Primary Palliative Care in Dementia.

Primary palliative care is a fundamental aspect of high-quality care for patients with a serious illness such as dementia. The clinician caring for a patient and family suffering with dementia can provide primary palliative care in numerous ways. Perhaps the most important aspects are high quality communication while sharing a diagnosis, counseling the patient through progression of illness and prognostication, and referral to hospice when appropriate.

Strategies to Improve Clinician-Patient Communication Experiences for Patients With Neurologic Conditions.

Increasing research supports that effective clinician communication with patients and families leads to improved patient outcomes, higher patient satisfaction, and improved clinician experiences. As a result, patient- and family-centered communication is the focus of a 2020 American Academy of Neurology quality measure and part of neurology residency training milestones. Clinicians across training levels can implement strategies for improving patient- and family-centered communication, including optimizing the communication environment, using verbal and nonverbal skills, focusing on the patient's agenda, practicing active listening, demonstrating respect and empathy, individualizing encounters to patient and family needs, and providing clear explanations.

From the grocery store shelves to the neurologist's office: spinal cord effects of nitrous oxide.

We describe a patient who presented with subacute ascending numbness who we diagnosed with nitrous oxide toxicity from recreational drug abuse. Characteristic neuroimaging is presented and the diagnostic process for this condition is reviewed.

Applying the Care and Communication Bundle to Promote Palliative Care in a Neuro-Intensive Care Unit: Why and How.

Delivery of palliative care in neurointensive care units (neuro-ICUs) can be inconsistent, often due to absence of formal care triggers. The Care and Communication Bundle (CCB) of Quality Indicators provides a standardized process to deliver effective palliative care services in ICUs, but application of these indicators in this setting has not yet been systemically assessed. To evaluate the fit of a CCB in the neuro-ICU through a novel scoring system and identify barriers to adherence.

Primary Palliative Care Education: A Pilot Survey.

The demand for palliative services is outpacing the availability of specialist palliative care clinicians. One strategy to fill this gap is to improve "primary palliative care" skills and knowledge of all clinicians who care for seriously ill patients. Previous educational efforts have shown mixed results, and one possible explanation is unrecognized discordance of educational goals between those offering education and potential primary palliative care learners.