Learn how to create an inclusive and equitable environment for applicants, with a focus on reviewing applications prior to interview and structuring interview day.  

The AAHPM Fellowship Training Committee, as part of its mission to promote and support diversity, equity, and inclusion (DEI) in Hospice and Palliative Medicine, is pleased to present the second in a series of webinars on how to foster DEI in fellowship recruitment.

Messaging to the public regarding advance care planning, palliative care and hospice is inconsistent and confusing. Hospice and palliative care specialists are often asked to talk to the public about care for people with serious illness, but most have received little or no training in public messaging or media engagement. This activity reviews the need for improving public messaging about advance care planning, palliative care, and hospice along with the empirical evidence for public attitudes and awareness of these aspects of care for serious illness.

The current palliative management of delirium involves (1) identification of reversible causes of delirium, (2) non-pharmacologic measures, and (3) pharmacologic interventions for palliation. Clinicians reserve pharmacologic interventions for cases of hyperactive delirium or refractory delirium. Specific pharmacologic agents treating delirium have typically involved using drugs from the neuroleptic class. Often families request sedation for their loved one, complicating neuroleptic choice. Early randomized controlled trials found that benzodiazepines cause worsening delirium. Other research showed that benzodiazepines and central nervous system depressants cause significant complications in the elderly leading to further avoidance. The avoidance of benzodiazepines continued as guidelines warned of their use in delirium except in the case of alcohol withdrawal. Recent randomized controlled trials suggest that benzodiazepines are effective when sedation is required as part of the delirium treatment strategy. There is also evidence for their benefit as breakthrough agents for delirium. As benzodiazepines are potent sedatives, clinicians need to carefully weigh the risks and benefits before prescribing benzodiazepines in patients with delirium and discuss the goals of care with family caregivers and patients (if possible). Identifying when to use, how to use, and what patients will benefit from benzodiazepines becomes essential.