Mental status changes in hospice patients are extremely common. Yet are they always due to disease progression? If a patient suddenly gets confused or sleeps all day, what should you do? Should you counsel the family that this is normal? Order testing? Assess the medication list? Family members sometimes worry that sending their loved one with advanced cancer, dementia, or other serious illness to hospice will mean that they'll just get morphine but no medical attention. Let's make sure that thi...
Sep 06, 2024•12 min•Season 3Ep. 133
Your patient is in terrible pain from cancer and you have the tools to relieve it. Yet they won't take the oxycontin or morphine that you prescribed. You can see that they are suffering yet you feel powerless to help. This is a common scenario and it can lead to discord between you and your patients. You may feel like saying, "Well fine then. I can't force you to help yourself..." You feel frustrated and the patient may not feel supported. Here are 30 reasons why your patient may be hesitant to ...
Aug 24, 2024•33 min•Season 3Ep. 132
Ketamine is in the news right now because Matthew Perry died from improper use of ketamine and his physicians just got arrested for making that possible. It is always a bit shocking when physicians get arrested for prescribing medication. It does seem like his physicians were not acting in accordance with their hippocratic oath - if that's true, shame on them. I do wonder, though, will this make clinicians less inclined to use ketamine to help reduce their patients' suffering. In addition to bei...
Aug 16, 2024•12 min•Season 3Ep. 131
We live in a soup of uncertainty and so do our patients and clients. Caring for patients with serious illnesses such as cancer or Alzheimers dementia can be extremely stressful because the experience is filled with uncertainty. Having a clear approach to dealing with uncertainty reduces stress and increases joy. This week we discuss 4 Dos and 4 Don'ts for dealing with uncertainty in health and in life. I'm happy that you're part of the joyful palliative care tribe! Delia Delia Chiaramonte, MD ww...
Aug 09, 2024•14 min•Season 3Ep. 130
The LovingKindness, or Metta, meditation (not a typo - that's how it is spelled) is one of my favorite meditations. It offers kindness and healing to you, the people in your life and the world. This week I offer you a LovingKindness meditation for your own wellbeing. You'll notice that there is no intro or ending because I'd like you to hang on to this meditation to use any time you could use a boost of positive energy. Enjoy! (And then share with a friend) Delia P.S., Can you do me a favor? If ...
Aug 01, 2024•11 min•Season 3Ep. 129
Leave your heirs the gift of organization. Estate planning is crucial but many people put it off because they aren't sure how to proceed. Adam Zuckerman is an attorney and entrepreneur who created a company, Buried in Work, after losing his father to cancer. Adam is passionate about making estate planning and end of life preparations as easy as possible for families facing serious illness. His site covers vast topics, from having tough conversations to green burials. He even has card "games" to ...
Jul 25, 2024•42 min•Season 3Ep. 128
We've all had challenging patient or client interactions. It can be hard to know how to handle them and it can make us feel lousy or even derail our day. You want to be an empathetic physician, nurse, therapist, PA or other clinician but how do you balance empathy with boundaries when a patient or family is angry or mean? This week join me to reflect on the 8 steps to managing a challenging patient interaction. Let me know what I missed! Join us on Facebook in the Integrative Palliative Medicine...
Jul 18, 2024•19 min•Season 3Ep. 127
Dr. Gary Sprouse is the Less Stress Doc. He is a family physician with expertise in stress management and he's the author of Highway to Your Happy Place: A Roadmap to Less Stress. This week Dr. Sprouse shares tools and insights to help you manage stress, banish guilt and regret, and live a happier life. You can find more information about Dr. Sprouse at www.thelessstressdoc.com Coping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself is available h...
Jul 11, 2024•38 min•Season 3Ep. 126
Caring for a loved one who is aging or ill is hard. It is especially hard if you've had a challenging relationship with them. If you had a difficult childhood and now find yourself caring for a parent with cancer, a stroke, or Alzheimer's dementia, you may be experiencing extreme stress and overwhelm. Ask yourself these 3 questions and ponder these 3 truths to make a hard time less stressful. Thanks for listening, Delia Chiaramonte, MD www.integrativepalliative.com Coping Courageously: A Heart-C...
Jun 27, 2024•11 min•Season 3Ep. 125
Chiropractic care is widely misunderstood by the medical community. In this interesting interview, chiropractor Brian Morrison clues us in to how we got here and the ways in which chiropractic education and clinical care have changed for the better in recent years. Dr. Morrison discusses who benefits most from chiropractic care, and which patients should not be referred. Here's to an expanded clinical toolbox. Delia Chiaramonte, MD www.integrativepalliative.com Coping Courageously: A Heart-Cente...
