Join Dr Louise Walker and the PALPRAC team in an informative webinar as we discuss breaking bad news in Zulu speaking cancer patients.
Breaking bad news (BBN) is a common event in palliative care and communication skills are critical to good practice of the discipline. There is a dearth of guidance for communicating with African language/cultural groups. The qualitative study discussed in this webinar highlighted phrases & techniques in the international BBN literature, adapted them for use with Zulu speaking cancer patients & discussed their appropriateness with this group of patients. An understanding of Zulu speaking cancer patients’ BBN experience was also gained. Valuable insights regarding the perspectives of Zulu speaking cancer patients was gained.
While this study focuses on one specific African language, valuable information regarding BBN in cross-cultural and cross-language situations can be gleaned from it. Findings encourage clinicians to reflect on their patient population & tailor BBN to the specific scenario.
** The PALPRAC Webinar Series is available to FULL & ASSOCIATE PALPRAC Members, and registration is open on our Membership ‘self-serve’ platform. To qualify for a CPD Certificate (2 CPD points), participants must be present for 90% of the webinar.
Please login and register for the event via the events page on your Membership homepage.
Thank you to the POWER FM lunch team for this interview with PALPRAC Chair, Dr Julia Ambler, discussing the lack of availability of morphine. Reminding us that this poses a genuine concern for patients and doctors trying to manage pain.
This conversation was also highlighted on NEWS 24 – insert below,
Access to morphine in the South African healthcare sector remains a concern as availability is under pressure.
Morphine is on the WHO’s List of Essential Medicines and South Africa’s Essential Drugs List. Knysna Sedgefield Hospice, Dr Janet Stanford, said: “We have been facing a human rights crisis for the past three months if we go by the WHO guidelines of a patient’s right to pain relief. Severe pain has a significant impact on quality of life.
It’s also highly distressing to the patient’s family, carers, and healthcare professionals who have to witness people in pain and not be able to do anything for them and not have an answer for families about when the drug will become available.
Stanford said the public sector had been particularly hard hit since the morphine was usually the only drug stocked for severe pain relief at public facilities. Morphine is considered an inexpensive drug at an estimated R60 a gram, and a package of Mist Morph syrup contains 10mg or 5ml with a typical dose of 5ml every four hours or as required.
“In the private sector, there are other strong opioids that are available, but they are expensive and are not in a liquid form, so they’re facing the same challenges,” said Stanford.
“A liquid form of the drug is beneficial when people can’t swallow because it causes them more pain and liquid morphine has a rapid onset of action compared with tablets.”
Dr Margie Venter of non-profit PalPrac (Association of Palliative Care Practitioners of South Africa) said the untenable situation that had unfolded needed to be called out as an “ongoing national crisis”.
“It’s desperate and dire. To allow this suffering to continue without alternatives is not humane,” she added.
Even with Barrs Pharmaceuticals’ response to IPAC that its operations have been restarted, Venter said liquid morphine remained unavailable at the end of September, adding there had also been no communication from the Department of Health on the way forward.
“We have been trying to delve through the supply network to try and find out where the hiccup is – whether it’s a supply issue, whether it’s an issue of non-payment from government, or even if there’s a global shortage, and we cannot get any communication from Barrs or the Department of Health.
We’ve sent enquiries through various channels, and we still don’t have any clarity on the problem. The government has been reticent, which means we don’t know where to focus our attention.
“We can’t plan or start finding solutions, especially in the public sector where there aren’t available alternatives to morphine,” she added.
Venter added that pain management was essential throughout the course of cancer treatment.
“With pain management, some people can function well, maybe even feel strong enough to work, so morphine is not just an end-of-life medication. It’s needed early on as part of cancer pain management.”
Join the PALPRAC team as we discuss Bridget’s journey with grief and the collection of assets that inspired The Grief Handbook and The Grief Course, which offers hope to those that might feel less alone during bereavement.
PALPRAC members can attend for FREE of charge, and PALPRAC Guests are charged R50/session to attend.
Please visit https://bit.ly/3S14u7R to register online and remember, that to qualify for a CPD Certificate, participants must be present for 70% of the webinar.
If you would like to join PALPRAC as a Member, please visit our PALPRAC website, where you will find more information about our membership categories, member benefits, valuable resources, and upcoming events you can attend for free.
Today is National Grief Awareness Day. The death of someone close to us is an event we are all likely to experience. And the grief that comes along with it. For many of us, we don’t know what to do or how to deal with grief – whether it’s our own or the grief of someone we know.
National Grief Awareness Day is an opportunity to talk about grief, and loss, in an open-hearted way, knowing that others are going through the same thing. A chance to support those who have lost someone they love, and are now trying to pick up the pieces of daily life.
Bridget McNulty’s story.
When my mom died very suddenly – 13 days from diagnosis till death – I looked for a book that would help me. I’m a writer and a reader, and books have helped me with every stage of my life… Like medicine, they can ease pain and shed a little light, and make things slightly easier to bear.
