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Advance Care Planning: What, When, and How? 提前护理计划：做什么，何时做，如何做？
Missouri medicine Pub Date : 2025-03-01
Lina Toledo-Franco, John Peters, Ashna Fatima Kamal, Christina Traber
{"title":"Advance Care Planning: What, When, and How?","authors":"Lina Toledo-Franco, John Peters, Ashna Fatima Kamal, Christina Traber","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Advance care planning (ACP) is a fundamental part of the patient-provider relationship. It is a process that evaluates a person's values and determines preferences for care in various clinical scenarios, based on personal goals and expectations. ACP has two main goals: 1) identifying the surrogate decision maker; and 2) establishing the patient's goals of care for treatments or procedures which align with their wishes. ACP provides an opportunity to help patients and their families to prepare, on their own terms, for the changes brought by serious or progressive illness. This fosters a collaborative, therapeutic relationship in planning for the future.1 When addressing goals of care, it is essential to evaluate the perceived burden of certain procedures or life conditions such as depending on others for activities of daily living (ADLs) or living in a long-term care facility. As providers, we use patient history, laboratory data, exam findings, pathology reports, imaging studies, and more in making medical decisions for patients and recommending a plan of care. ACP can provide additional valuable information to guide patient-centered medical management. In this article, we will discuss the current state of goals-of-care conversations, compare the different ACP documents currently available, and provide guidance to providers on how to engage in these conversations. This includes addressing patient's values, wishes, and fears, without diminishing their sense of hope.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"129-137"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical Education Must Have Objective Metrics: Diminishing Objectivity in the Residency Application Process. 医学教育必须有客观的衡量标准：住院医师申请过程中客观性的减少。
Missouri medicine Pub Date : 2025-03-01
{"title":"Medical Education Must Have Objective Metrics: Diminishing Objectivity in the Residency Application Process.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Getting to the Inner Circle: The Long, Hard Way. 进入核心圈子：漫长而艰难的道路。
Missouri medicine Pub Date : 2025-03-01
Jo-Ellyn M Ryall
{"title":"Getting to the Inner Circle: The Long, Hard Way.","authors":"Jo-Ellyn M Ryall","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"97-99"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Praise for Missouri Medicine. 密苏里医学表扬。
Missouri medicine Pub Date : 2025-03-01
Steven M Shields
{"title":"Praise for <i>Missouri Medicine</i>.","authors":"Steven M Shields","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"100"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preparing for the Next Deadly Pandemic: What Did COVID-19 Try to Teach Us? 为下一次致命的大流行做准备：COVID-19试图教会我们什么？
Missouri medicine Pub Date : 2025-03-01
Farrin A Manian
{"title":"Preparing for the Next Deadly Pandemic: What Did COVID-19 Try to Teach Us?","authors":"Farrin A Manian","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"90-93"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognitive Stimulation Therapy: Making a Difference for Older Missourians Experiencing Dementia. 认知刺激疗法：对老年痴呆症的密苏里人产生影响。
Missouri medicine Pub Date : 2025-03-01
Ebow Tawiah Nketsiah, Marla Berg-Weger, Max Zubatsky
{"title":"Cognitive Stimulation Therapy: Making a Difference for Older Missourians Experiencing Dementia.","authors":"Ebow Tawiah Nketsiah, Marla Berg-Weger, Max Zubatsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cognitive Stimulation Therapy (CST) is an evidence-based, non-pharmacological intervention designed to enhance cognitive function, quality of life, and emotional well-being in individuals with dementia. With the high prevalence of dementia and Alzheimer's disease in Missouri, CST provides an effective approach to address dementia-related symptoms. This paper aims to inform healthcare professionals about the benefits and practical applications of CST, demonstrating its effectiveness in addressing the cognitive, emotional, and social needs of dementia patients. Despite the heavy reliance on pharmacological treatments for dementia, CST stands out as a viable alternative, offering improvements in memory, language, executive function, and alleviating symptoms of depression and anxiety. CST's adaptability across diverse settings, including community centers, residential care homes, and virtual platforms, ensures broad accessibility. Research and training initiatives led by Saint Louis University further highlight CST's growing role in dementia care within the US healthcare system. Embracing CST in clinical practice is not just an option but a necessity to improve the lives of individuals with dementia and alleviate the growing burden on healthcare systems in Missouri and beyond.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"124-128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical Errors Should Not Be Criminalized. 医疗事故不应被定罪。
Missouri medicine Pub Date : 2025-03-01
Emily Methangkool, Karolina Brook
{"title":"Medical Errors Should Not Be Criminalized.","authors":"Emily Methangkool, Karolina Brook","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"100-101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In the News. 新闻报道。
Missouri medicine Pub Date : 2025-03-01
{"title":"In the News.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Final Stretch. 最后的冲刺。
Missouri medicine Pub Date : 2025-03-01
David L Pohl
{"title":"The Final Stretch.","authors":"David L Pohl","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing an Aging-Friendly Healthcare System. 建立老年人友好型医疗保健体系。
Missouri medicine Pub Date : 2025-03-01
Angela M Sanford, Susan J Elliott
{"title":"Developing an Aging-Friendly Healthcare System.","authors":"Angela M Sanford, Susan J Elliott","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With the rapidly increasing population of older adults, there is a great need to develop Aging-Friendly Healthcare Systems (AFHS) equipped in providing comprehensive healthcare to a complex population across an expansive care continuum. While there are several important components in a successful AFHS, the pinnacle of the AFHS is quality of life for the patients it serves. The John A. Hartford Foundation has launched the 4Ms (What Matters, Mentation, Mobility, and Medication) initiative as a structured approach to assist in the development of AFHS. The AFHS is highly supported by the interdisciplinary team, geriatricians, and primary care physicians, all whom are facing serious workforce shortages, particularly in Missouri. Beginning in 2025, hospitals that participate in Medicare's Hospital Inpatient Quality Reporting (IQR) Program will be required to report on Aging-Friendly Hospital Measures based on the 4Ms framework or face possible reimbursement penalties.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 2","pages":"102-110"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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