Palliative care and neurology: Continuing collaboration at 2019 World Congress of Neurology

Professor David Oliver, Chair of the European Association for Palliative Care Neurology Reference Group – Palliative Care, was part of a cohort of palliative care clinicians and academics who presented at this year’s World Congress of Neurology.

Professor David Oliver, Chair of the EAPC Palliative Care Neurology Reference Group.

The Twenty Fourth World Congress of Neurology was held in Dubai in the United Arab Emirates at the end of October. There were more than 4,000 delegates from all over the world, looking at all areas of neurological practice. Palliative care was again included, with two teaching sessions and two scientific sessions within the five-day schedule. This collaboration between the specialties echoed the theme of the 2019 World Congress of Neurology – ‘Accelerating the pace of change’.

The sessions included discussion of the collaboration between neurology and palliative care and several palliative care practitioners and academics, familiar to readers of the blog, were among those presenting. I looked at the development of the collaboration, including presentation of the recent survey, involving the European Academy of Neurology and the European Association for Palliative Care (EAPC), of collaboration across Europe. Nearly 300 professionals completed an online survey, that showed there is growing collaboration, especially for people with amyotrophic lateral sclerosis/motor neurone disease and cerebral tumours.

Professor Janis Miyaski from Edmonton, Canada, spoke on the role of palliative care in Parkinson’s disease and related disorders and Dr Peter Eastman from Melbourne, Australia, spoke on the role of palliative care in the care of people who have suffered a stroke.

Speaking up for palliative care at the World Neurology Congress 2019: (left to right) Idris Baker (Wales UK), Omar Shamieh (Jordan) and Sheila Payne (UK).

Professor Shelia Payne, from Lancaster, UK, discussed advance care planning and its importance for people with progressive neurological disease, who may face difficulties in communication and cognitive loss. She also looked at the issues surrounding requests for hastened death. Dr Idris Baker, from Swansea, Wales, discussed the many ethical issues that may arise in the care of neurological disease. Dr Omar Shamieh, from Jordan, helped the audience to look at the cultural issues in care.

The sessions were well appreciated and well attended. Speaking for all my colleagues, we were very pleased to be invited to be involved and develop the sessions.

Palliative care is now a regular area for discussion and this shows the extent of the development of collaboration between the specialities. We are now looking forward to the next World Congress of Neurology in Rome in 2021.

Links

 

Posted in EAPC Task Forces/Reference Groups, NATIONAL & INTERNATIONAL REPORTS, Neurology, SYMPTOM CONTROL | Tagged , | Leave a comment

New images of palliative care: Winning photos from Berlin

A new feature of this year’s 16THWorld Congress of the European Association for Palliative Care (EAPC) held in Berlin, Germany, was the first ever photography competition. Anne Letsch (Member of the Scientific Committee and Head of the Local Organising Committee for #EAPC2019) and Claudia Sütfeld (Congress Coordinator EAPC) explain.

Claudia Sütfeld (centre) announces the winners of the New Images of Palliative Care photo competition in Berlin: Revital Nave (left) and Damaris Köhler.

Does a photo of hands holding hands truly portray modern palliative care? What image says palliative care to you?

In the run-up to the world congress in Berlin, the EAPC was seeking ‘New images of palliative care’. For the first time ever we asked you to take the opportunity to send in images that would help to change the conversation about palliative care.

And more than a hundred people did – wonderful photos from 19 countries around the globe reached our team! The themes could not have been more different – landscapes, portraits, nature shots, graphics… Some participants took photos at hospitals or hospices; others in the home care setting. Some photos were abstract, others very intimate.

But all of them touched us and made the decision of the jury very difficult. A particular thank you goes to these jury members: Christof Müller-Busch, Bernd Alt-Epping, Julie Ling, Martina Preissler and Karin Dlubis-Mertens.

The winning photos…

‘Know reality, find peace’, photograph by Revital Nave.

The jury chose 13 photos that were the most meaningful to them. The overall winner was Revital Nave from Israel whose photo is pictured above. Entitled ‘Know reality, find peace’, the winning photo was taken at Baruch Padeh Medical Center, Poriya,in Tiberias, Israel.

All 13 winning photos were displayed during the congress in Berlin and congress participants had the chance to vote for their favourite. “Take a red sticky dot”, we said –hundreds did!

‘Palliative care goes way beyond medical care’, photograph by Damaris Köhler.

