33rd SHC-LCPC Postgraduate Course in Palliative Medicine

33 SHC-LCPCThe SHC-LCPC postgraduate course in palliative care is back this year!

Taking place on 26-28 April 2017, this 3-day foundation course is designed for doctors across all settings and covers basic principles and practices of palliative medicine. Read more about this course here. Registration opens today and will end 5 April 2017.

How to uphold patient dignity at the end of life

This article is from Palliative Matters.

According to Dr Harvey Max Chochinov, international expert in dignity and palliative care, dignity is not just a concept associated with managing bodily functions but also a dying person’s perception of how they are seen by others. For people who are dying, they feel a loss of dignity when focus on their illness or disease leaves them with the sense they have been defined generically as a patient and all they have.

The research also shows significantly higher rates of depression, anxiety and feelings of hopelessness in people experiencing a loss of dignity and healthcare workers have a responsibility in understanding the impact of their interactions with patients.

Read the full article here.





Barry Ashpole Media Watch #494

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

International news:

Hospice care linked to higher family satisfaction

REUTERS | Online – 4 January 2017 – A recent study suggests that families of terminally ill cancer patients may be more satisfied with the end-of-life treatment their loved ones receive when it involves hospice care. Study co-author Dr Alexi Wright added that their findings suggest earlier hospice enrollment is associated with better symptom management, less pain, better quality of care and higher likelihood that patients will receive the care they want in their own environment. https://goo.gl/il9BTT

Specialist Publications:

Palliative care exposure in internal medicine residency education : A survey of [the U.S.] Accreditation Council for Graduate Medical Education internal medicine program directors

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | Online – 5 January 2017 – Training for palliative care physicians is currently inadequate to meet the current palliative care needs as the baby boomer generation ages. Nonspecialty-trained physicians will need to supplement the gap between supple and demand, yet no uniform guidelines exist for the training of internal medicine residents in palliative care. However, there has not been any systematic study performed to evaluate how internal medicine residencies currently integrate palliative care into their training. https://goo.gl/tIstIG

SHC-LCPC Forum – Deprescribing in Palliative Care



Abstract Submission for APHC 2017


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


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