHospice. Alltweets are my own. :) #hpm

Wed Dec 14 18:21:07 PST 2011

colleen_young @GodtheHealerDev Hospice and palliative medicine. #hpmWed Dec 14 18:21:11 PST 2011

nursefriendly Hello Everyone, Andrew Lopez, RN from #newjersey#hpmWed Dec 14 18:21:14 PST 2011

MeredithGould @GodtheHealerDev#hpm = hospice and palliative medicineWed Dec 14 18:21:14 PST 2011

renee_berry RT @aliciabloom: Hope is an emotion, a focal point, a goal. It's many different things topeople. Ask: "what do you hope for?" #hpm

Wed Dec 14 18:21:14 PST 2011

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milhealth @renee_berry#hpm cultures play lrg role 2, -whether family even discusses/issues.Cuban-Am cult/some diseases aren't 'talked about'

Wed Dec 14 18:21:16 PST 2011

apjonas T1 I sense a difference in types of hope. Most seem to imply hope for life. I see lots whohope for wholeness of self or oneness w/God #hpm

Wed Dec 14 18:21:18 PST 2011

MarksPhone @MeredithGould#hpm I am not thinking better per se but more about the movementemotionally w/the illness a touch stone w/management #hpm

Wed Dec 14 18:21:25 PST 2011

hollyby For the next 40 min, my tweets will be from the #hospice and #palliative medicinetweetchat. #hpm

Wed Dec 14 18:21:34 PST 2011

nursefriendly Hospice, Palliative Care Medicine :) RT @GodtheHealerDev: What does #hpm stand for?#hpm

Wed Dec 14 18:21:35 PST 2011

aliciabloom @hollyby glad you're here! we're finishing up topic 1 about hope. #hpmWed Dec 14 18:21:48 PST 2011

MeredithGould @MarksPhone Ah, okay...that makes sense. You always make sense! #hpmWed Dec 14 18:21:55 PST 2011

aliciabloom @GodtheHealerDev hospice & palliative medicine #hpmWed Dec 14 18:22:02 PST 2011

MarksPhone @crgonzalez#HPM thanks you are excellent at making me sound 25 points higher on myIQ

Wed Dec 14 18:22:03 PST 2011

hollyby @aliciabloom Thanks! Always a good topic. #hpmWed Dec 14 18:22:38 PST 2011

colleen_young @nursefriendly@hollyby Gosh I forgot to introduce myself. Plain language writer andcommunity moderator at VirtualHospice.ca. #hpm

Wed Dec 14 18:22:38 PST 2011

renee_berry good question! I think it's so different but will have to think abt RT @schwartzbrown How ishope different from optimism or pessimism? #hpm

Wed Dec 14 18:22:54 PST 2011

crgonzalez @milhealth Right.Same for Mex-Amer. and discussions of dementia. #HPMWed Dec 14 18:22:58 PST 2011

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KathyKastner #hpm I heard about caregivers (family/friends) withdrawing support bcause dying friendkeeps on hoping for a miracle !

Wed Dec 14 18:23:01 PST 2011

aliciabloom sometimes clinicians are so afraid of taking away hope that they give patients/families afalse sense of hope. it's a fine balance. #hpm

Wed Dec 14 18:23:07 PST 2011

MarksPhone The emotional content of the patient is like a chem panel use it as part of the long termmanagement #hpm

Wed Dec 14 18:23:08 PST 2011

crgonzalez @MarksPhone You are quite the wise dude. #HPMWed Dec 14 18:23:19 PST 2011

KathyKastner RT @aliciabloom: sometimes clinicians are so afraid of taking away hope that they givepatients/families a false sense of hope. it's a fine balance. #hpm

Wed Dec 14 18:23:22 PST 2011

milhealth RT @crgonzalez: Right.Same for Mex-Amer. and discussions of dementia. #HPM/right! &"abuela/lo doesn't know (e.g. Cancer). < >

Wed Dec 14 18:23:46 PST 2011

jfclearywisc jim cleary joining (late) hospice & palliative med tweetchat for the next 35 min #hpmWed Dec 14 18:23:59 PST 2011

milhealth @crgonzalez#HPM was going 2 say "hispanic" but didn't want to 'generalize' but I thnk it'sfairly common/across the board.

