Hot topics – Melbourne 27th March

Keen to learn more? Here is the page you need

 

PaCCSC survey for health professionals on cancer cachexia anorexia syndrome

EXPERIENCES OF HEALTH CARE PROFESSIONALS DEALING WITH CANCER ANOREXIA CACHEXIA SYNDROME (CACS) (UTS HREC ETH18-2870)

As a health care professional seeing advanced cancer patients who have CACS in your daily practice, you are invited to take part in this online survey. The research will identify barriers, knowledge and management gaps in clinical practice. The survey will take approximately 15 minutes to complete and participation is voluntary and anonymous.
The project is supported by the Palliative Care Clinical Studies Collaborative (PaCCSC) located at the University of Technology Sydney. For more information, please feel free to contact Ms Linda Brown, National Manager, PaCCSC on PaCCSC@uts.edu.au.

Thank you for your time.

link: https://redcap.research.uts.edu.au/surveys/?s=Y984LHMD3Y

Please note: if you have previously completed the survey, please ignore the request.

Sertraline in symptomatic chronic breathlessness: a double blind, randomised trial

It’s a Thing, that we tend to publish and read studies that show that new medications or interventions improve things, rather than that a possible treatment or intervention does not help. But both are important, right? If a treatment that is being given to people is shown to not work, we need to know about that too.

The prolific team at PaCCCS including Professors Currow and Agar have published a trial of sertraline (an antidepressant) in breathlessness and found it did not improve breathlessness scores compared with those taking a placebo tablet. Quality of life improved slightly in those taking the sertraline, however. Overall, they felt that sertraline did not provide benefit.  Continue reading

Final Program for Palliative Care Nurses Australia (PCNA) Biennial Conference: Fostering Excellence in Palliative Care

It’s not too late to register for this year’s Palliative Care Nurses Australia Conference in Brisbane!

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ABC radio Perth says that it’s time to talk about death and your end of life plan

http://www.abc.net.au/radio/perth/programs/focus/an-organised-death/9563772

This FOCUS discussion examines what it means to respect the final wishes of the dying.

And how can any of us do that, when most of us are reluctant to even bring it up?

There’s the nitty-gritty stuff like a will, powers of attorney and advanced-health-directives.

And then there are the things around the edges; where do you want to spend your final hours, what will happen to your pets and what do you want played at your funeral?

Taking part in the discussion is nurse practitioner, Shannon Tassell and Dr Margaret Sealey, a palliative care counsellor from Murdoch University.

Duration: 36min 35sec

Broadcast: 

Death and digital media seminar Melbourne 26th April 17:00

The Centre for Palliative Care is hosting what will be a thought-provoking session on the intersection of death and digital media. As someone who is periodically startled by Facebook mentions of people who have died, I am looking forward to this.

“The focus of this presentation will be to outline some of the key issues surrounding death in the digital age. This will include a critical overview of how people mourn, commemorate and interact with the dead through digital media.

The presenters will briefly map the historical and shifting landscape of digital death by considering a range of social, commercial and institutional responses to technological innovations. Discussion will centre around multiple digital platforms through a number of case studies drawn from Australia, North America and Europe.

Through these case studies they will offer fresh insight and analysis into emerging practices through which digital technologies are used to mourn, commemorate and interact with the dead.

You won’t want to miss this 21st century overview of death and social media.”

For more information email centre.palliativecare@svha.org.au

http://www.centreforpallcare.org/events/32/hot-topic-death-and-digital-media

Cheers, Sonia

 

What does a successful (US) palliative care program look like?

A little different from that found in Australia or New Zealand. 28097_PEC_Palliative_Care_Poster

Here are some ideas which might have resonance in our region.

I love the idea of automatic triggers to referral, which takes away the emotional content for the referrer of whether to refer or not. But our electronic medical record systems lag a long way behind that seen in the US, which is problematic.

I am not sure what I think about the suggested re-brand to “supportive care”. Less threatening for some patients and referrers, for sure. Does it mean we are joining the ranks of the death deniers, though?
Excellent reminder about the importance of meticulous communication with referrers. However I suggest that an item missing is laser focus on communication with patients. As patients sit at the centre of our care, I often write the letter to the patient in non medical language, and copy in the referrer and general practitioner. The letters may be light on medical detail for some referrers, but the patients often find them useful to remind them of what we talked about, and to show family, friends and other care givers.

I liked the data down the bottom about readmission rates, that would be a powerful lever for our managers to promote palliative care consultation services. Patients seen by palliative care had dramatically lower readmission rates compared with those not seen.

