2011 06 08 hpm tweetchat transcript

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#hpm Healthcare Hashtag Twitter Transcript From: Wed Jun 08 18:00:00 PDT 2011 To: Wed Jun 08 19:00:00 PDT 2011 Customize transcript dates and layout Learn more about #hpm at The Healthcare Hashtag Project hollyby For the next hour I'll be tweeting from the #hospice and #palliative medicine tweetchat. #hpm Wed Jun 8 18:01:03 PDT 2011 elderpages 15 year old girl who is terminal with cancer has made a bucket list. One of her wishes: to trend on Twitter. Give a RT #alicebucketlist #hpm Wed Jun 8 18:01:09 PDT 2011 jodyms Hello everyone, I'm Jody Schoger and will be moderating tonight's #HPM chat. I'm a cancer survivor, co-survivor, writer and blogger. Wed Jun 8 18:01:10 PDT 2011 jfclearywisc Hi, Joining #hpm from the basement. Major thunderstorms here in Madison, WI. Fingers crossed and praying. #hpm Wed Jun 8 18:01:25 PDT 2011 jodyms Who's joining us for tonight's discussion? Please introduce yourself. It's great to be connected with all of you again. #HPM Wed Jun 8 18:01:54 PDT 2011 ctsinclair RT @hollyby : For the next hour Ill be tweeting from the #hospice and #palliative medicine tweetchat. "me too!" #hpm Wed Jun 8 18:01:55 PDT 2011 equijada Hi all. Thanks for hosting @jodyms #hpm Wed Jun 8 18:02:13 PDT 2011 hollyby @jfclearywisc Stay safe! #hpm Wed Jun 8 18:02:35 PDT 2011 elderpages Nice to "see" you all. I'm a hospice volunteer, research scientist, family caregiver and webmaster committed to community devt via Web #hpm Wed Jun 8 18:02:38 PDT 2011

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Transcript of 2011 06 08 hpm tweetchat transcript

Page 1: 2011 06 08 hpm tweetchat transcript

#hpm

Healthcare Hashtag Twitter Transcript

From: Wed Jun 08 18:00:00 PDT 2011

To: Wed Jun 08 19:00:00 PDT 2011

Customize transcript dates and layout

Learn more about #hpm at The Healthcare Hashtag Project

hollyby For the next hour I'll be tweeting from the #hospice and #palliative medicine

tweetchat. #hpmWed Jun 8 18:01:03 PDT 2011

elderpages 15 year old girl who is terminal with cancer has made a bucket list. One of her

wishes: to trend on Twitter. Give a RT #alicebucketlist #hpmWed Jun 8 18:01:09 PDT 2011

jodyms Hello everyone, I'm Jody Schoger and will be moderating tonight's #HPM chat. I'm a

cancer survivor, co-survivor, writer and blogger.Wed Jun 8 18:01:10 PDT 2011

jfclearywisc Hi, Joining #hpm from the basement. Major thunderstorms here in Madison, WI.

Fingers crossed and praying. #hpmWed Jun 8 18:01:25 PDT 2011

jodyms Who's joining us for tonight's discussion? Please introduce yourself. It's great to be

connected with all of you again. #HPMWed Jun 8 18:01:54 PDT 2011

ctsinclair RT @hollyby: For the next hour Ill be tweeting from the #hospice and #palliative

medicine tweetchat. "me too!" #hpmWed Jun 8 18:01:55 PDT 2011

equijada Hi all. Thanks for hosting @jodyms #hpmWed Jun 8 18:02:13 PDT 2011

hollyby @jfclearywisc Stay safe! #hpmWed Jun 8 18:02:35 PDT 2011

elderpages Nice to "see" you all. I'm a hospice volunteer, research scientist, family caregiver and

webmaster committed to community devt via Web #hpmWed Jun 8 18:02:38 PDT 2011

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MedicalMarcom I showed up an hour early! Now I know better. Joe Hage, #MedDevice founder, mktg

comm for med companies. #HPMWed Jun 8 18:02:52 PDT 2011

jodyms @jfclearywisc @equijada @ctsinclair - greetings! #HPMWed Jun 8 18:02:57 PDT 2011

authordhallman #hpm - David here. lost my partner to pancreatic cancer 2 wks after diagnosis.Wed Jun 8 18:03:05 PDT 2011

aliciabloom MSW, LSW from @VITASHospice & Palliative Care. #hpm consults, clinical

education & program development. #hpmWed Jun 8 18:03:28 PDT 2011

equijada @authordhallman Hi David, welcome. #hpmWed Jun 8 18:03:38 PDT 2011

MedicalMarcom I am looking to meet a HPM professional with experience selling into #HPM orgs +

figured y'all would have recos?Wed Jun 8 18:03:57 PDT 2011

hollyby Hello, Holly Yang. HPM doc from @SanDiegoHospice. Interests in international

#palliative med, pt care, med ed, SoMe, communication #hpmWed Jun 8 18:04:11 PDT 2011

Freshwidow Supa, widow blogger, #HPM advocate and family member. Crazy hair. Thanks for

hosting, @jodyms!Wed Jun 8 18:04:31 PDT 2011

jodyms Welcome @authorhallman @aliciabloom @medicalmarcom #hpmWed Jun 8 18:04:32 PDT 2011

DrSnit @jodyms Hey cats! Longtime no see Jodycakes!! Muah!! #hpmWed Jun 8 18:04:46 PDT 2011

PracticalWisdom HI I'm Lisa Trainer/Speaker/Creative Connector. Looking forward to @jodyms and

the other leaders in #HPM Field #HPMWed Jun 8 18:04:51 PDT 2011

hollyby As always, all tweets are my own #hpmWed Jun 8 18:05:08 PDT 2011

drseisenberg Hi there! Steven Eisenberg. Medical oncologist. Lyrical Life guy. I co-write original

songs with cancer and hospice patients. #hpmWed Jun 8 18:05:21 PDT 2011

PinkRibbonBlues #HPM Gayle here, medical sociologist, focus on breast cancer culture, industry,

advocacy, and survivorship. Love @jodymsWed Jun 8 18:05:24 PDT 2011

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doctatum RT @doctatum Paul from Mo. Before the floods hit. On phone. Oops. #hpmWed Jun 8 18:05:27 PDT 2011

ctsinclair Intros: Hello, Christian Sinclair here, Palliative MD @KChospice, Editor @Pallimed,

fan of @SportingKC and the new @LiveSTRONGPark #hpmWed Jun 8 18:05:32 PDT 2011

jodyms I'll asking #HPM questions tonight on behalf of the cancer survivor community. And

I'm sure if I misrepresent them we'll hear otherwise:)Wed Jun 8 18:05:32 PDT 2011

jfclearywisc @MedicalMarcom PRobably not tonight given topic is "Abandonment-what patients

really feel. Don't mean to abandon you :-) #hpmWed Jun 8 18:05:41 PDT 2011

jodyms @drsnit @hollyby @practicalwisdom Awesome to see you:) #hpmWed Jun 8 18:06:00 PDT 2011

uvmer Hi! Lurking in the shadows and might butt in. (: #HPMWed Jun 8 18:06:10 PDT 2011

MatthewsMichele <--#hospice, #hpm advocate, patient and community empowerment enthusiast!

#hpmWed Jun 8 18:06:11 PDT 2011

revdoc RT @ctsinclair: RT @hollyby: For the next hour Ill be tweeting from the #hospice and

#palliative medicine tweetchat. "me too!" #hpmWed Jun 8 18:06:34 PDT 2011

MedicalMarcom @jfclearywisc thanks. I'll stick around all the same + meet some new #HPM folks!Wed Jun 8 18:06:41 PDT 2011

DrSnit Me 3 RT @ctsinclair RT @hollyby: For the next hour Ill be tweeting from the #hospice

& #palliative medicine tweetchat. "me too" #hpmWed Jun 8 18:06:47 PDT 2011

ctsinclair @hollyby RE: Twwets are my own: Intersting take from @Doctor_V Should We Ditch

Social Media Disclaimers? http://hpm.md/lzTW9G #hpmWed Jun 8 18:06:47 PDT 2011

PracticalWisdom Sorry are the floods close? RT @doctatum: RT @doctatum Paul from Mo. Before the

floods hit. On phone. Oops. #HPMWed Jun 8 18:06:58 PDT 2011

MatthewsMichele <---oh and #socialmedia junkie! :-) #hpmWed Jun 8 18:07:20 PDT 2011

ctsinclair @uvmer Hi Nancy, I am sure we will lure you in with some good conversation! #hpmWed Jun 8 18:07:25 PDT 2011

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jodyms #HPM - Our topic tonight is what patients really fear: abandonment. Abandonment by

doctors, friends, and family.Wed Jun 8 18:07:31 PDT 2011

PracticalWisdom Thanks excited about tonight. RT @jodyms: @drsnit @hollyby @practicalwisdom

Awesome to see you:) #HPMWed Jun 8 18:07:42 PDT 2011

revdoc Pam Harris MD @KCHospice, ordained minister #hpmWed Jun 8 18:07:47 PDT 2011

DrSnit RT @jodyms: I'll asking #HPM questions tonight on behalf of the cancer survivor

community. And I'm sure if I misrepresent them we'll hear otherwise:)Wed Jun 8 18:08:06 PDT 2011

revdoc @revdoc @KCHospice Tweets are my own #hpmWed Jun 8 18:08:14 PDT 2011

RossJeanette Hi I'm Jeanette Ross HPM doc associate Fellowship director @uthscsa in san

Antonio passionate about teaching. Will lurk tonight #hpmWed Jun 8 18:08:14 PDT 2011

elderpages @jodyms I would like to hear more about some of those fears. Can you start with a

few? #hpmWed Jun 8 18:08:17 PDT 2011

hollyby @ctsinclair It's part of my employer's SoMe policy, I believe, so... I do it. #hpmWed Jun 8 18:08:26 PDT 2011

ctsinclair @PinkRibbonBlues Hi Gayle! Welcome to the chat! #hpmWed Jun 8 18:08:33 PDT 2011

uvmer @ctsinclair Most probably... (: Not the silent type. Thanks. #HPMWed Jun 8 18:08:40 PDT 2011

jodyms So my first T1: how can we work together to help transition patients into healing,

supportive care? #hpmWed Jun 8 18:08:42 PDT 2011

equijada RT @jodyms: I'll asking #HPM questions tonight on behalf of the cancer survivor

community. And I'm sure if I misrepresent them we'll hear otherwise:)Wed Jun 8 18:09:08 PDT 2011

ctsinclair Just a tip if you do use cancer in your tweet feel free to hashtag it. Some people

might be looking for that, and stumble here. #hpmWed Jun 8 18:09:10 PDT 2011

MatthewsMichele RT @jodyms: So my first T1: how can we work together to help transition patients

into healing, supportive care? #hpm

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Wed Jun 8 18:09:11 PDT 2011

hollyby RT @jodyms: So my first T1: how can we work together to help transition patients

into healing, supportive care? #hpmWed Jun 8 18:09:13 PDT 2011

JohnGirdwood @ctsinclair I love this #hpm thing so much, almost as much (maybe equally) as

watching Tigers or BoSox vs Yankees!Wed Jun 8 18:09:28 PDT 2011

ctsinclair RT @hollyby: @ctsinclair Its part of my employers SoMe policy, I believe, so... I do it.

"good answer!" #hpmWed Jun 8 18:09:31 PDT 2011

jodyms RT @ctsinclair: Just a tip if you do use cancer in your tweet feel free to hashtag it.

