Palliverse has heard about two PhD scholarships in the area of improving psychosocial support and education for people with cancer and their carers, at Curtin University in Perth, WA. Scholarships are available to health professionals (particularly nurses and radiation therapists). For more details see the Curtin University website.
What is important to palliative care patients, beyond physical concerns?
Patient self-defined goals: Essentials of person-centered care for serious illness
In this project (part of a larger US study of an upstream community-based palliative care approach) lay health care workers provided monthly supportive visits for 160 patients with advanced heart failure, cancer or dementia, and expected to die within two to three years. As part of the project, the care guides explored what was most important to the patients and documented their self-defined goals.
Four key themes were identified from the responses – medical, non-medical, multiple and global and these were distributed as follows:
The authors concluded that it is feasible to elicit and record serious illness goals in this patient population. They noted that the diverse range of goals that were identified related to global aspirations and many facets of the whole person, which presents an opportunity to individualise assessments and care planning processes and assist decision-making that more fully reflects current health status and psychosocial and spiritual aspects of patients’ lives.
Sandra Ellen Schellinger, Eric Worden Anderson, Monica Schmitz Fraser and Cindy Lynn Cain, Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious IIlness, American Journal of Hospice and Palliative Medicine, published online 23 March 2017, doi:10.1177/1049909117699600.
Reflecting on my own practice, it’s easier to concentrate on physical issues and it’s a timely reminder of the importance of non physical issues for holistic patient care.
Thanks to the PCV newsletter for the heads up….
Difficulties accessing medications which carers need to look after someone dying at home can mean that the person needs to be sent in by ambulance to hospital to die. Having been on the hospital end of this transaction many times, I know how sad it is for the patient and family when something as simple as access to medicines gets in the way of care at home.
A study carried out by Paul Tait and a team from South Australia has shown that the proportion of community pharmacies stocking a list of medications needed for end of life care at home has nearly tripled from 2012 to 2015.
Significantly more SA community pharmacies carried all five core medicines following the delivery of a range of multidisciplinary education strategies.
This indicates that the likelihood of South Australians being able to access items from the List through community pharmacies in 2015 has significantly improved.
They concluded that “These results suggest that there is value in developing and promoting a standardised list of medicines, ensuring that community palliative patients have timely access to medicines in the terminal phase.”
Tait P, et al. BMJ Supportive & Palliative Care 2017;0:1–8. doi:10.1136/bmjspcare-2016-001191
If if you live in Victoria you might have to get your head around some new advance care planning legislation which was passed last year and comes into force in March 2018.
Whether you are a consumer, or a health professional, you may be interested in these webinars run by the Cancer Council Victoria and the McCabe centre for law and cancer.
For more details see here
Palliverse’s very own Dr Craig Sinclair will be hosting this free webinar for Decision Assist concerning advance care planning in the aged care setting.
“George wants resuscitation”. This webinar explores some of the decision-making dilemmas experienced by aged care staff, health professionals and the clients and families they support.
The webinar will be broadcast live on Thursday 23 February 2017
1.30 pm till 2.15 pm AEDT but can be viewed afterwards.
See here for more information
How can we improve communication about medical treatment and future care?
The Journal of Clinical Oncology has published a paper about how we can have conversations about treatment decisions better. They found that patient coaching and question prompt lists were effective in improving communication.
Patients who had the one hour coaching session were three times as likely to ask about prognosis…. but discussions about prognosis were still rare and patients were often overly optimistic about their prognosis.
The intervention improved communication between oncologists and patients.
Most patients with advanced cancer say they want honest, sensitive communication about end-of-life issues. These conversations help patients and their families prepare, make informed decisions, and avoid potentially burdensome aggressive medical treatments near death.
Yet, patients are often misinformed about cancer survival and curability.
Those with over-optimistic prognosis estimates are more likely to die in a hospital and receive burdensome aggressive care that does not help the person.
Doctors often do not know their patients’ preferences about end-of-life issues.
The paper suggests that an intervention to improve communication around these issues was partly successful.
Decision Assist is running a series of free webinars on advance care planning and palliative care.
For those of you new to webinars, you can watch the presentation live on the internet and interact with the presenters, or just watch the presentation later. Some health services and aged care facilities are watching them together as part of their continuing professional development or education programs.
Here is a link to register. The next one is presented by Ilsa Hampton, CEO, Meaningful Ageing Australia
Regards, Sonia (who also works for Decision Assist!)
We all struggle to live a good life but what about a good death? Can we ever be truly prepared for the inevitable?
Molly Carlile is a ‘death talker’ who is committed to helping Australians ‘die well’. She talks about physician-assisted dying, planning for death, and the need for a cultural shift in the way we think about death and dying.
Here is a link from the ABCs Radio National to an interview with Molly Carlile, palliative care activist and author.
Cannabis is a plant which produces a large number of potentially useful chemical compounds. Patients have figured this out and are far ahead of the medical establishment in their understanding of how to use the plant. Palliative care and other health providers have to rapidly catch up with the necessary research, and in the meantime work with patients as partners as we learn.
If you want to learn more about the basic physiology and pharmacology of cannabinoids, the therapeutic evidence for cannabinoids, or hear about the international experience with prescription cannabinoids – join the Australia and New Zealand Society of Palliative Medicine Conference to be held in Perth on the 8th -11th September 2016.
#ANZSPM16 will feature two presenters on medical cannabis including International Keynote Dr Pippa Hawley from British Colombia Cancer Agency’s Pain & Symptom Management/Palliative Care Program and Dr Maureen Mitchell.
For some good bedtime reading on this topic ahead of #ANZSPM16, check out this recent review of cannabinoids for medical use & please share below if you’re aware of other good literature on this topic!