Delirium med cage fight - haloperidol vs lorazepam

which is the best to knock out delirium?

An instructional video based on this excellent post by Drew Rosielle in Pallimed, and last year's study by David Hui and colleagues at the MD Anderson Cancer Center.

Answering once and for all the persistent and misguided question, "Which medication is better for treating delirium?"

Looking forward to Hui's presentation and others at the HPNA/AAHPM Annual Assembly next month in Boston.

Story time - nutrition and end of life

UPDATED 3/1/18
Here's a version with a female narrator and better sound.

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Another spiritual experience, Bowie-style

For the students and the coming march.

Weekend spiritual experience

SAINT BRIGID'S PRAYER

I'd like to give a lake of beer to God.

I'd love the Heavenly

Host to be tippling there

For all eternity.

I'd love the men of Heaven to live with me,

To dance and sing.

If they wanted, I'd put at their disposal

Vats of suffering.

White cups of love I'd give them,

With a heart and a half;

Sweet pitchers of mercy I'd offer

To every man.

I'd make Heaven a cheerful spot,

Because the happy heart is true.

I'd make the men contented for their own sake.

I'd like Jesus to love me too.

I'd like the people of heaven to gather

From all the parishes around.

I'd give a special welcome to the women,

The three Marys of great renown.

I'd sit with the men, the women of God

There by the lake of beer.

We'd be drinking good health forever

And every drop would be a prayer.

More on the abandoned nursing home

With its back to the street at twilight

Note - I first wrote about the abandoned nursing home here, with an update here.

Here's what I've been able to piece together so far about the abandoned nursing home:

1. At some point around 2016, Kindred sold/transferred the facility to Wachusett Healthcare, LLC. 

Kindred had embarked on a major acquisition/merger with Gentiva and Centerre to form a new corporate giant that planned to dominate the post-acute / rehab / long term care / home care / hospice market in (2015). 

A year later, they decided to get out of the nursing home business, and are set to sell it off to a group that includes Humana and some private funds. There's much more on this saga by Strange Tony at the very fine Generic Hospice, "Kindred sells on the cheap."

2. I haven't found a website for Wachusett Healthcare, LLC. There's a listing for Wachusett Ventures, LLC in the directory, CTOPENDATA, which lists companies registered in Connecticut. The only individual listed is Raymond Dennehy.

There's also a list of open positions with the company at various facilities in MA and CT. 

3. Based on public documents I obtained from the Massachusetts Department of Public Health (DPH), attorney Andrew Levine sent a letter on August 29, 2017 informing DPH that, "It has been determined by the owners that the facility should close."

4. This action requires a plan and public hearing. A plan signed by Scott Bullock as Executive Director of the facility and routed through attorney Levine was submitted to DPH on September 11, 2017.

A notice of the public hearing was included in the plan, posted in the facility, and held there on September 25, 2017. DPH regulations also require notice to be posted in the local newspaper, similar to a classified ad.

Though the public hearing notice references the ability of "interested parties" to comment on the closure and plan, it slipped under the radar of area residents and Town officials.

Steven Vera presented the closure plan in his role as Chief Operating Officer of Wachusett Healthcare. The plan included freezing new admissions, transferring patients to other facilities, terminating staff, and maintaining medical records.

5. DPH approved the plan on October 19, 2017.

6. A letter from attorney Levine to DPH notes the last resident was transferred on November 19, 2017.

7. That letter also identifies WV-Concord SNF OPCO, LLC as "the facility's owner." That LLC lists the same address and individual as for Wachusett Healthcare LLC. I'm not entirely sure what happened or what this means.

8. Fast forward to late January. A Town official noted several departments were aware the building was vacant and were trying to contact the owner. The only available contact listed is Alan Kelly at 353 N. Clark St Ste. 2900 Chicago IL 60654. I found a listing for this name and address, but my attempts to call never went through and ended in busy signals.

Not an abandoned nursing home

9. What's next? I really don't know, but will follow.

Thanks for reading. See you next time.

A few pictures about a green burial

Grave opened for winter burial. Body in shroud, cushioned by pine boughs, covered with lilies. Summer visit. Stone found at burial ground. Burial at Cedar Brook Burial Ground. Shroud by Kinkaraco. Flowers by Stow Greenhouses. Carving by Blasted in Stone.

Pictures at link

Concord Green Burial Ground