Category: Case Studies

Articles about two or more studies to explore a given topic.

Doctors Ignoring Family Concerns in Dementia Care

Welcome to our discussion on a topic close to many hearts: the care of our loved ones with dementia. When a family member is diagnosed with dementia, it feels like a part of them slowly fades away. But as they lose parts of themselves, your role in their life becomes even more crucial. This article isn’t just words on a page; it’s a beacon of hope and understanding, shining a light on why your voice, as a family member, is vital in the care of your loved one.
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Unveiling the Truth: The Accuracy of FDG PET Scans in Dementia Diagnosis

diagnostic scans for dementia healthy brain vs. brain with dementia
One of the tools doctors uses is called an FDG PET scan. It’s a special kind of test that takes pictures of the brain. FDG is a type of sugar, and PET stands for Positron Emission Tomography. When someone has a PET scan, they get a tiny amount of this sugar injected into their body. Because the brain uses sugar as fuel, the scan can show which parts are working well and which parts aren’t. This is super helpful because in people with dementia, some parts of the brain don’t use sugar the same way healthy parts do. So, the scan can show doctors these changes and help them understand what’s going on.
Read MoreUnveiling the Truth: The Accuracy of FDG PET Scans in Dementia Diagnosis

How to Use the Beers Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

thoughtful prescribing and deprescribing
In this article, we will discuss how to use the Beers Criteria to identify PIMs and potential prescribing omissions (PPOs) in hospice patients. PPOs are medications that are indicated but not prescribed for a specific patient or population, or that are prescribed at a suboptimal dose or duration. We will also present 10 case studies to illustrate the medication reconciliation and deprescribing process and the outcomes of medication changes in different scenarios.
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How to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

thoughtful prescribing and deprescribing
If you are caring for a terminally ill patient in hospice, you know how challenging it can be to manage their medications. You want to make sure they are getting the best possible care, but you also want to avoid unnecessary or harmful drugs that may worsen their quality of life or cause adverse effects. That’s where medication reconciliation and deprescribing come in. Medication reconciliation is the process of reviewing and updating the patient’s medication list to ensure accuracy and completeness. Deprescribing is the process of reducing or stopping medications that are no longer needed, effective, or appropriate for the patient’s condition and goals of care.
Read MoreHow to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

Why Saying Goodbye to Your Dying Loved One Matters

One Of The Greatest Gifts You Can Give To A Dying Friend Is Your Time And Attention During Their Final Days
Losing a loved one to a terminal illness is an incredibly challenging experience. It's a journey filled with emotions, uncertainties, and the need for profound empathy. One crucial aspect of this journey is saying goodbye to your dying loved one and granting them permission to pass peacefully. In this article, we'll explore the significance of these acts, which not only bring comfort to the terminally ill but also aid in the grieving process for those left behind. We'll also share three case studies to illustrate the importance of these actions.
Read MoreWhy Saying Goodbye to Your Dying Loved One Matters

Four Case Studies About External Oxygen on Hospice

It is common for family members and caregivers who are not trained in end-of-life topics to be concerned about their loved one's oxygen concentration (SpO2 and sometimes also abbreviated SPaO2) reading from a pulse oximeter. If their loved one refuses external oxygen or takes off the external oxygen, this often causes distress to the family and caregivers because they are focused on the numbers vs. the patient themselves. Hospice is about patient-centered care, and I would like to present four case studies to demonstrate how hospice manages this situation with compassion.
Read MoreFour Case Studies About External Oxygen on Hospice

Early Detection of Serotonin Syndrome in Dementia Patients: Three Case Studies

diagnosing serotonin syndrome
Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the body. Detecting this condition early is crucial, but it can be particularly challenging when dealing with dementia patients due to communication barriers and the complexity of their symptoms. In this article, we will present three case studies that highlight the early detection and successful management of serotonin syndrome in patients with different types of dementia: Alzheimer's disease, vascular dementia, and Lewy Body Dementia.
Read MoreEarly Detection of Serotonin Syndrome in Dementia Patients: Three Case Studies

Ethical Dilemmas in Hospice

I have seen many ethical dilemmas arise in end-of-life situations over my time as a hospice RN case manager. Hospice care is unique in that it focuses on providing comfort care to patients who are no longer seeking curative treatment for their illness. As a result, the ethical concerns that arise in hospice care are different from those in other healthcare settings. In this article, we will explore some of the ethical dilemmas that can arise in hospice care and how they can be addressed. Before I go over several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.
Read MoreEthical Dilemmas in Hospice

Rally as part of the dying process

Dying is an inevitable facet of life, a natural progression that touches us all. This journey towards the end of life can unfold in diverse ways—peaceful and graceful or turbulent and fraught with stress. Amid this journey, there exists a phase known as the "rally." It occurs just prior to the final moments of a person's life. This rally phase often shrouds itself in misunderstanding and misconceptions. It's imperative to unravel what it truly signifies.
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The D.O.G.I. at the window case study

As nurses, when we see an acute change of condition, part of what we should be doing in our assessment is determining if there are reversible or treatable elements that are causing the change. In RN school, Dr. Dagen taught the students about using the D.O.G. mnemonic to help us remember that if a patient has an acute change of condition to check whether there were new medications the patient is taking, their O2 saturation level and their glucose level. I would further add that as a hospice nurse dealing with mainly geriatric patients that if there is an altered level of consciousness (LOC)/personality change, to also consider the patient may have an infection. For any of you dealing with geriatric patients add “I” for infection, hence “D.O.G.I.” While this mnemonic is typically used for acute changes of level of consciousness, the thought process behind it can be used for other acute change of patient condition as well.
Read MoreThe D.O.G.I. at the window case study

Fall Reduction – Reducing Falls in Personal Care Homes and Private Homes

Screen Assess Intervene
Falls among the elderly can have severe consequences, including hip fractures, which can be life-threatening. As an experienced hospice registered nurse case manager, I understand the importance of fall prevention, especially in private homes, personal care homes, and assisted living facilities. This article aims to provide practical tips for reducing falls in these settings by following the nursing process: assessment, diagnosis, planning, implementation, and evaluation.
Read MoreFall Reduction – Reducing Falls in Personal Care Homes and Private Homes

General Inpatient (GIP) Level of Care for Hospice Explained

general inpatient hospice
General Inpatient Hospice, often abbreviated as GIP, is a crucial but frequently misunderstood aspect of hospice care. This level of care is provided to patients in an inpatient setting, typically in a Medicare-certified hospital, inpatient unit, or skilled nursing facility. It is designed for short-term, acute situations that require intensive management by skilled nursing care. In this article, we will clarify the basics of GIP for hospice, including eligibility requirements, settings, doctor's orders, plan of care, documentation, and education. Additionally, we will provide real-life cases to illustrate the application of GIP in hospice care.
Read MoreGeneral Inpatient (GIP) Level of Care for Hospice Explained

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