Day 2 :
Keynote Forum
Amy Clements-Cortes
University of Toronto, Canada
Keynote: Tranformative music therapy at end-of-life
Biography:
Amy Clements-Cortés,s Assistant Professor, University of Toronto, Music and Health Research Collaboratory; Music Therapy Instructor & Graduate Supervisor, Wilfrid Laurier University; and Senior Music Therapist/Practice Advisor, Baycrest Centre, Toronto. She is a Registered Psychotherapist, President of the World Federation of Music Therapy, Managing Editor of the Journal of Music and Medicine, and Board Member of the Room 217 Foundation. She has served as a President and Internship Chair for the Canadian Association for Music Therapy (CAMT). She has published in multiple journals and has given over 100 invited academic and conference presentations.
Abstract:
Relationships are often a cause of substantial psychological pain for patients and their families at end-of-life. Anticipatory grief is commonly experienced by dying persons, focusing on multiple issues including: the loss of relationships, as well as the loss of forthcoming life events of which they will not be able to participate. Music therapy is commonly used in palliative care settings to address anticipatory grief, and is a valuable therapy for addressing relationship concerns.
Dileo and Dneaster’s (2005) Model of music therapy in palliative care defines three levels of practice. At the support level, music therapy is used to support the patient and palliate symptoms. At the communicative and expressive level, music therapy facilitates the patient in reflecting upon and conveying feelings, and at the transformative level, music therapy may facilitate growth and insight at the end-of-life.
This presentation will overview this model and music therapy techniques implemented to assist patients with reference to how they have been described and implemented in the literature; with a focus on songwriting, the creation of musical autobiographies, and the construction of legacy gifts. A clinical case study of a 63 year old terminally ill patient will be shared, alongside the results of a research study which assessed the transformative role of music therapy in facilitating relationship completion. Further, the presenter’s analysis of the current practice of music therapy in palliative care will be shared identifying the emergence of nine themes of practice, falling into three categories: physical, psychosocial, and whole person care.
Keynote Forum
Kenichi Kume
Chunichi Beauty College, Japan
Keynote: Beauty therapy for palliative care in Japan
Biography:
Mr. Kenichi Kume has graduated from the Foster School of Business at the University of Washington in Seattle, USA, and holds an MBA. He has held numerous professional positions in the USA, Japan, and Switzerland. He is currently the Dean of the Total Beauty School at Chunichi Beauty College in Nagoya, Japan, and also the President of the Association of Japanese Estheticians and Beauty Therapists (AJESTHE). AJESTHE is the oldest and most prestigious beauty therapy association in Japan with over 10,000 individual members and 150 member schools all over Japan.
Abstract:
Appearance is important for people’s QOL. Both the diseases itself and the treatments negatively impact the patients’ appearance. And the changed appearance influences the willingness for the treatment, and the patient’s social activities in general. This often has a negative impact on the treatment.
The socio-esthetique, which has started in Tours, France in the 1970’s, uses the beauty therapy treatments as a part of the medical care. In order to prepare the beauty therapists for this task, the training courses are developed to give the knowledge about the patients’ body and mind, the communication skills, how to work effectively as a member of the care team, and other relevant knowledge.
The socio-esthetician training started in Japan in 2007. For the last 10 years, there have been nearly 100 beauty therapists who got trained to work as a socio-esthetician. The socio-estheticians are effective in the variety of medical fields; and we have found that it is most effective in the palliative care. If an experienced beauty therapist with proper training and careful planning is in the palliative care team, it improves not only the patients’ physical appearance but also their willingness for the other treatment. It helps the patient to be active in their daily life. It also enables the palliative care team to get more information from the patients, and the patients feel more comfortable with the beauty therapist. Adding a trained beauty therapist to the palliative care team has a great potential to improve the quality of the palliative care.