Wed Dec 14 18:24:30 PST 2011

KathyKastner @crgonzalez Hey Carmen #HPMWed Dec 14 18:24:34 PST 2011

schwartzbrown I don't believe clinicians can confer or take away hope. #hpmWed Dec 14 18:24:39 PST 2011

MeredithGould RT @schwartzbrown: I don't believe clinicians can confer or take away hope. #hpmWed Dec 14 18:24:51 PST 2011

crgonzalez @KathyKastner Have you ever chosen a healthcare provider / caregiver because of anenlightened view of HPM? #HPM

Wed Dec 14 18:24:54 PST 2011

renee_berry RT @aliciabloom: sometimes clinicians are so afraid of taking away hope that they givepatients/families a false sense of hope. it's a fine balance. #hpm

Wed Dec 14 18:25:09 PST 2011

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KathyKastner It's the patient/caregiver who wants to hear RT @schwartzbrown: I don't believe clinicianscan confer or take away hope. #hpm

Wed Dec 14 18:25:23 PST 2011

renee_berry @aliciabloom what would you say to non #hpm professionals trying to grapple with thatbalance, what's most important?

Wed Dec 14 18:25:27 PST 2011

MarksPhone @schwartzbrown#hpm I disagree HCP can leverage emotions through actions behavior atouch and response to questions

Wed Dec 14 18:25:38 PST 2011

equijada RT @schwartzbrown: I dont believe clinicians can confer or take away hope. #hpmWed Dec 14 18:25:42 PST 2011

AnkurB_MD @renee_berry Yes!! sometimes we may fog a straightforward conv. - fearing "taking awayhope" but infact we need to "redirect that hope" #hpm

Wed Dec 14 18:26:11 PST 2011

jfclearywisc One of my favorite papers. Tulsky's "hope or Hubris" Hope is "trust and reliance" ratherthan "expectations" #hpm

Wed Dec 14 18:26:12 PST 2011

nursefriendly One who has had a good life, hopes for a good death. MT @jordangrumet: T1: Hope is thawhether one lives or dies they w #hpm

Wed Dec 14 18:26:15 PST 2011

renee_berry RT @MarksPhone@schwartzbrown I disagree HCP can leverage emotions throughactions behavior a touch and response to questions #hpmWed Dec 14 18:26:25 PST 2011

GodtheHealerDev @MeredithGould I have no idea what palliative means. Guess I will just hang back. #hpmWed Dec 14 18:26:32 PST 2011

JenMarsh2 RT @aliciabloom: sometimes clinicians are so afraid of taking away hope they givepts/families false sense of hope. its a fine balance. #hpm

Wed Dec 14 18:26:35 PST 2011

KathyKastner @crgonzalez I haven't been in the situation yet (needing a hcp who believes in #HPMWed Dec 14 18:26:50 PST 2011

crgonzalez @milhealth That is a topic for HPM chat right there: cultural inhibitions regarding hospice#HPM

Wed Dec 14 18:26:51 PST 2011

#hpm here's a study (2011) across US re: #palliativecare prgms (eval) http://t.co/fShtjtAS

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milhealth Wed Dec 14 18:26:53 PST 2011

aliciabloom @renee_berry there is always something to hope for, even in the absence of cure-- find it focus on it. #hpm

Wed Dec 14 18:27:03 PST 2011

nursefriendlyT1 At a very basic level, patients will realize that the end is near. Some despair, many

others make peace, prepare themselves #hpmWed Dec 14 18:27:23 PST 2011

schwartzbrown The same info can devastate one person, and not touch another's outlook. The info has tobe given. #hpm

Wed Dec 14 18:27:43 PST 2011

hollyby Hope is something that can continue no matter what the reality. The focus of the hope maychange, but hope is always possible. #hpm

Wed Dec 14 18:27:49 PST 2011

KathyKastner #hpm What about hope for that which we all strive for: a 'good death'Wed Dec 14 18:27:51 PST 2011

aliciabloom loving this rich discussion on hope! let's share some final thoughts & move on to topic 2.#hpm

