A key theme of ANZSPM 2016 is providing palliative care for the older person. There is perhaps no greater change to the palliative care landscape than that of our ageing population, and the challenges that this will pose how we approach and define palliative care. This short series of posts will explore some of the key issues in this area of practice.
Cannabis is a plant which produces a large number of potentially useful chemical compounds. Patients have figured this out and are far ahead of the medical establishment in their understanding of how to use the plant. Palliative care and other health providers have to rapidly catch up with the necessary research, and in the meantime work with patients as partners as we learn.
#ANZSPM16 will feature two presenters on medical cannabis including International Keynote Dr Pippa Hawley from British Colombia Cancer Agency’s Pain & Symptom Management/Palliative Care Program and Dr Maureen Mitchell.
Here are the first ten tips that came to mind for the management of delirium in specialist palliative care.* Of course, there are many more to list. Please share your top tips in the comments. Continue reading →
Delirium is a common, distressing complication of life-limiting illness, yet poorly understood, often misdiagnosed and poorly managed. The Australian Commission on Safety and Quality in Health Care (ACSQHC) recently launched its Delirium Clinical Care Standard. I was fortunate to attend the official launch event on 15th July 2016 – the stand-out of which was the powerful story of Michael, as told by his wife Joan Jackman, who was Community Representative on the Delirium Clinical Care Standard Working Group.
She has kindly allowed me to reproduce her speech here and I hope it will spark discussion about delirium, what we can learn from Michael and Joan’s experience, and how we can do better.
Michael loved the Australian bush. Photo: Wayne Robinson
‘Every medical condition is about a person with an individual history, friends and family, and a personal story. The person in the centre of this story is my husband Michael – a healthy, fit, intelligent man – who had been a fitness trainer in the British Air Force before becoming a British-trained Remedial Gymnast in Rehabilitation, for people with a disability. He was an elite sportsman, with a love of life, and also for his family.
Around the age of fifty-nine or sixty, Michael began to experience changes, utmost being that he became increasingly disengaged –with us, and with life! Something was wrong! We sought help. After three misdiagnoses and six years, Michael was finally diagnosed with a Younger Onset Dementia. He was by then, 66 years old. Continue reading →
In palliative care, delirium is everyone’s business. Anyone can get delirium if they are seriously ill. It is a distressing symptom – for the person with delirium, their loved ones and the professionals who care for them. Although it is common, potentially preventable and may be reversible, it is often missed, misdiagnosed and mismanaged despite our best intentions.
This 5-minute video is an excellent resource for the public and health professionals alike, (and seems to cover everything that it takes me 45 minutes to teach to nurses or doctors!). I discovered it via its co-creator, Delirium Champion Dr MS Krishnan.
This week, I am taking over Palliverse to share posts about delirium in palliative care – from conferences to clinical standards to a heart-wrenching personal story. Continue reading →
Demoralisation has been described as a form of psychological distress that is associated with hopelessness, helplessness, and a loss of meaning and purpose. It has been explored across a number of settings, but is thought to be particularly important in palliative care settings, where it may affect up to 20% of patients who face end-stage disease.
Such a pattern of distress goes to the core of our identity, and presents challenges to well-being and the often-cited idea of ‘living well until we die’. It also has important implications for decision-making and consent in relation to medical treatments.
Practitioners in palliative care understand the far-reaching impact of demoralisation, and Professor David Kissane, along with colleagues at Monash University have been advancing our understanding of this concept Continue reading →
Getting excited about heading to the Australian New Zealand Society for Palliative Medicine conference in September in Perth. With Melbourne’s frigid weather, the thought of a flight to sunny warm Perth in Spring has to be attractive. But more than that, the topic of how palliative care is changing in the 21st century is fascinating.