Palliative Care Conversations

At End of Life, Family Often Too Optimistic on Survival Educating a family about a poor prognosis has always been difficult. Now a study appearing in the  Journal of the American Medical Association  reveals the extent of misunderstanding when patients and physicians both try predict the chance of a loved one's survival. In this 150-second analysis,  MedPage Today  clinical reviewer F. Perry Wilson MD, MSCE, breaks down the data.

There has been an increasing trend in the pastoral care movement to move away from chaplaincy and pastoral care in favor of promoting and providing "spiritual care." Many hospital departments have changed their names to reflect this shift in philosophy and practice. Spirituality circumvents religion and promotes chaplaincy as a generic practice. Religions are messy. They have rules, doctrines, beliefs, ethics---some of which are flawed to be sure. But religions usually stand for something. Spirituality is an amorphous thing, an oblong blur, with implications of cosmic connection, but with no price tag---no demands no dogmas, and no ethics. Not even a dogma demanding justice and mercy. The only perceptible doctrine promoted by the spirituality movement is that people should feel good about themselves. At its best the clinical pastoral movement teaches religious professionals to be available to everyone. It also teaches them to be critical of all religion---but dismissive of no

  Health Affairs has published a moving essay and podcast on the power of effective communication in the doctor-patient relationship. . .   'I Don't Want Jenny To Think I'm Abandoning Her': Views On Overtreatment   Diane E. Meier   The article, published in the current issue of Health Affairs ,  the leading journal of health policy thought and research,centers on an experience with a cancer patient whose oncologist was struggling to give up on experimental treatment. The problem, as Dr. Meier came to realize through palliative care consultations with her patient, as well as discussions with the patient's oncologist, was not that the oncologist lacked compassion but instead lacked the proper training to discuss the realities of the illness with the patient.   "To change behavior, we must change the education and training of young physicians and the professional and clinical culture in which they practice."

Palliative care, a multidisciplinary approach to treating people with chronic illnesses, can be a viable and valuable option for people with ALS (PALS). Palliative care focuses on symptom/pain control as opposed to trying to cure an illness. It combines a robust roster of medical, spiritual and emotional services as well as support to meet each patient's individualized needs. "Palliative care is a service offered to people who have chronic illnesses and who need to focus on symptom and pain control, perhaps forsaking or delaying further curative attempts," said Julien Olivier, DMin, BCCC, Fellow in Hospice & Palliative Care and Chaplain at Wentworth-Douglass Hospital in Dover, NH. "PALS could seek palliative care at any time, beginning with their diagnosis. An expert team helps patients and their families address coping skills, anxiety, use of assistive devices, necessary support services, end-of-life issues and more." Read the full article at the lin

A questioner asked: We want our patients to receive chaplain services and want to ensure that our patients are not proselytized. How can we do this? Concerning Proselytization: The College of Pastoral Supervision & Psychotherapy (CPSP) accredits Clinical Pastoral Education Training programs and certifies Board Certified Clinical Chaplains. We trust that the following would address some of the concerns about proselytization: From the CPSP Code of Professional Ethics: Respect: Colleagues, students, clients, parishioners, and patients deserve our respect. Therefore, members will not proselytize nor impose their own theologies on others. CPSP members will refrain from exploiting relationships or using them to their own advantage. Exploitation includes emotional, financial, sexual, and/or social gain. Records, evaluations, personal notes, and informational conversations will be kept confidential. Competency in Pastoral Care/Counseling : The basic requirements in CPSP for

End-of-Life Care | Pediatric Medicine And a Dying Child Shall Lead Them By David Ollier Weber December 17, 2013 Hospitals can improve their support for seriously ill children and their families by investing in clinician education and integrating care near the end of life into patient safety, quality improvement and other systems. Read The full article by clicking here