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Hot Topics in Palliative Care Webinars - 2021

August 2021 - Providing palliative care in prisons

Providing optimal palliative and end-of-life care for people in prison with advanced disease is a growing challenge globally. 

This presentation by Professor Jennifer Philip and Dr Stacey Panozzo will reflect on the complexities and constraints of providing care for people in prison with life limiting illness and explore opportunities to improve models of care for those dying in custody.



June 2021 - Management of NIV in MND & elective withdrawal of ventilation

Motor Neurone Disease (MND) is a fatal neurodegenerative disease affecting some 2000 Australians. Average life expectancy from symptom onset is around 30 months.  Patients show different clinical phenotypes and rates of progression. Death usually results from ventilatory failure secondary to progressive respiratory muscle weakness and can be complicated by aspiration and respiratory infection. Offering respiratory support through non-invasive assisted ventilation (NIV) is considered best practice and can improve quality of life, symptoms and survival in selected patients. Patients usually begin using NIV overnight to improve sleep and daytime wellbeing. Over time, most will use it increasingly across the day, with some becoming NIV dependent.  Some patients who are dependent on NIV may ask that it be stopped. This is their right. It is not assisted suicide or assisted dying, it is withdrawal of medical treatment. Withdrawal of ventilation needs to be thought through and carefully discussed and planned to ensure that the patient is comfortable throughout the process and both staff and family/carers are supported.  This presentation gives the opportunity to hear from and ask questions of specialists in Neurology, Respiratory Medicine and Palliative Medicine about the management of NIV in MND and elective withdrawal of ventilation.



April 2021 - Recent developments in bereavement risk assessment & bereavement care

The presentation by Chris Hall will consider validated methods of assessing bereavement risk, the efficacy of bereavement interventions for sub-groups of bereaved individuals and how we might link bereavement risk assessment to a range of bereavement interventions.

Bereavement risk assessment in end-of-life care has been identified as a critical indicator of quality practice. Palliative care standards and policies promote support to bereaved caregivers; however, research indicates that bereavement support tends to be delivered on a piecemeal, ad hoc basis without formal assessment of risk or need. Risk assessment is often based on staff observation using in-house checklists or multidisciplinary team opinion.

Handout 




Feb 2021 - Respiratory Supportive Care: A flexible model of respiratory & palliative care for patients with advanced lung disease

Patients with advanced lung disease often have higher symptom burden and lower quality of life than patients with advanced lung cancer. Additionally, as their disease progresses these patients require frequent hospitalisation with their length of hospital stay estimated to be twice the average. Worldwide, the financial cost to healthcare services is significant. 

To better meet the complex needs of these patients, an innovative program based on best available international evidence was established at a large metropolitan Australian health service. The respiratory supportive care service is an ambulatory, flexible care model that consists of a respiratory supportive care outpatient clinic, and a physician home visit for patients with barriers to attending the clinic. The service has been robustly analysed to describe the model of care, and to measure the impact on health care utilisation. Overall, health care utilisation decreased following review, with a 33% decrease in acute hospital admissions, and a 38% decrease in admission length. The service continues to grow and develop in response to the needs of its patients.


 


Hot Topics in Palliative Care Webinars - 2020

Annual Lecture - Improving Palliative Care for People with Neurological Illness: National and International Perspectives (December 2020)

This lecture explored different models and strategies to better meet the palliative care needs of patients with neurological illnesses and their families drawing upon the latest evidence from Australia and overseas.

Neuropalliative care is an emerging field that recognises the need to address the unique palliative care needs affecting people living with neurologic illness and their families. Research over the past decade has demonstrated the existence of significant palliative care needs in neurologic populations, an openness to palliative approaches, and initial signs of effectiveness when incorporating palliative care. However, to create a significant impact, the field of Neuropalliative care must develop models to integrate the palliative care approach into real world everyday practice. The lecture will present a public health perspective on several models and strategies to better meet the palliative care needs of patients and families affected by neurological illness. 



The Power of Language: Perspectives From Palliative Care (October 2020)

The language used to describe illness, treatments, prognosis and death in our world is steeped in history, culture, meaning and implications. Over time, our language changes as cultural understandings and practices change, and perhaps nowhere is this more evident than in the care of those who are dying.

Words can evoke fear, resentment and joy. In clinical care, though they may be intended to help patients and families, at times the words we use can create confusion and missed opportunities, while at other times a carefully chosen word may open new possibilities.

