Day 1 :
The Centre for Counselling and Sexual Health, USA
Michael Ian Rothenberg, Ph.D., LCSW is a Board Certified Clinical Sexologist, Certified Sex Therapist and the Founder and Clinical Director of the Center for Counseling and Sexual Health of Winter Park, Florida. As a sexuality educator, Rothenberg has held a long term faculty position, in Orlando, Florida, at the University of Central Florida (UCF), School of Social Work, where he developed the curriculum in Human Sexuality and taught courses on human sexuality and sexual behavior. Rothenberg, a former Hospice Social Worker, credited with creating the Sexological sub-field of Thanatological Clinical Sexology, has published numerous articles relating to human sexuality and lectures, both nationally and internationally, at universities, hospitals and hospices, on topics related to human sexuality, sexual behavior and sexual health.
This presentation explores the dying process and the reasons include conversations about human sexuality as part of the dying process when providing psycho-educational support to patients, caregivers and families. The presentation utilizes a study, conducted by Michael Ian Rothenberg, Ph.D., LCSW, and discusses the results, published, with co-author Andres Dupras, Ph.D., in an article titled Sexuality at the End of Life Stage that examines Elisabeth Kubler Ross' five stages of death theory to explore these stages from a sexological perspective. In order to gain a better understanding of the unique difficulties experienced by terminally ill people and their caregivers when dealing with their sexuality during the various end-of-life stages, a qualitative methodological approach was utilized and resultant data were presented as case histories gathered in the context of clinical sexology consultations. Clinical interviews contributed to the resolution of varied sexual challenges faced by terminally ill people and their family caregivers. This presentation hopes to raise important questions about the palliative care professional's responsibility regarding the understanding of sexuality for individuals in the end-of-life stage as well as illustrated how to begin to engage in needed discussions on sex and sexuality.
University of Toronto, Canada
Time : 10:15-11:00
Dr. Senderovich is a physician at Baycrest Health Science System. Her practice is focused on Palliative Care, Pain Medicine and Geriatrics. She is an Assistant Professor at the Department of Family and Community Medicine, and Division of Palliative Care at the University of Toronto who is actively involved teaching medical students and residents. She has broad international experience and a solid research background. Her research was accepted nationally and internationally. She is an author of multiple manuscripts focused on geriatrics, patient - centered care, ethical and legal aspect of doctor-patient relationship, palliative and end-of-life care
Congestive Heart Failure (CHF) is an increasingly prevalent terminal illness in a globally aging population. Despite optimal medical management, prognosis remains poor – a fact seldom communicated to patients and/or their families. Evidence suggests numerous benefits of palliative care consultation in advanced CHF but to date, their services remain woefully underutilized.
To identify specific challenges to accessing and implementing palliative care in patients with advanced CHF, and to use this information to formulate recommendations for practice.
Literature review whereby recommendations for practice were formulated on the basis of primary quantitative/qualitative data and consensus expert opinion.
Accessing palliative care services for patients with CHF remains a challenge for numerous factors including prognostic uncertainty, misconceptions about what palliative care is, and difficulty recognizing when a patient is suitable for referral. Strategies to improve access/delivery of palliative care to this population include education and proper discussion about prognosis/goals of care. A team-based approach is essential as we move towards a model where symptom palliation exists concurrently with active medical disease-modifying treatment.
Despite evidence that palliative care has a role in improving symptom control and overall quality of life in patients with end-stage CHF, a multitude of challenges exist and this ultimately hinders access to palliative care services. Education to abolish pre-existing misconceptions about the role of palliative care and a movement towards a team-based approach focused on simultaneous palliative and traditional medical care will undoubtedly improve access to, and benefit from, palliative care services in this population.
Zuflucht e.V, Germany
Cordula Dietrich has completed her medical specialisation in psychiatry and psychotherapy in 2005. Since then she has been working in her own private practice in Berlin as a psychotherapist, musictherapist and relaxationtherapist. Besides her medical education, she is a trained classical singer and underwent a further training in receptive music therapy. ( GIM). Since 2010 she was seriously involved in two research studies in receptive music therapy with the Body Tambura in the field of palliative care in Lazarus hospice in Berlin and St. Joseph´s hospice in Dindigul/ Southindia. She recently completed her further training in palliative medicine. She is the chief trustee and founder of Zuflucht e.V germany, which is constantly supporting the work of St. Joseph´s hospice/ Dindigul, Southindia.
A prospective case study was carried out with patients of St.Joseph`s hospice for Dying destitute in Dindigul/Southindia. Patients were treated with a treatment at baseline and on the next day. Outcomes were measured quantitatively by using a numeric rating scale (0-10, 10 maximum intensity of pain felt) at baseline, directly after treatment and at the day after the treatment to determine the description of the intensity of the pain.
Ten patients (5 women and 5 men) participated in the study.The majority described the therapy as a pleasant experience. The pain intensity at baseline was reduced from 8.3 ± SD 1.16 to 4.6 ± 1.52 at day one and from 4.6 ± 2.07 to 2.4 ± 1.58 at day two.
A clinical relevant pain reduction was described as a short time outcome, the therapy was received and perceived well. Forthcoming research should include a control group, randomization, a higher number of participants and a longer period of treatment.