#ANZSPM16 tweet chat: Medicinal cannabis and palliative care


In recent years scientific research into the effects of cannabinoids has been on the increase. Some would say that not-so-scientific research on the effects of cannabis has been underway for many hundreds of years, in many different countries and cultures.

Until recently I didn’t know that our own bodies produce endogenous cannabinoids, the various effects of which are still being studied. 

Two years ago, colleagues had informed me that at the Montreal Conference 2015 it was a ‘smokingly hot’ topic. The most widely studied cannabis-derived cannabinoids are Cannabidiol (CBD) and Tetrahydrocannabinol (THC.) You may have heard of some of the medications that have ‘come to market’ since then:  Continue reading

#ANZSPM16 Cost of caring tweet chat

I thought our most recent tweet chat on the cost of caring featuring Dr Merryn Gott was one of our best!

Thanks to James for moderating.

If you were unlucky enough to miss it, I have written a Storify which would provide a quick summary.


Have a lovely weekend, Sonia

#ANZSPM16 tweet chat: the (hidden) cost of caring


A game changer at the recent Australian and New Zealand Society of Palliative medicine 2016 Conference (#ANZSPM16) was Dr Merryn Gott’s plenary presentation on the hidden costs of caring. Little is known about the financial impact of caring for people at the end of life.

She detailed some powerful anecdotes, including the story of two sisters whose mother lay dying in a hospital. The cost of parking was prohibitive and the daughters took it in turns to sit in the car watching out for the parking inspector. When their mother died, only one of the daughters was there; the other was in the car. Continue reading

Art therapy for the palliative care clinician


I had wanted to learn to paint for many years, and finally found the time to take some classes during my research fellowship year. It was really good fun and I loved it. Unfortunately, my fellowship year soon finished and clinical commitments meant I could no longer attend the classes.


Nevertheless, I decided that I would keep painting, once a week (usually on a Wednesday), just for me. At the end of a busy day, it’s often easier to just slump on the couch and watch some TV. I’ll be honest, sometimes the couch wins. However, I do manage to drag myself out of the house again most Wednesdays, get myself down to the studio for a couple of ours of what I fancifully call my ‘art therapy’ before bed. And when I do, I never regret it.


As you can see, I’m just a beginner and still have a lot to learn about painting. But I love losing myself in the work, just thinking about form and colour – anything other than patients and families and suffering and medicine, or audits or guidelines or research or presentations. I also love heading out and painting outdoors when I can get away.


If you also like painting, or any other form of art – please join us for #PallANZ tweet chat on the 29th, which will be on the topic of “palliative care and the arts”! You can find the details here.

#ANZSPM16 Wrap up

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Days two and three of the Australian and New Zealand Society of Palliative Medicine (ANZSPM) 2016 Conference: The Changing Landscape of Palliative Care was just as brilliant as the first. The plenary sessions featured:

  • Merryn Gott (@MerrynGott) spoke about the ‘last taboo’ in our community: the invisible and sometimes unexpected costs of providing care at the end of life, which are often not explored in clinical and almost never measured in policymaking and research. She also discussed  the impact of culture, ethnicity and gender on who is bearing these financial and non-financial costs. To find our more, read her open access @PalliativeMedJ article here.
  • Meera Agar (@meera_agar) discussed the growing evidence base around delirium care in the palliative care setting. Management of this complex, distressing, life-threatening, but often reversible syndrome is challenging. Non-pharmacological strategies and a system-wide approach to organizing and delivering care are crucial, as research into various drug treatments continue to demonstrate a lack of clear benefit and the potential for harm. Meera recommends iDelirium for more information about this important area of palliative care.
  • Pippa Hawley reflected on the lack of evidence around the use of medicinal cannabis – despite the immense interest from (and considerable experience of) our communities. How should clinicians respond while the scientific and legal issues are sorted out? Ask questions, keep an open mind & work with our patients!
  • Douglas McGregor explored the interface between heart failure and palliative care. He referenced Sarah Goodlin’s open access article, Merryn Gott’s study while discussing prognostic uncertainty and clinician paralysis; and observed that most guidelines still see palliative care as relevant only at the very end of life, rather than a key component of chronic disease management. Amy Gadaud’s (@agadoudreview was flagged as a good place to start when considering issues around early integration.
  • Sam Bloore stimulated and inspired delegates with his fascinating talk about dying well in a culture of bitcoin and botox. How can palliative care adapt, survive and thrive in this changing cultural landscape characterized by information overload, mindless distraction and incoherence? We must remain a “subversive” counterculture and continue to strive towards caring deeply and meaningfully!

