Monthly Archives: January 2017

Ira Byock chats with B.J. Miller

In a short podcast Dr. Ira Byock, founder and chief medical officer of the Providence Institute for Human Caring, and Dr. BJ Miller, a palliative care physician at UCSF Medical Center, share thoughts on being in the moment, caring for the seriously ill, caring for yourself, and the secret to life. You can listen to their chat (3:50) and other chats about palliative care in the series from the Hear Me Now website.

Foundations of Cultural Competence

Wednesday 22 February 2017, 9.00am – 12.00pm
Centre for Culture, Ethnicity & Health (CEH),
23 Lennox Street, North Richmond – $150
Further information and to register here

Aged care education

Here are details of the NARI Education and Professional Development program for 2017. Registration is now open for the first two workshops, “Assessment, Care Planning and CDC” and “Falls and Cognitive Impairment”.

Assessment, Care Planning and CDC

Falls and Cognitive Impairment

If you have any questions about any of these workshops or require any further information please do not hesitate to contact education@nari.unimelb.edu.au.

NARI is also able to tailor professional development and education workshops to suit your organisation’s needs. Please contact education@nari.unimelb.edu.au or (03) 8387 2305 to discuss further.

My Learning: Modules on how evidence can help in practice

You can access a newly-redeveloped set of online education modules called My Learning. My Learning is a web-based learning initiative made up of several interactive modules designed to show professionals how to use the valuable resources available on CareSearch to aid decision-making and inform clinical care.

The My Learning modules are free to use. Each module is made up of a learning package that uses a patient story to show how CareSearch resources can help. A brief quiz helps reinforce understanding. Once the student completes each module, they are able to print a certificate for their professional records or their CPD requirements, where appropriate. Modules are independent so the learner can choose what interests them.

There are currently seven My Learning Modules.
My Learning 1: Finding Evidence (Published Literature)
Eileen has non-small cell lung carcinoma. This module shows you how the Clinical Evidence pages, Review Collection and PubMed Topic Searches helped Eileen’s breathlessness.

My Learning 2: Finding Evidence (Searching for Evidence)
Clare is caring for her husband John. She is concerned about the vivid and realistic dreams he is having about his dead brother. You use some PubMed resources to answer her questions.

My Learning 3: Searching the Web
Ruth was diagnosed with stage II melanoma five years ago and has now had maximal treatment for liver and brain metastases. She lives with her husband Bruce and their two teenage children.

• My Learning 4: Residential Aged Care
Ken is a resident in the Kangaroo Valley Aged Care Facility. The staff are not sure if Ken is approaching the end of his life. This module profiles resources in the Residential Aged Care Hub

My Learning 5: Dementia
Anna’s father Lou has dementia. As his condition worsens, the family disagrees about his care. This module highlights dementia resources in CareSearch.

My Learning 6: Carers
Lana is a 35 year old woman who is a sole parent to Rhiannon and John, 10 year old twins. Her mother June became very ill and moved in with Lana. Lana struggles to cope.

My Learning 7: Knowledge TranslationThis module looks at how a clinical team uses the Knowledge to Action cycle to improve outcomes for their patients.

The revised modules are now available. You can find them in the Finding and Using Evidence section of CareSearch.

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?
Read more

EOL Essentials Project

All six modules are now available!

Tips on managing conflict:

Start with a non-judgemental
mind set

Reframe emotional issues

Learn more on effective teamwork with us.

In Module 5 you can learn more about the importance of teamwork.

Effective teamwork encompasses leadership, clear goals, clear roles, trust, respect and a cultural readiness to allow patients to steer their care.

However, sometimes things don’t go well in teams and this can greatly affect patient care.

Learning about the best way to approach conflict is of benefit to everyone in the team.

Learn more here.

Sector News

Many Australians don’t plan or think about dying.

The GroundSwell Project is a not for profit organisation who promote resilience and wellbeing in response to end-of-life issues and to encourage people to build their death literacy.

Their website outlines facts such as:
• Why do doctors die differently and how exactly?
‘While it may seem scary to think about your own mortality, becoming death literate and building your capacity for end-of-life planning can help create healthier community attitudes about death.’

Latest Evidence
Each month we will feature a few articles that cover topics relevant to end-of-life care in hospitals:
• Hosker CM, Bennett MI. Delirium and agitation at the end of life. BMJ. 2016 Jun 9;353:i3085.

Delirium is common in the last weeks or days of life. It can be distressing for patients and those around them. Successful management involves excluding reversible causes of delirium and balancing drugs that may provoke or maintain delirium while appreciating that most patients want to retain clear cognition at the end of life.

• Henson LA, Higginson IJ, Daveson BA et al. ‘I’ll be in a safe place’: a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care. BMJ open. 2016 Nov 1;6(11): e012134.doi:10.1136/bmjopen-2016-012134.

Understanding what influences people with advanced cancer to seek emergency department (ED) care is key to developing initiatives aimed at reducing high attendance. This qualitative interview study explores the decision-making process of people with advanced cancer and their caregivers to seek ED care.

For your Notice Board
Each month we will feature a fact sheet, a poster or other resources that you can print and share on your notice board or in your tearoom. This month we highlight ‘A better way to care for patients with delirium’ poster (106kb pdf) from the Australian Commission on Safety and Quality in health care.

