How a resource-oriented approach can enhance palliative care.

Posted on May 9, 2023 by pallcare

Palliative care aims to improve patient and relative quality of life, and this can be supported by helping them to identify and draw on their internal, external, community and society-based resources. For today’s blog, Prof. Mathieu Bernard tells us about the ‘resource oriented’ approach which can complement palliative care practice.

The World Health Organization’s definition of palliative care focuses on the identification and treatment of health problems in the physical, psychosocial and spiritual domains – a deficit-oriented (what is missing and what is needed) approach, aimed at identifying and resolving physical symptoms, psychosocial and spiritual issues, and thus relieve suffering. However, recent research shows that patients’ and families’ quality of life improves more significantly and sustainably if the treatment also builds on enhancing the patients’ and relatives’ identified resources – a resource-oriented approach, which can be seen as a necessary complement to the deficit-oriented one. This approach is in line with the focus on patient autonomy and empowerment which characterises palliative care. A resource-based approach is not new in palliative care. It is consistent with the notion of resilience, which has been the subject of much work over the last 20 years in many scientific disciplines, including palliative care (1).

Resources for palliative care patients and families can be classified into four levels: internal (e.g., spirituality, gratitude), external (e.g., family, friends, home environment), community (e.g., caring communities, hospice volunteers), and societal (e.g., health care policies, palliative care availability). The first two levels concern the psychosocial and spiritual care of the individual patients and their significant others. Several studies have shown the importance and efficiency of strengthening patient and family resources such as gratitude or social relations in order to sustainably improve their quality of life. The last two resource levels concern palliative care as a public health issue, which involves creating the necessary political and society-based conditions for delivering palliative care (both through the deficit-oriented and the resource-oriented approach) to all members of the community in an equitable fashion.

To find and encourage these resources, it is necessary to look in depth at interactions between patients, their loved ones, and health care professionals, as well as support on offer from communities and society – a task that could be performed, for example, by a specifically trained social worker. Such support needs to be integrated and planned for within services to support people receiving palliative care, as it could take time to work with people to identify their resources. A resource-based approach also underlines the importance of inter-professionality in palliative care, as resources can be identified and fostered by all domains of care. One example of this interprofessional approach is a current multicentre research project led by the Lausanne Palliative Care Center which focuses on ‘Understanding patient altruism at the end of life’. Altruism is defined here as a personal and intentional interest in improving the wellbeing and welfare of others. The principal investigators of its five subprojects come from five different disciplines: medicine, ethics, nursing, psychology, and sociology, because the multi-faceted nature of resources such as altruism requires the intersection of different perspectives in order to understand the whole picture.

We believe that a resource-based approach to palliative care represents a complementary paradigm which may lead to significantly better quality of life, and clinical results, for patients and families, and should be valued more widely in health care.

Reference

1 Monroe, Barbara, and David Oliviere (eds), Resilience in Palliative Care: Achievement in adversity (Oxford, 2007; online edn, Oxford Academic, 17 Nov. 2011), https://doi.org/10.1093/acprof:oso/9780199206414.001.0001.

Links and resources

  • An international scientific symposium at the Lausanne University Hospital on Tuesday, 13th June 2023, including esteemed international experts such as Prof. William Breitbart and Prof. Daniel Sulmasy, will highlight research on the diverse array of resources in palliative care. Thanks to the support of non-profit foundations, the symposium is free of charge and will be streamed online. Click here to register.
  • Read EAPC public health and palliative care blog series here.

About the author

Prof. Mathieu Bernard is Chair in Palliative Psychology at the Palliative and Supportive Care Service of the Lausanne University Hospital (CHUV). In line with the general concept of ‘resource-oriented palliative care’, his main research interest concerns the application of positive psychology to palliative psychosocial care, and this has included research on the meaning in life, gratitude, post-traumatic growth, will to live, and altruism, and he has published extensively on these subjects. ORCID: 0000-0003-2823-8806.

Posted in OPINION PIECES, PATIENT & FAMILY CARE | Leave a comment

EAPC Board Elections 2023: How to vote! 

Posted on May 2, 2023 by pallcare

In the last blog, we introduced the candidates for the EAPC board of directors, and soon it’s over to EAPC members to make their decision. Voting opens on 5th June 2023 and closes on the 16th June 2023. Catherine Walshe and Danila Valenti, from the EAPC’s Election Oversight Committee will now tell you all you need to know about who can vote and how to vote at this important election. 