In addition to these amazing plenaries, fully (and at times even over-)subscribed workshops on the overlap between palliative care and addiction medicine / chronic pain, aged care, literature and the arts were held, alongside numerous excellent oral and poster presentations from specialists and trainees. The enthusiastic and well-informed audience present during all of the sessions was another highlight for me (and I’m sure all of the other speakers and delegates)!

It’s been a wonderful few days in Perth. A big thank you to the Conference organizing committee, chaired by Derek Eng (@dr_engd), for inviting team @Palliverse to be part of this great event. Thanks also to all of you for engaging with #ANZSPM16 on social media. Keep an eye out for our upcoming tweet chats, during which we will continue the conversation about the changing landscape of palliative care!


Highlights from day 1 #ANZSPM16

We had a terrific day one at the #ANZSPM16 conference in Perth. The conference, mainly catering to palliative doctors in Australia and New Zealand, takes place in the luxurious Duxton hotel close to the Swan River in Perth.

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Highlights from #ANZSPM16 pre-conference workshops

The Australian and New Zealand Society of Palliative Medicine (ANZSPM) 2016 Conference opens today. A number of excellent pre-conference workshops were held yesterday, including:

  • A comprehensive trainee day, including a great workshop from Katrina Anderson on self-care and reflection about love, strength, vulnerability and respect; the use of methadone (Pippa Hawley); the challenges of providing palliative care in residential aged care facilities (Douglas McGregor), patients and families with vulnerable personalities (David Kissane), and the neuroanatomy of distress (Lisa Miller)
  • A great presentation on the role of media in palliative care, followed by a hands-on workshop in the afternoon, under the encouraging guidance of Marie Mills; and
  • Supervisor workshop, lead by Michelle Gold and Brian Le

Team Palliverse will be broadcasting from the #ANZSPM16 Conference for the next three days. If you are at the conference, please come and say g’day – and recharge your devices – at the social media hub!

Room for reflection #ANZSPM16

Reflection room

Nothing will sustain you more potently than the power to recognise in your humdrum routine, as perhaps it may be thought, the true poetry of life – the poetry of the commonplace, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their griefs.

– Sir William Osler

In order to enrich the conference theme of honouring the art of palliative medicine, the conference organisers at the upcoming Australian and New Zealand Society of Palliative Medicine (ANSZPM) 2016 Conference in Perth, Western Australia have created a specific room for self reflection.

The Reflection Room will provide a nurturing space for conference participants to consider the human connection that we all experience as palliative care clinicians, and the impact this has on our own personal growth. The room will contain powerful art pieces that depict resilience in the face of dying, which aim to help delegates reflect on their experiences over the course of the conference, undertake guided mindfulness, or most importantly, just be.

Have you been to another conference recently where self-reflection, mindfulness and art featured strongly in the program? Was there space set aside for delegates to practice these activities amidst all the hustle and bustle of the conference program? Was it useful for you?


#ANZSPM16 – How does literature enrich our understanding of illness and dying?

ANZSPM Conf Banner

If, like me, you appreciate the arts and enjoy becoming engrossed in the literature (not indexed on PubMed)—then this workshop is for you!

On the morning of Sunday, 11th September #ANZSPM16 delegates will be treated to the workshop:

From Tolstoy to Garner: How literature enriches our understanding of illness & dying.

The workshop will be facilitated by: Gabrielle Brand, Felicity Hawkins, Carol Douglas, Mary McNulty, Valerie Henry, and Anna Petterson.

For more background on the use of arts and literature in palliative care, continue reading!

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#ANZSPM16 – Frailty, the older person and palliative care

At ANZSPM16 one topic up for discussion will be the palliative care and frailty in older people.  If you are interested in knowing a bit more about this then read on.


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