#454

[@donkiebals123]

At the end the discussion was about elderly patients who are declining. I would strongly encourage a palliative discussion. Whether PCP is comfortable with this conversation or a referral to palliative is appropriate is a choice on the part of the PCP. But, the conversation has to happen at some point. Sometimes patients get looped into aggressive medicine, continuing preventative care for the sake of quality measures, family pressuring patient to continue aggressive treatment to extend life, without taking into account the quality of life. It happens. Ask the patient point blank, "Do you know where you are at with regards to your medical treatment and prognosis, and would you prefer to continue, or focus more on quality of life?" Being palliative, I can read a patient and usually open that conversation. Most patients know they aren't doing well, but don't know how to start the conversation themselves.

[@SayteaMorrilex-n8b]

Jackson Donna Robinson Paul Brown William

[@farooqashraf6091]

One for Paul: Hey Paul, Why don't kidneys ever make good decisions? Because they're always filtering out the good stuff! 😁