Throughout the congress, participants made their choice and red sticky dots began to appear on the photos. This time, the overall winner was Damaris Köhler from the Palliative Unit GRN-Clinic Sinsheim in Germany. Pictured here is Damaris’s winning photo that portrays an aspect of palliative care that goes way beyond medical care.

The winning photos were announced during the closing ceremony and both winners received a book prize.

 

 

Congress delegates view the winning photographs.

Congratulations to all the winners: Revital Nave (Israel), Damaris Köhler (Germany), Fraucke Backes (Germany), Ruth Corney (UK), Monica Coll (Spain), Jennifer Hancox (UK), Elodie Cretin and Hospital Team Besancon, (France), Ramzan Cirakoglu (Turkey), Rob Bruntink (The Netherlands), Nynke Thien (The Netherlands), Cindy Hegger (USA) and Zana Saunders (UK).

And a big thank you to all who participated. We appreciate all the wonderful photos submitted that celebrate the creativity and diversity of palliative care worldwide. We hope that you’ll enjoy the photos as much as we did and please – stay tuned for more ideas and opportunities to promote palliative care!

Links

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How do we change the narrative around volunteers and clarify the value of their contribution?

UNDER THE LENS A NEW SERIES ABOUT VOLUNTEERING HIGHLIGHTING THE IMPORTANT ROLE PLAYED BY VOLUNTEERS IN PALLIATIVE CARE… 

Professor Anne Goossensen, Steering group member, and Dr Ros Scott, Co-chair, both connected to the European Association for Palliative Care (EAPC) Task Force on Volunteering, explain why it’s important to choose the right words to describe the essence of volunteering.

Dr Ros Scott

Professor Anne Goossensen

It is not uncommon for hospice and palliative care organisations to declare that “Our volunteers are friendly and welcoming”, or to describe volunteers as “stars” and “heroes”. What does this really tell us about volunteers in hospice and palliative care (HPC) and the difference they make to the lives of patients, families, staff, organisations and themselves? While these descriptions are likely to be true and intended as compliments, in reality they can have the effect of patronising and diminishing the contribution of volunteers to palliative care.

Also, to describe HPC volunteering in terms of motivations, tasks and activities that are provided by assistants to paid staff will reduce recognition of the value of volunteering.These words reflect professional language – language that appears quite different from the words of volunteers themselves.

Volunteers from eight European countries described what they did and what volunteering meant to them in the story project. (Detail from the slide presentation).

The EAPC Task Force on Volunteering undertook a story project in which volunteers from eight different European countries were asked to write about what they did and what volunteering meant to them. Volunteers wrote about their experiences in very different terms. The language they used was about building relationships, being there, attentiveness, vulnerability and compassion. They focussed on the relational meaning of their work, on how it had changed their lives, how they learned from patients and families and of their depth of respect and admiration for those they supported. They spoke of love and laughter, of sorrow and of joy and the privilege of being trusted to be the person that the patient and family needed in that moment. (View PDF of Story Project Presentation).

Speaking of roles and tasks and boundaries does not seem to grasp the essence of volunteering. These are not words that reflect the impact of the volunteer that sits with a patient at the end of life because there is no one else, nor do they reflect volunteers in Kerala, India who are often the people who identify those in need of palliative care. They do not describe the difference made by the volunteer who provides respite to family members, who sits quietly and listens to the fears, anxieties, sadness, and joy of patients and families, or who continues to support families through bereavement. Nor do they tell of the difference that volunteers make, by spending their time helping to cook meals, keeping HPC environments clean and welcoming, raising vital funds or educating the public about HPC.

Perhaps it is not surprising that volunteering is still trying to find recognition and its place within HPC. A universally understood, flexible but recognised place, alongside paid staff, patients and carers, that encompasses the ethos of volunteering in terms of spontaneity, creativity and the ability to respond relationally to human need.

Finding this place might be about choosing the right words to describe this valuable resource in palliative care. Words that bring human-to-human connections of attention and compassion.

Links and resources

 

Please sign the EAPC Charter on Volunteering.

