online resources: palliative care for Aboriginal and Torres Strait Islander peoples

CareSearch has created online resources that will help build a path of cultural capability and understanding for supporting care with Aboriginal and Torres Strait Islander people.

Ensuring that Aboriginal and Torres Strait Islander patients feel culturally safe and receive culturally responsive care is a key responsibility of every health care provider.

Guided by an expert advisory group comprised of Aboriginal and Torres Strait Islander people representing various organisations within the health sector across Australia, CareSearch has created online resources that will help build a path of cultural capability and understanding for supporting care with Aboriginal and Torres Strait Islander people.

The Aboriginal and Torres Strait Islander Care pages include information for providing culturally appropriate care for all health care providers, the Aboriginal health workforce, and the wider health workforce; share information with Aboriginal and Torres Strait Islander patients, their families and communities; and provide information on finding relevant research and evidence. There is a strong emphasis on the person’s care journey and how members of the health care workforce join their journey along the way.

You can access the Aboriginal and Torres Strait Islander Care pages at http://www.caresearch.com.au.

Contact caresearch on caresearch@flinders.edu.au

Acknowledgements:  Aboriginal and Torres Strait Islander Reference Group, PEPA & PCC4U (The Collaborative), Leigh Harris, Igneous Studios

Funeral services in Australia: Moves toward greater clarity at a time of great vulnerability

When you think about funerals, what is the first thing that comes to mind?

It may be a favourite scene from ‘Six Feet Under’ – the cult TV drama series depicting a family-run funeral home in Los Angeles. Or, it might be an iconic image of those prominent funeral companies that can seem to dominate the industry. If, however, you are currently in the throes of organising a funeral – chances are you may not really know what to think, or where to go in terms of navigating this very difficult passage of time.

As a social worker or nurse working in palliative care, you may be unsure of what resources are available to help support families’ decision making during a time of mourning. That’s where a novel funeral home comparison site can be of great assistance – you may find what you are looking for Gathered Here.

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Pushing up daisies

I learned a few new euphemisms for dying in this Conversation article. Confession time – it’s kind of my job to use the “D” word but even I, as a palliative care doctor, can find it awkward. But if we hide behind phrases like “passed away”, “gone” or “lost”, we contribute to confusion in some and participate in death denying.

 

wordmap.dying.wordsIf health professionals use euphemisms, they need to consider whether patients really understand what they’re trying to say. The article concludes that “Euphemisms have their place. But being able to talk openly (and clearly) about death and dying is important as it helps normalise death and avoids confusion.”

Happy palliative care week!

Sonia

Evolve – reducing low value interventions in palliative care

Embarrassingly, I didn’t know about this until I heard it at a RACP conference last week.
EVOLVE is a physician led initiative to ensure the highest quality patient care through the identification and reduction of low-value practices and interventions. Many specialties have created their own lists.

ANZSPM, the Australian and New Zealand Society for Palliative Medicine, have nominated 5 interventions which they recommend against in palliative care.

Curious?

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PhD scholarships available – improving psychosocial support for people with cancer & their carers

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.

exploring the goals of patients with serious illnesses

 

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.

http://journals.sagepub.com/doi/abs/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….

Improving community access for end of life care medications at home in South Australia

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

https://www.ncbi.nlm.nih.gov/pubmed/28167655

 

Webinars for consumers and health professionals on new medical treatment planning and decisions Act in Victoria

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

Free webinar on advance care planning in the aged care setting 23 Feb 2017

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.

Register here

Questions? agedcaretraining@austin.org.au

See here for more information

How can we improve communication about medical treatment and future care?

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.