Join team Palliverse (@Palliverse) and Liz Callaghan, CEO of Palliative Care Australia (@PCACEO), for a tweet chat about “Hidden Lives / Hidden Patients” – the theme of World Hospice and Palliative Care Day 2015, focusing on patients living in unique situations who often struggle with access to palliative care, including children, LGBT individuals, prisoners, soldiers and those living in rural areas.
“Thank you for submitting your paper titled [insert title] to [insert journal name]. You will notice that the reviewers had a number of concerns, and we invite you to respond to their comments and re-submit a revised document.”
A few years ago I had formulated a plan to reunite a patient, who had been in inpatient care for a number of months, with his horse who I had been informed, he missed dearly. Something had been lost during the clinical handover – the patient had actually sold his horse some months prior. Instead I arranged for him to receive the Trackside horse-racing channel, and assured him that he could do phone-betting. I filed the plan away in the recesses of my brain, and looked forward to bringing it out again if the opportunity ever arose again to make use of it.
[Prof Mark Brown discussing the renal supportive care model at St George Hospital]
21-23rd August, 2015 | St George Hospital, Sydney
It was the fifth annual symposium but the first master class. A truly multi-disciplinary audience comprising nephrology, palliative care, geriatrics, trainees, specialists, nurses, social workers, dieticians, et al met on a warm and wet weekend at the St George Hospital in Sydney. All shared a commitment to making life better for individuals with advanced kidney disease. Continue reading →
It’s hard to predict events in the final days and hours of a person’s life. Some deaths are wonderful – a gentle decline preceding a gracious demise. Certainly these are the sorts of deaths we see in films or on television, where the dying patient bids farewell to gathered family and friends before softly closing his eyes.
These gentle departures happen in real life too – many people simply die in their sleep, and many families and friends share the privilege of witnessing the calm and serene departure of a loved one. Of course, grief follows, but those left behind are able to take solace in the knowledge and memory of a peaceful passing.
Unfortunately for every “good” death, there are many which are much more stormy and drawn out. These deaths can leave families traumatised for many years or simply make the grief that much harder.
As many of you would know the Royal Australasian College of Surgeons has recently released its expert advisory group Draft Report into discrimination, bullying and harassment in surgery. The results of the report are confronting even if they are unfortunately not altogether surprising.
The morning session was an opportunity to share advance care planning (ACP) success stories from different countries – Singapore (Living Matters), UK (Gold Standard Framework) and the US (Honoring Choices Wisconsin, Kaiser Permanente). Helen Mason from NZ also presented the findings of her Harkness Fellowship, identifying key components of health systems for successful ACP.
To me, the recurring themes were:
– the need for grassroots, community engagement
– identifying and using clinical and community champions of ACP
– the need for a coordinated whole systems approach
– not limiting ACP to end of life – focus on living well, not just dying, and
– employing continuous quality improvement.
The International Society of Advance Care Planning and End of Life Care (ACPEL) Conference began today, with addresses from leading practitioners and researchers from across the world. Set in Munich, Germany, the opening panel discussion examined factors contributing to successful advance care planning implementation, and discussed how implementation might progress in European countries.
309 legally competent medical inpatients aged 80 or more were randomised to “normal care” or “normal care plus advance care planning” and followed for six months or until death. The main outcome measure was whether wishes were known and respected in the patients who had died.
Of the 56 patients who died by six months, end of life wishes were much more likely to be known and followed in the intervention group (25/29, 86%) compared with the control group (8/27, 30%; P<0.001). In the intervention group, family members of patients who died had significantly less stress (intervention 5, control 15; P<0.001), anxiety (intervention 0, control 3; P=0.02), and depression (intervention 0, control 5; P=0.002) than those of the control patients. Patient and family satisfaction was higher in the intervention group.
The authors concluded that “Advance care planning improves end of life care and patient and family satisfaction and reduces stress, anxiety, and depression in surviving relatives.”