Jun 13, 2024•49 min•Season 3Ep. 124
Our internal judge has us judging ourselves, other people, and our circumstances. This makes practicing palliative care (and any patient care) harder and generates stress for us that we certainly don't need. This week you'll learn strategies for noticing your own judge and practical techniques for calming it, so you can enjoy your practice more, have less burnout, and be a happier person. Try it out and let me know how it goes! I'm glad you're here, Delia Delia Chiaramonte, MD www.integrativepal...
Jun 06, 2024•16 min•Season 3Ep. 123
Dr Gordon is a world-recognized authority and pioneer in mind-body medicine, and he is the founder and executive director of The Center for Mind-Body Medicine in Washington, DC. He is a Harvard educated psychiatrist and a clinical professor at Georgetown Medical School. He was chair of the White House Commission on Complementary and Alternative Medicine Policy, and he has a recent book called Transforming Trauma: The Path to Hope and Healing. Dr. Gordon has created and implemented extraordinary ...
May 30, 2024•46 min•Season 3Ep. 122
Moral distress and moral injury are common in healthcare, yet few physicians, nurses or other clinicians talk about it on a regular basis. Stuffing the shame, guilt, anger and other powerful emotions that can accompany moral injury can lead to clinician burnout, compassion fatigue, depression or even suicide. And it can also result in excellent, empathetic clinicians leaving healthcare, Let's talk about it! Delia Delia Chiaramonte, MD www.integrativepalliative.com Coping Courageously: A Heart-Ce...
May 23, 2024•19 min•Season 3Ep. 121
The term self-care has a bad rap lately. It can seem like healthcare organizations use terms like "self-care" and "resilience" to make their doctors, nurses, and other healthcare practitioners work harder and harder. They offer free yoga, while piling on more and more work! There is truth to this scenario, yet pushing away the concepts of self-care is not the solution. This week we cover 4 myths of clinician self-care. This episode is appropriate if you are a physician, nurse, nurse practitioner...
May 16, 2024•14 min•Season 3Ep. 120
Many clinicians, especially physicians, don't learn in school what to do when a patient is crying. When we don't know what to do we feel uncomfortable, and no one likes to feel uncomfortable. I've seen many physicians sit in the presence of a crying patient, continue to work on their computer, or awkwardly shift in their seat. This gives the patient the message that their tears and feelings aren't welcome. This week we talk about what to do when your patient starts crying. I'm glad you're here, ...
May 10, 2024•12 min•Season 3Ep. 119
Is Joyful Palliative Care possible? Palliative care clinicians are often kind and highly empathetic people, but uncontrolled caring can lead to compassion fatigue or even burnout. Yet approaching the care of seriously ill people with an intentional approach can indeed make palliative care joyful. Here are the steps: 1. More tools to relieve your patients' suffering (integrative symptom management) 2. Develop your healing presence 3. Know yourself 4. Become a heart-centered leader 5. Fill your cu...
May 03, 2024•23 min•Season 3Ep. 118
The 2024 Integrative Congress on Integrative Medicine and Health was held recently in Cleveland and there were so many wonderful sessions. I attended and have picked out 8 key learnings to share with you. The 8 topics are: 1. Microskills for wellness 2. Healing presence 3. Boundaries 4. Photobiomodulation 5. Vagus nerve 6. Psychedelics 7. A key values question 8. A surprise! Listen, share and subscribe! Here's the website of the Academic Consortium for Integrative Medicine and Health https://imc...
Apr 25, 2024•15 min•Season 3Ep. 117
Effective doctor-patient communication is crucial for effective patient care. Yet effective communication is challenging when visits are time pressured, and both clinicians and patients are often stressed. Using the tools of negotiation can help make doctor/clinician-patient communication more effective. This week I discuss an 8 step approach to negotiating effectively with patients. In support of heart-centered healing, Delia Chiaramonte, MD www.integrativepalliative.com Coping Courageously: A ...
Apr 18, 2024•14 min•Season 3Ep. 116
Harvey Chochinov, MD, PhD is an esteemed clinician and researcher in the field of palliative care. He shares his research on dignity, dignity therapy and the Dignity Question that is vital for providing the highest quality end of life care. You will be inspired by his work and learn tools that you can bring right to the bedside. You can find Dr. Chochinov on Linked in or at: Twitter: @hmchochinov Harvey.chochinov@cancercare.mb.ca Thank you for being a heart-centered healer! Delia Chiaramonte, MD...
Apr 11, 2024•42 min•Season 3Ep. 115
Michelle Pearce, PhD is a psychotherapist, coach and integrative health educator who is passionate about guiding people to well-being. She shares her insights about health coaching, both private and group. She also shares information about the integrative health and wellness certificate program that she leads at the University of Maryland, Baltimore. This program is for physicians, nurses, nurse practitioners, physician assistants, physical therapists, occupational therapists, psychotherapists, ...
