STREAM 4: CLINICAL PRACTICE – PAIN AND SYMPTOM MANAGEMENT

This stream will focus on pain and symptom management.  Attendees will participate in intermediate to advanced workshops, academic working groups, and case-based discussions.

Friday, June 15, 2018 – Morning Session – 8:30 a.m.

Palliative Care for Cancer and Renal Fields

This session will examine the palliative management of end-stage renal disease.  Included will be a review of current evidence for conservative care and dialysis.  As well, we will discuss models for incorporating palliative care principles into the management of patients with ESRD. This session will provide an update on oncologic therapy for the more common oncologic illnesses.  The focus of this session will be on newer treatment options, including immunotherapy.  This will be a practical session.

Learning Objectives:

1. Understand an integrated approach to conservative (non-dialysis) kidney management
2. Describe evidenced-based management of 3 common symptoms in ESKD
   • Pruritus
   • Restless legs syndrome
   • Pain
3. Describe a framework for providing  palliative dialysis
4. Update on new anti-nausea drugs
5. Update on new anti-cancer drugs
6. Recognize unique side effects seen with these therapies in different cancer types
7. Discuss the five pillars of immunotherapy toxicity management

Faculty:

1. Sara Davison, Professor of Medicine, Division of Nephrology & Immunology, Director, Kidney Supportive Care Research Group, University of Alberta
2. Dr Martin Chasen MBChB FCP(SA) MPhil(Pall Med), Medical Oncologist/Palliative Medicine Specialist, Director of Palliative Care William Osler Health Services

 Friday, June 15, 2018 – Afternoon Session – 1:30 p.m.

Engaging the Continuum of Dignity in Care

Dignity in care encompasses several domains – respecting personhood, increasing meaning and hopefulness, appreciating legacy, and preserving a sense of self.  As such, providing dignity in care is an on-going and multi-faceted process.

• This session will provide the theoretical foundations of dignity in care, as well as the practical tools and resources for its application in a variety of contexts.
• Specifically, information about the Patient Dignity Question, Dignity through Music, as well as Dignity Therapy will be provided.
• Attendees will have the opportunity to practice several dignity-in-care techniques during the session and will leave with ideas for how to incorporate these practices into their work.
• The session will conclude with a period of self-reflection regarding how aspects of dignity can also be fostered in our own lives as helpers, appreciating that true dignity in care begins with us.

Learning objectives:

1. Learn about the theoretical foundations of dignity in care.
2. Learn about practical tools and resources for its application in a variety of contexts.
3. Opportunity to practice dignity-in-care techniques.

Faculty:

1. Jill Taylor-Brown, MSW, RSW
2. Lori Montross-Thomas, Ph.D., Assistant Professor and Licensed Psychologist, University of California San Diego, Department of Family Medicine and Public Health

Saturday, June 16, 2018 – Morning Session – 8:30 a.m.

 The “Opioid Crisis” and its Relevance to Palliative Medicine

If we subscribe to “Early, Integrated, Collaborative & Interprofessional Palliative approach to Care, Palliative Care and End of Life Care” as we move forward; we must explore the “Opioid Crisis.”  This session will examine the way the opioid crisis is seen in Canada and the rest of the world, and its relevance to caregivers, patients, families, and community.  The session will examine this topic through looking at social determinants of health, genetics, negative experiences with poor coping along with poor practices by the caregivers contributing to the opioid crisis, and how this issue requires community engagement at different levels to address.

This session will also take a look at the principle of how “Palliative Care is Everybody’s Business.”  As generalists are currently giving most of the care, this session examines how attempts are being made to improve care through education and competency.

Facilitators will also look at an example of how Calgary has been encountering and caring for oncological and non-oncological (55%-45%) palliative care patients and families, and apply the idea that palliative care is becoming a “Spectrum of Care.”  The notion that palliative care is a spectrum of care is being seen through an increase of individuals who are requiring interventions early in the trajectory of illness, treatment related to symptoms with cure of primary illness, recurrence and advanced illness at the end of life.   This session also looks at chronic non-cancer pain and discusses the idea that some of the loco-regional and national guidelines that have been created may not directly apply to patients who are at the end of life, but by getting specialists and generalists involved early in the trajectory of illness the individual and societal needs remain similar.

Lastly, this session will also explore the concept of ‘risk management’ and examines the idea that there may be some unintentional misunderstandings of “risk management” amongst the patient population; media, politicians, and researchers.

Learning Objectives:

1. This session will explore the present state and discussion may occur around how to improve care.
2. This session will explore the role of community engagement

Faculty:

1. Dr. Srini Chary, MBBS, MRCS; LRCP, CCFP (PC), DA, FRCSEd, Consulting Physician, Regional Palliative & Hospice Care, Calgary Zone, Palliative Medicine, Clinical Assistant Professor, Department of Oncology & Family Medicine,
   Cummings School of Medicine, University of Calgary
2. Dr. J. David Henderson, Medical Director Colchester East Hants Palliative Care Program,  Assistant Prof. Dept. of Family Medicine, Dalhousie University, President Canadian Society of Palliative Care Physicians