Wed Dec 14 18:27:57 PST 2011

renee_berry @nursefriendly agree, but I think our #healthcare system places too much burdon onfamilies having to figure all of it out #hpm

Wed Dec 14 18:28:14 PST 2011

KathyKastner RT @schwartzbrown: The same info can devastate one person, and not touch another'soutlook. The info has to be given. #hpm

Wed Dec 14 18:28:15 PST 2011

crgonzalez @KathyKastner I wasn't referring to situation where it arose, but prospectively as in aregular PCP. I'm thinking more critically #HPM

Wed Dec 14 18:28:20 PST 2011

renee_berry RT @aliciabloom: @renee_berry there is always something to hope for, even in theabsence of cure-- find it & focus on it. #hpm

Wed Dec 14 18:28:26 PST 2011

milhealth @crgonzalez#hpm absolutely! when things R discussed/resolved, then at end/life U canjust 'be' w/your loved one.

Wed Dec 14 18:28:26 PST 2011

nursefriendly @MarksPhone Think hope lies mostly within the #patient and #family. Our roles is chiefly tlisten, support. #hpm

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Wed Dec 14 18:28:37 PST 2011

nursefriendly RT @JenMarsh2: I second @renee_berry - hope is subjective and can't be projected ontoanother #hpm

Wed Dec 14 18:28:50 PST 2011

gina_LJ RT @hollyby: Hope is something that can continue no matter what the reality. The focus o

the hope may change, but hope is always possible. #hpmWed Dec 14 18:29:02 PST 2011

aliciabloom RT @hollyby: Hope is something that can continue no matter what the reality. The focus othe hope may change, but hope is always possible. #hpm

Wed Dec 14 18:29:06 PST 2011

jfclearywisc @GodtheHealerDev Palliative comes from latin "pallia" a cloak. Palliative care: caredirected at comfort in people with major illness #hpm

Wed Dec 14 18:29:11 PST 2011

apjonas @schwartzbrown I've seen people with dashed hopes or squished but not killed hopes frominteraction w/doctor #hpm

Wed Dec 14 18:29:23 PST 2011

AnkurB_MD YES!!!! RT @renee_berry: there is always something to hope for, even in the absence ofcure-- find it & focus on it. #hpm

Wed Dec 14 18:29:25 PST 2011

jordangrumet t1: hope is the kindness and beauty we show eachother while we allow the uncontrollablein life to happen. #hpm

Wed Dec 14 18:29:33 PST 2011

KathyKastner @crgonzalez Ah. Well. As it turns out my PCP loves what I'm doing (mobile app for e-o-ldecisions) and ikes to learn from me! #HPM

Wed Dec 14 18:29:35 PST 2011

nursefriendly @JenMarsh2 Yep, #hope is like #pain, very subjective and in the eye of the beholder. Ouris not to judge or or criticize. #hpm

Wed Dec 14 18:29:36 PST 2011

equijada Hope isn't an expectation. It's a context that moves one forward #hpmWed Dec 14 18:29:36 PST 2011

aliciabloom T2: Holidays are challenging after a loss or when seriously ill. How can patients find peaceat EoL & families find it after the death? #hpm

Wed Dec 14 18:29:39 PST 2011

renee_berry RT @hollyby: Hope is something that can continue no matter what the reality. The focus othe hope may change, but hope is always possible. #hpm

Wed Dec 14 18:29:54 PST 2011

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MarksPhone I think the bigger issue here is not the exceptions but the issue of tapping into the softscience of medicine #hpm

Wed Dec 14 18:30:23 PST 2011

nursefriendly Our chief concern is the #patient. MT @KathyKastner: #hpm What happens when carerhas different different ideas about what should be h

Wed Dec 14 18:30:29 PST 2011

crgonzalez @KathyKastner Aren't you the lucky dog! I haven't had the conversation with my new docand I think I ought to. #HPM

Wed Dec 14 18:30:36 PST 2011

KathyKastner #hpm T2 both my parents died round this time. We sibs get together and tell stories, shedtears. disagree about perspectives. Hug. Kiss. Joy