Some people might be looking for that, and stumble here. #hpmWed Jun 8 18:09:34 PDT 2011

jodyms @uvmer Nancy, you have a lot to add here. I'm glad you've joined us. #hpmWed Jun 8 18:09:59 PDT 2011

andybaldwin @ctsinclair @kchospice @pallimed @sportingkc @hollyby @livestrongpark #hpm hi

everyone! Dr. Baldwin here #AskDrAndyWed Jun 8 18:10:00 PDT 2011

Doctor_V And The Palliatives convene #hpmWed Jun 8 18:10:19 PDT 2011

elderpages Can you help by clarifying transition from what? Do you mean changing goals of care

from curative to comfort? #hpmWed Jun 8 18:10:26 PDT 2011

hollyby @andybaldwin Hi Andy! Great to have you join us! #hpmWed Jun 8 18:10:38 PDT 2011

PracticalWisdom RT @jodyms: RT @ctsinclair: Just a tip if you do use cancer in tweet feel free 2

hashtag. # people might B looking4 & stumble here. #HPMWed Jun 8 18:10:44 PDT 2011

DrSnit RT @jodyms: So my first T1: how can we work together to help transition patients

into healing, supportive care? #hpmWed Jun 8 18:10:45 PDT 2011

ctsinclair T1 (Clarification) @jodyms Which 'we" did you have in mind with this question? We

the chatters, we the social media-ists, etc? #hpmWed Jun 8 18:10:50 PDT 2011

elderpages RT @Doctor_V: And The Palliatives convene...T: Sounds like a backup band :-) #hpmWed Jun 8 18:11:02 PDT 2011

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JohnGirdwood I was called to HR before to clear up my use so... RT @hollyby: @ctsinclair It's part of

my employer's SoMe policy, so... I do it #hpmWed Jun 8 18:11:06 PDT 2011

aliciabloom early integration #palliative care brings supportive care throughout the continuum of

illness, making it less of an abrupt transition #hpmWed Jun 8 18:11:14 PDT 2011

uvmer @jodyms Thanks Jody. (: #hpmWed Jun 8 18:11:16 PDT 2011

PracticalWisdom Are you going to join us tonight? That would be great RT @Doctor_V: And The

Palliatives convene #HPMWed Jun 8 18:11:17 PDT 2011

jodyms @elderpages T1: Transition from curative to comfort and supportive. #hpmWed Jun 8 18:11:21 PDT 2011

DrSnit @jodyms Yes yes yes! so glad you're here @uvmer!! xo #hpmWed Jun 8 18:11:26 PDT 2011

ctsinclair T1: I think healing supportive care should come as part of the package regardless of

goals #hpmWed Jun 8 18:11:38 PDT 2011

equijada t1 prior to working together, I have to be prepared to go into a place that is sacred,

scary. Make sure I'm in a good place #hpmWed Jun 8 18:11:50 PDT 2011

drseisenberg T1: Talk early, talk often and talk authentically about #cancer and hospice. Med oncs

just gotta do it. #asco11 #hpmWed Jun 8 18:11:59 PDT 2011

DoctorFisher Hello Palliators #hpmWed Jun 8 18:12:02 PDT 2011

ctsinclair RT @aliciabloom: early integration #palliative care brings supportive care across

continuum of illness, making less abrupt transition #hpmWed Jun 8 18:12:07 PDT 2011

PracticalWisdom RT @aliciabloom: early integration #palliative care brings supportive care throughout

continuum illness, making it (-) an abrupt trans. #HPMWed Jun 8 18:12:17 PDT 2011

revdoc T1 IMHO we need better training, inservices, curriculum for non-HPM types so that

referrals are made by usual MDs, nonthreatening #hpmWed Jun 8 18:12:20 PDT 2011

ctsinclair @aliciabloom Nice concise statement! #hpmWed Jun 8 18:12:20 PDT 2011

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PracticalWisdom RT @drseisenberg: T1: Talk early, talk often and talk authentically about #cancer and

hospice. Med oncs just gotta do it. #asco11 #HPMWed Jun 8 18:12:30 PDT 2011

DoctorFisher RT @ctsinclair: T1: I think healing supportive care should come as part of the

package regardless of goals #hpmWed Jun 8 18:12:39 PDT 2011

elderpages Guess I'm in listening mode (questions mode). What would survivors like

professionals to do to be more collaborative? #hpmWed Jun 8 18:12:53 PDT 2011

aliciabloom @ctsinclair thanks! i'm getting better at this 140 character thing ;) #hpmWed Jun 8 18:12:55 PDT 2011

PracticalWisdom RT @revdoc: T1 IMHO we need better training, inservices, curriculum for non-HPM

types so referrals R made by usual MDs, nonthreatening #HPMWed Jun 8 18:13:03 PDT 2011

Doctor_V Lurking #hpmWed Jun 8 18:13:13 PDT 2011

PracticalWisdom RT @elderpages: Guess Im in listening mode (questions mode). What would

survivors like professionals to do to be more collaborative? #HPMWed Jun 8 18:13:17 PDT 2011

thinkalot RT @drseisenberg: T1: Talk early, talk often and talk authentically about #cancer and

hospice. Med oncs just gotta do it. #asco11 #hpmWed Jun 8 18:13:29 PDT 2011

jodyms @ctsinclair T1: Understand that the end of life is a big mystery to most cancer

patients. Its the chapter in the book we don't read. #hpmWed Jun 8 18:13:43 PDT 2011

ctsinclair T1: Important to address w/ psychology of the patient and the family, seen wide

variety of adjustment to illness (some good, some bad) #hpmWed Jun 8 18:13:47 PDT 2011

hollyby T1: It should not feel like an "either/or" issue. Supportive/palliative care should begin

early, regardless of ability to cure. #hpmWed Jun 8 18:13:57 PDT 2011

ihatebreastcanc @jodyms Katherine with bone-only MBC #hpmWed Jun 8 18:14:10 PDT 2011

drseisenberg Med oncs can become involved with a hospice. Continuity. #hpmWed Jun 8 18:14:24 PDT 2011

DrSnit I'm always intrigued by how afraid and alone people (the patients, the caretakers

sometimes even the docs) feel during treatment #hpm

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Wed Jun 8 18:14:24 PDT 2011

MatthewsMichele RT @elderpages: 15 year old girl who is terminal with cancer has made a bucket

list. One of her wishes: to trend on Twitter. Give a RT #alicebucketlist #hpmWed Jun 8 18:14:25 PDT 2011

ctsinclair @elderpages Yes I would like to here from #cancer survivors as well on this topic.

#hpmWed Jun 8 18:14:28 PDT 2011

jodyms @PracticalWisdom @elderpages First we need to make connections between

clinical #HPM and survivor communities. Bridge must be constructed.Wed Jun 8 18:14:41 PDT 2011

equijada RT @jodyms: @ctsinclair T1: Understand that the end of life is a big mystery to most

cancer patients. Its the chapter in the book we don't read. #hpmWed Jun 8 18:14:42 PDT 2011

jodyms @ihatebreastcanc Thank you for joining us. #hpmWed Jun 8 18:14:59 PDT 2011

ctsinclair T1: the curious challenge is identifying transition points. All stakeholders may have

different perceptions of timing. #hpmWed Jun 8 18:14:59 PDT 2011

PracticalWisdom RT @ctsinclair: T1: Imp.2 address w/ psychology of pt & family, seen wide variety of

adjustment to illness (some good, some bad) #HPMWed Jun 8 18:15:03 PDT 2011

hollyby RT @ctsinclair: T1: the curious challenge is identifying transition points. All

stakeholders may have different perceptions of timing. #hpmWed Jun 8 18:15:28 PDT 2011

elderpages RT @equijada: RT @jodyms: T1: End of life is a big mystery to most cancer patients.

Its the chapter in the book we dont read. #hpmWed Jun 8 18:15:34 PDT 2011

DrSnit @uvmer :) so glad you've joined the conversation. Your voice is necessary! xo #hpmWed Jun 8 18:15:38 PDT 2011

ctsinclair @ihatebreastcanc We really appreciate the perspective of patients and families in

this chat. Glad you are here. #hpmWed Jun 8 18:15:47 PDT 2011

MatthewsMichele pls. rt @JohnAmussen: I'm a marrow donor. here's 1 reason why. http://t.co/72Kubdy

/ #alicebucketlist” me too! www.marrow.org via @mswz #hpmWed Jun 8 18:15:53 PDT 2011

PracticalWisdom RT @jodyms: @PracticalWisdom @elderpages 1st we need 2 make connect

Btween clinical #HPM/survivor commu. Bridge must be constructed. #HPMWed Jun 8 18:15:57 PDT 2011

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elderpages TI: I think part of collaboration is starting where "they/we" are. Families and patients

not always on same page as each other. #hpmWed Jun 8 18:16:20 PDT 2011

authordhallman #hpm In Ontario, we benefitted from the coordinating agency that links the PC MDs,

community nurses, homemakers for the family’s benefitWed Jun 8 18:16:23 PDT 2011

jfclearywisc In #cancer & other diseases, do we reduce sense of abandonment with clear

definition of goals of care: cure, prolong, palliate #hpmWed Jun 8 18:16:39 PDT 2011

ctsinclair RT @hollyby: T1: Shouldn't feel like an "either/or" issue. Supportive/palliative care

should begin early, regardless of ability to cure #hpmWed Jun 8 18:16:50 PDT 2011

JohnGirdwood Like your twitter name : ) RT @jodyms: @ihatebreastcanc Thank you for joining us.

#hpmWed Jun 8 18:17:00 PDT 2011

equijada @jodyms how do cancer patients wish to transitioner? As a physician, I slowly push

boundaries till I get resistance then back off #hpmWed Jun 8 18:17:05 PDT 2011

PracticalWisdom RT @elderpages: TI: Part of collaboration is starting where "they/we" R.

Families/patients not always on same page as each other. #HPMWed Jun 8 18:17:07 PDT 2011

DrSnit @elderpages YES! And even when they ARE on the same page, EMOTIONS come

up and people feel like a "failure" for having feelings #hpmWed Jun 8 18:17:23 PDT 2011

MatthewsMichele T1: End of life is a big mystery to most cancer patients. Its the chapter in the book we

dont read. via @jodyms #hpmWed Jun 8 18:17:24 PDT 2011

aliciabloom stop perpetuating the everything/treatment vs. nothing/hospice dichotomy #hpmWed Jun 8 18:17:25 PDT 2011

uvmer As care giver to my partner w/a brain tumor, an early conversation & an advanced

directive were key.Knew then the path I was to follow. #hpmWed Jun 8 18:17:34 PDT 2011

jfclearywisc RT @hollyby: T1: Shouldnt feel like an "either/or" issue. Supportive/palliative care

should begin early, regardless of ability to cure #hpmWed Jun 8 18:17:36 PDT 2011

Freshwidow I disagree about transition points. @ctsinclair: As a #cancer widow, I wish we had

some orientation to hospice/PM at dx... or earlier! #hpmWed Jun 8 18:17:39 PDT 2011

ctsinclair T1: I think the concept of 'navigator' has been helpful in breast #cancer, wondering if

applied more broadly? #hpm

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applied more broadly? #hpm

Wed Jun 8 18:17:47 PDT 2011

PracticalWisdom RT @equijada: @jodyms how do cancer patients wish2 transitioner? As MD, I slowly

push boundaries till I get resistance then back off #HPMWed Jun 8 18:18:01 PDT 2011

elderpages I love the work of Dr. David Casarret: Talk first about hopes and achievable goals.