Apr 04, 2024•29 min•Season 3Ep. 114
Dementia is hard on families. It is hard to watch a loved one decline, hard to provide personal care, and hard to lose the connection with the person that you once knew. One of the hardest things may be that the person loses their language, and language is often how we connect. This week I share 7 ideas for fostering connection with people with dementia. If you're a clinician, share these ideas with the families that you care for. If you have a person in your family with dementia, try them out y...
Mar 28, 2024•10 min•Season 3Ep. 113
Behavior change is hard. Integrative nutrition and wellbeing coaches are an important part of a healthcare team. Joel Edman, DSc, FACN is an integrative nutrition and health coach and he shares his wisdom this week about how to facilitate practical and realistic behavior change. Healthy nutrition, exercise and stress management is important for people with autoimmune disease, obesity, cardiovascular disease and more. If you'd like to contact him for a consult, check out his website at: edmanwell...
Mar 23, 2024•41 min•Season 3Ep. 112
As clinicians it is crucial that we are aware of our blinders. Sometimes the obvious cause of pain isn't the actual cause of pain and we need to be willing to look past our first impressions. This week I discuss the case of one of my patients (de-identified of course). He had widely metastatic cancer and a pain that I couldn't control with medication. Come find out what worked to relieve his pain. Celebrating the heart-centered healer that you are, Delia Chiaramonte, MD www.integrativepalliative...
Mar 14, 2024•12 min•Season 3Ep. 111
It is painful to watch other people suffer, whether they are your patients or your loved ones. They may suffer with illnesses, such as cancer or dementia, or may suffer with emotional pain, anxiety or depression. You want to help, but don't want to be swallowed up by their suffering. Join me this week to learn six important ways to protect your own well-being while also being a loving caregiver, physician or clinician. Celebrating the heart-centered healer that you are, Dr. Delia Delia Chiaramon...
Mar 07, 2024•14 min•Season 3Ep. 110
This week I share the story of one of my patients and the woman he loved. Nick was a man in his 20s with an advanced cancer and caring for him touched my heart. He had to face the difficult reality in front of him in order to create the life that he wanted. He embraced acceptance and it changed his future. Come listen to a reading from Coping Courageously: A Heart-Centered Guide for Navigating a Loved One's Illness Without Losing Yourself. You'll hear Nick's story and several others and you'll c...
Feb 29, 2024•15 min•Season 3Ep. 109
Breath is powerful. We carry it with us, it keeps us alive, and it can either increase our stress or reduce it. Slow breathing is a secret weapon for reducing the stress response, reducing anxiety and improving wellbeing. This week you'll hear from Fernando David Pinon and Nancy Estaphanous, the co-founders of BreathNote. BreathNote is a unique and effective tool that uses music to guide relaxation breathing. It can be used in clinical settings, such as chemo suites or physician exam rooms, and ...
Feb 24, 2024•31 min•Season 3Ep. 108
There is wonder in unexpected places. When you look for it you will find it, and when you find it life feels just a bit lighter. From an Uber ride that turned into an impromptu therapy session to a conversation in a wellness store that may just save a local business, this week we'll uncover the magic hidden within everyday interactions. How is this relevant to palliative care? Dealing with patients with dementia, cancer, and other serious or progressive illness can entice us to slow down and loo...
Feb 15, 2024•10 min•Season 3Ep. 107
Neurofeedback is a brain-based treatment that is effective and safe. It can be used to manage ADHD, anxiety, depression, insomnia, Parkinson’s disease, mild cognitive impairment, post concussive syndrome and more. This week we have Francesco Amico, PhD and Alvaro Villegas who are experts in neurofeedback, especially neurofeedback that can be administered remotely, sharing their expertise. They work with a product called Myndlift that allows people to have personalized neurofeedback treatment fro...
Feb 08, 2024•42 min•Season 3Ep. 106
Guided imagery is a powerful tool to use with your patients who have generalized anxiety or are just feeling anxious about getting chemotherapy or having a procedure. It is easy to learn and every physician, nurse, nurse practitioner, PA, radiation technologist, and every other clinician should have this tool in their toolbox. In addition, I've recorded a LovingKindness meditation (Metta) that is available for you for free at www.copingsupport.com . Have a listen, because your wellbeing matters ...
Feb 01, 2024•15 min•Season 3Ep. 105
Do you know the different between yoga and yoga therapy? Which one is better for people getting treatment for cancer? How about people with neurologic conditions or those who have had a stroke? What benefits can patients get from yoga therapy? What are the risks? Yoga therapy expert Kelli Bethel, PT, DPT, C-IYAT shares her wisdom about all things yoga therapy. Learn more tools to help your patients manage their pain, anxiety, chemo symptoms, and sleep. You can reach her at kelli@kmbethel.com . H...
Jan 25, 2024•31 min•Season 3Ep. 104