Recorded on 27 October 2020, we were very fortunate to have four experienced speakers for this webinar, who presented their reflections on language used in the care of those with advanced illness and in palliative care from their key perspectives, and offered thoughts on how we can improve our communication.


CarerHelp: Helping your family carers be prepared for end of life care (August 2020)

CarerHelp (www.carerhelp.com.au) is a new online resource for people who are caring for a friend or family member with an advanced disease during the last months of life. It helps prepare carers by providing evidence based information via fact sheets, learning modules, videos, and interactive resources. CarerHelp can also be a useful resource for health professionals who work with people with advanced disease and their families. Australians who are caring for a family member or friend at the end of life are at risk of psychosocial distress.  COVID-19 has brought more challenges to family carers including social isolation, increased reliance on telehealth, restrictions on visits to their relative or friend outside the home, and a possible increase in anxiety around the virus itself. This is in addition to the already high demands of caring and an increased risk to both physical and psychological health that carers may experience.


Planning for the COVID-19 pandemic (May 2020)

From the ICU and palliative care perspectives, this highly informative and extremely timely discussion was recorded during our live webinar on Tuesday 19 May 2020.   Associate Professors Antony Tobin and Mark Boughey discuss how the challenges of the 2003 SARS epidemic may have helped inform our practices during the current pandemic and how the emerging frameworks can be considered for palliative care need during future pandemics.  They also take a look at whether the COVID-19 pandemic planning and management process provided palliative care with a leadership opportunity, and if this has highlighted the role for palliative care in broader ethical, clinical and public health domains of care.


The Family Carer Group Education Program - 2018

Palliative care aims to help people with an advanced incurable disease and one of the key features of palliative care is support for family carers. Research shows that a significant proportion of family carers are prone to negative financial, physical, psychological and social outcomes. Furthermore, family carers consistently report that they desire information and guidance to prepare them for their role.

Supporting family carers also indirectly promotes the wellbeing of the person diagnosed with advanced disease. The Family Carer Group Education program outlined in this resource has been comprehensively evaluate. The program has shown it can significantly improve how prepared and competent carers fee. Furthermore, after attending the program, family carers also report less unmet needs and are more able to acknowledge positive aspects associated with being a carer.

This resource has been designed to assist health care professionals to conduct The Family Carer Group Education Program in their setting. It includes demonstrations of key parts of the program, interviews with health professionals and family carers who have participated in the program, and a full set of instructional slides for the program. This resources may also be useful as a teaching aid for students of palliative care. 

Part One


Part Two

Hot Topics in Palliative Care - 2018

How can you be compassionate when it feels like you have a gun to your head? (September 2018)

Filmed on 11 September 2018 – Watch Dr Margaret Ross’ presentation on ‘How can you be compassionate when it feels like you have a gun to your head?’ as part of the Centre for Palliative Care's regular Hot Topic lecture series.

This presentation addresses the issue of challenging families in palliative care – exploring the socio-cultural changes for modern families grappling with a dying loved one, how this translates to the healthcare environment and what we can do in the face of it.  

Areas of discussion include:

  • Understanding their world – what families bring into the ward environment
  • Socio-cultural perspectives – do modern families have increasing demands/expectations?
  • Standing in the face of it – how we can approach complex families and how to not take it too personally



Death and Digital Media (April 2018)

A fresh insight of how digital technologies are used to mourn, commemorate and interact with the dead was presented by Dr Martin Gibbs (A/Prof , Department of Computing & Information Systems, University of Melbourne) and Dr Bjorn Nansen (Senior Lecturer in Media and Communications, University of Melbourne) on Thursday, 26 April 2018 at the Centre for Palliative Care’s Hot Topic Forum.

A combination of research and humour was used to engage the audience in a thought-provoking session on the juncture of death and digital media. The presentation briefly mapped the historical and shifting landscape of digital death by considering a range of social, commercial and institutional responses to technological innovations. The discussion centred around multiple digital platforms through a number of case studies drawn from Australia, North America and Europe and through these case studies an insight and analysis into emerging practices was provided.

Find out more by watching the video below:



Hot Topics in Palliative Care - 2017

New Directives, New Obligations: The Medical Treatment Planning and Decisions Act 2016 (August 2017)
How will the new Medical Treatment Planning and Decisions Act impact your practice?

This presentation made by A/Prof Mark Boughey (on behalf of Dr Sonia Fullerton) and Dr John Chesterman on 2 August 2017 provides an overview of the impact that the new Medical Treatment Planning and Decisions Act will have on your practice. Changes include new advance directives, new ways of appointing decision makers and the changed role of the Office of the Public Advocate. Find out how the new Act will impact your work on a daily basis by watching the video below.