Strategize transition in context of achieving these #hpmWed Jun 8 18:18:11 PDT 2011

jodyms Elaborate - I like that RT @aliciabloom stop perpetuating the everything/treatment vs.

nothing/hospice dichotomy #hpmWed Jun 8 18:18:12 PDT 2011

MatthewsMichele @PracticalWisdom @elderpages how do we get them on the same page...is that

not where the process should begin? #hpmWed Jun 8 18:18:12 PDT 2011

MatthewsMichele RT @aliciabloom: stop perpetuating the everything/treatment vs. nothing/hospice

dichotomy #hpmWed Jun 8 18:18:18 PDT 2011

ctsinclair @aliciabloom Got to talk to a nurse today about that. She was very receptive to

having good language to describe the role of pall care #hpmWed Jun 8 18:18:19 PDT 2011

jfclearywisc @uvmer So how tough was that early conversation and did it take away hope? #hpmWed Jun 8 18:18:30 PDT 2011

Freshwidow I believe once you get the idea that there is a "transition" point, you are too delicate to

ever start with most ppl. #hpm @ctsinclairWed Jun 8 18:18:41 PDT 2011

drseisenberg T1: Compassionate communication must be there from day 1. #hpmWed Jun 8 18:18:45 PDT 2011

ctsinclair @Freshwidow So glad you are here! Tell me more why you disagree about transition

points. I think we are probably on the same page. #hpmWed Jun 8 18:18:50 PDT 2011

jodyms @freshwidow I agree completely from what I've seen and experienced. #hpmWed Jun 8 18:18:54 PDT 2011

equijada RT @Freshwidow: I disagree about transition points. @ctsinclair: As a #cancer

widow, I wish we had some orientation to hospice/PM at dx... or earlier! #hpmWed Jun 8 18:18:54 PDT 2011

revdoc T1 Maybe we need doulas (sp?) for death as well as for birthing? #hpmWed Jun 8 18:19:00 PDT 2011

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elderpages RT @MatthewsMichele: how do we get them on the same page...is that not where

the process should begin?...T: "Whose" page is first? #hpmWed Jun 8 18:19:17 PDT 2011

Freshwidow With us, the disease was slow for a long time... it started to change v. quickly, then

more quickly. NO time to adjust. #hpm @ctsinclairWed Jun 8 18:19:33 PDT 2011

elderpages RT @revdoc: T1 Maybe we need doulas (sp?) for death as well as for birthing?... T:

As a former midwife, YES!!! #hpmWed Jun 8 18:19:35 PDT 2011

DrSnit RT @revdoc: T1 Maybe we need doulas (sp?) for death as well as for birthing?

#hpmWed Jun 8 18:19:39 PDT 2011

ctsinclair @uvmer Was knowing the path helpful, even if you veered off the path? Like knowing

when things were not as planned? #hpmWed Jun 8 18:19:40 PDT 2011

RossJeanette T1 healthcare providers should accept that palliative care can improve quality and

length of life too. #HPMWed Jun 8 18:19:43 PDT 2011

PracticalWisdom Not sure there is a simple nor easy answer. G8 ?RT @MatthewsMichele:

@PracticalWisdom @elderpages how do we get them on the same page. #HPMWed Jun 8 18:19:47 PDT 2011

aliciabloom if we are to have true informed consent, patients need to know best & worst case

scenarios and everything in between. #hpmWed Jun 8 18:19:51 PDT 2011

ihatebreastcanc #cancer the word palliative is misunderstood. Some equate it with giving up or no

hope. Need to clearly define for patient and family #hpmWed Jun 8 18:19:58 PDT 2011

jodyms EOL navigators, doulas? Those are interesting thoughts. #hpmWed Jun 8 18:20:02 PDT 2011

ctsinclair @revdoc There have been some doulas for EOL but I think they would avoid calling

themselves Death Doulas. #hpmWed Jun 8 18:20:07 PDT 2011

EldrcareConsult Wait!!! Dont start yet!!! I am here now! :) #hpmWed Jun 8 18:20:17 PDT 2011

aliciabloom @ctsinclair language is critically important and a focus of the clinical education i do.

#hpmWed Jun 8 18:20:22 PDT 2011

hollyby T1: Providers need to develop communication skills to address goals & what is

important to the patient at diagnosis and revisit them #hpm

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Wed Jun 8 18:20:27 PDT 2011

MatthewsMichele @elderpages @MatthewsMichele the patient's page...definitely the patient's page.

#hpmWed Jun 8 18:20:29 PDT 2011

PracticalWisdom RT @Freshwidow: With us, disease was slow 4 a long timeit started 2 change v.

quickly/then quickly. NO time to adjust. #hpm @ctsinclair #HPMWed Jun 8 18:20:35 PDT 2011

westr RT @drseisenberg: T1: Compassionate communication must be there from day 1.

#hpm #pm101 #hcsmWed Jun 8 18:20:35 PDT 2011

Pallimed Death doulas in the NY Times from Pallimed: A Hospice and Palliative Medicine

Blog http://hpm.md/lSsRkM #hpm cc @revdocWed Jun 8 18:20:36 PDT 2011

MatthewsMichele RT @aliciabloom: if we are to have true informed consent, patients need to know

best & worst case scenarios and everything in between. #hpmWed Jun 8 18:20:40 PDT 2011

ctsinclair RT @jodyms: EOL navigators, doulas? Those are interesting thoughts. "but then we

have the tough EOL/labeling issue" #hpmWed Jun 8 18:21:00 PDT 2011

PracticalWisdom So glad to see you. Always add value and kindness.RT @EldrcareConsult: Wait!!!

Dont start yet!!! I am here now! :) #HPMWed Jun 8 18:21:12 PDT 2011

jodyms RT @westr: RT @drseisenberg: T1: Compassionate communication must be there

from day 1. #hpm #pm101 #hcsmWed Jun 8 18:21:12 PDT 2011

revdoc RT @ctsinclair: I think they avoid calling themselves Death Doulas. "Are we still that

death avoidant? It's birth to different realm" #hpmWed Jun 8 18:21:40 PDT 2011

DrSnit @revdoc The idea of a "death doula" is powerful. But death, loss, & dying are so

culturally centered, who would do it best? #hpmWed Jun 8 18:21:46 PDT 2011

EldrcareConsult The little one and I were out washing my truck..... :) #hpmWed Jun 8 18:21:47 PDT 2011

JoshGriffin RT @RossJeanette: T1 healthcare providers should accept that palliative care can

improve quality and length of life too. #HPMWed Jun 8 18:21:49 PDT 2011

Freshwidow I hear this a LOT from my widows... and we often focus it (wrongly I think) on the

excessive hope in disease communities #hpm @ctsinclairWed Jun 8 18:21:53 PDT 2011

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jodyms T2: You all agree on early discussion. Where/when does that take place? #hpmWed Jun 8 18:21:56 PDT 2011

jfclearywisc I talk to all patients with advanced disease about #hpm. They can choose not to have

anticancertherapy. Hospice is important then. #hpmWed Jun 8 18:21:57 PDT 2011

PracticalWisdom Listening to needs 1st start.RT @westr: RT @drseisenberg: T1: Compassionate

communication must be there from day 1. #hpm #pm101 #hcsm #HPMWed Jun 8 18:22:02 PDT 2011

PinkRibbonBlues RT @MatthewsMichele: RT @aliciabloom: if we are to have true informed consent,

patients need to know best & worst case scenarios and everything in between.

#hpmWed Jun 8 18:22:07 PDT 2011

ctsinclair @Freshwidow The different trajectories of illness is often discussed by palliative

teams. Some are gradual, others very erratic #hpmWed Jun 8 18:22:15 PDT 2011

elderpages See link on tipsheet for talking about hospice: Identify hopes first. http://bit.ly/m1wYsJ

#hpmWed Jun 8 18:22:16 PDT 2011

jodyms @revdoc @ctsinclair We ARE death avoidant. How do we tell the truth in cultures

where the truth is not to be told? #hpmWed Jun 8 18:22:37 PDT 2011

Freshwidow For me, hope for change is in the grassroots already active: disease communities

MUST start to talk about "not every makes it." #hpmWed Jun 8 18:22:42 PDT 2011

vj_CR @PracticalWisdom hello Lisa! I´m I too late to jump in #hpm ??Wed Jun 8 18:22:49 PDT 2011

jodyms RT @jfclearywisc: I talk to all patients with advanced disease about #hpm. They can

choose not to have anticancertherapy. Hospice is im ...Wed Jun 8 18:22:51 PDT 2011

PinkRibbonBlues RT @Freshwidow @ctsinclair We often focus it (wrongly I think) on the excessive

hope in disease communities #hpmWed Jun 8 18:22:55 PDT 2011

equijada @jodyms would it be helpful if a healthcare provider was identified from day one as

the "non-abandoner" (obviously need better term) #hpmWed Jun 8 18:23:21 PDT 2011

ihatebreastcanc #cancer everybody wants to go to heaven but nobody wants to die. Denial is a

powerful coping mechanism! #hpmWed Jun 8 18:23:21 PDT 2011

buffalogator RT @Pallimed: Death doulas in the NY Times from Pallimed: A Hospice and

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buffalogator RT @Pallimed: Death doulas in the NY Times from Pallimed: A Hospice and

Palliative Medicine Blog http://hpm.md/lSsRkM #hpm cc @revdocWed Jun 8 18:23:23 PDT 2011

jodyms Agree! RT @Freshwidow I hear this a LOT from my widows... and we often focus it

(wrongly I think) on excessive hope #hpm @ctsinclairWed Jun 8 18:23:32 PDT 2011

MatthewsMichele @vj_CR @PracticalWisdom my two cents...no way, jump in anytime! ;) #hpmWed Jun 8 18:23:36 PDT 2011

hollyby @jfclearywisc Some patients on hospice continue palliative chemo, don't

necessarily have to d/c anticancer therapy. #hpmWed Jun 8 18:23:39 PDT 2011

drseisenberg I saw so many young patients today; new patients. Connection first. #hpmWed Jun 8 18:23:46 PDT 2011

ctsinclair @revdoc Yes we (culture) are 'death avoidant' in terms of our own mortality. Most

acknowledge death is inevitable, just not dying yet. #hpmWed Jun 8 18:23:47 PDT 2011

Freshwidow We widows OFTEN see this as a culture change issue across the board b/c of our

isolation and perspective btwn 2 worlds #hpm.Wed Jun 8 18:23:54 PDT 2011

PracticalWisdom @Jodyms is our leader 2 night sure she/we are glad you R hereRT @vj_CR:

@PracticalWisdom hello Lisa! I´m I too late to jump in #hpm ?? #HPMWed Jun 8 18:23:56 PDT 2011

revdoc @jodyms @ctsinclair We learn to tell truth in the language of each culture; takes a lot

of work and cultural sensitivity #hpmWed Jun 8 18:24:09 PDT 2011

ctsinclair RT @Freshwidow: hope for change is in the grassroots already active: disease

communities MUST start to talk about "not every makes it." #hpmWed Jun 8 18:24:13 PDT 2011

vj_CR @MatthewsMichele @PracticalWisdom great! #hpm thanks for the warm welcome!Wed Jun 8 18:24:17 PDT 2011

jfclearywisc RT @MatthewsMichele: RT @aliciabloom: if we are to have true informed consent:

Yes it is informed consent so need it from diagnosis. #hpmWed Jun 8 18:24:18 PDT 2011

equijada @jodyms @Freshwidow I like what @jfclearywisc has been teaching about

hope/hubris #hpmWed Jun 8 18:24:30 PDT 2011

ctsinclair RT @drseisenberg: I saw so many young patients today; new patients. Connection

first. "Helps establish trust, and non-abandonment" #hpmWed Jun 8 18:24:34 PDT 2011

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DrSnit @Freshwidow People often take "hope" or make "meanings" in amazing ways

during the illness process. How or should we even shift this? #hpmWed Jun 8 18:24:46 PDT 2011

elderpages RT @PinkRibbonBlues: We often focus it (wrongly I think) on the excessive hope...T:

Hope has many faces. http://bit.ly/mUBNWI #hpmWed Jun 8 18:24:49 PDT 2011

VillageMemorial @ctsinclair What about collaborating w/friendly funeral directors? #hpmWed Jun 8 18:24:53 PDT 2011

ctsinclair RT @ihatebreastcanc: #cancer everybody wants to go to heaven but nobody wants to

die. Denial is a powerful coping mechanism! #hpmWed Jun 8 18:25:06 PDT 2011

aliciabloom at time of diagnosis with an advanced illness there should be discussion about

values, preferences and wishes. balance hope & reality. #hpmWed Jun 8 18:25:08 PDT 2011

jodyms Absolutely @equijada would it be helpful if a healthcare provider was id'd frm day as

one "non-abandoner" (obviously need better term) #hpmWed Jun 8 18:25:14 PDT 2011

MarksPhone Sorry had a senior day totally forgot #hpmWed Jun 8 18:25:24 PDT 2011

ctsinclair @ihatebreastcanc Important too, to recognize that denial as coping mechanism is

not always 'negative' can be helpful at times. #hpmWed Jun 8 18:25:35 PDT 2011

jfclearywisc @hollyby @jfclearywisc Not suggesting can't have chemo and hospice. Informed

consent is reason for early Hospice discussion @diagnosis #hpmWed Jun 8 18:25:36 PDT 2011

EldrcareConsult @VillageMemorial @ctsinclair I have established some great relationships with

funeral directors...they are great resources #hpmWed Jun 8 18:25:48 PDT 2011

revdoc RT @revdoc: @jodyms @ctsinclair lot of work & cultural sensitivity "also not a one

time thing, reveal the truth over time as pt/fam tol #hpmWed Jun 8 18:25:57 PDT 2011

hollyby RT @aliciabloom: at time of dx w/ advanced illness there should be discussion abt

values, preferences & wishes. balance hope & reality. #hpmWed Jun 8 18:26:04 PDT 2011

JohnGirdwood Great! Every step of the way RT @equijada: @jodyms helpful if healthcare provider

identified from day 1: "non-abandoner" #hpmWed Jun 8 18:26:24 PDT 2011

VillageMemorial Does anyone have experience w/home monitoring distance care over internet?