It will soon be time to vote to elect a new EAPC board of directors. This year the election process will take place online, which is a first for EAPC, so this post will provide a bit more detail on how we are going to organise this.  

Who can vote?  

Any paying member of the EAPC who lives or works in Europe, and whose subscription fees are paid in full (by 31 May 2023) has the right to vote in the election. You may be an individual paying member or, as a board member of a national palliative care association, your association may pay your EAPC membership fee.  

If you are an EAPC associate member (that means you joined the EAPC for free via your national association), you do not have a right to vote. However, if you would like to vote in the election, you can upgrade your membership and pay the individual membership fee before 31 May 2023. You will then be eligible to vote. Find out more here. 

All EAPC members who are eligible to vote will be notified in writing by email in May 2023. This email will include more information about how to vote.  

Are proxy votes (voting on behalf of someone else) allowed?  

No, proxy voting is not possible. The election process is completely online, so all members who are eligible to vote can do so.  Therefore, proxy voting is not needed.  

How and where will the vote take place? 

The vote will take place online from 1pm (CEST) on Monday 5th June 2023 to 1pm (CEST) on Friday 16th June 2023.  

Voting will take place in a secure online area that is only accessible to eligible voters. It is set up to ensure that each eligible voter can only vote once. All votes will be placed anonymously. The election committee will only be able to see how many votes each of the candidates received, not who voted for them.  

Who should I vote for? 

You will be voting for a compete EAPC Board, so you need to vote for 13 candidates. Please read the list of candidates and information about them here.  

Some points to think about when considering your vote: 

  • You must select 13 candidates. If you do not, your vote will be invalid. 
  • Board members commit to a four-year term but with an option for re-election for a further four-year term. We have four current board members who are standing for re-election. Their role is important in making the link between the work of the current board and the new board, so we do ask that you give careful consideration to re-electing them.  
  • The EAPC speaks to the broad range of people involved in palliative care. Diversity, equality and inclusion are important to us, and it is essential that our Board reflects this. The board should also be representative of a range of professional disciplines, gender balance and the whole of Europe: North, South, East and West. This is especially important because in the event of a tie for the final board place, the election committee will need to make a decision based on these criteria to ensure the overall balance of the board. 
  • You can only vote once. Changing your vote will not be allowed.  

What happens when voting has closed on the 16th June 2023? 

Once the voting is complete, the election committee will count the votes. The 13 candidates with the highest number of votes will be elected to the board. Results will be announced at the EAPC General Assembly on Friday 16th June 2023 at 18.00 CEST. 

The new board will meet immediately after the election to select a new President and Treasurer from amongst the board members. The President, Treasurer and the rest of the new board will also be presented to the Congress delegates before the plenary session on Saturday morning 17th June 2023. 

What if I have questions? 

If you have any questions, please email info@eapcnet.eu. EAPC head office staff will also be available at the EAPC stand during the Congress if you need to check anything. 

About the authors 

Catherine Walshe is Professor of Palliative Care at the International Observatory on End of Life Care at Lancaster University, UK. She is also editor-in-chief of the journal Palliative Medicine. She has sat on the board for two terms, since 2015, and will leave the board at the forthcoming elections. She has served as secretary and treasurer to the EAPC board.  

Danila Valenti is Director of the Palliative Care Unit Network, in the local health authority in Bologna, Italy. She has been an EAPC Board member since 2015, and will be leaving the board at the forthcoming elections. 

Posted in EAPC ACTIVITIES, EAPC Board Members | Leave a comment

EAPC Board elections 2023: Meet the candidates! 

Posted on May 2, 2023 by pallcare

The EAPC is delighted to see the wide range of individuals who are standing for nomination for the Board election for 2023. Professor Christoph Ostgathe, President of the European Association for Palliative Care, introduces them to you today – and in the next blog, will outline how EAPC members can vote. 

On the 16th June 2023, a new Board of Directors of the European Association for Palliative Care (EAPC) will be elected for a four-year term. The EAPC will also have a new president. This is a very important process because our board members are the lifeblood of the EAPC. Together, they comprise professionals from all disciplines, at all stages of their career, and from all parts of Europe. Each board member brings different expertise, experiences and skills which enable us to represent the cultural and political diversity of our members and to fulfil our aim of speaking with ‘one voice and one vision’ on topics that are important in palliative care. 

Writing in the blog in January this year, I stressed the importance of preparing for the EAPC Board elections and urged members to start thinking about who should represent their views for the next four years.  Members responded positively and we are delighted to introduce you to an exciting line up of candidates whose backgrounds include education, academic research, management, medicine, nursing and psychology, Four existing board members are standing for re-election who, if successful, will provide the continuity and wisdom of the previous board. 

