New Palliative Care phone advice service in Victoria, Australia

The Palliative Care Advice Service is a phone-based service for people in Victoria, Australia, seeking access to specialist guidance and advice. It offers an advice service for those living with a life-limiting illness and those who support them. The service is for family, friends and neighbours as well as all healthcare workers.

Specialist nurses and doctors provide information about serious illness and symptoms, being a caregiver and the palliative care service system.

For healthcare workers, it offers guidance about prescribing, symptom management, locating appropriate services and decision-making.

The Parkville Integrated Palliative Care Service at The Royal Melbourne Hospital runs the service from 7am – 10pm, seven days a week. The Advice Service is free, confidential and available for everyone in Victoria.

To contact the Palliative Care Advice Service you can call 1800 360 000 or visit www.pcas.org.au for further information.

Family meetings in palliative care reduce carer distress

Offering a structured family meeting conducted in a hospital setting for patients with advanced disease receiving palliative care may be helpful in reducing family caregiver distress and enhancing their sense of preparation for the caregiving role.


The cluster randomised, multi-site study was lead by Prof Peter Hudson at St Vincent’s Hospital in Melbourne. It examined results from around 150 control and 150 intervention patients and caregivers.

The purpose of this study was to assess the effect of structured family meetings on patient and family caregiver outcomes and to determine the cost-benefit and resource implications of implementing family meetings into routine practice.

Family caregivers in the intervention group had significantly lower psychological distress scores and higher preparedness scores two weeks after the intervention, but the scores were not significantly different two months after the patient died.

The family meetings in intervention participants were structured according to published guidelines and tailored to the needs of the patient and family.

In summary, the guidelines incorporate:
(1) principles for conducting family meetings;

(2) pre-meeting procedures, such as liaising with the patient/family and prioritising issues;

(3) deciding who needs to attend the family meeting;

(4) a procedure for conducting the meeting; and

(5) strategies for follow up after the meeting; including phoning the primary family caregiver 2 days later to discern if discussion and actions arising from the meeting were helpful.

What is already known about the topic?
A family meeting (also known as a family conference) is a clinical tool for healthcare providers to facilitate communication and care planning with patients and their family caregivers.
Whilst these meetings are considered integral to palliative care they are commonly not provided systematically, nor according to best available evidence.

Implications for practice
Hospital staff should consider conducting a family meeting as soon as feasible after admission of a patient with advanced disease, or referral to the palliative care team where resources allow. This is commensurate with guidelines and standards for family support. It is also in keeping with the concept of ‘early’ palliative care for which there is a growing evidence base.

Sonia

Weekend read/listen

Photo by camilo jimenez on Unsplash

Palliverse founder Dr James Jap has made some recent appearances in two non-palliative care websites. James was interviewed by NZ actress/writer Michelle Langstone writing for NZ’s The Spinoff.

After reading this article Australian writer Aimee Chan asked James to be interviewed on her Kids Pod podcast.

Click on the following hyperlinks if you fancy a read or a quick listen:

Dr James Jap on a life centred around death

Kids Pod Episode 127

Keep washing those hands and social distancing.

Take care and have a great weekend!

Accessible video about NFR (not for resuscitation) orders for patients and families

Image

Dr Barbara Hayes and Prof Joe Ibrahim have combined forces to make this elegant simple Youtube resource to explain not for resuscitation orders, cardiopulmonary resuscitation, and advance care planning for patients and families.

It works through the differing perspectives of medical teams and patients and their families to explain why sometimes CPR can do more harm than good.

Happy #advancecareplanning week!

Sonia

Palliating in a pandemic

It’s hard to overstate the impact of the novel Coronavirus on health systems around the world. It’s particularly poignant for palliative care workers, so familiar with dying, to imagine the loss and grief. We try to image what it could be like for health care workers at the front line. Soon we will not have to imagine, as we will be at the front line.

This article, written in 2010 about influenza by Dr Downar and Dr Seccareccia, is prescient.

Twitter as always is an invaluable source of dialogue on this issue. Try out this thread    from @AmitAryaMD  – you don’t need to be able to use Twitter to read it.

How are your teams and health care service preparing for the pandemic in Australia, New Zealand and elsewhere?

 

 

Study shows why cancer patients are asking for medicinal cannabis

I can tell you, it’s true! Many cancer patients are asking their clinicians for medicinal cannabis – but worryingly,  around one in four patients believing it will help in control or cure the cancer, a Victorian study has found.

This study was carried out by a team at the Victorian Comprehensive Cancer Centre and Parkville Integrated Palliative Care Service, lead by Dr Stacey Panozzo, investigated the characteristics and medicinal cannabis requests of 1700 patients with breast, colorectal, melanoma and oesophageal cancer patients attending the three centres over a six month period in 2018-2019.

The study was also featured in this Limbic Oncology article.

Continue reading

Putting the CAR-T before the horse?

Dr Benjamin Thomas’s excellent thread about economic justice for palliative care patients in the context of the announcement of a likely announcement regarding the Government funding around 200-250 patients for $500,000 each to receive CAR-T treatment.

He calculates what we could do for palliative care patients with the same money.

Worth a read! Thanks Ben @andiyarus

https://threadreaderapp.com/thread/1222006604289101824.html

 

 

Announcement re CAR-T funding

 

Advance care planning survey for health professionals in Australia

Message from Advance Care Planning Australia:

 

Are you a doctor, nurse, social worker or allied health professional working with people affected by cancer?  We need your help to better understand the barriers and enablers of advance care planning for people with cancer.

Advance Care Planning Australia, supported by funding by Cancer Australia, is leading research to help more Australians affected by cancer to access the benefits of advance care planning.

Participation is easy and requires only 15 minutes of your time to complete an online survey. With your involvement we can help more people with cancer to receive care consistent with their values, goals and preferences.

Survey: http://bit.ly/2Cm44Es

Inspired to improve your communication skills?

 Cancer Council WA delivers the very successful workshop on communication skills training, perfect for the situations described in our article earlier today.

For more information in WA see here

Cancer Council Victoria also has a variety of education and communication workshops and resources.

Know a great resource for communication skills? Comment below.

Continue reading

AusDoc article – Dying doctor has some lessons on how to tell patients bad news

I have shamelessly reposted from AusDoc and therefore some readers may not be able to see this behind the paywall – if so I do apologise!

As a doctor of almost 40 years, US internal medicine specialist Dr Ron Naito started to suspect he may have pancreatic cancer from his symptoms and test results.

Dr Ron Naito
Dr Ron Naito. Photo: Vimeo

But his own doctors made such a poor job of telling him the diagnosis, that he’s devoting his final months of life to teaching students the skills of delivering bad news.

“When doctors deliver bad news to their patients, every word carries meaning, and you need to choose your words very wisely. We can and must do better at this. All doctors can learn these skills, and the good news is that there are now excellent training programs available to support them.”

For more reading see here.

Sonia