My patient arrived in 1970s New Zealand (NZ) a refugee. One of the millions of innocent victims of a proxy war. She and her husband had worked hard, and raised their family well. Their children had grown up and had made good lives for themselves and their own families. She was the proud grandmother of six, with ages ranging between 2 to 18 years old. She was admitted for end of life care and had been comfortable. Her family attributed this to her Buddhist beliefs. She had always been the calm one in their family. “Dad was the fiery one, and he had died about seven years ago.” She had carried on with life, taking even the death of her partner with calm. She her family that she would see him in the next life. She wasn’t sure in what form he would be reincarnated, but she was sure they would meet him again.
She had lived a calm life and her family were not surprised that her dying process was also calm. She didn’t need much in the way of medications as she was mostly comfortable. She lost consciousness and we warned the family that death was likely imminent, that she would be dying soon. Two weeks passed and she was still alive. She remained comatose and non-responsive. She had not been alert enough to have any oral intake. The family made sure her mouth was kept moist.
Her family asked us how long she had left to live. We explained that from our experience that other patients in similar situation likely would have died two weeks ago. Our science could not explain why she was still alive. We asked if she had any unfinished business, was there anyone that she had not seen yet? The family gave us a puzzled look, she had seen everyone that she needed to see. Or so they thought. As clinicians we all wondered, what she was waiting for?
We found our answer a few days later. As I was heading upstairs for lunch, three men walked into the hospice. One of them walked ahead, followed by two others. The two men wore green uniforms and looked as if they could handle themselves. The man in front was a short, Asian man in his forties. His hands were cuffed together. He was led to his mother’s room and spent some time saying goodbye to her. He cried as he had not seen her for two years he had served in prison.
She may have been comatose and thought to be insensate, but she knew her son had come to say goodbye.
Featuring not one but two Palliverse tweeps, @csinclair28 and @sonialf, this seminar at Peter MacCallum Cancer Centre in central Melbourne, Australia will be of interest to the healthcare sector including aged care and acute care.
Well-coordinated and appropriate person-centred care is a key priority. It’s becoming increasingly important for the healthcare sector to better understand advance care planning, which supports an individual’s values, goals and preferences.
Presented by Advance Care Planning Australia, the Department of Health and Human Services, the Office of the Public Advocate and Peter MacCallum Cancer Centre, this Melbourne-based Victorian seminar will be run by recognised leaders in the field of advance care planning in Australia. To find out more about the program, see the agenda here.
The topics covered include advance care planning across sectors, legal considerations and local initiatives. The event is recommended for professionals leading and implementing advance care planning in health services, residential aged care and primary care.
Venue: Peter MacCallum Cancer Centre – Lecture Theatre B, 305 Grattan Street, Melbourne VIC 3000.
Date: Friday, 9 August 2019, 9:00am – 4:30pm. Registration and refreshments start at 8:00am.
Would you like to learn more about immunotherapy use and trials in cancer and in palliative care?
Immunotherapy Symptoms Clinical Trials: a new paradigm forum
Palliative, supportive and cancer care professionals are invited to attend the VCCC and CST co-hosted Immunotherapy Symptoms Clinical Trials: a new paradigm forum to progress clinical trials concepts in this evolving oncology field, recognise achievements, celebrate success and make connections for future directions.
Palliative care progress and achievements
The VCCC Building Trial Group Capability Program initial investment is focused on developing the palliative care group as a key priority area. The group’s development and activities have been underway for more than 12 months; it is timely to celebrate progress and achievements.
The Australian and New Zealand Society of Palliative Medicine 2018 Conference #ANZSPM18 is off the a great start, with many excellent plenaries & proffered papers presented on day 1 – following an excellent Trainee Day & pre-Conference workshop on thought leadership.
Day 2 promises to be even more awesome, starting off with keynote speaker Tom Le Blanc sharing his insights on collaboration & integration between palliative care & haematology. The rest of the day will feature a variety of plenaries & concurrent sessions on the new frontiers of palliative medicine – the theme of the conference. I’m also looking forward to the conference dinner tonight!
You can find the sides for my presentation on Palliative Care in Heart & Lung Transplantation here: HLTX PC ANZSPM18 Chi Li
Beautiful spaces inside the Victorian Comprehensive Cancer Centre, the new home of the Peter MacCallum Cancer Centre in Melbourne, Australia
[The following article by Dr Sarah Dunlop, advanced trainee in palliative medicine, was first published in the Australian & New Zealand Society of Palliative Medicine (ANZSPM) Newsletter. The next ANZSPM study day will be held on September 6th in Sydney prior the the upcoming ANZSPM 2018 Conference. Follow #ANZSPM18 for updates from this biennial meeting – Chi]
While there are many benefits of living in Western Australia (the weather, the beaches, and charming, debonair palliative medicine trainees), there are also downsides to living in one of the most isolated cities in the world… specifically the isolation! The decision to travel interstate to a course or conference usually hinges on three questions: can I get the time off, can I afford it, and is it going to improve my practice? So after charming my colleagues into giving a debonair trainee a day off and boarding the red-eye to Melbourne, I can confirm that the Study Day for Trainees and New Fellows met all my requirements. Continue reading →
Researchers from the Cognitive Decline Partnership Centre are releasing a Policy Development Guideline on Supported Decision-Making for aged care providers in Australia. Supported Decision-Making is a rights-based approach aimed at enabling people living with disability to make and/or communicate decisions about their own lives. Supported Decision-Making is promoted within the Convention on the Rights of Persons with Disabilities and the Australian Law Reform Commission’s National Decision-Making Principles. This area is also topical for aged care providers, given current reviews of guardianship legislation in a number of Australian states.
This free seminar will give an overview of the broader research project, and explain the process of guideline development, with tips for implementation in aged care settings.
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.”
Despite being a Melburnian, I must admit that Sydney really is an irresistibly beautiful city when the sun comes out, especially by the water. The 44th Clinical Oncology Society of Australia (COSA) Annual Scientific Meeting was held in the newly renovated International Convention Centre in Sydney between 12-15th November 2017. With the sunlight streaming in through its many windows, reflecting off the waters of Darling Harbour, it really was the perfect place to be at the beginning of summer.
I attended the pre-conference workshop on cancer supportive care, which was organised by Judith Lacey, a palliative medicine specialist at Chris O’Brien LIfehouse. The whole-day workshop featured an interesting mixture of passionate speakers promoting a range of complementary treatments including medicinal cannabis, massage and probiotics; alongside others examining the evidence base for acupuncture, reviewing current clinical trials and prescribing pathways, and comparing different funding models for supportive care. It was a long but worthwhile day that set the mood for the rest of the conference. Continue reading →