Meet our candidates 

And here they are!  There are 18 candidates from 17 countries.  Click here to find out all about these candidates. 

Standing for re-election are: 

Our new candidates are:  

The current board has done great work. I know the next one will do the same. Who they will be is entirely up to our EAPC members!  Voting opens on 5th June 2023 and closes on the 16th June 2023. In the next blog, we will let you know who can vote and how to do it. 

About the author 

Professor Christoph Ostgathe is Professor for Palliative Medicine at the University Hospital Erlangen Nürnberg, Germany.  He has been an EAPC Board member since 2015 and President of the EAPC since 2019. Christoph will complete his term as President in June 2023. 

Posted in EAPC ACTIVITIES, EAPC Board Members | Leave a comment

Updating international consensus on the best practice in care of the dying: A Delphi study.

Posted on April 25, 2023 by pallcare

We think we know what a good death is…but some key elements can change over time. The 10 Core Principles and 40 Core Outcomes from the ‘10/40 Model for Best Care for the Dying Person’ was first published a decade ago, so it was time for an update. For March’s Palliative Medicine’s Editor’s Choice, Tamsin McGlinchey tells us what they found.

Equitable access to high quality end of life care, no matter the disease, diagnosis or place of care, should be available to all. Despite knowing what a good death should look like – free from pain, in the place of your choice, cared for with dignity and supported by the best possible care – equitable access to good quality palliative care is still a goal, rather than a guarantee.

The 10/40 Model for Best Care for the Dying Person, first developed in 2013 by the International Collaborative for Best Care for the Dying Person, is an international model of care that aims to ensure dying people can be provided with safe, high quality care by appropriately educated healthcare professionals wherever they happen to die. It can be tailored to suit local context and clinical governance arrangements and provides a framework based on internationally agreed standardised outcomes of care that care organisations can use to design clinical documents. The standardised outcomes promote opportunities for local, national or international benchmarking, and can contribute to greater understanding of how care is provided at the end of life. The 10/40 model has been adopted and adapted across a range of different care providing organisations across eleven countries linked through the Collaborative.

The 10/40 Model has evolved since 2013, with modifications and amendments made in response to new research evidence. In 2021, we undertook a Delphi study to formally update the international consensus on the content of the 10/40 Model, to ensure continued relevance and applicability for palliative care practice. A Delphi study provides a structured approach to establishing consensus and has been used in healthcare research to develop clinical guidance where evidence is limited.

Three rounds of Delphi were conducted, with 160 respondents (mostly doctors and nurses working in palliative care) from across 31 countries taking part overall. This showed that minor amendments to the model were needed to seven items related to:

  • recognition of the dying phase,
  • ongoing assessment of the patient’s condition,
  • communication with patients about the plan of care, and
  • care in the immediate time after the death of a patient.

Free text comments submitted as part of the Delphi process led to the addition of a sub-core outcome to specifically signpost bereavement services for family, friends, carers or advocates.

This study was conducted as part of the research activities of the International Collaborative for Best Care for the Dying Patient, and benefitted from the expertise of its world-wide, multi-professional membership. Limitations include low participation from patient and public groups, and lower income and culturally diverse countries. Future work on the 10/40 Model will encourage greater involvement from these groups through utilising existing links within the membership to foster wider engagement and connect with other national and international organisations. The 10/40 Model is also embedded within the research framework of the International Collaborative for Best Care for the Dying Person, which seeks to develop research protocols to continually review and reassess what constitutes best practice in the care of dying patients.

We are pleased to see the evolution of the 10/40 Model for Best Care of the Dying Person and to know that it will continue to positively influence the provision of good care for patients and their families.

READ THE FULL ARTICLE IN ‘PALLIATIVE MEDICINE’ HERE!

‘International Core Outcomes for care of the dying: A Delphi Study to update consensus on the content of the 10/40 Model for Best Care of the Dying Person’ study. Tamsin McGlinchey, Rebecca Early, Stephen Mason, Carl Johan-Fürst, Lia van Zuylen, Susie Wilkinson & John Ellershaw. First published: Palliative Medicine 2023, Vol. 37(3) 329-342.

Links and resources

  • Find out more about the 10/40 Model and the work of the International Collaborative for Best Care of the Dying Person here.
  • Read other Palliative Medicine Editor’s Choice posts on the EAPC blog.
  • Follow Palliative Medicine on Twitter: @palliativemedj.

