SHC-LCPC Forum – Deprescribing in Palliative Care

Feb17 SHC-LCPC

 

Abstract Submission for APHC 2017

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Dear Colleagues

The 12th Asia Pacific Hospice Conference (APHC) 2017 will be accepting abstracts for poster and/or oral presentations till 18 February 2017, 23:59 (GMT+8). You may wish to read more on the criteria and submission details here.

We look forward to seeing you at the 12th APHC in July!

APHN – Hospis Malaysia Palliative Care Workshop: Palliative Care Nursing

APHN-Hospis Malaysia Workshop

WORKSHOP OF PALLIATIVE CARE NURSING (18-19 February 2017)

It is crucial that healthcare providers involved in palliative care services possess the necessary skill and knowledge to ensure that holistic patient-centred care is never compromised. Palliative nursing care kick starts our first module of our palliative care workshops every year.

This 2-day workshop addresses topics on patient assessment, wound management, use of syringe driver, communication and the entire spectrum of patient care which is vital towards ensuring patients receive the due care they need in their place of care.

For further information, please contact Wai Mun at 03 – 9133 3936 (ext: 267) or email  education@hospismalaysia.org

‘If you grieve well, you live well’: coming to grips with the death of a parent

This article is originally from PCAeNews.

Louise Blessington received a call late one night, where her dad told her that he was dying from liver cancer. He then passed away six weeks later, after her family got back to Australia.

She found there to be little support for kids who’d lost parents as the teen cancer support group, CanTeen, she joined, had a cut-off age of 24. She then set up the ACT Young People’s Bereavement Network, with just over $1500 from the ACT Government, for people aged between 16 and 30. A formal counselling session with counsellor Mandy Cox, where she talks about the process of getting over loss, makes up the first half of the group meetings.

Mandy said that young people are often reluctant to talk about death but they can feel the loss more deeply. She also pointed out that young people lack role models in the community who talks about loss in an open, honest way. Louise reckons grief is just another part of life and learning how to cope with it makes it easier to move forward.

Read the full article here.

 

Barry Ashpole Media Watch #493

Barry Ashpole Media Watch

International News:

Deaf and dying: How a volunteer team brings palliative care comfort through communication

ONTARIO | The Ottawa Citizen – 25 December 2016 – Monica Elaine Campbell had with palliative care was to help a woman who lost her ability to speak to throat cancer. This experience got Campbell thinking about the communication needs of people who are deaf and hard of hearing like herself. Conversations on experiences on death and dying led Campbell and her friend, sign language interpreter Christine Wilson, to start up the Ottawa Deaf Palliative Care Team, a group of volunteers who provide end-of-life care care for the deaf and hard of hearing and their families. Since 2009, the team has helped inform and console the deaf and hard of hearing, breaking though their sense of isolation at the mist frightening and challenging time of their lives. https://goo.gl/W0ZDVM

All he wants is to die in his native Cuba

INDIANA | The Indianapolis Star – 27 December 2016 – Since Lazaro Blanco Garcia arrived at Key West, Florida in 1980, he has not returned to his native Cuba for these 37 years. When told the prostate cancer he had been suffering from for the past 11 years could not be treated anymore, his final wish was to go home to Cuba. His doctor, Pablo Bedano, said “from a palliative treatment standpoint, I’m sure that they will be able to provide just as good care there as they would here.” Majority of Garcia’s treatment will consist of pain control and end-of-life care and no more of futile cancer treatments that could weaken him. https://goo.gl/IBRJHX

Specialist publications:

Ensuring quality in online palliative care resources

CANCERS | Online – 13 December 2016 – Evidence and information is used by health professionals in clinical practice and in developing their professional knowledge, by policy makers in decision making, and is sought by health consumers to help them manage their health needs and assess their options. Increasingly, this evidence and information is being disseminated and sought through online channels and clinicians, patients, community members and decision makers are able to find out more about palliative care and end-of-life care. Although research driven improvements in prevention and treatment have improved mortality rates within cancer, disease progression means that many patients will still have palliative care needs. Being able to access high quality palliative care resources is an essential part of integrated cancer care. https://goo.gl/c1RC98

Rural long-term care nurses’ knowledge of palliative care

ONLINE JOURNAL OF RURAL NURSING & HEALTH CARE, 2016;16(2):141-167.  The purpose of this study was to examine rural nurses’ knowledge of palliative care for end of life patients in long term care facilities. Although the study sample scored below 50%, registered nurses were more knowledgeable than licensed practical nurses on many of the items on the Palliative Care Knowledge Test. This study supports that the total years practiced in long term care does not affect the knowledge on the Palliative Care Knowledge Test.  Nurses cannot practice what they do not know. Nurses who lack knowledge about the philosophy and principles of palliative care may lower the quality of end of life care for patients in long term care facilities. An evaluation of the knowledge level of nurses for palliative care is an important first step in instituting an educational intervention. https://goo.gl/fwFXmW