Wed Dec 14 18:30:58 PST 2011

aliciabloomthanks to @KathyKastner for inspiring T1 on hope & for all of the engaged responses. I've

just sent T2 out.... #hpmWed Dec 14 18:31:08 PST 2011

doclake Plain Speaking at the End of Life http://t.co/Lv8d2ACr#hpmWed Dec 14 18:31:18 PST 2011

renee_berry RT @aliciabloom: T2: Holidays are challenging after a loss or when seriously ill. How canpatients find peace at EoL & families find it after the death? #hpm

Wed Dec 14 18:31:22 PST 2011

nursefriendly @KathyKastner Encounter #families#caregivers frequently that have different "plans" thanthe #patient. Need to reconcile pt wishes #hpm

Wed Dec 14 18:31:44 PST 2011

milhealth #hpm here's a state/state report card/#Palliativecarehttp://t.co/uzzHwn4h (tweeted a newJAMA article 2 :-)

Wed Dec 14 18:31:48 PST 2011

KathyKastner RT @nursefriendly: @KathyKastner Encounter #families#caregivers frequently that havedifferent "plans" than the #patient. Need to reconcile pt wishes #hpm

Wed Dec 14 18:32:06 PST 2011

MarksPhone This my first Thanksgiving w/o Donna and now Christmas it is important for me at least tolive each emotion go through it not around #hpm

Wed Dec 14 18:32:07 PST 2011

mdTalk Hope isn't an expectation. It's a context that moves one forward #hpmhttp://t.co/505rz6vOWed Dec 14 18:32:08 PST 2011

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GodtheHealerDev RT @equijada: Hope isn't an expectation. It's a context that moves one forward #hpmWed Dec 14 18:32:08 PST 2011

_lizzy_ T2 It seems to me that patients find peace sooner than families. With families, peace needtime. #hpm

Wed Dec 14 18:32:15 PST 2011

nursefriendly @renee_berry How so? Can you give an example of what #families need to figure out ontheir own? #healthcare#hpm

Wed Dec 14 18:32:24 PST 2011

MarksPhone @mdTalk#hpm yes!Wed Dec 14 18:32:24 PST 2011

AnkurB_MD I sometime frame it as: The 3Cs of HOPE - "Hope for Cure - If not then Hope for Control, Ifnot then Hope for Comfort" #hpm

Wed Dec 14 18:32:25 PST 2011

JenMarsh2 T2 To many people, peace is about acceptance. I like to think of it more asacknowledgement #hpm

Wed Dec 14 18:32:41 PST 2011

aliciabloom when i think about peace for patients & families, i immediately think about the importance oadvance care planning (@NHDD) #hpm

Wed Dec 14 18:32:53 PST 2011

KathyKastner @MarksPhone I think the first everyting after brings fresh stuff. My heart's with you. #hpmWed Dec 14 18:33:01 PST 2011

GodtheHealerDev RT @AnkurB_MD: I sometime frame it as: The 3Cs of HOPE - "Hope for Cure - If not thenHope for Control, If not then Hope for Comfort" #hpm

Wed Dec 14 18:33:10 PST 2011

nursefriendly @KathyKastner It is difficult to tell #families, that is not what the #patient wants. As a#patientadvocate, it is a duty we owe #hpm

Wed Dec 14 18:33:16 PST 2011

colleen_young This is brilliant! Thx RT @doclake: Plain Speaking at the End of Life http://t.co/cDhWBQOd#hpm

Wed Dec 14 18:33:19 PST 2011

crgonzalez @MarksPhone Being present is powerful. You are a hero! #HPMWed Dec 14 18:33:23 PST 2011

KathyKastner RT @colleen_young: This is brilliant! Thx RT @doclake: Plain Speaking at the End of Lifehttp://t.co/cDhWBQOd#hpm

Wed Dec 14 18:33:31 PST 2011

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KathyKastner RT @nursefriendly: @KathyKastner It is difficult to tell #families, that is not what the#patient wants. As a #patientadvocate, it is a duty we owe #hpm

Wed Dec 14 18:33:42 PST 2011

KathyKastner RT @AnkurB_MD: I sometime frame it as: The 3Cs of HOPE - "Hope for Cure - If not thenHope for Control, If not then Hope for Comfort" #hpm