 

 

 

More about the authors

Professor Anne Goossensen is Professor Informal Care and Care Ethics, University at Humanistic Studies in Utrecht, The Netherlands. Follow Anne on Twitter@anne_goossensen

Dr Ros Scott is a Volunteering Researcher and Consultant and Honorary Research Fellow at the University of Dundee, Scotland, UK. Follow Ros on Twitter @RoscRos

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Journal of Palliative Medicine: an EAPC official journal one year on…

Charles F von Gunten, Editor-in-Chief, and Lisa Pelzek-Braun, Managing Editor, Journal of Palliative Medicine, describe how the journal’s relationship with the EAPC is impacting on readership and manuscript submission, what you can expect from the journal and future plans.

Dr Charles F von Gunten and Lisa Pelzek-Braun.

 

Journal of Palliative Medicine is enjoying its new relationship with the European Association for Palliative Care (EAPC) announced at the congress in Bern, Switzerland in 2019. We are looking forward to repeating the award of a 1,000 Euro prize for the ‘best European Paper’ published in 2019 to be used toward attendance at the next EAPC World Research Congress in Palermo. Forty papers submitted by 1 July 2019 are eligible; the decision will be made in early 2020.

Journal of Palliative Medicine is a global journal with editorial board membership and manuscripts from around the world. We are not just an American journal. The journal enjoys exceptional global visibility, with over 250,000 full-text downloads each year, and 536,000 abstract-only downloads. There are 2,600 registered users on our web-based manuscript system from Europe alone. The top five European countries by number of readers are Italy, UK, Germany, France, and the Netherlands. Within Europe, the top-downloading countries are UK, Germany, Netherlands, Sweden and Switzerland. There were one to two papers from Europe published in each issue of the journal in 2018.

We have noticed an increase in readership and manuscript submissions from Europe since the announcement of our relationship with the EAPC. Only 60 per cent of readership is from North America. That proportion is falling as the growth in readership around the rest of the world continues: 20 per cent of readership is from Europe, and rising. The remaining 20 per cent is from Australasia. The single largest centre using Journal of Palliative Medicine is in China!

Journal of Palliative Medicine has the clinician in mind. In contrast with scientific journals, for whom the target is academic researchers, when we review submissions, we ask ourselves, what will help the clinician who is frequently working in our field to understand what is ‘new’ and what can influence practice.

Journal of Palliative Medicine is structured to correspond with the way that new information develops. Letters (500 words) describe interesting observations from clinicians that puzzle them or seem to merit further study. A distinct case discussion series works to ‘unpack’ interesting cases for purposes of teaching or enabling further study. Brief Reports (1,500 words) represent the next step – the publication and dissemination of initial studies (e.g. Phase II clinical trials or work to establish feasibility or confirm observations in individual cases that might have appeared as a letter). Research reports (3,000 words) represent complete studies that seek to answer an important clinical question.

The most read section is the Personal Reflections section. Individuals describe sometimes very personal experiences, or write poetry, or do something that illustrates the experience of working in our field. A review of recent literature helps the busy clinician ‘keep up’ without having to search and read all the pertinent scientific palliative literature. “In this Issue” gives bite-sized information – one or two sentence summaries for the busy clinician.

In contrast with most other scientific publications, Journal of Palliative Medicine enjoys a substantial number of individuals who subscribe to the hard copy version. Our publisher says it’s very unusual. We think it confirms our assumptions about what many of our subscribers need and want.

Lastly, as we look to our 23rd year of publication, we note the tremendous increase in the number of submissions, as well as requirement that some research be published open access if publicly funded. As a response, the publisher plans to introduce a new journal, Journal of Palliative Medicine Reports, an open-access journal beginning sometime in the next 12 months.

Links

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Opioids for breathlessness – standard of care in Germany

Responding to an earlier post by Professor David Currow and Professor Miriam Johnson, Professor Lukas Radbruch, President of the German Association for Palliative Medicine (Deutsche Gesellschaft für Palliativmedizin, DGP), gives another perspective from Germany.

Professor Lukas Radbruch.

David Currow and Miriam Johnson have explained in their recent post that even though many patients with chronic breathlessness will benefit from regular, low dose, sustained-release morphine, many physicians around the world are concerned about using morphine because it has not been licensed for chronic breathlessness. They describe that the Therapeutic Goods Administration (TGA) has approved the use of Kapanol™, a sustained release morphine capsule, for chronic breathlessness due to any cause. This is the first time that a medication for the symptomatic treatment of chronic breathlessness has been licensed. However, from our experience in Germany I am not so sure about the authors’ conclusion that this is a watershed from no indication to indication, and no standard to standard of care.

