Conversations with patients in palliative care by Dr Matthew Grant

Dr Matthew Grant, a palliative care specialist, has published this article in The Conversation describing normal conversations in the course of his daily work.

I love the way he sensitively maneuvers through difficult conversations, allowing the patient to control the content of prognostic information given.

   “Not everyone will feel comfortable talking about their future treatment plans like Keith. It’s important I allow Sharon to decide whether or not she wants to talk about a future where she dies, just as I shouldn’t necessarily dissuade Christos from smoking if it gives him pleasure.”

Continue reading

webinar – palliative care in hospitals 17th October 2PM AEST

Interested in palliative care in hospitals? I certainly am. In my work as a palliative care consultant in the consultation service in an acute hospital, I see a LOT of unmet need, late referrals, and treatment being undertaken without good conversations about the patient’s goals and needs.

We at Palliverse are very keen to promote improvements at a systems level to improve access to palliative care in the acute setting.

On 17th October, Safer Care Victoria is holding a free webinar on palliative care in hospitals. Our host is Claudia Virdun, who has worked in palliative care within a clinical, project management or education position for over 18 years. Claudia has completed an Honours degree (Nursing), Masters degree in Advancing Professional Healthcare Practice and is currently a Phd Candidate with her research focusing on supporting system-level improvements for palliative care within the hospital setting.

Pre-reading for the webinar include Ms. Virdun’s review and meta-synthesis on what is important to patients and families in end of life care in hospitals.

The webinar takes place at 2PM on 17th October AEDT. For those outside of eastern Australia, here’s a time zone converter.

deprescribing at end of life

My pen poised over the drug chart, I hesitate.

Mr Jones* is a 58-year-old patient that my consultation palliative care team is seeing while he’s in hospital with complications of chemotherapy for advanced lung cancer. I am reviewing his discharge medications before he returns home to the care of the community palliative care team.

He is a very optimistic person, not keen to discuss the possibility of his cancer not getting better. An overweight hypertensive smoker, he’s on a full hand of antihypertensives, anti cholesterol medications, vitamin D supplements, a multi-vitamin, and antiplatelet therapy.

His prognosis is likely less than a year in my mind. Does he need all these medications?

A retrospective cohort study by Todd et al examined this question in groups of people with advanced lung cancer in the United States and the UK. The patients had died and been admitted to hospital then discharged at least once in their last 6 months of life.  Continue reading

#ANZSPM18 Conference – New Frontiers

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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

Enjoy!

#ANZSPM Study Day for trainees & new fellows

VCCC

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

What matters most? #NPCW18

 

National Palliative Care Week 2018 is just around the corner. This year, we are asking Australians what matters most – to them, to their family & friends, and to their communities?  Continue reading

I think therefore I am? – The D word

It was only about 80 years ago when communities all over the world were much more familiar with Death and Dying. This was before antibiotics, modern surgical techniques and lots of medical technologies had been invented. Now Death and Dying are not so obvious and it is not uncommon for 30+ year olds to have never been to a funeral before in their life.

Even now, Death and Dying are still D words that are avoided by many clinicians as they try to ‘protect’ their patients. Who are they really trying to protect? Themselves?

Other D words could be:

Denial

Disavowal

Disillusionment

Disappointment

Despair

Defeat

These were some of the D words that came to mind while listening to this podcast:

Dr Kathryn Mannix talks about her best-selling book “With the end in mind,” and reflects on her Palliative Care career

Have a listen and let me know what you think.

James

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

 

#COSA17: #PalliativeCare reflections on the 44th Clinical Oncology Society of Australia Annual Scientific Meeting

Circular Quay

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

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