Cracking open death: Death conversations in primary care

JOURNAL OF PRIMARY HEALTH CARE | Online – 21 December 2016 – General practice in New Zealand has suffered encroachments on the traditional cradle-to-grave model of care over the last two decades, with steadily diminishing involvement in the beginnings and endings of life. Yet general practitioners (GPs), particularly GPs working in small and rural areas, remain grounded in the communities they serve, attuned to the flux of their patients’ life course. They are well placed to engage with sensitive issues such as death, based on the foundation of relationships built on trust that have developed over time.  The ease of death conversations may be facilitated by taking a family-centred approach, using community organisations and settings, and harnessing conversation entry points provided by the media. https://goo.gl/lEVDpo

Advances in Hospice and Palliative Care in Japan: A Review Paper

Supported by national policies, palliative care in Japan has developed essentially in the oncology field. This review summarizes updates from two previous reviews, and focuses on major palliative care settings, specialty, national associations, education, and research on palliative care in Japan. Palliative care in Japan has rapidly progressed in clinical, academic, educational, and administrative areas, especially since the Cancer Control Act. However, Japan has many challenges to advancing palliative care further. Clinically, Japan needs to develop a structure for palliative care in the community, and strategies to integrate palliative care not only with oncology earlier in the disease trajectory, but also with non-cancer disciplines such as cardiology, pulmonology, neurology, nephrology, internal medicine, and critical care. https://goo.gl/dkkD4p

Spiritual care at the end of life; how to reduce distress as we face dying

This article is originally from Palliative Matters.

Andrew Allsop, psychosocial and spiritual service support manager for Silver Chain and a Palliative Care Australia Board member, talks about how spiritual care differ from pastoral care and issues that tend to distress us in our dying days. Generally, spiritual distress is related to the dying person’s life story; their connections to people and places, the events and experiences that have given their life meaning and purpose.

Mr Allsop says the concept of spiritual care is often confused with religion and that providence of spiritual care requires being fully present to what the dying person is experiencing. There is increasing evidence showing spiritual care can improve general health outcomes, however, palliative care is one of the few specialties which recognises this importance.

Read the full article here.

Barry Ashpole Media Watch #492

Barry Ashpole Media Watch

Specialist Publications:

The influence of palliative care consultation on health-care resource utilization during the last two months of life: Report from an integrated palliative care program and review of the literature

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | Online – 17 December 2016 – This study was conducted to test the hypothesis that palliative care consultation (PCC) was associated with reduced health care resource utilisation for individuals approaching end of life. 102 consecutive deaths of veterans were taken into consideration, of which PCC was associated with lower number of ICU days during the last two months of life. Frequency of ED visits, acute care hospitalisations, number of ICU and hospital days were significantly less for 96 veterans with PCC, as compared to before. https://goo.gl/yoOe8M

A personal journey in Taiwan’s hospice palliative care movement

BAOJ PALLIATIVE MEDICINE | Online – Accessed 8 February 2017 – Hospice palliative care started in Taiwan in 1990, with foundations of different religious backgrounds and associations with different medical backgrounds joining in to promote. This was followed by Hospice Palliative Care Act (a Natural Death Act) enacted in 2000 and Patient Self-Determination Act passed in 2016. A Taiwan Coma Scale was also proposed for shortening of terminal suffering. At present, Taiwan has 57 hospice wards, 93 hospitals providing hospice home care, 141 hospitals providing hospice combined care and 155 hospitals providing community hospice care. https://goo.gl/YbAb6B

Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter?

JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, 2016;109(12):446-452. Empathy, sympathy and compassion are defined and conceptualised in different ways and they are used interchangeably in research reports and in everyday speech.They are also similar to other forms of pro-social behaviour such as generosity, kindness and patient-centredness. This paper argues that a broad concept of empathy, which combines affective, cognitive, behavioural and moral dimensions, is a more relevant and useful construct for clinical practice, medical research and education. https://goo.gl/E9byLi

Literature review of best health and social care practices for individuals with intellectual disabilities encountering the end of life

NURSING & PALLIATIVE CARE, 2016;1(5);118-123. This Literature Review (LR) aim to identify the best care practices for individuals with intellectual disabilities (ID) encountering end of life. Overall findings revealed that there was an absence of policies, procedures and guidelines governing these critical end-of-life care practices, including decision making processes. The LR also indicated inadequate collaborative, inter-agency and multi-professional working. It also noted an absence of theory and universal good practice guidance/framework on dying, death and intellctual disabilities and called for future research to be framed within the human rights approach. https://goo.gl/GHeJuq

Palliative Care Improves Quality of Life and Survival, Lessens Patient Symptoms: Study

This article is originally from PCAeNEws.