About the author

Tamsin McGlinchey is a research assistant in the Palliative Care Unit at the University of Liverpool, where she is also a PhD candidate. Twitter: @Tamsin_McG Orcid: 0000-0001-6245-4225.

Posted in EAPC-LINKED JOURNALS, EDUCATION & TRAINING, Journal of Palliative Medicine, Palliative Medicine: Editor's Choice, RESEARCH | Leave a comment

New for the EAPC’s 18th World Congress 2023! From breathlessness to media management… announcing our exciting Congress workshop line up!

Posted on April 18, 2023 by pallcare

Today we give you a sneak peak into what we know will be an #EAPC2023 highlight! These workshops are open to anyone who is attending the EAPC’s 18th World Congress 2023. Join the experts to learn more about these key palliative care topics.

Can you guess the workshop topics from these images?

See if you guessed right! Click on the title to learn more…

#EAPC23 Skills Workshop: Challenges in Symptom Management – The Compassionate Breath: Breathlessness Anxiety Management.

‘Breath is the bridge which connects life to consciousness, which unites your body to your thoughts’, Thich Nhat Hanh.

Join me to explore how body-oriented practices can help us and our patients (re)develop Breath and Body Literacy.  By working at the level of sensory input we are able share experiences of bodily security which – I argue – is foundational when supporting people whose lived experience is characterised by breathlessness and bodily doubt.

All Breathers Welcome!!

Credit: Pixaby.

#EAPC23 Psychological and Cultural Challenges: Miscommunication with the Media.

Come and practise actively miscommunicating! Why? Well, precisely because there can be pitfalls in media collaborations, and if you are interviewed by newspapers, online or tv media journalists, it is worth knowing how and when things can go wrong – and how to help to get positive palliative care stories out there.

So come and practise some miscommunication, and then work to finesse your positive soundbites. A more informed and a ‘safer’ media strategy is guaranteed by the end of this session!

#EAPC23 Psychological and Cultural Challenges:  We Are Also Going to Die.

‘If I take death into my life, acknowledge it, and face it squarely, I will free myself from the anxiety of death and the pettiness of life – and only then will I be free to become myself’, Martin Heidegger. 

Healthcare professionals can sometimes have an uneasy relationship with their own ill health and the concept of their own death.  This workshop creates a space to explore some key themes in relation to themselves – first by thinking of triggers in their lives, and those of others, for facing this important fact that ‘we are also going to die’.  Join me to discuss philosophical, ethical and psycho-spiritual elements of facing mortality.

Kenny Eliason (Unsplash

#EAPC23 Innovation and e-Health Solutions: Designing and Implementing Virtual Palliative Care Courses.

The COVID-19 pandemic has changed the global education landscape, and remote learning is here to stay!  The nine instructional events outlined by Robert Gagne provide an excellent framework for designing effective learning experiences. Good learning pedagogy cannot be compromised, even when courses are delivered remotely. Join me to keep up to date with advancements in digital education technologies to ensure that our programmes remain relevant, rich, and engaging. 

Cookie the Pom (Unsplash).

#EAPC23 Palliative Care for Older people: Strategies to Provide and Measure Palliative Care Delivery for People with Dementia in Long-Term Care Settings.

Clinicians and researchers working in long-term care settings see unmet needs from residents and families, such as inadequate symptom management and breakdowns in communication about care goals, that palliative care providers are well-qualified to address. Yet, despite recognition of its importance, particularly for people with dementia, palliative care is not consistently available in long-term care settings due to a variety of barriers. Come and take part in this pragmatic, solutions-focused workshop, where we will consider models of palliative care in dementia, how to implement these and how to measure effectiveness to improve outcomes for the person and family caregiver.

Credit: Belajati Raihan Fahrizi (Pixaby)

#EAPC23 Psychological and Cultural Challenges: A new type of interprofessional learning: the World Grief Café.

What is loss in palliative care? In this workshop, join us to reflect together on the many dimensions of loss. For patients and their families, the existential dimension is central – the need to find meaning at the end of life and after death. But how to address this dimension? We will present an understanding of the existential dimension and invite you to work together from different disciplines and perspectives. Together, using the format of a World Café, we will generate insights on the existential dimension of grief and how to address it.

Credit: Aitoff (Pixaby).

We hope this has inspired you to come and join the workshops at #EAPC2023.  You do not need to register for these workshops – just come to the workshop room at the date and time stated. Look forward to seeing you there!

Posted in 18th World Congress, EAPC ACTIVITIES, EAPC World Congresses | Leave a comment