2017; Volume 18, No 8, August
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
Overthrowing barriers to empathy in healthcare: Empathy in the age of the Internet
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE | Online – 27 June 2017 – Empathy-based medicine re-establishes relationship as the heart of healthcare. Practitioners often complain that their capacity to practise empathically is undermined by “tyrannical guidelines,” insufficient time and an ever-increasing burden of paperwork. Clinicians often see this system as lacking empathy – uninterested in practitioners’ perspectives, health or welfare. Within this context, it is unsurprising that National Health Service [in the U.K.] staff have significant work-related stress and ill health. As a result, patients suffer, claiming clinicians do not communicate adequately, often leaving their needs and concerns insufficiently addressed. The limitations of guideline- and evidence-driven care and healthcare’s rising costs, together with the overwhelming evidence that empathic care can improve a wide range of outcomes in diverse patient populations, suggest a new paradigm for medicine necessary. Empathy-based medicine promises to improve patient outcomes, reduce practitioner burnout and save money. Empathy-based medicine uses skills we all have, and that most of us can enhance. These skills should be embedded within, rather than added on to existing training and practice. Methods for teaching these skills need to be refined and digital technologies exploited to help make this a reality. Directly observing and measuring its impact in healthcare will support changing culture to placing a greater value on empathy.
Volunteer navigation partnerships: Piloting a compassionate community approach to early palliative care
BMC PALLIATIVE CARE | Online – 3 July 2017 – A compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity. In this project, the authors piloted one such capacity-building model in which volunteers and a nurse partnered to provide navigation support beginning in the early palliative phase for adults living in community. The goal was to improve quality of life by developing independence, engagement, and community connections. Seven volunteers were partnered with 18 clients. Over the one-year pilot, the volunteer navigators conducted visits in home or by phone every two to three weeks. Volunteers were skilled and resourceful in building connections and facilitating engagement. Although it took time to learn the navigator role, volunteers felt well prepared and found the role satisfying and meaningful. Clients and family rated the service as highly important to their care because of how the volunteer helped to make the difficult experiences of aging and advanced chronic illness more livable. Significant benefits cited by clients were making good decisions for both now and in the future; having a surrogate social safety net; supporting engagement with life; and ultimately, transforming the experience of living with illness. Overall the program was perceived to be well designed by stakeholders and meeting an important need in the community. Sustainability, however, was a concern expressed by both clients and volunteers.
End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care
PALLIATIVE MEDICINE | Online – 3 July 2017 – This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues. Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multi-disciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.
Palliative care development in Africa: Lessons from Uganda and Kenya
JOURNAL OF GLOBAL ONCOLOGY | Online – 30 June 2017 – Despite increased access to palliative care (PC) in Africa, there remains substantial unmet need. The authors examined the impact of approaches to promoting the development of PC in ... Uganda and Kenya, and considered how these and other strategies could be applied more broadly. Both countries have implemented strategies across all five domains [i.e., education and training, access to opioids, public and professional attitudes, integration into national health systems, and research] to develop PC. In both countries, successes in these endeavors seem to be related to efforts to integrate PC into the national health system and educational curricula, the training of health care providers in opioid treatment, and the inclusion of community providers in PC planning and implementation. Research in PC is the least well-developed domain in both countries. A multidimensional approach to development of PC across all domains, with concerted action at the policy, provider, and community level, can improve access to PC in African countries.
Media Watch is intended as an advocacy, education and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC Newsletter will publish an abstract or summary of an article or report of special interest noted in recent issues of Media Watch (see below).
Read the current and back issues of the weekly report.