Wed Dec 14 18:33:55 PST 2011

JenMarsh2 RT @AnkurB_MD: I sometime frame it as: The 3Cs of HOPE - "Hope for Cure - If not thenHope for Control, If not then Hope for Comfort" #hpm

Wed Dec 14 18:34:05 PST 2011

nursefriendly Yes, can be problematic ethically. RT @MeredithGould: @MarksPhone Some people aremore hope-oriented than others, it seems. #hpm

Wed Dec 14 18:34:11 PST 2011

aliciabloom +1 RT @JenMarsh2: T2 To many people, peace is about acceptance. I like to think of itmore as acknowledgement. #hpmWed Dec 14 18:34:25 PST 2011

renee_berry T2 I find peace when grieving through creativity, sometimes collages, sometimes videoprojects, also creating & maintaining traditions #hpm

Wed Dec 14 18:34:25 PST 2011

crgonzalez RT @_lizzy_: T2 It seems to me that patients find peace sooner than families. Withfamilies, peace needs time. #HPM

Wed Dec 14 18:34:25 PST 2011

nursefriendly @MeredithGould Yes, how often have you seen a pt "ready" to go, but hanging on inmisery because #family can't let go? #hpm

Wed Dec 14 18:34:38 PST 2011

MarksPhone Each one of us is different I consider my emotions about this like a teenage girl who is acutter the rawness of it is my connection #hpm

Wed Dec 14 18:35:11 PST 2011

nursefriendly Welcome :) RT @FDALawyers: hey all. Just made it. I am Darshan. FDA reg/pharma/device/bio compliance pharmacist & attorney. #hpm

Wed Dec 14 18:35:12 PST 2011

jfclearywisc RT @mdTalk: Hope isnt an expectation. Its a context that moves one forward #hpmhttp://t.co/ebFdAWgJ#hpm

Wed Dec 14 18:35:14 PST 2011

renee_berry @aliciabloom so important #hpm I've been honored to participate in #NHDD the past fewyears

Wed Dec 14 18:35:28 PST 2011

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GodtheHealerDev @JenMarsh2 Acceptance vs acknowledgement. Difference? #hpmWed Dec 14 18:35:40 PST 2011

hollyby T2: Holidays, anniversaries, etc. are tough. Keeping a family tradition, or keeping a part ofa tradition, while making it new helps. #hpm

Wed Dec 14 18:35:44 PST 2011

nursefriendly It does, meeting your "maker" can bring peace RT @jordangrumet: t1: Hope allows us tolook forward to something even when facing death. #hpm

Wed Dec 14 18:35:55 PST 2011

MeredithGould @nursefriendly Right. #HPMWed Dec 14 18:35:59 PST 2011

KathyKastner RT @crgonzalez: RT @_lizzy_: T2 It seems to me that patients find peace sooner thanfamilies. With families, peace needs time. #HPM

Wed Dec 14 18:36:12 PST 2011

aliciabloom @renee_berry finding a way to express grief can lead to peace. way to honor the loved on& memories. #hpm

Wed Dec 14 18:36:14 PST 2011

renee_berry interesting RT @JenMarsh2: T2 To many people, peace is about acceptance. I like to thinof it more as acknowledgement #hpm

Wed Dec 14 18:36:16 PST 2011

nursefriendly RT @renee_berry: @JenMarsh2 I think that can be a struggle for clinicians, where they

may not see what to hope for, often patients & families can #hpmWed Dec 14 18:36:23 PST 2011

equijada t2: Peace comes from spiritual growth. Rather than finding it, let it find you. Counter-intuitively, growth comes from being still. #hpm

Wed Dec 14 18:36:24 PST 2011

NHDD @aliciabloom thanks for #hpm the shout out Alicia!Wed Dec 14 18:36:46 PST 2011

aliciabloomMT @hollyby: T2: Holidays, anniversaries are tough. Keeping a family tradition, or part of atradition, while making it new helps. #hpm

Wed Dec 14 18:36:48 PST 2011

NHDD RT @aliciabloom: when i think about peace for patients & families, i immediately thinkabout the importance of advance care planning (@NHDD) #hpm

