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.

Transcript

Hello, my name is Dr. Maria Goddard, MD, CWS, FAPWCA and I'm a burn and wound care physician who lives in the state of Kansas.

What are the top 3 misconceptions about wounds and the geriatric population?

The first tip is physiologic age is not the same as biologic age. And so, often patients who are older in their 80s, there is a tendency to maybe not be as aggressive in pursuing wound closure and wound healing. And that's not the case.

That's why it's important to talk to your patient, which leads me to point 2, in establishing goals of care. For some people, if they have, especially like a weeping venous stasis wound, they want to look more at improving their quality of life. And then those patients are going to be really active, who are still traveling, who are more mobile, who want to achieve complete closure. And so you want to make sure that with your older patients, you're having that conversation constantly with them and their family members about what those goals of care are.

My third point is understanding the difference between palliative care and end of life care and knowing when those are appropriate. And that will stem from point 2, which is establishing those goals of care. There's still a common misconception that being on hospice means that you've given up on that patient with wound healing. And I've taken care of many patients who've been on hospice, and whether you're concentrating on reducing pain, getting comfort, and sometimes you can achieve wound closure, but you're doing that in a way that is more comfortable for the patient and not as aggressive as if you're trying to debride frequently and causing pain. And so it's just really doing thoughtful interventions for your patients that are older.

About the Speaker

Maria Goddard, MD, CWS, FAPWCA is a board-certified wound care specialist in the Midwest. She received training in general surgery at Wake Forest School of Medicine and completed fellowship training in burn surgery at both the University of Tennessee-Memphis and the University of Kansas Medical Center. She is board certified in wound care by both the American Board of Wound Management and the American Board of Wound Healing. She is an instructor for Advanced Burn Life Support and a member of the Global Health Committee of the American Burn Association. Dr Goddard also currently serves as the Chair of the Communications Committee and member of the Education Steering Committee of the Association for the Advancement of Wound Care. She has practiced in multiple care settings, including long-term care, and her extensive training, research, and clinical experiences provide a unique perspective of wound management. Her mission is to bridge the gaps that exist among care settings because of differences in regulations and resource availability. Her interests include burn care, geriatrics, global health, telemedicine, and reducing disparities in health care.