I would love to see an infographic about our palliative care services data, if you have seen one please let me know!28097_PEC_Palliative_Care_Poster

Sonia

New Zealand wins (again)

I have to confess I am a fan of the New Zealand health system from across the ditch. Sensible spending. strong palliative care health service connections… am I wrong Bro?

This article has not succeeded in reversing my bias in favour of New Zealand.

Palliative data nerds will no doubt recall this  fascinating study in Scotland by Professor Clark et al.  Published in Palliative Medicine, and quickly attaining the journal’s highest-ever Altmetrics score (1) , Clark showed that among 10,743 inpatients in 25 Scottish teaching and general hospitals on 31 March 2010,  3,098 (28.8%) patients died during the one-year follow-up period. The findings were replicated in 2013 with similar results.

The study by the fabulous  Professor  Merryn Gott et al showed that on the same date, the corresponding figure in New Zealand (including obstetrics) was about half at 14.5%. Patients at higher risk of dying were the elderly of over 80 years of age, Maori, those with cancer, those from socially disadvantaged backgrounds, and those admitted under medical specialties rather than surgical.

New Zealand seems to provide better end of life care outside the hospital setting, with stronger end-of-life care in the aged care setting. This has certainly been a focus for service development in Australia as well.

How would we rate in Australia I wonder?

I would love to hear from international colleagues

Ref (1)  https://www.gla.ac.uk/research/az/endoflifestudies/projects/imminence/

Sonia

#WorldAnaesthesiaDay – The role of peri-op ACP: “Mum may die during this operation”

Palliverse is lucky to have a guest submission from rural General Practitioner (GP) Jonathan Ramachenderan, who reflects here on his role as a GP Anaesthetist, with an interest in aged care and palliative care. (He is currently undertaking further training in palliative medicine.) By luck, his post about peri-operative advance care planning (ACP) coincides with World Anaesthesia Day (16th October) and this year’s theme in Australia and New Zealand is “Anaesthesia and Ageing.”

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“There is a real chance that your mum will not survive this operation” I said frankly to Sue.*

Her expression changed immediately to one of disbelief and she replied “What do you mean?!”

“The surgeon said to me that all mum needed was to have her hip fixed and then she would be fine to return back home to the village…I really thought she’d be home pretty soon, I wasn’t expecting you to say this.”

Patiently and well-practiced I said “I am sorry to tell you this but….”

Just then our surgeon burst into our little meeting room (the medication room on the ward). He was smiling, diffusing any thought that I had that I was delaying the operation by talking at length with Ingrid’s daughter.

Sue turned to him and said, “You didn’t tell me that mum may die during or after this operation.”

Her question caught him off guard and his expression changed rapidly to one of seriousness mixed with concern. “Jonathan is right, there is a chance your mum may not leave hospital even after we repair her hip fracture. Given her age, medical issues and frail state, her chances of returning home are significantly reduced”.

This changed the tone of the meeting as it brought into view the real implication of Ingrid undergoing this operation.

The conversation that followed was an important discussion about Ingrid’s stated end of life wishes and how this related to the specific complications of having her hip fracture repaired. Ingrid, aged 85 years old, had importantly completed an Advance Health Directive 3 years earlier with her GP, when she had begun to notice subtle changes in her memory and wanted to make sure her end of life wishes were known. Since then her mobility, general health and memory had declined, which led her to move into a “low level care” village environment, which had revived her zest and enthusiasm for life with the many interesting people and activities. She had suffered a mild heart attack a few years earlier and her breathlessness had recently restricted her movement to only around the house. But a sudden change of direction in the shower had caused her to slip and fall heavily, breaking her right hip.  Standing in that cool medication room on the busy ward, Sue understood the true impact of her mother’s accident and the implications of the proposed operative management.

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World Hospice and Palliative Care Day 2017 – a global call for Universal Health Coverage and Palliative Care

Author: Kate Jackson, WHPCA

On 14 October, over 200 organisations around the world will raise their voices to celebrate World Hospice and Palliative Care Day and Voices for Hospices 2017.

World Hospice and Palliative Care Day is a unified day of action to celebrate and support hospice and palliative care around the world. Voices for Hospices is a wave of concerts taking place on World Hospice and Palliative Care Day every two years.

The theme of this year’s World Hospice and Palliative Care Day is: Universal Health Coverage and Palliative Care: Don’t leave those suffering behind!

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