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Doctor insights on: Patient Communication

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Do social workers follow the patient confidentiality code?

Do social workers follow the patient confidentiality code?

All health care DO: All providers, including social workers are required to respect patient confidentiality, just like dentists, physicians, nurses, and pas. In the case of suspected child abuse for example, it is normall legally required for the provider to alert the authorities (child protection services). There are other situations that would require alerting authorities such as elder abuse and death threats. ...Read more

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How can someone with alexithymia enhance communication skills?

How can someone with alexithymia enhance communication skills?

Namenda (memantine): Although it is off-label, the medication used to treat alzheimer's disease, Namenda (memantine) can help improve verbal functioning in this area. I have personally treated hundreds of autistic (including aspergers) individuals successfully improving their ability to converse, make friends, connect better with others, enhance vocabulary and syntax skills at usual doses. ...Read more

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Patient safety in elderly populations; how do nurses communicate with the Alzheimer's folks?

Patient safety in elderly populations; how do nurses communicate with the Alzheimer's folks?

Patience/compassion: It is hard to watch a viable adult dwindle in to memory loss as with alzheimer's. Most people who communicate with them have patience, understanding, and can read body language and facial cues. Caregivers remember what these patients liked and how to help them and communicate that to nurses. Art, music, and old pictures reach the long term memories of these patients and that helps. ...Read more

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What are patient protections with privacy?

What are patient protections with privacy?

Honor: The majority of encounters with patients do not involve things of which privacy is critical. Privacy enters when the issue is drug habits, sexual habits, criminal behavior and mental disorder. Significant legislation limits the passage of such information and patient permission is almost always required. The limits are legal allowances such as public health matters, and insurance inquiries. ...Read more

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Can a md. Deny medicare-paid hospice end-stage dementia patient physical therapy if patient's family requests it to maintain movement with new law?

Can a md. Deny medicare-paid hospice end-stage dementia patient  physical therapy  if patient's family requests it to maintain movement with new law?

Hmmm . . . : Could there maybe be a disagreement between this physician and your family about what's in the patient's best interests? This is a deep discussion that involves much thought and consideration, and which deserves scheduled time with your relative's doctor to go over treatment plans, prognosis, etc. Maybe such a discussion can resolve these issues? Doctors want to help, not hurt or harm. ...Read more

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What are the differences between subacute care, outpatient care, hospice care, home health care?

What are the differences between subacute care, outpatient care, hospice care, home health care?

Also: Subacute care in many skilled nursing facilities usually entails significant specialized care, like patients on long term ventilators. These patients are too stable for the hospital but because the tracheostomy & vent require constant monitoring and nursing care. If a pt can't be taken off the vent they are usualy transferred to a facility where this type of care is usual. ...Read more

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Question regarding privacy between 17 year old patient and doctor?

Question regarding privacy between 17 year old patient and doctor?

Using this site: To get the most from this site you need to provide basic background on your issue and ask a clear related question. Just raising an issue, with no clear question or background does not work.The physicians on this platform donate their time to answer questions. Any fees on wordy posts support the site. You are welcome to start over. ...Read more

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Diagnostic assessment before fontan operation in patients with bidirectional cavopulmonary anastomosis: are noninvasive methods sufficient?

Diagnostic assessment before fontan operation in patients with bidirectional cavopulmonary anastomosis: are noninvasive methods sufficient?

Not traditionally: I don't believe so. There may be some programs that will experiment with noninvasive pre-fontan imaging, but i believe that this is risky. The pressures are obtainable only by catheterization and this data may change the operation (e.g., whether or not to fenestrate the fontan to allow a pop-off of blue blood to increase the cardiac output.) catheterization also allows presurgical interventions. ...Read more

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Term for communication difficulties?

Term for  communication difficulties?

See below: There's no single term for communication difficulties. Depending on the problem, the issue could be expressive (difficulty expressing self, using spoken language), or receptive (difficulty understanding what is communicated). There are various communication disorders ranging from mild to moderate to severe. ...Read more

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Who provides hospice care? Cnas?

Who provides hospice care? Cnas?

A team!: Hospice teams involve a doctor, nurses, social workers, physical therapists, pastoral care, volunteers, choreworkers, and others. A patient and family will typically interact with all of these clinicians over the course of care. Most hospice have a primary nurse who is the clinician they see the most. ...Read more

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Can you tell me, are job descriptions that require team skills and good communication skills discriminating against autistic?

Can you tell me, are job descriptions that require team skills and good communication skills discriminating against autistic?

There : May be some jobs out there that are, but sometimes the autistic mind can outperform piers if they are able to get by with some basic ability and training. Keep looking, there is something out there! ...Read more

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How does memory impairment affect the ability of an elder dementia patient to use verbal language?

How does memory impairment affect the ability of an elder dementia patient to use verbal language?

Not great: The verbal langauage declines as the dementia progresses. Any new verbal and non-verbal language will not process into the brain for learning purpose and carrying out function. So stick with the simple and familiar verbal langauage for now. There is an interested concept of conservation for dementia individuals called "landmark" or "elderspeak". ...Read more

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How does an individuals communication difficulties affect occupation- post stroke?

How does an individuals communication difficulties affect occupation- post stroke?

CVA disability: Some strokes affect the speech areas of the brain, causing inability to express speech, find appropriate words, or understand the words of others. Obviously, any profession requiring efficient communication may be too overwhelming for such stroke victims. Speech therapy does help and the drug Ritalin (methylphenidate) may facilitate rehab. ...Read more

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Does assisted living allow people with cognitive impairment in?

Does assisted living allow people with cognitive impairment in?

Yes they do!: Assisted living facilities are long-term programs, regulated independently by each state. In fact, a large number of residents often have alzheimer's or other dementias. Services are provided on a 24-hour basis and include treatment and care based on individualized assessments. Dignity and quality of life are also key elements of care (see www.Alz.Org). ...Read more

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Does having providers work extended shifts compromise patient safety?

Does having providers work extended shifts compromise patient safety?

It all does...: This question has been asked regarding residents and patient safety, since in hospitals residents are the workhorses in most units. Attending physicians and nurses aren't the issue generally. The idea of limiting resident hours were thought to help with concentration, but it results in more "patient handoffs" and people taking care of patients they don't know well, causing more complications. ...Read more

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Does hipaa allow facility administration to keep information from aides that work "very closely" with alf residents with c-diff?

Does hipaa allow facility administration to keep information from aides that work "very closely" with alf residents with c-diff?

No: It is medically necessary for all people that work with patients with c. Difficile to be aware that they have it so that they can take the necessary precautions to prevent its spread throughout the facility. Also the aides must gown and glove to prevent acquiring the infection themselves. ...Read more

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Geriatrics md: how can nursing home refuse to share care plan with woman's child citing hipaa even before she moves in? Older nonmedical sib has poa.

Geriatrics md: how can nursing home refuse to share care plan with woman's child citing hipaa even before she moves in? Older nonmedical sib has poa.

HIPAA strictly: Demands that medical personnel do not discuss medical care issues with anyone but the person designated by the patient. It appears it is not you. Don't get mad at the nursing home, your beloved government came up with the rule. If they are ever found in contempt, the home is fined and potentially taken out of business. So there's that! ...Read more

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