Using opioids, and specifically morphine, for the relief of breathlessness in cancer and non-cancer patients has been part of palliative care textbooks and palliative care guidelines for some years. The German evidence-based guideline on palliative care for patients with advanced cancer includes the following recommendation:

Patients with non-curable cancer and breathlessness should be treated wtih oral or parenteral opioids for the symptomatic relief of breathlessness.

There is another recommendation stating that the starting dose should be 15-30 mg oral morphine, but dosage increases might be necessary. This is in contrast to the Australian licence, which has a dose range up to 30 mg per day. This guideline was implemented in 2015, and was only recently updated in 2019.

This means that in Germany there is a standard, and an indication, for the use of opioids such as morphine for chronic breathlessness in cancer patients. I would use an evidence-based guideline in any (legal or scientific) guideline as proof of standard and proof of indication. There are quality standards in the production of high-level guidelines, for example the use of expert monitors, similar to quality standards for licensing procedures.

There is an ongoing discussion in Germany (as in other high-income countries) about off-label use of medications in palliative care. Off-label means that substances are used for specific indications, even though they have not been licensed for this indication. As Currow and Johnson have said, there is no opioid licensed for breathlessness (apart from Kapanol in Australia).

However, licensing often depends rather on how much money the company wants to spend on the licensing process. Licensing with the Food and Drug Administration (FDA) in the US or the European Medicines Agency (EMEA) in Europe is much more expensive and time-consuming than elsewhere. Many companies would not want to embark on this endeavour, especially as it would generate little additional income, as patients are already treated according to the guidelines recommending opioids for breathlessness. This is not only a problem for breathlessness, but also for many other indications and medicines. For example, a number of medicines such as gabapentin or paroxetine might be effective for the treatment of itching but none of those has been licensed for this indication.

As this is a frequent problem in palliative care, the German Association for Palliative Medicine has produced a brochure on the use of off-label medications. The use of morphine for breathlessness is used as an example in this brochure. This paper explains to palliative care specialists when and how medicines might be used off-label, and what the legal or financial implications are. For example, in most settings sickness funds will reimburse medication costs, even for off-label use, if there is adequate scientific evidence on the effectiveness, and no licensed alternative is available.

I would be really reluctant to use the Australian licence now to suggest that physicians in poorer countries use Kapanol for breathlessness instead of cheaper generic morphine. We can use the evidence, for example as provided in high-level evidence-based guidelines, to provide guidance and justify the off-label use of medicines!

What do other readers think?
If you would like to comment on this topic, please leave your comment below.

Links

  • Read the earlier post by David Currow and Miriam Johnson, ‘Good news for chronic breathlessness from Down Under’ here.
  • Read more posts about breathlessness on the EAPC blog.
  • Contact Lukas Radbruch by email.
  • German Association for Palliative Medicine website.

 

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Good news for chronic breathlessness from Down Under

For the first time in the world, an Australian company has licensed a medication for the symptomatic reduction of chronic breathlessness. Professor David Currow (Australia) and Professor Miriam Johnson (United Kingdom), explain.

 

Professor Miriam Johnson and Professor David Currow.

Breathing just happens. We don’t think about it, we just breathe. Sometimes we breathe harder and faster in response to the demand of physical exertion or emotion, but we don’t have to try – it just happens, and it can feel good. Our bodies produce their own morphine-like chemicals, endorphins, when we respond in this way – better known as the cause of the ‘runner’s high’.

However, millions of people around the world think about their breathing most, if not all, of the time. They live with medical conditions that affect breathing, such as chronic obstructive pulmonary disease (COPD), heart failure, or lung cancer. Everyday tasks like getting up, washed, and dressed, climbing stairs, preparing food or making a cup of tea – let alone getting to the shops – can cause distressing and disabling breathlessness. Eventually, life takes place within one room in the home apart from intermittent trips to hospital for terrifying times when their breathlessness gets even worse.

Fortunately, we are learning more about ways to help people manage such chronic breathlessness in addition to treating the person’s underlying medical conditions. 1  The mainstay of treatment is training to breathe efficiently, better ways to manage anxiety and panic, ways to keep physically and socially active, and by using a hand-held battery operated fan for cool facial airflow; mostly delivered by clinicians such as physiotherapists and occupational therapists. 2,3 

Unfortunately, as a person’s condition worsens, so chronic breathlessness becomes harder to control with non-drug measures alone. About two in three people 4,5 will also gain some relief with regular, low dose, sustained-release morphine (about the same dose as two tablets of paracetamol-codeine combination four times a day) to supplement our own body’s endorphin response to exertion. Around the world, although some doctors are happy to prescribe it, others are concerned about using morphine because it has not been licensed for chronic breathlessness. In addition, there have been ongoing discussions about starting doses and titration.