- Palliative Care & Geriatrics
Palliative Care & Spiritual Care
Palliative Care & End of Life Care
Palliative Care & Chronic Diseases
Palliative Care & End of Life Care
Palliative Care & Symptom Management
Palliative Care & Oncology
Location: Algonquin-C
Chair
Amy Clements-Cortes
University of Toronto, Canada
Co-Chair
Kenichi Kume
Chunichi Beauty College, Japan
Session Introduction
Heidi Dowse
The Salvation Army Aged Care Plus, Australia
Title: Assisted suicide international policy and palliative care : The implications on symptom management at end of life
Biography:
Heidi Dowse is currently employed by The Salvation Army Aged Care Plus, Australia, as the Clinic, Quality and Compliance Manager. Heidi has worked in Aged Care for almost 30 years, holding a variety of positions, including Dementia Specialist and Learning and Development Manager. She currently has a Master’s Degree in Nursing where she has researched culture change in aged care.Heidi is passionate about education and believes the key to change lies in moving the heart of staff before being able to move their thoughts to change. She is able to do this by sharing the stories of the people she has had the honour to care for, in particular at the end of their life. Heidi believes in always looking for the shiny in life. So often we spend our lives looking for mud. If that is all you look for, you will miss the shining moments in life.
Abstract:
This presentation explores the premise of assisted suicide and the impacts on symptom management with a consumer directed palliative approach. There is significant debate around assisted suicide and the premise of good palliative care. Legislation in many countries indicates assisted suicide is only available for ‘insufferable pain’, when this is considered from a symptom management perspective; no one should experience insufferable pain through the implementation of appropriate interventions to meet a person's pain experience. The debate from a social, spiritual and ethical position is diverse and complex, however, regardless of one's position in the debate, there is no substitute for best practice palliative care. Clinicians need to have an awareness and understanding of the issues, as well as keys to manage personal bias on this matter in order to ensure effective symptom management is achieved for the consumer.
Evaluation
As a not for profit Christian organisation, there are significant moral and ethical considerations associated with Assisted Suicide, however from a consumer directed focus, there is a requirement to ensure that individual needs are met and this means viewpoints which are plastic. The Salvation Army Aged Care Plus operates in an environment of dichotomies and to meet individual needs, there first needs to be an understanding of the issues; we have achieved this through education. Our education resources include –
• Assisted Suicide
• The Sanctity of Life
• Spirituality
• Palliative Care Interventions to ensure appropriate Symptom Management
Implications for practice
The resource was prompted by a realisation that all people experience the end of life differently and have specific views on euthanasia and assisted suicide. It is imperative our staff have a good understanding of the issues and ensure that best practice palliative care is not taken into consideration as a sil approach. There is always a need for appropriate symptom management regardless of the circumstance. Our aim is to ensure symptom management is not confused as something it is not by either clouding this by religious ideals or social ideations based on decisions which are made in regards to one’s own life choices.
Megan Vierhout
University Health Network, Canada
Title: The views of patients with brain cancer towards palliative care: A qualitative study
Biography:
Megan Vierhout is a fourth year Honors Life Science undergraduate student at McMaster University and a research student at Toronto Western Hospital, working under Dr. Mark Bernstein. She has been a volunteer in various palliative care settings, including Hamilton Health Sciences St. Peter's Hospital and St. Peter's Residence at Chedoke, since 2013. She is currently interested in qualitative research, and her past research focuses have included palliative care for brain cancer patients and the immunological gut-brain axis.
Abstract:
Palliative care is a specialty aimed at providing optimal care to patients with life-threatening conditions and has been shown to improve length of survival and quality of life, especially when introduced early. It can be administered in a hospital, a hospice (i.e. palliative care unit), or in a home-based setting. In this study the perceptions and attitudes regarding palliative care of patients with brain cancer were explored using qualitative research methodology. Convenience sampling was used to accrue patients at the Brain Tumor Clinic at Princess Margaret Cancer Center, University Health Network and 35 semi-structured interviews were conducted over a four-month period. Interviews were audiotaped and transcribed, and the data were subjected to thematic analysis. Seven overarching themes emerged from the data: 1) Patients prefer to be educated about palliative care as an option early in their illness, even if they are fearful of it; 2) there is a pre-conceived idea that palliative care is directly linked to active dying, and this generates fear in some patients; 3) patients are open to palliative care if they believe it will not diminish optimism; 4) patients would prefer to receive palliative care in the home; 5) increased time with caregivers and family are the main appeals of home care; 6) patients believe palliative care can contribute to their emotional well-being; 7) patients express dissatisfaction with brief and superficial interactions with health care providers. Overall, when educated on the true meaning of palliative care, most patients express interest in accessing palliative care services.