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VillageMemorial Does anyone have experience w/home monitoring distance care over internet?

#hpmWed Jun 8 18:26:27 PDT 2011

ctsinclair @jodyms RE: Non-abandoner - we need more negatives in there. I am a non-anti-

abandoning unavoider. ;-) #hpmWed Jun 8 18:26:28 PDT 2011

PracticalWisdom VAlentina is joining us from Argentina RT @vj_CR: @MatthewsMichele

@PracticalWisdom great! #hpm thanks for the warm welcome! #HPMWed Jun 8 18:26:30 PDT 2011

hollyby True. RT @jfclearywisc: @hollyby Not suggesting cant have chemo & hospice.

Informed consent is reason for early Hospice discussion @ dx #hpmWed Jun 8 18:26:40 PDT 2011

jfclearywisc RT @equijada: @jodyms @Freshwidow I like what @jfclearywisc has been teaching

about hope/hubris Thanks it is James Tulsky's work!! #hpmWed Jun 8 18:26:44 PDT 2011

aliciabloom #palliative care discussions before LVAD surgery did not take away hope & was

found to provide relief (mnt.to/3WDs) #hpmWed Jun 8 18:26:51 PDT 2011

Freshwidow I wonder if shrinks can offer some insight as to when ppl in shock from catastrophic

dx can best receive #HPM intro?Wed Jun 8 18:26:56 PDT 2011

PracticalWisdom RT @EldrcareConsult: @VillageMemorial @ctsinclair I have established # great

relationships w/ funeral directors they R great resources #HPMWed Jun 8 18:27:05 PDT 2011

jodyms @ctsinclair EOL facilitor doesn't work, either.....#hpmWed Jun 8 18:27:09 PDT 2011

drseisenberg I had to listen listen listen and then listen. Then gently talk about what we need to do

next. #hpmWed Jun 8 18:27:14 PDT 2011

ctsinclair @jfclearywisc Would love health care to really focus on informed consent. So

undervalued. World's biggest lie 'I have read the terms' #hpmWed Jun 8 18:27:27 PDT 2011

Freshwidow Agree -- or earlier! RT @hollyby: RT @aliciabloom: at time of dx w/ advanced illness

there should be discussion ..... #hpmWed Jun 8 18:27:30 PDT 2011

jodyms RT @aliciabloom: #palliative care discussions before LVAD surgery did not take

away hope & was found to provide relief (mnt.to/3WDs) #hpmWed Jun 8 18:27:31 PDT 2011

jodyms RT @PracticalWisdom: VAlentina is joining us from Argentina RT @vj_CR:

@MatthewsMichele @PracticalWisdom great! #hpm thanks for the warm ...Wed Jun 8 18:27:43 PDT 2011

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Wed Jun 8 18:27:43 PDT 2011

jodyms RT @Freshwidow: I wonder if shrinks can offer some insight as to when ppl in

shock from catastrophic dx can best receive #HPM intro?Wed Jun 8 18:27:53 PDT 2011

ctsinclair RT @Freshwidow: Can shrinks offer some insight as to when ppl in shock from

catastrophic dx can best receive #HPM intro? cc @DrShock #hpmWed Jun 8 18:27:59 PDT 2011

elderpages @jfclearywisc Do you have link to some of James Tulsky's work? #hpmWed Jun 8 18:27:59 PDT 2011

DrSnit Many fear if they don't have "hope" or a act a certain way during the illness process

they WILL be abandoned. Who teaches us to die? #hpmWed Jun 8 18:28:13 PDT 2011

uvmer @jfclearywisc Actually before initial surgery. Never spoke of it again. In the end ability

to speak was gone, but knew what I had to do #hpmWed Jun 8 18:28:29 PDT 2011

aliciabloom @Freshwidow i believe #palliative care clinicians can help patients & families cope

with catastrophic diagnosis. #hpmWed Jun 8 18:28:29 PDT 2011

VillageMemorial @aliciabloom Good points. Planning is vital. #hpmWed Jun 8 18:28:32 PDT 2011

PracticalWisdom Along w/ your songs!RT @drseisenberg: I had to listen listen listen and then listen.

Then gently talk about what we need to do next. #HPMWed Jun 8 18:28:34 PDT 2011

jodyms RT @DrSnit: Many fear if they don't have "hope" or a act a certain way during the

illness process they WILL be abandoned. Who teaches us to die? #hpmWed Jun 8 18:28:34 PDT 2011

Freshwidow Yes, one really must use holistic, positive language. Like SISTER/BROTHER...

navigator. @jodyms: @ctsinclair #hpmWed Jun 8 18:28:37 PDT 2011

MatthewsMichele RT @aliciabloom: @Freshwidow i believe #palliative care clinicians can help

patients & families cope with catastrophic diagnosis. #hpmWed Jun 8 18:28:50 PDT 2011

jfclearywisc RT @ctsinclair: @jfclearywisc Would love health care to really focus on informed

consent. Bet u bought ur house w/o reading fineprint #hpmWed Jun 8 18:28:51 PDT 2011

HumpbacksRule #hpm Hi all, Late to the party, but lurking :) Ro here- Research nurse, hospice

volunteer.Wed Jun 8 18:28:53 PDT 2011

JohnGirdwood Huh? Confused RT @hollyby: @jfclearywisc patients on hospice continue palliative

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JohnGirdwood Huh? Confused RT @hollyby: @jfclearywisc patients on hospice continue palliative

chemo, don't necessarily d/c anticancer therapy. #hpmWed Jun 8 18:28:57 PDT 2011

Gregmogel wow. “@revdoc: T1 Maybe we need doulas (sp?) for death as well as for birthing?

#hpm”Wed Jun 8 18:29:05 PDT 2011

jodyms At the cancer centers I've seen the #HPM department is off and away....down a hall,

on the top floor, set aside. Let's start there.Wed Jun 8 18:29:12 PDT 2011

elderpages @aliciabloom has hope to trend on twitter! David Casarret's book Last Acts is all

about what people choose to do in final weeks. #hpmWed Jun 8 18:29:17 PDT 2011

uvmer Sorry, my computer needs hospice! In slo-mo tonight. #hpmWed Jun 8 18:29:21 PDT 2011

equijada @DrSnit don't think dying has to be taught...just experienced. #hpmWed Jun 8 18:29:24 PDT 2011

JoshGriffin RT @ctsinclair: @jodyms RE: Non-abandoner - we need more negatives in there. I

am a non-anti-abandoning unavoider. ;-) #hpmWed Jun 8 18:29:38 PDT 2011

TreatThePain RT @painpolicy: 15 year old girl w/ terminal cancer has made a bucket list. One of

her wishes: to trend on Twitter. Plz give a RT #alicebucketlist #hpmWed Jun 8 18:29:44 PDT 2011

ctsinclair RT @DrSnit: Many fear if they dont have "hope" or a act a certain way during illness

they WILL be abandoned. Who teaches us to die? #hpmWed Jun 8 18:29:50 PDT 2011

hellen177 RT @uvmer: As care giver to my partner w/a brain tumor, an early conversation & an

advanced directive were key.Knew then the path I was to follow. #hpmWed Jun 8 18:29:50 PDT 2011

hollyby @JohnGirdwood Which part? #hpmWed Jun 8 18:29:54 PDT 2011

ctsinclair @DrSnit I see many patients who deny symptoms because they don't want people to

think anti-cancer treatments are failing. #hpmWed Jun 8 18:30:16 PDT 2011

joshgriffin RT @ctsinclair: RT @DrSnit: Many fear if they dont have "hope" or a act a certain way

during illness they WILL be abandoned. Who teaches us to die? #hpmWed Jun 8 18:30:24 PDT 2011

equijada “@jodyms: At the cancer centers I've seen the #HPM department is off &

away....down a hall, on the top floor, set aside..start there.” AmenWed Jun 8 18:30:26 PDT 2011

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vj_CR @DrSnit mmmm I don´t think you can be taught on how to die.... probably it´s part of

the journey.... #hpmWed Jun 8 18:30:39 PDT 2011

MatthewsMichele I agree wholeheartedly! RT @equijada: @DrSnit dont think dying has to be

taught...just experienced. #hpmWed Jun 8 18:30:56 PDT 2011

aliciabloom @elderpages absolutely-- lovely stories in the book. i have a signed copy:) worked

with dr. casarret when i was at penn. #hpmWed Jun 8 18:30:58 PDT 2011

ctsinclair RT @uvmer: Sorry, my computer needs hospice! In slo-mo tonight. "C'mon

computer, you can do it!" #hpmWed Jun 8 18:30:58 PDT 2011

DrSnit @equijada :) That's like saying birth is natural- just go push sweetie. Death and

illness are a process. We NEED EACH OTHER. #hpmWed Jun 8 18:30:58 PDT 2011

PinkRibbonBlues RT @DrSnit Many fear if they don't have "hope" or a act a certain way during the

illness process they WILL be abandoned. #hpmWed Jun 8 18:30:59 PDT 2011

Freshwidow @aliciabloom But we resist when we are marshalling 100% to get thru 1st therapy,

research.... etc. We create our disease mindset... #hpmWed Jun 8 18:31:04 PDT 2011

PracticalWisdom Wonder Why? RT @jodyms: all cancer centers Ive seen #HPM depar is off

away.down a hall, on the top floor, set aside. Lets start there. #HPMWed Jun 8 18:31:15 PDT 2011

MarksPhone @ctsinclair well said and I've seen that as well but I think it is a way for them to feel

hope #hpmWed Jun 8 18:31:16 PDT 2011

jodyms RT @ctsinclair @DrSnit ..many patients who deny symptoms because they don't

want people to think anti-cancer treatments are failing. #hpmWed Jun 8 18:31:22 PDT 2011

equijada @DrSnit @equijada true that. #hpmWed Jun 8 18:31:33 PDT 2011

revdoc @equijada @DrSnit But once U have the exper, U can't teach others except

passively. We can teach "how to die well" w/ our global exps. #hpmWed Jun 8 18:31:36 PDT 2011

ctsinclair RT @equijada: dont think dying has to be taught...just experienced. "disagree, I

teach patients/families what others have taught me" #hpmWed Jun 8 18:31:51 PDT 2011

ihatebreastcanc RT @jodyms: RT @ctsinclair @DrSnit ..many patients who deny symptoms because

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ihatebreastcanc RT @jodyms: RT @ctsinclair @DrSnit ..many patients who deny symptoms because

they don't want people to think anti-cancer treatments are failing. #hpmWed Jun 8 18:31:56 PDT 2011

PracticalWisdom Both can be scary/PainfulRT @DrSnit: @equijadaThats like saying birth is natural-

just go push sweetie. Death/illness are a process. #HPMWed Jun 8 18:32:04 PDT 2011

HumpbacksRule RT @ctsinclair: RT @equijada: dont think dying has to be taught...just experienced.