Hot Topics in Palliative Care:  The Challenges of Chronic Disease Management in the Prison Population (May 2017)

Filmed on 3 May 2017 - Listen to Dr Charles Roth speak about "The Challenges of Chronic Disease Management in the Prison Population", as part of the Centre for Palliative Care's regular Hot Topic lecture series.

This presentation provides a brief overview of Prisoner Health Services, patient demographics and statistics in Australian prisons and discusses the high risk behaviours encountered in the prison population and their association with mental health and various infectious diseases. The presentation also provides examples of the challenges of mental illness and chronic disease management, as illustrated with case studies, as well as discussion about the current processes and limitations of managing the dying patient in prison.


Hot Topics in Palliative Care - 2016

How 'hot' is dementia? Exploring issues for palliative and aged care (June 2016)

Filmed on 29 June 2016 - Watch Deirdre Fetherstonhaugh PhD speak about "How 'hot' is dementia? Exploring issues for palliative and aged care", as part of the Centre for Palliative Care's regular Hot Topic lecture series.

 In 2013 dementia was the second leading cause of death for Australians. Over 50% of people living in residential aged care have a diagnosis of dementia. Most people who live in residential aged care will die there and not everyone will receive specialist palliative care; in fact very few people do. Residential aged care is palliative care. Therefore, staff working in aged care need to ensure that residents have a ‘good’ death and care provided is evidence-based. This presentation will explore some of the issues faced by aged care and palliative care services with the increasing prevalence of dementia in the Australian community.  It will also draw on some of the research conducted by ACEBAC in this area.



Hot Topics in Palliative Care - 2015

Lifting their spirits: Who provides spiritual care at the end of life? (November 2015)

Filmed on 10 November 2015 - Over the past decade or so spiritual care has become enshrined in palliative care rhetoric and is increasingly reported upon in the general healthcare literature. This literature is not entirely coherent; nor is the rhetoric. There is no agreed definition of spirituality, for example, and this both undermines measurement and blurs the formulation and implementation of policy. But there is a growing consensus around the core themes of spirituality and the need for an organised response.

One of these core themes is meaning-making. Clearly an encounter with the health system is for many people an event that shatters security and disrupts meaning; creates spiritual need, in other words. What is less clear is how the health system should respond – to what extent should healthcare practitioners be responsible for the effects of news they deliver? And if spirituality is a whole-of-life phenomenon, what are limits to a healthcare contribution?

A multi-disciplinary team that takes spiritual care seriously thus faces a range of questions, and some of these were explored in the hot topic discussion.

Dr Bruce Rumbold (Director, Palliative Care Unit, Department of Public Health, La Trobe University)


Hot Topics in Palliative Care - 2014

Sedation in Palliative Care - Indications and Guidelines (October 2014)

Filmed on the 22nd October 2014, this webcast includes a lecture style presentation by A/Prof Jennifer Philip about the indications and guidelines around sedation in palliative care, followed by a multi-disciplinary discussion with the following panelists:

  • Dr Justin Dwyer, Psychiatrist in Psychosocial Cancer Care Team, St. Vincent’s Hospital
  • John Dalla, Palliative Care Nurse Coordinator at Alfred Health
  • Annette Cudmore, Palliative Care Nurse Consultant at Goulburn Valley Hospice Care Consultancy Service Inc
  • Dr David Brumley, Palliative Care Physician at Barwon Health and Lecturer at Deakin University

 *Three cases will be discussed after the presentation which are all fictitious and an amalgam of patient-clinician scenarios.*

Presentation Slides

Download the Sedation in Palliative Care - Indications and Guidelines slides.

Presentation Timeline

Slide the timer bar to each section.

  • Sedation in Palliative Care- Presentation: 00:25 - 23:35
  • Case Study 1 - Joe: 27.45
  • Case Study 2 - Mrs K: 40.55
  • Case Study 3 - Joyce: 49.06

Care at the end of life: Has the Liverpool Care Pathway lost its way? (March 2014)

Filmed in March 2014, A/Prof Mark Boughey (Director of Palliative Medicine, St Vincent’s Hospital Melbourne and Co-Deputy Director of the Centre for Palliative Care) presented on the outcomes of the Liverpool End-of-Life Care Pathway conference which he attended in late 2013. Additional resource: Response to the Neuberger Review by the International LCP Reference Group


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