Victorian Medical Treatment Planning and Decisions Bill

The Medical Treatment Planning and Decisions Bill 2016 passed the Parliament on 24 November, enshrining advance care directives in law.

The Medical Treatment Planning and Decisions Act creates clear obligations for health practitioners caring for people who do not have decision making capacity.

The Act will ensure medical decision making is more in line with contemporary views and is more consistent with how people make decisions about their medical treatment and personal autonomy.

The Act establishes a single framework for medical treatment decision making for people without decision making capacity that ensures that people receive medical treatment that is consistent with their preferences and values.

Victorians will be able to create a legally binding advance care directive that will allow them to:
• Make an instructional directive (which will provide specific directives about treatment a person consents to or refuses).
• Make a values directive (which will describe a person’s views and values. A medical treatment decision maker and health practitioners will be required to give effect to a values directive).
• Appoint a medical treatment decision maker (who will make decisions on behalf of a person when they no longer have decision making capacity).
• Appoint a support person (who will assist a person to make decisions for themselves, by collecting and interpreting information or assisting the person to communicate their decisions).
By changing the legislation Victorians can have confidence in the health system, which will respect their decisions about medical treatment.

The Act does not authorise physician assisted dying and, as the Standing Committee on Legal and Social Issues found, this is a separate issue to advance care planning.

The default commencement is 12 March 2018, allowing health services, health practitioners, and the public to prepare for the new laws.

Prior to this commencement date, extensive work will be undertaken to provide appropriate materials and education. The Victorian Department of Health & Human Services is working closely with the Office of the Public Advocate to develop an implementation and communication plan to prepare stakeholders for the commencement of the Act. This will include the development of a range of information and educational material and workshops to support the community, consumers and providers to understand their rights and obligations under the Act.

This work will begin in 2017 and will be overseen by an implementation advisory group to guide the development of practical resources to support the Act.

A copy of the Act is available at the Victorian Legislation and Parliamentary Documents website

Call for Expressions of Interest to join the Palliative Care Research Network (PCRN) Research Advisory Group in 2017

The PCRN vision is to foster a productive, collaborative and sustainable program of research aimed at enhancing the quality of palliative care. Our strategic objectives include: fostering capacity building via mentorship, providing development opportunities to early career researchers and creating local, national and international linkages and collaboration.

The PCRN is now calling for expressions of interest to join the PCRN Research Advisory Group (RAG). The Group is envisaged to comprise between 12-20 individuals from various disciplines, with varying skill sets and research experience. The primary function of the RAG is to assist the Network in its research endeavours, which may include involvement with the following activities:

• providing the Network with research advice and/or consultation as required;
• reviewing applications for scholarships, travel grants and small project grants;
• providing mentorship to early career researchers;
• involvement in PCRN Workshops and Forums;
• providing advice on key PCRN decisions and strategic research direction;
• collaborating on grants with other PCRN members.
Your involvement with the RAG would be called upon only when required based on your areas of expertise. Being a member of the PCRN RAG would allow you to expand your research network and collaborative ties. Members of the RAG will also be provided with an official letter of membership for their Curriculum Vitae.

The PCRN are interested in hearing from palliative care researchers at all stages of their careers who may be interested in this exciting opportunity.
To lodge your expression of interest for consideration as a future member of the PCRN RAG, please submit a brief CV, and cover letter outlining how your skillset would benefit PCRN activities, to pcrnv@svha.org.au by 30 January 2017.

PALLIATIVE CARE RESEARCH NETWORK
6 Gertrude Street, PO Box 2900, Fitzroy VIC 3065 Australia
Tel: +61 3 9416 0000 Fax: +61 3 9416 3919
PCRN flyer – call for EOI to join RAG 2017 v.3

Decision Assist-webinar: We’re All Different

Decision Assist launches into 2017 with the next webinar in our Aged Care series: We’re All Different, presented by Dr Jennifer Arnold-Levy.

This webinar will focus on providing care that is consistent with individual goals, values and beliefs.

We all have different values and beliefs, influenced by our culture, age, gender, religion, spirituality and life experiences. These shape our decisions and choices when it comes to how we would like to live and be cared for, and what is important to us in end of life care.

This webinar will explore ways to build rapport and help people to communicate their choices and preferences to support you in providing meaningful and respectful care.

At the end of this webinar you will:
• Recognise that people have varying beliefs and values
• Be able to use conversational tools to discover how people differ
• Find information relating to varying cultural perspectives
Thursday 19 January
1.30pm till 2.15pm AEDT

REGISTER NOW

Dr Jennifer Arnold-Levy

With doctoral qualifications in speech pathology and psychology, and as an accredited Personal and Executive Coach, Jennifer has worked as a human communication specialist for more than 30 years. Her background as a clinician and supervisor has been followed by more than 20 years’ experience as a researcher, educator, writer and presenter in tertiary education and corporate sectors. She has designed and delivered corporate training programs and trained allied health professionals as a lecturer in the Faculty of Health Sciences at La Trobe University.

Beautiful calendars – only a few left

With beautiful imagery, inspirational quotes and plenty of room to write appointments, notes and reminders, it is the perfect item to make 2017 an organised one.

The Compassionate Friends 2017 calendar is now available for delivery or collection from the centre.

Cost: $15ea (including postage)

Here is the link to order and pay online.

2017 Calendar – The Compassionate Friends Victoria

All proceeds going to provide much needed support and services for bereaved parents and siblings.