Wed Dec 14 18:36:51 PST 2011

nursefriendly @renee_berry Clinicians as in #doctors grabbing at straws for new treatments, refusing to

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"give up" ? #hpm

Wed Dec 14 18:37:00 PST 2011

renee_berry RT @equijada: Hope isn't an expectation. It's a context that moves one forward #hpmWed Dec 14 18:37:12 PST 2011

renee_berry RT @equijada: t2: Peace comes from spiritual growth. Rather than finding it, let it find you.Counter-intuitively, growth comes from being still. #hpmWed Dec 14 18:37:14 PST 2011

NatriceR RT @KathyKastner: #hpm T2 both my parents died round this time. We sibs get togetherand tell stories, shed tears. disagree about perspe ...

Wed Dec 14 18:37:15 PST 2011

MarksPhone If we tie T1 and T2 together what is the hope for a family member post EOL? It is nowdifferent. Hope become self centered #hpm

Wed Dec 14 18:37:19 PST 2011

hollyby MT @equijada: t2: Peace comes from spiritual growth. Rather than finding it, let it findyou... growth comes from being still. #hpm

Wed Dec 14 18:37:23 PST 2011

nursefriendly RT @renee_berry: @JenMarsh2 but the clinician may project their lack of ability to becreative in finding more hope than another clinical trial to offer #hpm

Wed Dec 14 18:37:29 PST 2011

NatriceR RT @nursefriendly: @KathyKastner Encounter #families#caregivers frequently that havedifferent "plans" than the #patient. Need to reconcile pt wishes #hpm

Wed Dec 14 18:37:34 PST 2011

KathyKastner #hpm What about regrets at life's end? Does that get in the way of peace and joy?Wed Dec 14 18:37:45 PST 2011

crgonzalez @renee_berry And it comes from accepting what "is" #HPMWed Dec 14 18:38:00 PST 2011

aliciabloom have seen patients struggle to find peace at EoL because their families are conflicted,which then impacts the grieving process. #hpm

Wed Dec 14 18:38:08 PST 2011

JenMarsh2 @GodtheHealerDev I think so. I don't accept that my mom had to die from cancer, but Iacknowledge that it happened. #hpm

Wed Dec 14 18:38:21 PST 2011

KathyKastner RT @aliciabloom: have seen patients struggle to find peace at EoL because their familiesare conflicted, which then impacts the grieving process. #hpm

Wed Dec 14 18:38:24 PST 2011

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nursefriendly @renee_berry In the end, it is not the clinicians decision. The #patient and #family decidedon further treatment, or not #hpm

Wed Dec 14 18:38:34 PST 2011

_lizzy_ T2: Of all the grief theories, Worden's Four Tasks of Mourning is my favorite. It seems toresonate with families #hpm

Wed Dec 14 18:38:35 PST 2011

NatriceR RT @nursefriendly: @KathyKastner It is difficult to tell #families, that is not what the#patient wants. As a #patientadvocate, it is a duty we owe #hpm

Wed Dec 14 18:38:37 PST 2011

renee_berry @nursefriendly in @Frontline "Facing Death" a few oncologists had direct quotes showingtheir discomfort being straightforward w/pts #hpm

Wed Dec 14 18:38:49 PST 2011

crgonzalez @nursefriendly In nursing school, are there exams that explore competency related to

issues of hospice? #HPMWed Dec 14 18:38:50 PST 2011

KathyKastner Linkd?RT @_lizzy_: T2: Of all the grief theories, Worden's Four Tasks of Mourning is myfavorite. It seems to resonate with families #hpm

Wed Dec 14 18:38:58 PST 2011

JenMarsh2 @GodtheHealerDev To me, acceptance implies some sort of permission, like it was okaythat it happened. #hpm

Wed Dec 14 18:39:19 PST 2011

renee_berry @nursefriendly often the patient & family don't understand their full options #hpmWed Dec 14 18:39:24 PST 2011

nursefriendly @renee_berry#doctors don't like to hear it, but many of them have a "hang-up" aboutthrowing in the towel (most oncologists get it) #hpm