However, that is changing. The Therapeutic Goods Administration (TGA), which licenses and monitors the use of medications in Australia has, for the first time in the world, licensed a medication for the symptomatic treatment of chronic breathlessness. This is a major step forward for millions of people around the world who are largely invisible to health practitioners, and for whom the response has been until now “Of course you’re breathless. You have advanced COPD.” This recognition opens a new conversation – “I can see you’re breathless doing basic things like getting dressed. How I can I help you to do this with less disabling breathlessness?”

Having independently and extensively examined the evidence on the effectiveness and safety of regular, low dose, sustained release morphine for chronic breathlessness, including having access to all analyses from the recently published MOP study  the TGA has approved the use of this medication. Kapanol™, the sustained release morphine capsule, is now licensed for use in chronic breathlessness due to any cause, starting at 10mg once daily, up to a maximum of 30mg once daily. From the beginning of September 2019, following a recommendation from Australia’s independent medication pricing authority the Pharmaceutical Benefits Advisory Committee (PBAC), the medication is also subsidised for the symptomatic reduction of chronic breathlessness.

So how does a licensing change on the other side of the world affect clinical practice elsewhere? Many countries can’t access Kapanol™. The answer is that this represents a watershed, from no regulatory-approved indication (independent of the clinicians who play a key part in clinical guidelines) to regulatory-approved indication, no licence to licence, and from no standard of care (developed using this level of scrutiny) to a world-first regulatory-approved standard of care. For too long, palliative care has relied on clinical guidelines driven by expert opinion, and of variable methodological quality. Even the most rigorous do not match the extent of data review, level of definition of net effect (benefits and harms), or independence from the clinicians invested in their proposed use necessary for regulatory approval. Where one country provides a licence, others are likely to follow to ensure people get access to medications that help, whilst keeping them safe.

The TGA review also identified gaps in the evidence – for example, the need for longer-term data, data from different disease groups (we have few data in relation to people with cancer), data relating to different opioids. This new baseline should stimulate a commitment to conduct the further studies that quality, evidence-based clinical practice relies on using methods that stand up to regulatory review. Such work requires us to work closely with colleagues in: the basic sciences; clinical pharmacology; in the case of opioids addiction services; family medicine; general medicine; and regulators whose sworn duty is to optimise the care that is offered to patients. Whenever we refuse to make this shift, we are potentially continuing to compromise the outcomes for the frailest of any patient population – those people with life-limiting illnesses. This is the level of rigour that the community rightly expects.

In the meantime, clinicians now have a standard dosing schedule to follow – even where Kapanol is unavailable, the principles of regular dosing to provide steady state can be applied – that has passed the scrutiny of independent monitors – also providing confidence and guidance. Clinicians therefore now have clearer guidelines to follow in the knowledge that they are prescribing in a responsible manner, including for the patients who may not be referred to palliative care services. This should result in many more people having safe access to a medication, which may help improve their quality of life and reduce their suffering.

References

  1. Johnson MJ, Yorke J, Hansen-Flaschen J, Lansing R, Ekström M, Similowski T,Currow DC. Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness. Eur Resp Journal 2017; 0: 1602277 [https://doi.org/10.1183/13993003.02277-2016].
  2. Swan, F., Newey, A., Bland, M., Allgar, V., Booth, S., Bausewein, C., … Johnson, M. (2019). Airflow relieves chronic breathlessness in people with advanced disease: An exploratory systematic review and meta-analyses. Palliative Medicine, 33 (6), 618–633. [https://doi.org/10.1177/0269216319835393].
  3. Cambridge University Hospitals NHS Foundation Trust Breathlessness Intervention Service (BIS).
  4. Ekström E, MD, Bajwah S, Bland JM, Currow DC, Hussain J, Johnson MJ, One Evidence Base; Three Stories: Do Opioids Relieve Chronic Breathlessness? Thorax. 2018 Jan; 73 (1):88-90. [doi: 10.1136/thoraxjnl-2016-209868].
  5. Currow DC, McDonald C, Oaten S, Kenny B, Allcroft P, Frith P, Briffa M, Johnson MJ, Abernethy A. Once daily opioids for chronic dyspnoea: a dose increment and pharmacovigilance study. J Pain Symptom Manage 2011; 42 (3): 388 – 399: [doi:10.1016/j.jpainsymman.2010.11.021].
  6. Currow D, Louw S, McCloud P, et al Regular, sustained-release morphine for chronic breathlessness: a multicentre, double-blind, randomised, placebo-controlled trial. Thorax. Published Online First: 26 September 2019. [doi: 10.1136/thoraxjnl-2019-213681].

