Palliative Wound Care

Editor's Note: Is there a difference between hospice and end of life care? In this interview, Dr. Maria Goddard MD, CWS, FAPWCA sheds light on 3 misconceptions in treating the geriatric population as well as some strategies she uses in her practice.

By Michael Miller DO, FACOS, FAPWCA, WCC A friend and colleague is going to die. This of itself is not news as the process of dying unquestionably begins from the moment of conception. This case is perhaps a bit sadder and more morose than many. As health care providers, we relish in the success of prolongation of life. The birth of a baby, healing after an illness and returning to our usual lives, the successful healing of a wound of longevity and strife. And yet the measurement of successful healing, like the measurement of a successful life, is one defined by an infinite number of parameters from an infinite number of opinions.

By Aletha Tippett MD Assessment of the individual for palliative wound care is not much different from the assessment for any wound patient. Initial questions that that should be asked in your assessment include:

By Aletha Tippett MD In considering this question as to whether amputation can be palliative, let’s keep clear that these are two separate subjects that sometimes interact. It is key to always keep our goals in mind. What is the goal in palliative care? The goals are to provide comfort, relieve pain, prevent infection, and improve or maintain quality of life. These goals are always to be in concert with the desires and wishes of the individual patient.

By Aletha Tippett MD For over a decade now I have treated wounds in palliative care patients and non-palliative care patients. The “funny” thing is that there is no difference in how I treat these wounds, all are approached the same way, with similar treatments used. As I teach more and more about palliative wound care, it seems obvious to me that all wounds and all people deserve this approach. Who does not deserve less pain? Who deserves to be embarrassed by wound odor? Who deserves to have an infection? Who deserves a lesser quality of life? When asked these questions I would think the answer would be NO ONE.

By Mary Ellen Posthauer RDN, CD, LD, FAND Recently there have been numerous articles and webinars focusing on the methods health care professional can employ to effectively communicate and engage in end of life conversations with patients receiving palliative and/or hospice care.

By Aletha Tippett, MD There is lots in store for the new year, and a great many wound care conferences just chock-full of information. There is one conference this year that you may not know about—small, quiet, highly informative and productive. That is the 2015 Palliative Wound Care Conference that will be held in Orlando, Florida, in May this year.

By Jonathan Rosenfeld, JD Whether the development of a bedsore, also commonly referred to as a pressure ulcer, is the fault of the nursing home or an existing medical condition, the actions taken by the health care facility after the sore is discovered can have a large impact in a lawsuit if the patient suffers from complications arising from the sore. How a nursing home treats patients with pressure sores is just as important during litigation as whether the home is responsible for the development of the sores to begin with. For this reason, nursing facilities should not implement treatment protocol that gives the impression that they are killing the patient or doing nothing to prevent the patient’s death.

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS In the past two blogs I have discussed a controversial topic, skin failure. We all have strong feelings on this topic and have experienced different cases in our practice. Dispute the controversial feelings on KTUs and skin failure; I would like to now just address the viewpoint of the family and how to approach these difficult conversations.

By Diana L. Gallagher MS, RN, CWOCN, CFCN While watching the CBS news show, Sunday Morning, my attention was captured by a piece offered by Steve Hartman. I admit that I am a fan of Steve Hartman. I always enjoy his sense of which stories are really important. Today's news is filled with turmoil, tragedy, and drama; a lot like life but on a much larger scale. There simply has to be something positive trapped in the midst of so much overwhelming negative information. Once again, Steve Hartman found that thread of optimism in the midst of tragedy. It is that invisible thread and hope that there is something positive to reap out of overwhelming tragedy that serves as a lifeline to so many of us.