Palace of Care – Upgrade to a Combo Deal

Photo by Masaaki Komori on Unsplash

Almost a year ago I visited a local Rongoā Clinic as I was interested in learning more about traditional Māori medicine which is comprised of diverse practices with an emphasis on the spiritual dimension of health. Rongoā includes herbal remedies, physical therapies such as massage and manipulation, and spiritual healing.

During my visit, I met a Rongoā clinic patient who had recently become one of my hospice patients. She was well at the time but over the course of the past 11 months her condition worsened. Pain developed and initially had been controlled by the herbal remedies applied. In recent months the pain had become intolerable and she had become bed-bound. Too sore to leave her bed let alone leave the house. Everyone involved in her care were worried and wanted to ease her suffering. She initially refused to take the strong pain relief agents that we had suggested, and preferred to continue with only her Rongoā treatments.

I asked for a joint assessment to be arranged with myself and the Rongoā practitioner both seeing the patient at the same time. I went to the clinic this morning and was joined by the nurse assigned to our shared patient. We were ready to show our patient that we were happy to work together in a fusion of traditional Māori medicine and modern Palliative Medicine. We were hoping that together we could convince our patient to have both traditional treatments and strong pain relief agents. We wanted her to have the best of both worlds of care.

That was the plan, but someone had already beaten us to it. The patient had recently been seen by her new general practitioner and he had already convinced her to take pain relief along with her traditional treatments. The combination worked and at the clinic this morning a smiling patient greeted us. Her beaming smile told us exactly how she felt. Her husband was happy that his wife had improved with the combination of treatments. She felt better and was now able to check up on his housework, to make sure that he was meeting her high standards. She was back, after having felt trapped in a dark place. Both of our organisations made plans to follow her up in the near future, and we pledged to each other that we would like to work together more in the future. In the meantime, the formerly bed-bound patient was being taken into town to have lunch with her husband.

#PALLANZ tweet chat: Palliative Care Yarning

PallANZ 201603 altPalliverse acknowledges the traditional custodians of the lands on which we live, and we pay respect to Elders past and present. We also acknowledge the important contribution of Aboriginal and Torres Strait Islander people to Australian society.

The delivery of high-quality, culturally sensitive and respectful palliative care services to Indigenous communities is critically important. In the Australian context, a recent press release from NACCHO highlights some of the key issues, including the need to partner with Indigenous communities to develop and implement culturally appropriate services.

In the spirit of respectful, inclusive communication and ongoing learning, we invite you to join us for an online “Palliative Care Yarning” tweet-chat on 31st March 2016. This tweet-chat will be an opportunity to discuss some key issues in palliative care for Indigenous and First Nation peoples, including Aboriginal and Torres Strait Islander people in Australia.

When? Thursday, 31st March 2016

  • 4:00pm AWST Perth
  • 5:30pm ACST Darwin
  • 6:00pm AEST Brisbane
  • 6:30pm ACDT Adelaide
  • 7:00pm AEDT Canberra, Sydney, Melbourne, Hobart
  • 9:00pm Wellington, Auckland, Christchruch

What? Topics for discussion:

  • T1 What does high quality Indigenous palliative care mean to you?
  • T2 How can we improve equity in palliative care delivery to Indigenous communities across remote, regional and urban settings?
  • T3 How can existing services collaborate with Indigenous communities in palliative care? (eg training, advocacy, service delivery)
  • T4 How will the services of the future deliver high quality Indigenous palliative care?

As always, we ask that you include the topic tag (e.g. T1) in your response to each topic, and include the #PALLANZ hashtag in your response. As the #PALLANZ community is international, we respectfully encourage use of the term ‘Indigenous people’ where referring to Indigenous and First Nations people and communities from across the world during the tweet-chat. The @Palliverse moderator for this tweet-chat (@csinclair28) will be responsive to any specific requests or feedback from participants regarding appropriate and respectful language.

You don’t have to be an expert, a Twitter whiz, or even live in Australia or New Zealand to join – in fact, we strongly encourage those new to Twitter and from beyond our shores to join us and share your views!

For those new to Twitter check out our tutorial here.

Looking forward to talking soon.

Elsewhere in the Palliverse – Halloween edition

photo by David Mao itsdavoToday (in some parts of the world) it’s Halloween or, as Caitlin Doughty (@TheGoodDeath) calls it, “Culturally Sanctioned Morbidity Appreciation Day.” Please enjoy these links, which have nothing to do with Halloween but may have something to do with palliative care.

Is death taboo? The Groundswell Project conducted a quick survey. The results may surprise you. (The Groundswell Project)

Health researcher on a mission to get Indigenous men talking about prostate cancer and sexual health (ABC News)

“It’s about starting a conversation…[Doctors need to] throw in a phrase like how you going, how’s the old boy, is he getting up, is he getting the job done?”

“…I find men want to talk about it, but someone has to start the conversation with them.”

The silver tsunami is actually silver-brown. How does end-of-life care differ for minorities? asks geriatrician and palliative care doctor VJ Periyakoil (@palliator) in the Washington Post.

Pulitzer prize-winner Tina Rosenberg visits La Crosse, Wisconsin, home of the Respecting Choices program, where 96% of adults reportedly participate in advance care planning discussions. (Talking Early About How Life Should End, New York Times).

And now, a video about advance care planning!

Going to work, writing letters for the future and speaking your mind: Day-to-day living when you know you’re dying (Independent, UK)

In Australia: Federal Government to legalise growing of medicinal cannabis; Labor calls for nationwide scheme (ABC News). Apparently, we’re all for it: Legalised medical marijuana opposed by only 7% of Australians, poll shows (Guardian Australia)

Here’s a strange story to finish the list – “Parkinson’s disease: Scottish woman Joy Milne prompts study after claiming ability to smell condition.” Odd. Thanks to my colleague Dr Bornshin for the link. (ABC News)