More about the authors…

David C Currow is Professor of Palliative Medicine, Faculty of Health, University of Technology Sydney, Ultimo New South Wales, Australia, and Associate Director of the Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK. David has been a paid consultant to, and received intellectual property payments from Mayne Pharma International Pty Ltd, the manufacturers of KapanolTM.

Miriam J Johnson is Professor of Palliative Medicine and Director of the Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Follow Miriam on Twitter @MJJohnson_HYMS 

Read more posts on breathlessness, including those from Miriam Johnson and David Currow, on the EAPC blog.

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Spiritual care in palliative care in Europe: Accomplishments and challenges in diversity

EAPC task forces are formed by interested EAPC members from different disciplines and countries that work together to deliver on focused, time-limited projects. Some task forces have evolved into EAPC Reference Groups with a broader scope of work and the ability to deliver on multiple projects.

Marie-José Gijsberts is a palliative care physician and researcher and also Co-chair of the European Association for Palliative Care (EAPC) Reference Group on Spiritual Care. Here, she explains how the accomplishments and challenges of the spiritual care task force have led the transition from task force to reference group and how you could help them to shape it.

Dr Marie-José Gijsberts.

Spiritual care is still the least developed dimension of palliative care. Therefore, a multidisciplinary EAPC Taskforce Spiritual Care was initiated in 2010, aiming to support ‘the development and implementation of spiritual care methods and standards to meet adequately the spiritual care needs of patients, informal and formal caregivers in all palliative care settings’.

Considering the progress the taskforce had made over the years, including several open meetings and sessions during EAPC congresses, a white paper on multi-disciplinary education for spiritual care in palliative care and a review on recent European literature on spiritual care in Europe, the core members of the taskforce agreed that it was time to take their activities to the next level, and applied to the EAPC Board of Directors for a transition to Reference Group Spiritual Care. This transition was approved and taken forward in an open meeting of the Reference Group on 25 May 2019 at the EAPC World Congress in Berlin. As a palliative care physician, dedicated to the challenge of implementation and education of spiritual care in palliative care, I am honoured to support the Reference Group as co-chair for the next three years.

Our new goals are:

‘To develop our public profile and engagement, including a presence on social media, and to identify colleagues who wish to form a team to lead on this.’ The EAPC board suggested specific attention to and engagement with eastern-European countries.

At our meeting in Berlin we invited several liaison members of the Reference Group from inside and outside Europe to share the accomplishments and challenges in their countries. The following themes came up during presentations:

  • In several countries, spirituality is almost synonymous with (Roman Catholic) religion. Some participants explained that attention to non-religious aspects was adopted by psychologists, which may explain the lack of recent papers on spirituality from eastern – and possibly also southern – Europe. The Reference Group could play a role in supporting and bringing together researchers and practitioners that want to explore and exchange spiritual caregiving in religious countries.
  • Also, specialists in spiritual caregiving (healthcare chaplains) and generalists (physicians, nurses, therapists, social workers, psychologists, volunteers) have different professional ‘scope’ and therefore a different challenge in communicating with their patients on spiritual needs. How do we support each other in paving a way in this challenging territory that may lead to customised training and ways to address spiritual issues that fit the professional profile of the generalists?

How to get involved

Looking into our archives, I found that researchers and professionals had indicated they wanted to be a part of the Reference Group’s initiative to implement spiritual care in palliative care. It is still a challenge to manage this ‘horn of plenty’, for instance by bringing people together that are working in the same country. A time-consuming task, but worth the effort.

And last but not least: how can we communicate with all researchers, professionals and volunteers on these subjects? In fall 2019, the core group of the reference group will continue their work on building an international liaison network, a comprehensive social media strategy and to organise a meeting in spring 2020.

If you are interested in participating in one of the above, please email Marie-José Gijsberts, co-chair EAPC Reference Group Spiritual Care.

Links

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