Jaydeep Sengupta
Indian Institute of Technology Kharagpur, India
Title: Dying in intensive care units in India: Medical practices, policies and position papers on palliative & end-of-life care
Biography:
Jaydeep Sengupta is pursuing his PhD at Indian Institute of Technology Kharagpur, West Bengal, India. He is formally trained in Anthropology and Development Studies. His area of interest is in issues related to palliative & EoLC, Death & Dying and Public Health.
Abstract:
ICU deaths are common in India. Many of the patients, admitted in ICUs, are medically futile. This compels attention to palliative and end-of-life (EoLC) care within ICUs. Since early 2005, till 2015, the Indian Society of Critical Care Medicine and the Indian Association of Palliative Care published total 6 Policy Papers and Guidelines, focusing on palliative and EoLC within ICUs. However, these documents, written solely from a medical perspective, failed to elicit wider public responses. This paper therefore takes non-medical stand for critically exam these 6 documents to find: discrepancies between the medical rhetoric and the contextual realities; and the extent to which the policies are able to clarify various clinical and ethical issues of palliative and EoLC within ICUs. The review comments are substantiated with field information, collected from a 550 bedded private hospital during 2015. It was found that although barrier-free doctor-patient communication, upholding patient’s autonomy, shared decision-making and compassionate Caregiving were strongly recommended by these guidelines, they were grossly missing in clinical practice. By and large, the physicians avoided taking the risk of shifting ICU patients from rescue to palliative care mode primarily due to inadequate infrastructure, poor human skill, medico-legal hassles and public rage associated with such shift of care. The policy documents failed to guide physicians in tackling these deficiencies. In addition, their over-simplistic model of palliative and EoLC in ICUs did not take into account several clinical and ethical complexities. The paper concludes by highlighting the need to contextualize the policies in Indian situations.
Leila Falahi
Islamic Azad University, Iran
Title: Understanding the role of spirituality and faith in relation to life expectancy and end of life experience in terminally-ill cancer patients
Biography:
Leyla Fallahi is a PhD student in health psychology at Islamic Azad University. She is a psychologist in the cancer section in Shohadaye Tajrish hospital. She has held more than 40 workshops about psycho-oncology, and palliative care. She is a board member of the clinical psychology community in Tehran. Also she is a member of specialized psycho-oncology committee in Iran. She has written and translated a number of books in the field of psycho-oncology and health psychology. She has actively been engaged in teaching, and researching of spirituality.
Abstract:
Spiritual beliefs and faith are important in the lives of many terminally cancer patients, spiritual beliefs and faith can help patients cope with the emotional experiences of end of life and face death and also influence life expectancy in terminally cancer patients. The spiritual and faith dimensions fuse the essential estimations of terminally cancer patients, their considerations on what gives life meaning and religious or non-religious perspective. It additionally incorporates convictions about what happens after death. The purpose of this literature review was to describe the role of spirituality and faith in life expectancy and end of life experience in terminally Cancer patients. The reviewers searched electronic databases, and performed a manual search for studies published. The inclusion criteria covered spirituality and faith for terminally cancer patients in relation to life expectancy and end of life experience. The studies were, originally, randomized controlled trials or quasi-experimental designs. Studies were selected using the inclusion criteria. The results indicate that spirituality and faith produce positive effects on patients’ end of life experience and psychological conditions and an increase their life expectancy. Spirituality and faith improve the adjustment and coping strategies with cancer. Further research into the cost effectiveness of spirituality, faith and its long-term effectiveness for cancer suffering is needed.