"disagree, I teach patients/families what others have taught me" #hpmWed Jun 8 18:32:29 PDT 2011

equijada @ctsinclair true #hpmWed Jun 8 18:32:32 PDT 2011

ctsinclair @MarksPhone Agreed, it is a complex phenomenon that has effects on the

individual and the team around them #hpmWed Jun 8 18:32:36 PDT 2011

drseisenberg yep RT @jodyms @ctsinclair @DrSnit ..many patients who deny symptoms because

they dont want people to think anti-cancer tx are failing. #hpmWed Jun 8 18:32:40 PDT 2011

jfclearywisc RT @ctsinclair: dont think dying has to be taught...just experienced. "disagree, I

teach patients/families what others have taught me" #hpmWed Jun 8 18:32:42 PDT 2011

vj_CR @jfclearywisc @ctsinclair in Lat Am informed consents differ quite a lot from the

ones used in the states #hpmWed Jun 8 18:32:58 PDT 2011

VillageMemorial Anyone else attending this Friday's Statewide #Palliative Care Conference in

Portland OR? #hpmWed Jun 8 18:32:58 PDT 2011

jodyms @PracticalWisdom @drsnit Both are SCARY. Control freaks like myself want to

know: how does this work?? #hpmWed Jun 8 18:33:04 PDT 2011

MarksPhone @ctsinclair I think before dying someone needs to teach patients about acceptance

to face what is there. That is difficult #hpmWed Jun 8 18:33:14 PDT 2011

elderpages Wondering how patients are feeling abandoned and what they would like by way of

support. #hpmWed Jun 8 18:33:46 PDT 2011

ctsinclair @jodyms Ha! At our hospital the palliative medicine department is on top floor down

a...dead end. Never realized till you said that. #hpmWed Jun 8 18:33:48 PDT 2011

hollyby I'm not sure that teaching dying is the right term, maybe guiding people through the

process, since each person's path is different. #hpm

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process, since each person's path is different. #hpmWed Jun 8 18:33:53 PDT 2011

PracticalWisdom Think need 4 All! RT @jodyms: @PracticalWisdom @drsnit Both are SCARY. Control

freaks like myself want to know: how does this work?? #HPMWed Jun 8 18:33:57 PDT 2011

ctsinclair @vj_CR In what way are informed consents different? #hpmWed Jun 8 18:34:04 PDT 2011

MarksPhone Remember in our live we learn through experiences and reflect on them this is a

different learning we may not have time to reflect #hpmWed Jun 8 18:34:17 PDT 2011

drseisenberg RT @MarksPhone @ctsinclair I think before dying someone needs to teach patients

about acceptance to face what is there. Difficult #hpmWed Jun 8 18:34:21 PDT 2011

ctsinclair @equijada And it is not so much telling them this is the way to die well, but here are

how other families/patients coped well. #hpmWed Jun 8 18:34:36 PDT 2011

jodyms RT @drseisenberg: RT @MarksPhone @ctsinclair I think before dying someone

needs to teach patients about acceptance to face what is there. Difficult #hpmWed Jun 8 18:34:40 PDT 2011

joshgriffin RT @hollyby: I'm not sure that teaching dying is the right term, maybe guiding people

through the process, since each person's path is different. #hpmWed Jun 8 18:34:46 PDT 2011

PracticalWisdom @jodyms @PracticalWisdom @drsnit When people understand many times helps

lower anxiety. This certainly is good for Body/Soul/Mind/Famiy #HPMWed Jun 8 18:34:49 PDT 2011

uvmer @ctsinclair Wicked scary!!! I wanted to be the caregiver through the entire process,

and they were wonderful support givers. #hpmWed Jun 8 18:34:49 PDT 2011

ctsinclair @equijada The main theme to healthy coping with illness is adaptation. #hpmWed Jun 8 18:35:05 PDT 2011

Freshwidow I strongly disagree - Pt, family, etc, can B learn that death is one real outcome. /

@vj_cr don´t think u can be taught how 2 die.. #hpmWed Jun 8 18:35:06 PDT 2011

elderpages RT @MarksPhone: Remember in our lives we learn thru experiences and reflect on

them. This learning we may not have time to reflect #hpmWed Jun 8 18:35:09 PDT 2011

HumpbacksRule #hpm Dying is a lot of work for pt & caregiver. Talking, sharing & teaching are very

important. Helps w the 'control freak' to some degree.Wed Jun 8 18:35:09 PDT 2011

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DrSnit Even knowing others have been through the process before & talking it through

leaves breadcrumbs. This matters! #hpmWed Jun 8 18:35:31 PDT 2011

ctsinclair RT @MarksPhone: we learn through experiences and reflect on them; this is a

different learning we may not have time to reflect #hpmWed Jun 8 18:35:34 PDT 2011

jodyms @ctsinclair @equiljada We can't ever forget the entire family context and the cultural

context. #hpmWed Jun 8 18:35:34 PDT 2011

aliciabloom @Freshwidow hear that & yet believe if pt's know what #palliative care is (enhances

QoL & can improve survival) they would be receptive #hpmWed Jun 8 18:35:44 PDT 2011

jfclearywisc RT @vj_CR: @jfclearywisc @ctsinclair in Lat Am informed consents differ quite a lot

"not just the forms, a true discussion!" #hpmWed Jun 8 18:35:54 PDT 2011

MarksPhone What action on reflection does one take when told terminal? That is the step that is

critical to learn how to die. #hpmWed Jun 8 18:36:05 PDT 2011

PracticalWisdom Again also helps patient.RT @jodyms: @ctsinclair @equiljada We cant ever forget

the entire family context and the cultural context. #HPMWed Jun 8 18:36:14 PDT 2011

drseisenberg RT @HumpbacksRule: #hpm Dying is a lot of work for pt & caregiver. Talking,

sharing & teaching are very important. #hpmWed Jun 8 18:36:17 PDT 2011

ctsinclair RT @DesiChicInPA: @ctsinclair we have navi's in neuroscience/brain malignancy,

surgical oncology, lung and esophageal, geriatrics. #hpmWed Jun 8 18:36:26 PDT 2011

vj_CR @MarksPhone @ctsinclair sometimes patients accept the reality and their families

don´t. Then they are the ones to be taught #hpmWed Jun 8 18:36:28 PDT 2011

uvmer Offered the opportunity to meet with someone about end of life care at MGH...way too

early in our fight. Still were clinging to hope #hpmWed Jun 8 18:36:33 PDT 2011

Freshwidow NO. Dying is a family and community process. NOT just one experience. @drsnit -- /

@equijada: dont think dying has to be taught... #hpmWed Jun 8 18:36:45 PDT 2011

vj_CR RT @hollyby: I'm not sure that teaching dying is the right term, maybe guiding people

through the process, since each person's path is different. #hpmWed Jun 8 18:36:45 PDT 2011

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ctsinclair @vj_CR So true #hpm

Wed Jun 8 18:36:50 PDT 2011

jfclearywisc RT @hollyby: I'm not sure that teaching dying is the right term, "Doctor" = teacher

(was that my Latin class?) #hpmWed Jun 8 18:36:57 PDT 2011

PracticalWisdom RT @vj_CR: @MarksPhone @ctsinclair sometimes patients accept the reality and

their families don´t. Then they are the ones to be taught #HPMWed Jun 8 18:37:04 PDT 2011

revdoc We can demystify the mechanics of the dying process so that pts/fams are then free

to concentrate on meaning/deal w/emotional cmpts #hpmWed Jun 8 18:37:04 PDT 2011

MarksPhone @vj_CR Great point how to balance family and pateint because that is journey they

are on #hpmWed Jun 8 18:37:11 PDT 2011

elderpages RT @MarksPhone: What action on reflection does one take when told terminal? That

is the step that is critical to learn how to die. #hpmWed Jun 8 18:37:20 PDT 2011

PracticalWisdom RT @MarksPhone: @vj_CR Great point how to balance family and pateint because

that is journey they are on #HPMWed Jun 8 18:37:33 PDT 2011

ctsinclair @uvmer Was that how it was said 'talking to someone about end of life care?' Being

a palliative doc, always curious how HPM introduced #hpmWed Jun 8 18:37:41 PDT 2011

equijada RT @uvmer: Offered the opportunity to meet with someone about end of life care at

MGH...way too early in our fight. Still were clinging to hope #hpmWed Jun 8 18:37:46 PDT 2011

jodyms Dying is a group experience, agree @ Freshwidow NO. Dying is a family and

community process. NOT just one experience #hpmWed Jun 8 18:37:48 PDT 2011

drseisenberg What can med oncs do to support #cancer patients if treatments not working? #hpmWed Jun 8 18:37:53 PDT 2011

ctsinclair RT @revdoc: We can demystify the mechanics of the dying process so pts/fams are

free to concentrate on meaning/deal w/emotional cmpts #hpmWed Jun 8 18:38:02 PDT 2011

revdoc Type slower--you guys are making me dizzy tonight! #hpmWed Jun 8 18:38:05 PDT 2011

PracticalWisdom @Freshwidow: What is one lesson you would like for us to hear from you tonight.

This is a caring group and we are open to learning. #HPMWed Jun 8 18:38:19 PDT 2011

Page 24: 2011 06 08 hpm tweetchat transcript

Wed Jun 8 18:38:19 PDT 2011

equijada @uvmer how was it introduced? #hpmWed Jun 8 18:38:21 PDT 2011

Freshwidow Absitively! RT @drsnit: Even knowing others have been through the process before &

talking it through leaves breadcrumbs. This matters! #hpmWed Jun 8 18:38:26 PDT 2011

jfclearywisc Has anyone analysed #hpm tweetchats to examine prevelance of the word "hope"

Comes up over & over #hpmWed Jun 8 18:38:34 PDT 2011

elderpages RT @revdoc: We can demystify the mechanics of dying...T: Our webpage on "Last

Few Days" is one of most visited! http://bit.ly/mfenFJ #hpmWed Jun 8 18:38:35 PDT 2011

HumpbacksRule #hpm I think every1 is different on when/where/how they are ready to discuss the

process. Gotta start where the pt is.Wed Jun 8 18:38:38 PDT 2011

jodyms @revdoc If you're dizzy - imagine me....I am crazed #hpmWed Jun 8 18:38:43 PDT 2011

VillageMemorial Dr. Erik Fromme always puts on a great talk at every #Palliative Care Conference.