In a new study published in the Journal of the American Medical Association, researchers from the University of Pittsburgh School of Medicine found that palliative care allowed people with serious illness to enjoy better quality of life, improved survival rates and fewer symptoms. Palliative care helps to provide relief from symptoms, stress and pain brought about by a health condition, and may be provided by specialists or primary care doctors.

The researchers found that the people with serious illnesses were satisfied with their overall health after receiving palliative care and saw that palliative care was connected to better planning for advanced care, lower utilisation of health care and satisfaction of the care provided. Dio Kavalieratos, the study’s lead author, added that it is crucial to figure out how to integrate palliative care into patients’ usual care experiences so it can be a health care standard for those who are seriously ill.

Palliative care has received much attention as a means of improving patient survival rates over the last five years. But, the researchers note that there remains a need to develop ways of examining how palliative care affects caregivers, on top of people with serious illnesses.

Full article can be found here.

 

Barry Ashpole Media Watch #491

Barry Ashpole Media Watch

Articles from Asia Pacific Region:

End-of-life care among six human service areas flagged for reform

AUSTRALIA | Australian Ageing Agenda – 7 December 2016 – Australia tasked the Productivity Commission with investigating if the efficiency and effectiveness of the government’s human services could be improved by introducing greater competition and user choice. End-of-life care is one of the six priority areas which have been identified as best suited to deliver improved outcomes in a more competitive environment. The commission also said preferences could be better satisfied and outcomes improved if people nearing end of life were provided with more choice about the timing and setting of end-of-life care. https://goo.gl/cqi6AT

Specialist Publications

Embedding a palliative approach in nursing care delivery: An integrated knowledge synthesis

ADVANCES IN NURSING SCIENCE | Online – 6 December 2016 – A palliative approach involves adapting and integrating principles and values from palliative care into the care of persons who have lifelimiting conditions throughout their illness trajectories. The aim of this research was to determine what approaches to nursing care delivery support the integration of a palliative approach in hospital, residential, and home care settings. The findings substantiate the importance of embedding the values and tenets of a palliative approach into nursing care delivery, the roles that nurses have in working with interdisciplinary teams to integrate a palliative approach, and the need for practice supports to facilitate that embedding and integration. https://goo.gl/ALhGWp

How effective are volunteers at supporting people in their last year of life? A pragmatic randomised wait-list trial in palliative care (ELSA)

BMC MEDICINE | Online – 9 December 2016 – Clinicians can confidently refer to volunteer services at the end of life (EOL). More hours or increased frequency of contact with a volunteer has a statistically significant effect on the rate of decline of physical quality of life… Other measured outcomes of the volunteer provided support showed no statistically significant benefit over usual care, although a trend in favour of the intervention can be seen. This is the first trial of volunteer provided support in the last year of life and provides an emergent answer to questions of whether volunteer support should be used at the EOL to evaluate the effectiveness of such interventions. https://goo.gl/M8d0yH

Insight into being a carer

Republished with permission from CareSearch

When Donne was diagnosed with late stage oesophageal cancer, her daughter took up the responsibility to care for her needs. For most of the 6 months of caring, Donne was either asleep or had friends over for chats. Their efforts in trying to go on their normal daily routines were criticised and labelled as being in denial.

However, it was the additional responsibilities of keeping track of medication schedules and doctor appointments which left little time for communication. During the times Donne’s daughter felt overwhelmed or unsure, they had the support of the Royal District Nursing Service and the Western Palliative Care Service. At the end of Donne’s journey, her daughter saw meaning in having cared for her mother, through the grief and loneliness. She was also glad to have loved and accompanied her mother out of this world.

Read the full article here.

How Palliative Care Helped My Son Live

Republished from PCAeNews

With a misunderstanding on paediatric palliative care, the author thought that she had been asked to let her son die. However, she came to understand palliative care will help her son, Micah, live as fully as possible and began to appreciate them.

With the palliative care team’s support, they were able to care for Micah’s needs above theirs and made the best decisions for him. She feels that every family of a child with chronic condition should have access to palliative care, which can help them to find peace.

Read more here.

Amy’s story

Republished with permission from eHospice

In this article, Amy-Claire Davies shares her experience with children’s palliative care. She talked about how her family grieved as they came to terms with her being palliative. She was grateful that palliative care had helped manage her symptoms, supported her psychologically and enhanced her quality of life. She came up with a bucket list to encourage herself and was able to complete some of them eventually.

Palliative care is not just about medical care; it about treating your symptoms, supporting you, and giving the patient a better quality of life. It’s a partnership that works on the basis of trust, belief in each other, and an awful lot of hope.

“We believe that quality of life is better than quantity; I’ve learned that it’s not the dates on your gravestone that matter, it’s the dash in between.” – Amy-Claire Davies

Read the full article here.