I think therefore I am ? – A special Totara Hospice South Auckland event this Friday.

07/12/17 – Update – Attendees please note that tomorrow morning in Auckland there will be a Railway Workers Strike meaning that road traffic will likely be much heavier than usual. We have asked attendees to arrive at 8.45am for a 9am start, please factor in the strike traffic delay when planning your travel for tomorrow morning. If you arrive early you can visit our on-site Cafe Totara for a fresh Barista-made coffee, with a range of fresh food available as well, all prepared on-site. An email update will be sent to attendees who have already registered.

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Hi everyone,

Can healing occur at the end of life?

To whom does compassion need to extend to at the end of life?

These are the type of questions that will be explored in Totara Hospice South Auckland’s education centre this Friday morning, 08 December 2017 9am to 12pm.

We are privileged to be hosting two international speakers.

Dr Rob Rutledge will be joined by a special guest.

We will be honoured to also have in attendance, Tibetan Buddhist Monk, Za Choeje Rinpoche.

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Please join us for a very special interactive workshop in which we will attempt to challenge your thinking and change the stasis quo.

RSVP details are contained in the below pdf.

Morning tea refreshments will be provided.

Please pass on this invitation to anyone in your networks who might be interested in attending.

Cheers,

James

Invitation Compassion and Healing Seminar.pdf

An open letter to Victorians on #PalliativeCare #VAD #euthanasia

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PC clinician open letter Final

“Hippocratic: 18 Experiments in Gently Shaking the World” – see the film & meet Dr Rajagopal, palliative care legend

Have you heard about the new film, “Hippocratic“, about Nobel Peace Prize nominee and global palliative care hero Dr MR Rajagopal?

 

From the film-makers:

Hippocratic is a feature-length film exploring the life story of this acclaimed Indian physician, Dr MR Rajagopal.  From cowardly child to fearless visionary, this compelling tale sees its hero come full-circle to rediscover the first principals of medicine.

This exquisite first-person account tells the story of an extraordinary global health leader in Dr MR Rajagopal, or Dr Raj, who is described by the New York Times as ‘the father of palliative care in India’.

Dr Raj is a small man with a big dream: a pain-free India.

His mission is to bring ethical practice to modern medicine through whole person care.  To achieve this he must provide universal access to essential, and heavily restricted, pain medicines.

Hence, this spiritual leader of ethical medicine now shares the story of his life’s work.  Reflecting on effecting change and relieving unnecessary human suffering in a country of 1.25 billion people, almost one sixth of the world’s population. Continue reading

#CrazySocks4Docs on June 1st

 

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Crazy Socks for Docs – by Dr Eric Levi @DrEricLevi

June 1st. #CrazySocks4Docs. But not just for Docs only. This day is for nurses, dentists, pharmacists, social workers, physiotherapists, psychologists, dietitians, speech pathologists, audiologists, respiratory therapists, anaesthesia techs, paramedics, medical students, veterinarians and all other specialties that work in the health care industry for patients. Continue reading

Advance care directives, palliative care, and euthanasia

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[Image by Nick Youngson]

Why do palliative care people bang on about advance care planning all the time?

Well, when you break it all down, advance care planning is all about respect. Respecting the values, goals and preferences of the person making the plan. And palliative care is really big on respecting people’s preferences and values, especially when it comes to their end-of-life care.

Unfortunately, when it comes to respecting people’s choices around their health care, the law has been lagging behind. Existing laws around advance care plans and medical decision making are often confusing for patients and families, as well as their treating clinicians. Fortunately, this is all about to change in Victoria.  Continue reading

Raise awareness for World #Delirium Day 15 March 2017

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Delirium is a favourite topic of ours at Palliverse – it is experienced by many people with palliative care needs, including at the end of life, and is often distressing to the person, their loved ones and health professionals providing care. Despite this, it remains poorly recognised, underdiagnosed and poorly treated – not least because the evidence base is still growing.

iDelirium, a federation of the Australasian Delirium Association, European Delirium Association and American Delirium Association, has launched World Delirium Day (#WDD2017) in an attempt to raise awareness of delirium and improve its management.

They have suggested some Actions to Take on #WDD2017. I’ve listed them below & with some thoughts on how to take action.

  • Commit to using the term ‘delirium’

If you hear someone using terms like “agitated”, “restless”, “aggressive” or “pleasantly confused”, think – could this be delirium? I use the term delirium, document it and make sure it’s communicated in the medical record and letters. Recognising and diagnosing delirium allows us to educate patients and their loved ones, as well as providing the best delirium care possible.

  • Screen your patients for delirium

People at risk of delirium, who should be screened, include those with serious illness, those aged over 65 years and those with underlying cognitive impairment. This includes many of the people cared for by palliative care services! The diagnosis of delirium may be missed, delayed or misdiagnosed without screening, as signs may be subtle (especially in hypoactive delirium).  There are multiple simple bedside screening tests for delirium, and although not all these have been validated in the specialist palliative care setting, they are still useful. The 4AT is a freely available screening tool that can be administered by any health professional and does not require training.

  • Listen to patient and family stories about the experience of delirium

What may seem “pleasantly confused” to staff members can be very distressing for the delirious person and their families. Being agitated, aggressive or “just not themselves” can be distressing for patients and families to witness – it is important to acknowledge these emotions and provide education about delirium. (See “Michael’s Story: the fear on his face was palpable” for a wife’s experience of her husband’s undiagnosed delirium.)

