Comment: From here to there: reaching out for palliative care
Sheila Payne
pp 264-265
It befalls few people the honour and privilege to witness momentous life events, such as birth and death, on a regular basis; yet in palliative care, this is our raison d’être. Compassionate, evidence-based, timely, appropriate and affordable care are all laudable goals that we should aspire to. As I take on the role of leading the newly elected Board of Directors of the European Association for Palliative Care (EAPC), I want to reflect on where new challenges may lie, and to argue that it is time for us to reach out to all those who are experiencing ‘disadvantaged dying’.
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Preventing iatrogenic pain in oncology patients: considerations and solutions
Ana Infante
pp 266-269
There is little information available on the pain caused to patients by healthcare professionals during caregiving or diagnostic and treatment procedures. Much progress has been made in evaluating and relieving the pain suffered by oncology patients, and several studies have been carried out on the iatrogenic effects of chemotherapy and radiotherapy treatments. However, not all pain can be attributed to the illness or the treatment. Some pain is caused during caregiving and by invasive procedures, and it is necessary to examine in greater depth the impact this can have on patients.
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Diabetes in advanced cancer: are we following best practice?
Lucy Balding, Tessa M Phillips and Jane S Fleming
pp 270-273
Diabetes mellitus is one of the earliest recorded diseases in mankind. Management has improved greatly since the ‘water tasters’ of the 11th century. From the ground-breaking discovery of insulin in 1921, research, innovation and discovery in the field of diabetology has resulted in ever more sophisticated and effective means of treating diabetes. The introduction, ten years ago, of insulin analogue depots, such as insulin glargine and insulin detemir, has further revolutionised diabetic management. Latterly, research into the incretin effect and the subsequent development of incretin-based therapies, such as GLP-1R agonists and DPP4 inhibitors, has expanded the range of drugs available for the treatment of diabetes.
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Case study masterclass 59: Managing renal failure at home near the end of life
Helen Noble and Sheila Johnston
pp 274-275
Rafiq is a 77-year-old man, originally from Bangladesh, who is referred to a renal supportive care service (RSCS) with stage 5 chronic kidney disease (CKD) in August. This comes following several years of meeting with a consultant nephrologist due to reduced renal function. Rafiq has also suffered from ischaemic heart disease and hypertension. He moved to the UK with his wife over 30 years previously, and has eight children.
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Case study masterclass 58 answers: A 70-year-old woman with motor neurone disease and changing advance care plans
Sarah Bailey and Bernadette Lee
pp 276-276
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The use of ultrasound in hospice units
Bernadette Lee, Marek Plaskota and Max Watson
pp 277-279
In the past decade, ultrasound machines have become cheaper and more accessible and are increasingly used by non-radiologists; for example, in obstetrics and gynaecology, anaesthesia, accident and emergency medicine, and cardiology, as part of clinical examination or to assist in practical procedures. Two neurosurgical units introduced a bladder ultrasound programme and showed that it reduced unnecessary catheterisation and the rate of urinary tract infections.
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Advance care planning: will it work in diseases other than cancer?
Irene Stevens and Fiona Whyte
pp 280-284
By the age of 65, nearly two-thirds of people in Scotland will have developed a long-term condition; 27% of those over 75 will have two or more conditions, and 60% of all Scottish deaths are attributable to a long-term condition.
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Complementary therapies for carers: a pilot study
Sue Higgins, Hilary Minter and Clare Tarling
pp 285-287
Informal caregivers are valuable members of the healthcare team, especially on a palliative care unit. Looking after a relative with a life-threatening illness can be the most difficult task a person has ever undertaken, and yet, their contribution and needs are often overlooked. Caring, by its very nature, is often a private and personal activity; this has led to a lack of recognition from the government and society as a whole. However, there are over 6 million carers in the UK providing unpaid care – the economic value of which is £119 billion.
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Children: different – but the same species
Richard Hain and Nigel Ballantine
pp 288-292
It is an article of faith among paediatricians that ‘children are not just small adults’. At the same time, too stringent an emphasis on the differences between adults and children can impede progress in delivering palliative care to children of the same standard as that received by adults. It has been pointed out that ‘progress in medicine … can be applied to and be of benefit to all, and the transition from childhood to adulthood should be one of continuity rather than migration’.
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ATOME training of lawyers and national counterparts workshop: a report
Tom Lynch, Sheila Payne, Willem Scholten, Saskia Jünger and Lukas Radbruch
pp 293-297
The Access to Opioid Medication in Europe (ATOME) project commenced in December 2009, funded over five years by the European Commission. Its objective is to improve patients’ access to opioids in 12 European countries where there is statistical evidence of very low per capita morphine consumption: Bulgaria, Cyprus, Estonia, Greece, Latvia, Lithuania, Poland, Slovakia, Hungary, Slovenia, Serbia and Turkey.
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Developing palliative care in Nigeria – a collaborative approach
David Oliver, Dayo Olupitan and Falaju Oyebola
pp 298-301
Nigeria has the largest population in Africa: 140 million people from over 250 cultural tribes occupy a huge area of 923,768 km2. With a high prevalence of HIV infection (5%) and social issues relating to poverty and low availability of healthcare, there are many health issues to face in the country.
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A day in the life of Bob Heath, Music Therapist
Bob Heath
pp 302-303
My day usually begins at 6.45 am, when I set off on my regular commute from Swindon to Oxford. Surviving the gridlock, I arrive at the hospice; I’m usually able to open the office and the music room by 8 am. Coffee and emails follow, with my doors open to allow music from my studio to drift in. This can be anything from Mozart to an Indian raga – often with a little Tom Waits thrown in for good measure.
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European insight: The Palliative Care Research Society: facilitating research in the UK
Erna Haraldsdottir
pp 305-307
Research has always been an important part of the development of palliative care. However, embedding research in the culture of palliative care is a continuous challenge. While there is no doubt that there has been considerable progress in this respect over recent years, the number of people engaged in palliative care research is relatively low.
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