Drugs for #delirium don’t work, and may in fact harm

Meera Agar, University of Technology Sydney

Delirium robs dying people of their autonomy, dignity and last conversations with loved ones, at a time when every moment is precious.

Symptoms are highly distressing to experience and watch. Confusion, incoherent communication, poor attention, agitation, drowsiness and hallucinations are some markers of this common complication for people dying in hospital from cancer and other advanced illnesses. On average one in three people in end-of-life hospital care are affected.

Doctors commonly prescribe antipsychotic medications to try to relieve these symptoms. However, our study just published in JAMA Internal Medicine, raises serious concerns about their safety and efficacy.

So, what are we to do for people experiencing delirium, who are robbed of their mental awareness and ability to communicate?

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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

End of life caring a women’s workforce

Ed:  As you may know this month our #pallanz tweetchat in partnership with PCA is focused on Caring for the Carers.  In this article Tessa Morgan, Merryn Gott, and Lisa Williams explore the experience and care needs of women who are palliative carers.  This piece is part of an ongoing series of blog articles entitled “Gender in palliative care” .

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It doesn’t take an expert to conclude that the palliative care workforce is dominated by women. Globally, women make up the vast majority of the paid palliative care workforce. Ninety percent of the nurses and health care assistants involved with end of life care are women and there are a higher proportion of women in Palliative Medicine than in most other specialities. Over half of Palliative Medicine physicians in Australia, for example, are women. This is in addition to the vast (and ever-increasing) number of women who provide unpaid care for their dying relatives. It is hardly a stretch, then, to regard palliative care as essentially a woman’s domain. Indeed, with the rise in population of the oldest-old, the need for more people – presumably women – to provide palliative care in hospice, aged care and community settings will continue to grow.

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guest interview – Soula Ganiatsas, Palliative Care Research Network Victoria

Tell us about your job.

I am the program manager for the Palliative Care Research Network Victoria (PCRNV).

What does PCRNV do?

We try to gain funding to conduct clinical and community intervention research. The PCRNV also  provides an opportunity to network and collaborate with other palliative care researchers through PCRNV forums and workshops.

We also help with access to a variety of PCRNV funding schemes including; PhD scholarship, small project and travel grants. There can be support with developing your research idea into a potential project and grant proposals via the PCRNV Concept Development Workshops and also mentoring.

But, it’s not right to do research on people who are dying, is it? 

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Family doctor involvement in palliative care: what’s its prognosis?

I feel like such a fraud. What am I doing writing a guest post for Palliverse, when I am a doctor who rarely provides palliative care? My justification for writing here is that it’s this very sense of uncertainty and underqualification that I’m feeling which is the subject of my post.

I’m a “general practitioner” — a “GP” as we’re called here in Australia. If you’re reading this post from North America, think “family physician” — it means much the same thing — but for convenience I’ll use the term “GP” today.

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3rd Australian Palliative Care Research Colloquium

Prof Patsy Yates sharing her reflections on setting up a NHMRC Centre of Research Excellence in end-of-life care at the PCRNV Breakfast Forum

Prof Patsy Yates sharing her reflections on setting up a NHMRC Centre of Research Excellence in End of Life Care at the PCRNV Breakfast Forum

For the third year in a row, the Australian Palliative Care Research Colloquium was held at the Rendezvous Grand Hotel in Melbourne on October 22-23. The meeting was once again preceded by a breakfast forum hosted by Palliative Care Research Network Victoria (PCRNV), which served as a tempting entrée to the two-day main course of fantastic presentations and workshops exploring a diverse range of topics pertaining to palliative care research. Conversations about research continued over tea and meal breaks, next to quality poster presentations, and during the convivial conference dinner on the banks of the Yarra.  Continue reading

Palliverse people’s database

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(Image: University of Michigan Library Card Catalog by dfulmer / CC BY)

We have updated the Palliverse researchers database and temporarily renamed it “Palliverse people’s database“.

Why, I hear you ask?  Continue reading

Elsewhere in the Palliverse – Weekend Reads

photo by David Mao itsdavo

Welcome to the 23rd edition of Elsewhere in the Palliverse. I hope you find value in this week’s links about palliative care and research – complete with animal story.

You’re welcome, animal-lovers.

As always, please share your thoughts in the comments.


Brand new blog DocGrief is “a dedicated space for health professionals to reflect and explore our relationship with death and grief, particularly when personally affected by a death in the family.” It was started by a rural GP based in South Australia. Her first post is heartfelt and I am following with interest. Continue reading

MyPal Podcasts

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Do you like technology? Innovation? Palliative care? Research? Why, these things are what @palliverse is all about – and why you/we are here in the first place!

Guess what? These things are exactly what the #MyPal podcasts from @amaranwosu are all about as well. How about that!

Check it out here and also on iTunes. Be amazed. Happy listening!

Elsewhere in the Palliverse – Weekend Reads

photo by David Mao itsdavo

I hope you enjoy this week’s reads, which include topics like wills, funerals, dementia, research ethics and the experience of a hospice nurse who becomes carer for her mother. I hope there’s no typos – I’m rushing off to a communication skills workshop but wanted to post this before I leave.

As always, please leave your thoughts in the comments box below.

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