  • Engage your leadership in a discussion of delirium

If the above isn’t enough to convince your leadership to take note, delirium also increases the risk of health care complications like falls, pressure injuries, prolonged length of stay, and mortality. For those in Australia, World Delirium Day is a great time to introduce your leadership to the recently released Delirium Clinical Care Standard (which we’ve covered here before).

  • Educate health professionals about delirium

Delirium does not “belong” to just one group of health professionals or one specialty. It’s common, especially in palliative care, and important for us all to know about it.  Some of my favourite educational resources are freely available at the Scottish Delirium Association, plus this 5-minute video from UK-based  Delirium Champion Dr MS Krishnan. (I’ve shared this before but it’s worth sharing again!)

As a final bid to raise awareness, you can participate in a #WDD2017 Thunderclap via your Facebook, Twitter or Tumblr account, to alert your friends and followers to the importance of delirium.

Journal club on delirium #hpmjc

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Delirium is a syndrome associated with a sudden change in a person’s mental function that interferes with their thinking and awareness. It is a common problem that confronts many patients, families and clinicians in the palliative care setting. Delirium usually develops as a result of a serious medical condition, which can often be found and treated. However, the symptoms of delirium – such as fluctuating confusion, reduced attention, disturbed sleep-wake cycle, and/or hallucinations – can be very distressing for everyone involved, and may persist for many days to weeks.

Medications – including antipsychotics such as haloperidol and risperidone – are often used to manage the symptoms of delirium. But do they actually work?

To answer this question, Professor Meera Agar (@meera_agar) and colleagues from the Palliative Care Clinical Studies Collaborative (PaCCSC) conducted a study examining the use of these medications. The results of their research was published in JAMA Internal Medicine recently, and also discussed on various media platforms (examples here, here and here).

Please join Hospice and Palliative Medicine Journal Club (#hpmjc) in January 2017 for an in-depth discussion about this important study. The journal club will be hosted by Chi Li (@Dr_Chi_Li) from Palliverse and feature the paper’s first author, Meera Agar (@meera_agar)!

When? The hour-long online journal club will start at (please note the different dates):

  • Auckland: 9am, Tuesday 24th January
  • Sydney: 7am, Tuesday 24th January
  • London: 8pm, Monday 23rd January
  • New York / Toronto: 3pm, Monday 23rd January
  • Other cities

Who? Anyone and everyone who has:

  • Experienced delirium themselves
  • Cared for or lived with someone with delirium
  • An interest in improving the treatment of delirium
  • An interest in enhancing palliative care

How? It’s easy!

What? We will be discussing the following topics during the journal club

  • Topic 1: Why was the study conducted? Are the study questions / aims relevant to you and/or your work?
  • Topic 2: How was the study conducted? What did you like about the study methodology? Would you have done anything differently?
  • Topic 3: What were the main findings from the study? Were you surprised by any of the study results?
  • Topic 4: Has this study changed the way you think about delirium in the palliative care setting? Why and why not? What’s next?

If you would like more information, or are having trouble accessing the paper, please feel free to contact us via Twitter (@Dr_Chi_Li or @palliverse) or by email (chi.li.australia@gmail.com or palliverse@gmail.com).

We hope you can join us for a great discussion about this important study!

 

Ramblings from the past, as I think about 2017…

Excellent writing from Kate Swaffer, with links to some of her previous posts. Her blog is essential reading for anyone who works with people living with dementia.

World Dementia Council members 2016 World Dementia Council members 2016

It is already mid January 2017, and I’ve not yet posted a blog, so am hoping to rectify the today! I started this ages ago, but have had trouble paddling since December so have not achieved very much at all. Anyway, it may be worth looking back and reflecting as we prepare for yet another year. The years certainly fly by so quickly as one gets older, which I wrote about many years ago, but cannot find that particular blog.

As I have a lot of new followers of this blog, I thought I’d highlight a few from over the years (easier than writing a new one, by the way!). The grief of dementia is one of the most unspoken of topics, not our grief families feel as we change and lose function, then die, but the grief we feel as we lose capacity and as our abilities change to disabilities, and we are…

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“Failure to maintain”: do hospitals cause suffering in older people?

Today Palliverse talks to Assistant Professor Kasia Bail (@Kasia_Bail) from the University of Canberra. Kasia is a nurse, a researcher, a kung fu instructor and a drummer in a metal band. She came to our attention via social media when we noticed her crowdfunding campaign for the next stage of her research into nursing care of complex, hospitalised older people. Here at Palliverse we are fans of crowdfunding, although we’re yet to use it for research purposes!

Kasia’s research aims to improve sustainable acute care health delivery for an ageing population, while her clinical experience includes general medical and acute palliative care. In her PhD, Kasia developed an approach to measure nurse-sensitive outcomes, which is currently being used to evaluate a Government-funded implementation of a cognitive identifier. Kasia has a passion for identifying and researching the structures and processes which impede or enable quality patient care, and sharing her learning and inquiry with nursing students, industry and professional groups. Here, Palliverse asks her about her latest research project and dipping her toe into the world of social media.

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Dr Kasia Bail (image via Dr Bail)

Your research has led to a new concept in the care of older people with complex medical problems, “Failure to Maintain”. What does this mean? Continue reading

#4APCRC: 4th Australian Palliative Care Research Colloquium

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Members of team Palliverse had the pleasure of attending the 4th Australian Palliative Care Research Colloquium between October 27-28th, which was once again held in the comfortable surroundings of the Rendezvous Hotel in Melbourne, Victoria.  Continue reading