Broad Program Reflects Multi-professionalism - More Consideration To Cultural Diversity Of Those Cared For - European Association For Palliative Care

Main Category: Palliative Care / Hospice Care
Article Date: 11 May 2009 - 2:00 PDT

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The guiding principles of the 11th Congress of the European Association for Palliative Care (EAPC), as outlined by the Chairmen of the Scientific Committee, Prof. Friedemann Nauck (Hannover, Germany) and Prof. Phil Larkin (Dublin, Ireland): "Our commitment is to offer a dynamic, innovative and scholarly programme which reflects contemporary palliative care." More than 3,000 experts from throughout the world are gathering in Vienna (Austria) for this major scientific event from 7 to 10 May. "We have brought together an international field of experts to share their work and their passion for palliative care. The scientific programme reflects the broad spectrum of palliative care and the enormous development in the last years. This Congress is a balance between the varied components that make up palliative care - attention to physical, psychological, social and spiritual needs is paramount for the delivery of best care."

The programme mirrors the diversity of the profession

Perhaps more than in other medical disciplines, palliative care is characterized to a very high degree by interdisciplinarity and multi-professionalism - a fact that is reflected in the conference programme. Thus, for the first time there will be a session just for volunteers from German speaking countries. "Volunteers are often described as the backbone of palliative care. Many hospices and palliative care units are supported by members of their local communities in many different ways, from caring roles to bereavement support to fundraising", Prof. Larkin describes the importance of volunteer support. "What volunteers represent in palliative care is a link between the local community and those members of that community who are now in need of care. Volunteers come from a variety of professional and social backgrounds. What is important is that irrespective of their background, they can offer something valuable to the practice and vision of palliative care."

Other novelties at this congress are workshops on physiotherapy, music therapy and undergraduate education in palliative care. "Several scientific presentations show the positive effects of music in the provision of palliative care", says Prof. Nauck. We know that music has the ability to enable patients to feel the powerful emotions that are sometimes difficult to express in words. Through songs which evoke memory, or using rhythm and sound, the deeper experiences of facing the possible end of one's life can be addressed."

Home as the best place of care for children

Pediatric palliative care is also an important theme that is reflected in a special symposium part of the Congress programme. "Very complex problems are posed when determining the most appropriate place of care for children with life-limiting disease," Prof. Nauck points out. "It is a difficult, but very important issue to provide respite care, that is short-stay periods in an in-patient unit, to offer a break to families." Discussions on this at the Congress are important because there is a need to promote a clear public understanding of children's palliative care as different to what is commonly understood as palliative care for adults, Prof. Nauck says. "We advocate home as the best place of care for children, oncology-orientated hospice and palliative care units may not be able to meet the diverse needs of children who have often life-limiting conditions which are not cancer related but are more often related to congenital abnormalities or multiple handicap", according to Prof. Nauck. "So, the question is how we, as the palliative care community, can respond effectively to the needs of families and whether more children's hospices are the real answer to a difficult problem." Included among the special features of palliative care for children, for example the need to use higher doses of opioids in some children to achieve optimum pain control when compared to adults or how siblings are best supported when their brother or sister is actively dying."

Right for people with dementia to access competent palliative care

At the other end of the spectrum, another scientific session at the EAPC Congress is addressing the needs of older people. "Although palliative care and dementia care would share common values in terms of their caring approach, there are clearly gaps in service provision for dementia patients at end-of-life, particularly in terms of clinical management and resource allocation to develop services", Prof. Larkin explains the importance of the topic. "We need to stress the right for people with dementia to access competent palliative care which integrates skilled geriatric care to support their living and not just their dying. This means two things: That there needs to be closer integration of palliative care and older person care service for mutual exchange and knowledge and skills to provide better care packages for older people and second, that palliative care develops a stronger public education message that it is not only about cancer but offers a system of care relevant to a wide range of illnesses and diseases."

Important role for nursing

Also addressed at the EAPC Congress in Vienna: The contribution of palliative nursing to modern conceptions of palliative care. "Nursing has been fundamental to the development of caring for dying people and there are many excellent examples of nursing scholarship and clinical practice across the palliative care world", Prof. Larkin points out. "However, the message that nursing contributes significantly to palliative care is not universal and there is a need to use what Prof. Margaret O'Connor from Melbourne terms 'courageous creativity' to enhance not only the role of nursing, but the development of palliative care services through innovation and change for healthcare systems with limited resources and marked incapacity."

PRISMA study

Congress participants are awaiting with great interest a presentation to be given by the PRISMA research collaborative on culture and its importance in understanding best end-of-life care from researchers at the University of Barcelona. PRISMA is a major three year project funded by the European Union under the 7th Framework programme. "Sensitivity to diversity and difference mean that we cannot consider palliative care as a uniform approach and this presentation draws on anthropology to make its claim for greater attention to this important topic", says Prof. Nauck.

Bereavement and loss are important issues for palliative care professionals to consider. These themes are therefore getting lots of space in the Congress programme. "Obstructed grief following traumatic loss has a major impact on the human psyche", says Prof. Larkin. "The reasons why grieving becomes difficult are often related to the relationship with the deceased, things said or left unsaid, or something in the past which has remained unsolved. It is not uncommon that the person in such grief does not realize the extent of their suffering and may present to their physician with psychosomatic symptoms which are difficult to treat or are unresponsive. Palliative care practitioners who deal with the trauma of loss are skilled in 'un-picking' the story of the bereaved person in a sensitive way which enables their feelings to emerge in a safe and protected way and enable them to move away from their trauma to a position of hope and future."

Young investigators award

The EAPC is showing particular awareness of the need for appropriate cultivation of a new scientific generation. For the first time, the EAPC will bestow a "Young Investigator Award" at its 11th Congress. "Criteria for selection were, inter alia, a strong interest in research in palliative care, evidence of academic, clinical and/or applied development with relevance to palliative care", Prof. Nauck explains. Jenny van der Steen from Amsterdam (NL) was selected for this award and presents her research to the Congress entitled "Palliative care for dementia patients and benefits of cross-national longitudinal studies".

European Association for Palliative Care

Source:
Dr. Birgit Kofler
B&K Medien- und Kommunikationsberatung GmbH

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