Looking forward to Friday's event in Portland. #pdx #hpmWed Jun 8 18:38:51 PDT 2011

revdoc @drseisenberg Either construct a palliative care plan for your pts (and know what

you're doing) or consult HPM EARLY #hpmWed Jun 8 18:39:00 PDT 2011

jodyms YES @PracticalWisdom @Freshwidow: What is one lesson you would like for us to

hear from you .. we are open to learning. #HPMWed Jun 8 18:39:26 PDT 2011

equijada @jfclearywisc interesting, I was just thinking that and how I used hope 10 years ago

compared to now #hpmWed Jun 8 18:39:36 PDT 2011

ctsinclair RT @MarksPhone: What action on reflection does one take when told terminal? "I

have seen as a time of immense growth" #hpmWed Jun 8 18:39:40 PDT 2011

Freshwidow But you are treating this as a RATIONAL factual problem. It's NOT. RT @aliciabloom:

if pts know what #palliative is they'd B receptive #hpmWed Jun 8 18:39:40 PDT 2011

vj_CR @ctsinclair after I read the first ICF in english I was surprised to see how down to

the facts it was #hpmWed Jun 8 18:39:45 PDT 2011

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elderpages RT @MarksPhone: @vj_CR Great point how to balance family and pateint because

that is journey they are on #hpmWed Jun 8 18:39:50 PDT 2011

drseisenberg RT @HumpbacksRule: #hpm I think every1 is different on when/where/how they are

ready 2 discuss process. Gotta start where the pt is. #hpmWed Jun 8 18:39:55 PDT 2011

JoshGriffin RT @jodyms: Dying is a group experience, agree @ Freshwidow NO. Dying is a

family and community process. NOT just one experience #hpmWed Jun 8 18:39:57 PDT 2011

vj_CR RT @MarksPhone: Remember in our live we learn through experiences and reflect

on them this is a different learning we may not have time to reflect #hpmWed Jun 8 18:39:57 PDT 2011

jodyms RT @drseisenberg: What can med oncs do to support #cancer patients if treatments

not working? #hpmWed Jun 8 18:40:05 PDT 2011

ctsinclair RT @revdoc: Type slower--you guys are making me dizzy tonight! "that's because

this chat is a rockin! Having a great time!" #hpmWed Jun 8 18:40:18 PDT 2011

MarksPhone @HumpbacksRule I totally agree where is the patient? w/o having studied it there is

a tipping point in understanding which happens #hpmWed Jun 8 18:40:33 PDT 2011

equijada @VillageMemorial I heart Erik. Please send him my regards. #hpmWed Jun 8 18:40:43 PDT 2011

aliciabloom we educate patients & families about dying process to support acceptance & guide

the experience. never forget every process is unique. #hpmWed Jun 8 18:40:53 PDT 2011

DrSnit @HumpbacksRule You and @Freshwidow are SO SO SO on tonight with your

insight!!!! #hpmWed Jun 8 18:40:53 PDT 2011

PracticalWisdom @Freshwidow Would you like for us to learn one lesson? I"m sure we can slow

down to listen. #HPMWed Jun 8 18:41:09 PDT 2011

jfclearywisc RT @drseisenberg: What can med oncs do to support #cancer patients if treatments

not working? "Define goal of therapy early!!" #hpmWed Jun 8 18:41:10 PDT 2011

ctsinclair RT @jfclearywisc: Anyone analysed #hpm tweetchats to examine prevelance of the

word "hope" Comes up over & over "I have transcripts!" #hpmWed Jun 8 18:41:14 PDT 2011

authordhallman #hpm A lesson - coordinate well the various care services so family can focus on

patient.

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authordhallmanpatient.Wed Jun 8 18:41:15 PDT 2011

DoctorFisher Just ordered "The Art of Dying" by my friend @mollrob looking forward to reading it

#hpmWed Jun 8 18:41:19 PDT 2011

joshgriffin RT @ctsinclair: RT @revdoc: Type slower--you guys are making me dizzy tonight!

"that's because this chat is a rockin! Having a great time!" #hpmWed Jun 8 18:41:22 PDT 2011

revdoc @drseisenberg Have a sx mgmt assessment and plan for every pt every visit--as

important as what CTX does pt need #hpmWed Jun 8 18:41:26 PDT 2011

jodyms @drseisenberg My thought - patients/familys are afraid that their PCP & med onc will

abandon them. Period. #hpm Very real.Wed Jun 8 18:41:32 PDT 2011

ctsinclair RT @DrSnit: @HumpbacksRule You and @Freshwidow are SO SO SO on tonight

with your insight!!!! "Seconded!" #hpmWed Jun 8 18:41:36 PDT 2011

elderpages RT @authordhallman: #hpm A lesson - coordinate well the various care services so

family can focus on patient. #hpmWed Jun 8 18:41:40 PDT 2011

equijada @DrSnit @HumpbacksRule @Freshwidow I learn so much from you. #hpmWed Jun 8 18:41:52 PDT 2011

HumpbacksRule Thanks! >> @DrSnit @Freshwidow You and @Freshwidow are SO SO SO on tonight

with your insight!!!! #hpmWed Jun 8 18:41:56 PDT 2011

vj_CR @MarksPhone balance when you are not sick is hard enough...... imagine when you

are #hpmWed Jun 8 18:41:57 PDT 2011

PracticalWisdom Thank you for this lesson.RT @authordhallman: #hpm A lesson - coordinate well the

various care services so family can focus on patient. #HPMWed Jun 8 18:41:58 PDT 2011

hellen177 RT @uvmer: Offered the opportunity to meet with someone about end of life care at

MGH...way too early in our fight. Still were clinging to hope #hpmWed Jun 8 18:41:58 PDT 2011

MarksPhone @ctsinclair That is a great point how can we quantify it so we can understand it

better #hpmWed Jun 8 18:42:10 PDT 2011

vj_CR RT @revdoc: Type slower--you guys are making me dizzy tonight! #hpm | hehe me

too!!!!Wed Jun 8 18:42:24 PDT 2011

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LJaneTn @jodyms #HPM fear is often the place where patients start.Wed Jun 8 18:42:26 PDT 2011

drseisenberg RT @vj_CR: @MarksPhone balance when you are not sick is hard enough......

imagine when you are #hpmWed Jun 8 18:42:38 PDT 2011

PracticalWisdom It's one of the reasons I respect all of you. RT @equijada: @DrSnit

@HumpbacksRule @Freshwidow I learn so much from you. #HPMWed Jun 8 18:42:40 PDT 2011

DrSnit @jodyms agreed! @drseisenberg Fear of abandonment and guilt is far bigger than

fear of pain #hpmWed Jun 8 18:42:43 PDT 2011

jodyms We need a reality-based hope in #HPM @ctsinclair MT @jfclearywisc ..prevelance of

the word "hope" Comes up over & overWed Jun 8 18:42:44 PDT 2011

drseisenberg RT @LJaneTn: @jodyms #HPM fear is often the place where patients start. #hpmWed Jun 8 18:42:51 PDT 2011

uvmer @ctsinclair To us,knew prognosis was grim but there are always miracles out

there.Once end of life care came up,hour glass was running #hpmWed Jun 8 18:42:58 PDT 2011

ctsinclair RT @revdoc: @drseisenberg Have a sx mgmt assessment and plan for every pt

every visit--as important as what CTX does pt need "Yup!" #hpmWed Jun 8 18:42:59 PDT 2011

VillageMemorial We like to remember Kubler-Ross' DABDA doesn't always happen in order. #hpmWed Jun 8 18:43:10 PDT 2011

equijada I think we need to have a journal club on hope/hubris. #hpmWed Jun 8 18:43:24 PDT 2011

ctsinclair @revdoc @drseisenberg But important to realize the oncologist may have enough to

do with just focusing on the anti-cancer treatment #hpmWed Jun 8 18:43:28 PDT 2011

PracticalWisdom Profound~such an important Factor! RT @vj_CR: @MarksPhone balance when you

are not sick is hard enough...... imagine when you are #HPMWed Jun 8 18:43:30 PDT 2011

aliciabloom sometimes we have to help patients & families reframe their hope. there are many

kinds of healing. #hpmWed Jun 8 18:43:33 PDT 2011

DrSnit RT @LJaneTn: @jodyms #HPM fear is often the place where patients start.Wed Jun 8 18:43:42 PDT 2011

Page 28: 2011 06 08 hpm tweetchat transcript

Wed Jun 8 18:43:42 PDT 2011

hollyby RT @jodyms: We need a reality-based hope in #HPM @ctsinclair MT @jfclearywisc

..prevelance of the word "hope" Comes up over & over #hpmWed Jun 8 18:43:48 PDT 2011

elderpages RT @equijada: I think we need to have a journal club on hope/hubris. #hpmWed Jun 8 18:43:50 PDT 2011

PracticalWisdom G8 Idea RT @equijada: I think we need to have a journal club on hope/hubris. #HPMWed Jun 8 18:43:52 PDT 2011

jodyms @drseisenberg @LJaneTn That is true and sounds good but it boils down to things

like this: who helps and when? #hpmWed Jun 8 18:44:18 PDT 2011

jodyms EXCELLENT RT @PracticalWisdom G8 Idea RT @equijada: I think we need to have

a journal club on hope/hubris. #HPMWed Jun 8 18:44:39 PDT 2011

ihatebreastcanc @drseisenberg #cancer Be honest, don't give false hope. Know patient's grasp of

his/her disease. Don't wail til very late for eol talk #hpmWed Jun 8 18:44:40 PDT 2011

hollyby RT @aliciabloom: sometimes we have to help patients & families reframe their

hope. there are many kinds of healing. '...and miracles' #hpmWed Jun 8 18:44:41 PDT 2011

elderpages RT @DrSnit: RT @LJaneTn: @jodyms #HPM fear is often the place where patients

start....T: What helps move to acceptance/transcendence? #hpmWed Jun 8 18:44:45 PDT 2011

Pallimed Articles on miracles and spirituality/religion in health care from Pallimed

http://hpm.md/k98Z6D cc@uvmer #hpmWed Jun 8 18:44:45 PDT 2011

jfclearywisc @uvmer @ctsinclair Miracles can come in many shapes and forms! "What do you

mean by a miracle" is a teachable questions to residents #hpmWed Jun 8 18:44:45 PDT 2011

JohnGirdwood http://ow.ly/1tC6qX RT @ctsinclair: RT @jfclearywisc: Anyone analysed #hpm

tweetchats to examine prevelance of the word "hope"Wed Jun 8 18:44:48 PDT 2011

PracticalWisdom RT @aliciabloom: sometimes we have to help patients & families reframe their

hope. there are many kinds of healing. #HPMWed Jun 8 18:44:52 PDT 2011

DrSnit @VillageMemorial I like to remember that though I adore her, Kubler-Ross's DABDA

doesn't happen for everyone and is culturally bound. #hpmWed Jun 8 18:45:02 PDT 2011

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Satchwill

"@revdoc: T1 Maybe we need doulas (sp?) for death as well as for birthing?

#hpm">excellent idea!Wed Jun 8 18:45:08 PDT 2011

aliciabloom @hollyby so true! #hpmWed Jun 8 18:45:23 PDT 2011

revdoc @ctsinclair @drseisenberg Then involve a dedicated HPM consultant in process

before the active tx "fails" #hpmWed Jun 8 18:45:27 PDT 2011

uvmer @equijada At end of an office visit....kinda "oh, by the way, would you like to

participate in an end of life discussion w/ some docs...#hpmWed Jun 8 18:45:39 PDT 2011

VillageMemorial Anyone in the group attending funeral of Dr. #Kevorkian this Friday? #hpmWed Jun 8 18:45:41 PDT 2011

Intlphysicians RT @fischmd: symptom science website: ECOG Symptom Outcomes and Practice

Patterns (SOAPP) study, ecogsoapp.com, http://ow.ly/5dlKQ , #hpmWed Jun 8 18:46:16 PDT 2011

drseisenberg RT @revdoc: @ctsinclair @drseisenberg Then involve a dedicated HPM consultant

in process before the active tx "fails" #hpmWed Jun 8 18:46:16 PDT 2011

LJaneTn @jodyms #HPM existential fear dominates- strikes at the heart of hopeWed Jun 8 18:46:18 PDT 2011

jfclearywisc #alicebucketlist hit 1.43% of tweets for last 24 hours at 1730 CDT #hpmWed Jun 8 18:46:22 PDT 2011

aliciabloom we also need to be clear about what a "successful" treatment is-- patients often

assume success = cure, which may not be the case. #hpmWed Jun 8 18:46:23 PDT 2011

uvmer @equijada Absolutely scared the shit out of us. Neither one of us could speak, and

finally I said no thank you. #hpmWed Jun 8 18:46:31 PDT 2011

GroundSwellAus sorry I'm chiming in late I just wanted to happy birthday pallimed #hpmWed Jun 8 18:46:31 PDT 2011

elderpages Dr. Casarret suggests talking first about deliverables of hospice (nurse visits, aide

visits, SW). Once buy-in, then mention hospice. #hpmWed Jun 8 18:46:43 PDT 2011

equijada RT @uvmer: @equijada At end of an office visit....kinda "oh, by the way, would you

like to participate in an end of life discussion w/ some docs...#hpmWed Jun 8 18:46:46 PDT 2011

Page 30: 2011 06 08 hpm tweetchat transcript

Wed Jun 8 18:46:46 PDT 2011

drseisenberg RT @LJaneTn: @jodyms #HPM existential fear dominates- strikes at the heart of

hope #hpmWed Jun 8 18:46:49 PDT 2011

HumpbacksRule #hpm @LJaneTn @jodyms Absolutely & sometimes fear looks like something else.