Wed Dec 14 18:39:37 PST 2011

_lizzy_ @KathyKastnerhttp://t.co/UxxTnOkF#hpmWed Dec 14 18:39:52 PST 2011

NatriceR RT @nursefriendly: It does, meeting your "maker" can bring peace RT @jordangrumet: t1:Hope allows us to look forward to something even when facing death. #hpm

Wed Dec 14 18:40:14 PST 2011

JenMarsh2 @KathyKastner@_lizzy_ We'll be talking a little bit about Worden's Task theory tomorrowon #eolchat#hpm

Wed Dec 14 18:40:19 PST 2011

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nursefriendly Of course not, that is our job to explain RT @renee_berry: often the patient & family don'tunderstand their full options #hpm

Wed Dec 14 18:40:25 PST 2011

CarolynMcC @renee_berry They should read the book "Fierce Conversations" Teaches us how to havehard conversations #hpm

Wed Dec 14 18:40:43 PST 2011

hollyby @MarksPhone That is a very interesting thought Mark. I wonder if by turning focus outwarby supporting other family/friends helps. #hpm

Wed Dec 14 18:41:05 PST 2011

KathyKastner @_lizzy_ Thanks especially since I won't be at tomorropw's #EOLchat (fooey) #hpmWed Dec 14 18:41:09 PST 2011

NatriceR RT @KathyKastner: #hpm What about regrets at life's end? Does that get in the way ofpeace and joy?

Wed Dec 14 18:41:21 PST 2011

nursefriendly @renee_berry Yes, see that every day. Some #doctors will insist, it wasn't the "treatment"that killed them, it was the #cancer#hpm

Wed Dec 14 18:41:30 PST 2011

MarksPhone @KathyKastner#hpm thanks for the leadWed Dec 14 18:41:39 PST 2011

renee_berry @CarolynMcC will have to look that up! #hpmWed Dec 14 18:41:53 PST 2011

schwartzbrown Can we be at peace at the end of life if we're not during life? #hpmWed Dec 14 18:41:53 PST 2011

MeredithGould @KathyKastner Holding it all simultaneously -- regrets & joy & peace -- is a spiritualpractice. #hpm

Wed Dec 14 18:42:05 PST 2011

_lizzy_ @KathyKastner FYI that was just a random link that had the info... just googled it quickly#hpm

Wed Dec 14 18:42:14 PST 2011

GodtheHealerDev @JenMarsh2 That makes sense. I would think the patient would need both, thoughacceptance is the harder one. #hpm

Wed Dec 14 18:42:14 PST 2011

nursefriendly @MarksPhone Of course we can. Give them an idea of what to expect, not to expect fromtreatment. Give other options. #hpm

Wed Dec 14 18:42:19 PST 2011

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renee_berry RT @CarolynMcC: @renee_berry They should read the book "Fierce Conversations"Teaches us how to have hard conversations #hpm

Wed Dec 14 18:42:22 PST 2011

pamressler Sorry to be checking in so late...teaching tonight #hpmWed Dec 14 18:42:28 PST 2011

aliciabloom the language we use in EoL discussion can impact the level of peace & comfort peoplehave in decision making #hpm

Wed Dec 14 18:42:40 PST 2011

_lizzy_ RT @schwartzbrown: Can we be at peace at the end of life if were not during life? #hpmWed Dec 14 18:42:42 PST 2011

_lizzy_ RT @schwartzbrown: Can we be at peace at the end of life if were not during life? #hpmWed Dec 14 18:42:42 PST 2011

KathyKastner @_lizzy_ thanks :) #hpmWed Dec 14 18:42:49 PST 2011

KathyKastner @pamressler Hey Pam! #hpmWed Dec 14 18:43:02 PST 2011

crgonzalez @schwartzbrown Now you are getting deep. That is the trick, isn't it? Being alive andpresent in the now. #HPM

Wed Dec 14 18:43:03 PST 2011

nursefriendly @MarksPhone Every #oncologist worth their salt, will give percentages, chances ofsuccess, with treatments. Not many are rosy. #hpm

Wed Dec 14 18:43:08 PST 2011

equijada @schwartzbrown yes but difficult. #hpmWed Dec 14 18:43:10 PST 2011

renee_berry RT