Advance Care Planning - less about tubes and more about talk

Have you seen the cartoon of a couple watching TV and talking about "life supports". The man says "If I am ever dependent on a machine I want it to be unplugged". At which point the woman gets up and unplugs the TV!

When people discuss living wills and preferences at end of life, the conversation seems to quickly move to discussing life supporting technology. It seems to me that these discussions are less about tubes and technology, and more about talking and exploration.

This morning the newsletter from the Canadian Hospice Palliative Care Association announced:

"On April 12^th, 2011 CHPCA will launch the National Advance Care Planning Day, a day for Canadians to reflect on decisions made at the end of life.

The Speak Up - Start the conversation about end-of-life care campaign will seek to encourage Canadians to have conversations about planning for end of life care by providing access to shared tools and terminology for Canadians, making it easier for them to share their preferences with family, friends and health professionals, no matter where they live. Watch for more information (www.chpca.net)."

Live longer with palliative care?

A study published last summer in the New England Journal of Medicine showed that patients with non-small-cell lung cancer who received palliative care early after diagnosis had a better quality of life and lived longer than those who received standard care. These patients also received less aggressive care. This research has received much publicity in the American newspapers in the past month. Link for the journal article: http://www.nejm.org/doi/full/10.1056/NEJMoa1000678

This may help to clarify the goals of palliative care for people who are concerned that palliative care shortens life.

Kath

Canadian Virtual Hospice has done it again....

Last week a colleague showed me a most excellent article by Dr. Mike Harlos about DEHYDRATION. The thorough but easy to read article addresses: what it is, causes, sorting out the symptoms, managing dehydration, what you can do, and what your team can do.
Link: http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Symptoms/Dehydration.aspx

Kath

Palliative Social Work - new book

I just got home from the annual assembly of the American Academy of Hospice Palliative Medicine and the Hospice Palliative Nurses Association in Vancouver BC. The Americans received a warm and wet/rainy welcome from the BCHPCA, CHPCA and the Canadian Society of Palliative Care Physicians. Dr. Fraser Black (Victoria Hospice Medical Director) and Wendy Wainwright (President of CHPCA) presented a lunchtime forum titled "Showcasing Canada". They highlighted major initiatives in HPC in Canada - and even the Canadians who attended learned a few things!

I was excited to see the strength of Social Work manifest at the conference. Oxford University Press has just published the Oxford Textbook of Palliative Social Work, Edited by Terry Altilio and Shirley Otis-Green. Betty Ferrell's foreword articulates the vital contribution of Social Workers to palliative care practice and to the effective functioning of team. The chapters help to address the breadth and depth of SW in Palliative Care. It looks to be an excellent resource.

For further information go to: http://www.oup.com/us/catalog/general/subject/Medicine/PalliativeMedicine/?view=usa&ci=9780199739110#

As well as the new text, several conference sessions presented research and best practice in palliative social work.

Sessions were recorded and can be ordered.



Kath

"It's not what you do it is how you do it...." Lessons from the Flag Lady

On route to the post office. Road constructions. Stop sign.
I pull over to the side, now is as good a time as any to check for messages.
A knock on my window, "Love, can you move over further? Cars and trucks are having to swerve to get past you."
"Really? Oh, sorry, I didn't realize"
"No problem love, just pull on up there and pull over further, .... there you go, that is perfect."
When I finished with my emails, she directed me forward and into the line up, waved, smiled, gave me a thumbs up and wished me a wonderful day.

Don't you love it when you meet people that remind you of how to live?

Yesterday Christina Foerster and Deb Starck and I were recording podcasts. As we talked about caring for the body after death, Christina said, "It is not what you do so much as how you do it".

Whether we are flag persons, surgeons, nurses or undertakers - it is less about what we do, and more about how we do it!

Have a great day.

Kath