Have to listen to pt>> fear is often the place where patients..Wed Jun 8 18:46:53 PDT 2011

MarksPhone Long ago in oncology pharma adriamycin nationally recognized oncologist said as

did Jimmie Holland every cancer patient reacts diff #hpmWed Jun 8 18:46:55 PDT 2011

jodyms The things I'm learning: I've never heard of a #HPM consultant.Wed Jun 8 18:47:08 PDT 2011

equijada @uvmer yes, I would not accept that either. #hpmWed Jun 8 18:47:09 PDT 2011

ihatebreastcanc RT @ctsinclair: RT @revdoc: We can demystify the mechanics of the dying process

so pts/fams are free to concentrate on meaning/deal w/emotional cmpts #hpmWed Jun 8 18:47:14 PDT 2011

elderpages RT @aliciabloom: we need to define "successful" treatment is-- patients often

assume success = cure, which may not be the case. #hpmWed Jun 8 18:47:16 PDT 2011

PracticalWisdom Wise RT @aliciabloom: we also need 2 B clear what a "successful" treatment is

patients often assume success = cure may not be the case. #HPMWed Jun 8 18:47:17 PDT 2011

JohnGirdwood Good thought, i'm nearby RT @VillageMemorial: Anyone in the group attending

funeral of Dr. #Kevorkian this Friday? #hpmWed Jun 8 18:47:33 PDT 2011

VillageMemorial @DrSnit Can you talk about the cultural differences of DABDA? #hpmWed Jun 8 18:47:34 PDT 2011

hollyby Yahoo! RT @GroundSwellAus: sorry Im chiming in late I just wanted to happy

birthday pallimed #hpmWed Jun 8 18:47:35 PDT 2011

Freshwidow Absolutely. RT @drseisenberg: involve a dedicated HPM consultant in process

before the active tx "fails" #hpmWed Jun 8 18:47:37 PDT 2011

Pallimed RT @GroundSwellAus: sorry I'm chiming in late I just wanted to happy birthday

pallimed #hpm "Hey thanks! 6 years of blogging!"Wed Jun 8 18:47:38 PDT 2011

ihatebreastcanc RT @ctsinclair: RT @DrSnit: Many fear if they dont have "hope" or a act a certain way

Page 31: 2011 06 08 hpm tweetchat transcript

ihatebreastcanc RT @ctsinclair: RT @DrSnit: Many fear if they dont have "hope" or a act a certain way

during illness they WILL be abandoned. Who teaches us to die? #hpm

Wed Jun 8 18:47:50 PDT 2011

Gregmogel RT @LJaneTn: @jodyms #HPM fear is often the place where patients start.Wed Jun 8 18:47:55 PDT 2011

BCSisterhood @jodyms Loved one diequickly vs prolonged illness-shock of 1st way mind blowing

& 2nd u have time to prepare. Lost husbands 2 each way. #hpmWed Jun 8 18:48:09 PDT 2011

drseisenberg RT @MarksPhone: Long ago nationally recognized oncologist said as did Jimmie

Holland every cancer patient reacts diff #hpmWed Jun 8 18:48:10 PDT 2011

uvmer @equijada It was tough. #hpmWed Jun 8 18:48:16 PDT 2011

DrSnit @jodyms I get DM's all the time from patients in need of hospice and have NO IDEA

where to go or how to deal with it. #hpmWed Jun 8 18:48:16 PDT 2011

ctsinclair RT @jodyms: The things Im learning: Ive never heard of a #HPM consultant. 'Really!?

I'm one! Seeing more patients ask for us." #hpmWed Jun 8 18:48:23 PDT 2011

revdoc @Pallimed Happy birthday! #hpmWed Jun 8 18:48:26 PDT 2011

PracticalWisdom Like the thought of analyzing Tweetchat afterward. Learned a great deal of ways I

could improve/listen better as moderator after chat #HPMWed Jun 8 18:48:34 PDT 2011

vj_CR @Freshwidow sorry.... I forgot the #hpm .... I get your point..... just think teach is no

the word....Wed Jun 8 18:48:46 PDT 2011

equijada @Gregmogel @LJaneTn @jodyms Fear. I personally have a lot of it. I'm learning and

growing. #hpmWed Jun 8 18:48:50 PDT 2011

DrSnit @VillageMemorial We are in a chat right now. Using the #hpm hastag. Will talk later.

Thanks.Wed Jun 8 18:48:52 PDT 2011

GroundSwellAus @Pallimed 6 years! wow! #hpmWed Jun 8 18:48:56 PDT 2011

HumpbacksRule Such a good point. @DrSnit @VillageMemorial I like to remember that though I

adore her, Kubler-Ross's DABDA doesn't...#hpmWed Jun 8 18:49:02 PDT 2011

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PinkRibbonBlues

RT @elderpages @aliciabloom we need to define "successful" treatment- patients

often assume success = cure, which may not be the case. #hpmWed Jun 8 18:49:03 PDT 2011

JohnGirdwood Volunteers too!!! RT @elderpages: Dr. Casarret suggests talking first about

deliverables of hospice (nurse visits, aide visits, SW). #hpmWed Jun 8 18:49:15 PDT 2011

aliciabloom effective conversations re: #hospice don't start w/ word. can't drop the "h-bomb" right

away. establish goals & determine needs 1st. #hpmWed Jun 8 18:49:18 PDT 2011

PracticalWisdom They trust U.RT @DrSnit: @jodyms I get DMs all the time from pt's in need of

hospice have NO IDEA where to go or how to deal with it. #HPMWed Jun 8 18:49:18 PDT 2011

jodyms My thought is if more survivors understand this - when we're well - the mystery is

easier to accept when it does happen #hpmWed Jun 8 18:49:32 PDT 2011

ctsinclair RT @DrSnit: I get DMs all the time from patients in need of #hospice & have NO

IDEA where to go or how to deal with it. "wow!" really?" #hpmWed Jun 8 18:49:40 PDT 2011

uvmer @BCSisterhood Strongly disagree! Can not prepare for the loss of someone you

have spent your whole adult life with, and watch them die. #hpmWed Jun 8 18:49:55 PDT 2011

elderpages RT @vj_CR: @Freshwidow I get your point..... just think teach is no the word.... T:

Exploring? Sharing? #hpmWed Jun 8 18:50:06 PDT 2011

ctsinclair @DrSnit There are a ton of us in social media who can help you with your hospice

referral challenge. I would love to tackle this. #hpmWed Jun 8 18:50:15 PDT 2011

jfclearywisc @ctsinclair @jodyms COnsultant=Attending in many commonwealth countries

#hpmWed Jun 8 18:50:31 PDT 2011

hollyby @jodyms Ppl need to know we focus on whole person & symptom control, & may

even help people complete symptom-causing curative therapy. #hpmWed Jun 8 18:50:37 PDT 2011

vj_CR @PracticalWisdom so true! #hpm and I think it´s part of the tweetchat point, trying to

learn from itWed Jun 8 18:50:39 PDT 2011

DrSnit @ctsinclair YES PLEASE #HPMWed Jun 8 18:50:43 PDT 2011

revdoc @aliciabloom Onc needs to make HPM part of the initial tx plan for anyone with

Page 33: 2011 06 08 hpm tweetchat transcript

revdoc @aliciabloom Onc needs to make HPM part of the initial tx plan for anyone with

incurable dz, tho, so there is no big "give up" later #hpm

Wed Jun 8 18:50:47 PDT 2011

drseisenberg Every single one reacted sooooo differently today #hpmWed Jun 8 18:51:00 PDT 2011

jodyms Critical issue: T4: How do we share the #hpm mission to those in need of hospice?

Don't we all have a responsibility?Wed Jun 8 18:51:04 PDT 2011

elderpages RT @aliciabloom: effective conversations re: #hospice cant drop the "h-bomb" first.

establish goals & determine needs 1st...T: YES! #hpmWed Jun 8 18:51:13 PDT 2011

ctsinclair @vj_CR so you don't have to forget the #hpm use http://Tweetchat.com/room/hpm

#hpmWed Jun 8 18:51:13 PDT 2011

jodyms RT @ctsinclair: @DrSnit There are a ton of us in social media who can help you with

your hospice referral challenge. I would love to tackle this. #hpmWed Jun 8 18:51:18 PDT 2011

MarksPhone if you look at #hcsmvac they are using a grass roots SM effort to increase flu vac

rates in MO can we model that idea about hospice? #hpmWed Jun 8 18:51:28 PDT 2011

GroundSwellAus is there no "peak" org in the US that has a listing of all hospice? #hpmWed Jun 8 18:51:28 PDT 2011

jfclearywisc !!!@aliciabloom Onc needs to make HPM part of the initial tx plan for anyone with

incurable dz, tho, so there is no big "give up" later #hpmWed Jun 8 18:51:35 PDT 2011

equijada @DrSnit @ctsinclair let me know as well. #hpmWed Jun 8 18:51:38 PDT 2011

HumpbacksRule RT @revdoc: @aliciabloom Onc needs to make HPM part of the initial tx plan for

anyone with incurable dz, tho, so there is no big "give up" later #hpmWed Jun 8 18:51:46 PDT 2011

ctsinclair RT @drseisenberg: Every single one reacted sooooo differently today "That can be

emotionally draining." #hpmWed Jun 8 18:51:53 PDT 2011

mollrob RT @DoctorFisher Just ordered "The Art of Dying" by my friend @mollrob looking

forward to reading it #hpm // Thanks Doc!Wed Jun 8 18:51:59 PDT 2011

PracticalWisdom Continuous Learning.RT @vj_CR: @PracticalWisdom so true! #hpm and I think it´s

part of the tweetchat point, trying to learn from it #HPMWed Jun 8 18:52:05 PDT 2011

Page 34: 2011 06 08 hpm tweetchat transcript

aliciabloom MT @ctsinclair: @DrSnit There are a ton of us in SoMe who can help w/ hospice

referral challenge. I would love 2 tackle this. "me too!" #hpmWed Jun 8 18:52:13 PDT 2011

ctsinclair @MarksPhone Will need to look into #hcsmvac #hpmWed Jun 8 18:52:15 PDT 2011

jodyms Great points. I want to write about this @elderpages @aliciabloom: effective

conversations re: #hospice..est. goal...t..T: YES! #hpmWed Jun 8 18:52:23 PDT 2011

VillageMemorial Any thoughts as to how male caregivers feel about being called 'doulas'? Have

heard word 'whisperer' being thrown around. #hpmWed Jun 8 18:52:26 PDT 2011

authordhallman #hpm re T4: that's why I decided to publish "August Farewell", to promote PC

education/optionsWed Jun 8 18:52:39 PDT 2011

vj_CR RT @MarksPhone: if you look at #hcsmvac they are using a grass roots SM effort to

increase flu vac rates in MO can we model that idea about hospice? #hpmWed Jun 8 18:52:52 PDT 2011

equijada “@drseisenberg: Every single one reacted sooooo differently today #hpm” Many

different pages. Part of the difficulty of transition. .Wed Jun 8 18:52:54 PDT 2011

BCSisterhood @jodyms Yes, we all have a responsibility & as baby boomers age, we need to

reach out & do what we can to help one another. #hpmWed Jun 8 18:52:57 PDT 2011

Pallimed Find a Provider - The National #Hospice and Palliative Care Organization

http://hpm.md/kJY2NZ #hpm cc @GroundSwellAus @DrSnitWed Jun 8 18:53:02 PDT 2011

jodyms Ditto - we are all in this together:) @equijada @DrSnit @ctsinclair let me know as

well. #hpmWed Jun 8 18:53:08 PDT 2011

jfclearywisc @GroundSwellAus Palliative Coalition. NHPCO, AAHPM, HPNA, CAPC and others.

Given state power, no huge Federal peak body (jfclearyaus) #hpmWed Jun 8 18:53:28 PDT 2011

GroundSwellAus @Pallimed @DrSnit cheers #hpmWed Jun 8 18:53:33 PDT 2011

jodyms RT @Pallimed: Find a Provider - The National #Hospice and Palliative Care

Organization http://hpm.md/kJY2NZ #hpm cc @GroundSwellAus @DrSnitWed Jun 8 18:53:59 PDT 2011

joegormally RT @aliciabloom: stop perpetuating the everything/treatment vs. nothing/hospice

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joegormally RT @aliciabloom: stop perpetuating the everything/treatment vs. nothing/hospice

dichotomy #hpm

Wed Jun 8 18:54:03 PDT 2011

VillageMemorial RT @Pallimed: Find a Provider - The National #Hospice and Palliative Care

Organization http://hpm.md/kJY2NZ #hpm cc @GroundSwellAus @DrSnitWed Jun 8 18:54:12 PDT 2011

vj_CR RT @ctsinclair: @vj_CR so you don't have to forget the #hpm use http://bit.ly/b1nePp

#hpm || TY :)Wed Jun 8 18:54:15 PDT 2011

hollyby @Pallimed @GroundSwellAus @DrSnit http://www.palliativedoctors.org/ #hpmWed Jun 8 18:54:18 PDT 2011

DrSnit RT @Pallimed: Find a Provider - The National #Hospice and Palliative Care

Organization http://hpm.md/kJY2NZ #hpm cc @GroundSwellAus @DrSnitWed Jun 8 18:54:20 PDT 2011

doctatum Pulled away by patient issue. Looks like i missed great #hpm chat. Transcript

coming?Wed Jun 8 18:54:35 PDT 2011

PracticalWisdom RT @vj_CR:RT @MarksPhone: if U look #hcsmvac they R using grass roots SM

effort 2 increase flu vac rates MO can we model idea hospice? #HPMWed Jun 8 18:54:41 PDT 2011

ctsinclair @vj_CR Also makes it easy to favorite, and reply and retweet! Love it! #hpmWed Jun 8 18:54:48 PDT 2011

jodyms What a lightning talk...so much to say about bridging needs of patients with

understanding #hpmWed Jun 8 18:54:52 PDT 2011

joshgriffin RT @revdoc: @aliciabloom Onc needs to make HPM part of the initial tx plan for

anyone with incurable dz, tho, so there is no big "give up" later #hpmWed Jun 8 18:54:53 PDT 2011

equijada @uvmer Sucks. Sorry to hear it rolled that way. #hpmWed Jun 8 18:55:00 PDT 2011

elderpages Anyone know about Concerns Without Borders? They are doing grassroots palliative

care in India. Website not real helpful :-( #hpmWed Jun 8 18:55:01 PDT 2011

MarksPhone This topic as a communication strategy needs to be considered by segment

Terminal patient vs. not vs. family vs. way before death #hpmWed Jun 8 18:55:06 PDT 2011

GroundSwellAus @elderpages yes well! #hpmWed Jun 8 18:55:26 PDT 2011

Page 36: 2011 06 08 hpm tweetchat transcript

joegormally I'm sorry I missed this chat now.. it looked like a great discussion #hpmWed Jun 8 18:55:38 PDT 2011

PracticalWisdom @vj_CR @MarksPhone @doctatum is a Mo MD. #HPMWed Jun 8 18:55:49 PDT 2011

jodyms Spot on RT MarksPhone This topic as a communication strategy needs to be

considered by .... way before death #hpmWed Jun 8 18:55:49 PDT 2011

dspacl Sorry to be getting here late, mates #hpmWed Jun 8 18:55:55 PDT 2011

GroundSwellAus @elderpages what do you want to know? #hpmWed Jun 8 18:56:04 PDT 2011

vj_CR @ctsinclair thanks! makes it easier :) #hpmWed Jun 8 18:56:05 PDT 2011

DrSnit @hollyby thank you @Pallimed both ! #hpmWed Jun 8 18:56:10 PDT 2011

PracticalWisdom RT @jodyms: Spot on RT MarksPhone This topic as a communication strategy

needs to be considered by .... way before death #HPMWed Jun 8 18:56:16 PDT 2011

jodyms We probably need to start wrapping up....loose thoughts, deep thoughts, take away

from tonight's #hpm discussion?Wed Jun 8 18:56:20 PDT 2011

InpatientMed RT @Pallimed: Death doulas in the NY Times from Pallimed: A Hospice and

Palliative Medicine Blog http://hpm.md/lSsRkM #hpm cc @revdocWed Jun 8 18:56:31 PDT 2011

JoshGriffin RT @hollyby: @Pallimed @GroundSwellAus @DrSnit

http://www.palliativedoctors.org/ #hpmWed Jun 8 18:56:32 PDT 2011

daitpcg RT @aliciabloom: effective conversations re: #hospice don't start w/ word. can't drop

the "h-bomb" right away. establish goals & determine needs 1st. #hpmWed Jun 8 18:56:34 PDT 2011

MarksPhone Canadian oncologist told me that we've lost the understanding of death when we

moved off the farm. it is not longer part of life 2day #hpmWed Jun 8 18:56:41 PDT 2011

ctsinclair RT @doctatum: Pulled away by patient issue. Looks like i missed great #hpm chat.

Transcript coming? "Yes" #hpmWed Jun 8 18:56:44 PDT 2011

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Wed Jun 8 18:56:44 PDT 2011

jfclearywisc @jodyms Well done!! #hpmWed Jun 8 18:56:51 PDT 2011

HumpbacksRule Yes! >@MarksPhone This topic as a communication strategy needs to be

considered by segment Terminal patient vs. not vs. family vs. .... #hpmWed Jun 8 18:56:54 PDT 2011

elderpages RT @GroundSwellAus: @elderpages what do you want to know? T: Unable to find

detailed description of activities. URL would be great! #hpmWed Jun 8 18:56:56 PDT 2011

ctsinclair RT @dspacl: Sorry to be getting here late, mates 'no problem, brother!' #hpmWed Jun 8 18:56:56 PDT 2011

DrSnit @jodyms WOW! Thank you so so so much for the amazing topics tonight! I've

missed you so much!! xo #hpmWed Jun 8 18:56:59 PDT 2011

dspacl I have an idea to describe what we do in terms of the latest lexicon of #HCR #HPMWed Jun 8 18:57:08 PDT 2011

hollyby @jodyms Thanks so much Jody! Wonderful chat. Thanks to everyone for joining in

with all your thoughts! #hpmWed Jun 8 18:57:52 PDT 2011

jodyms Wonderful message via @hollyby and others in #HPM: survivors, this is wholistic

care...kind and gentle, delivered by incredible people.Wed Jun 8 18:57:52 PDT 2011

dspacl Goal Oriented = Patient Centered = GO PC #hpmWed Jun 8 18:57:53 PDT 2011

PracticalWisdom Confetti Tweetchat Seems 2 me. Agree @Drsnit?RT @dspacl: I have an idea to

describe what we do in terms of the latest lexicon of #HCR #HPMWed Jun 8 18:57:53 PDT 2011

ctsinclair @aliciabloom Never heard the term 'H-bomb' I am stealing that one. With credit to

you of course. #hpmWed Jun 8 18:57:53 PDT 2011

MarksPhone That is the issue we are so far removed from death that when we face it it's in our

grill We no longer grow up with farm animals dying #hpmWed Jun 8 18:57:53 PDT 2011

GroundSwellAus @elderpages http://concernwithoutborders.org/initiatives.htm #hpmWed Jun 8 18:58:02 PDT 2011

JohnGirdwood @hollyby hospice patient on chemotherapy? Not where I'm at. Maybe I read it

wrong... But at my hospice, no curative on primary dx #hpm

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wrong... But at my hospice, no curative on primary dx #hpmWed Jun 8 18:58:02 PDT 2011

jodyms RT @MarksPhone: Canadian oncologist told me that we've lost the understanding of

death when we moved off the farm. it is not longer part of life 2day #hpmWed Jun 8 18:58:05 PDT 2011

elderpages Did we get to actionable items concerning abandonement (and not abandoning?)

#hpmWed Jun 8 18:58:14 PDT 2011

HumpbacksRule @jodyms #hpm Thank you so much! I always learn from this chat and tonight was

wonderful. Great job!Wed Jun 8 18:58:21 PDT 2011

ctsinclair RT @MarksPhone: Canadian oncologist told me that weve lost the understanding of

death when we moved off the farm. 'have heard also' #hpmWed Jun 8 18:58:28 PDT 2011

apjonas Pat Jonas, Family Doc, OH, lurking. I mention death to about 20% of my pts daily:

allow them to hear the word from MD for conditioning #hpmWed Jun 8 18:58:29 PDT 2011

jodyms @DrSnit Thank you my friend. I wish I could have kept up with all your incredible

#hpm thoughts & comments.Wed Jun 8 18:58:30 PDT 2011

MarksPhone @JohnGirdwood it can be palliative? #hpmWed Jun 8 18:58:41 PDT 2011

PinkRibbonBlues RT Our culture avoids it. @MarksPhone we've lost the understanding of death when

we moved off the farm. no longer part of life 2day #hpmWed Jun 8 18:58:41 PDT 2011

GroundSwellAus @elderpages have been to IPM in Kerala a coupld of times too! #hpmWed Jun 8 18:58:45 PDT 2011

ctsinclair RT @elderpages: Did we get to actionable items concerning abandonement (and

not abandoning?) 'no, explore next time?' #hpmWed Jun 8 18:58:52 PDT 2011

aliciabloom @ctsinclair gets people laughing when i'm lecturing. feel free to use it anytime!

#hpmWed Jun 8 18:58:54 PDT 2011

dspacl Let me try that again! Goal Oriented + Patient Centered = GO PC #hpmWed Jun 8 18:58:56 PDT 2011

equijada @jodyms thanks for hosting. thanks! #hpmWed Jun 8 18:58:59 PDT 2011

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VillageMemorial Hope to see those of you heading to the Statewide #Palliative Care Conf. at the

Oregon Convention Center this Fri. #hpm

Wed Jun 8 18:59:03 PDT 2011

vj_CR We should all do our best so that death is a tranquile journey surrounded by pple

who care abt you #hpmWed Jun 8 18:59:07 PDT 2011

drseisenberg HPM = Humanity Providing Moments #hpmWed Jun 8 18:59:15 PDT 2011

jodyms We didn't & must @elderpages Did we get to actionable items concerning

abandonement (and not abandoning?) #hpmWed Jun 8 18:59:15 PDT 2011

jfclearywisc RT @apjonas: Pat Jonas, Family Doc, OH, lurking. I mention death to about 20% of

pts daily: allow them to hear the word "conditioning" #HPMWed Jun 8 18:59:20 PDT 2011

equijada @DrSnit @jodyms Snit - you rock my socks off *confetti* #hpmWed Jun 8 18:59:22 PDT 2011

elderpages RT @dspacl: Let me try that again! Goal Oriented + Patient Centered = GO PC#hpm

#hpmWed Jun 8 18:59:24 PDT 2011

PracticalWisdom @jodyms I think a great way to measure the success of a TweetChat is to see how

many folks continue to stay engaged/learn/Listen A! 2 U #HPMWed Jun 8 18:59:26 PDT 2011

ctsinclair RT @dspacl: Let me try that again! Goal Oriented + Patient Centered = GO PC

"Nice!" #hpmWed Jun 8 18:59:33 PDT 2011

elderpages RT @drseisenberg: HPM = Humanity Providing Moments #hpmWed Jun 8 18:59:37 PDT 2011

PracticalWisdom Lovely thought RT @vj_CR: We should all do our best so that death is a tranquile

journey surrounded by pple who care abt you #HPMWed Jun 8 18:59:45 PDT 2011

uvmer @equijada Thanks.Not sure of best way to handle it.The way I found out about

palliative care/hospice, in the end, worked best for us/me #hpmWed Jun 8 18:59:55 PDT 2011

drseisenberg RT @equijada: @DrSnit @jodyms Snit - you rock my socks off *confetti* #hpmWed Jun 8 18:59:58 PDT 2011