Except, I couldn’t find that book. I could find religious books about death, philosophical books about grief, and texts about grief counselling, but nothing warm, empathetic, and kind. I wanted something easy to read because my mind was foggy. I wanted something kind because life felt so hard. I wanted something that gave me space to express myself – rather than told me how I should be feeling. But I couldn’t find it – so I wrote it.
The Grief Handbook: A guide through the worst days of your life is the book I wished I’d had when my mom died. It’s a collection of all the things I found most helpful when I was grieving – from poems to podcasts to excerpts from books and articles – along with reflections on my grief journey, expert input on things like PTSD and complicated grief, and exercises that might help move through certain emotions. Things like colouring in and journaling, venting, and externalizing grief.
This year, together with two very wise women (artist Clare Louise Thomas of The LOVE Kitchen, and Alignd and Swansong co-founder Shivani Ranchod), I’ve created The Grief Course – an online companion through the grief journey. It’s an online course with zero expectations, self-directed and purely there to provide support and guidance as you move through grief.
My hope, with both The Grief Handbook and The Grief Course, is that others who are grieving can feel less alone. We are all in this together – this messy journey of loving, and losing those we love. Let’s be as kind as we can on the journey.
Bridget McNulty is the author of The Grief Handbook: A guide through the worst days of your life.
PALPRAC Members are invited to join Drs Shannon Odell and Thilo Govendar to discuss the palliative care needs of drug-resistant tuberculosis (DR-TB) patients in our South African setting, with an emphasis on focusing on person-centred care rather than an algorithmic approach.
Shannon Odell will discuss her research findings on the topic, which took place pre-COVID, whilst Thilo Govender will also discuss the current changes to treatment regimens, the impact on patients, and her ongoing research. She will also touch on how the COVID pandemic has affected DR-TB patients and strategic management goals.
PALPRAC is proud to host both PalliCHAT Conversations as well as our PALPRAC Webinars for our members.
PALPRAC PalliCHAT Conversations* are CPD accredited discussion forums available to our PALPRAC Members free of charge, healthcare professionals are invited to join these informative discussion panels at a fee of R50. The PALPRAC Webinar Series* is available to PALPRAC Members, with a series of palliative care topics covered during the year and a full list of upcoming topics available online. In addition, all topics are recovered and made available on our membership portal, with webinars available as post-CPD articles whereby members can review webinars in their own time and attain CPD points by completing an online evaluation.
*All development training is kindly accredited by UKZN and 1 CPD point is offered per hour for our online training.
Welcome to the 2023 South African Palliative Care Conference.
PALPRAC is proud to share the exciting news of the South African Palliative Care Conference 2023 to be presented as a collaborative venture between the three leading palliative care organisations in our country, the Association of Palliative Care Practitioners of South Africa (PALPRAC), Palliative Care for Children South Africa (PatchSA) and the Hospice Palliative Care Association of South Africa (HPCA).
This pioneering in-person conference will take place from 26 – 29 April 2023 at the world-class Vineyard Hotel in the beautiful mother city of Cape Town. REGISTRATION IS OPEN
In the wake of a deadly pandemic which exposed the lack of preparedness of many healthcare providers to offer appropriate end-of-life care to patients and families and addressing the urgent need to raise awareness of the multiple benefits of early referral to palliative care, the compelling theme chosen for our conference is Palliative Care is Everyone’s Business.
The conference aims to reach out to and welcome people from a broad diversity of vocations whose work brings them in contact with adults, adolescents, and/or children with life-threatening and life-limiting conditions and to encourage the exciting exchange of knowledge, new and innovative ideas, research, and experiences.
The overriding focus of the workshops, plenary and parallel presentations at the conference will be on the imperative for palliative care of the future to be inclusive, relevant, and sustainable.
Our aim: To draw together a broad diversity of practitioners for important conversations and shared learning with a focus on the imperative for palliative care to be:
• Inclusive: Encompassing clinical conditions across every discipline of medical care, all age groups, and every care setting. • Relevant: Involving a bio-psycho-socio-cultural and existential multidisciplinary team approach to every patient with multiple pertinent ethical considerations. • Sustainable: Engaging health systems (policymakers, regulators, medical schemes, professional bodies, hospital administrators, and academia) to ensure access and integration.
Conference activities: Activities will commence on Wednesday 26 April with an optional full day of workshops, an opening ceremony followed by two and a half days of plenaries, abstract-driven oral and poster presentations, and a gala dinner, ending at midday on Saturday 29 April.
Please look out for our call for abstracts which will be distributed on 1 September 2022. For more information, please contact diné at email@example.com
Join Dr. Raksha Balbadhur MBChB (UCT) DA (SA) Dip PallMed MPhil Pallmed as we discuss understanding the wholistic Dignity experience of Patients with advanced disease – from a South African Perspective
Medical doctor of 21yrs with MPhil in Palliative Medicine UCT, with a master’s degree in understanding the dignity experience and exploring the impact of dignity therapy and guided imagery on the dignity experience of patients with advanced disease – a SA perspective.
PALPRAC members can attend for FREE of charge, and PALPRAC Guests are charged R50/session to attend. To qualify for a CPD Certificate, participants must be present for 70% of the webinar.
If you would like to join PALPRAC as a Member, please visit our PALPRAC website, where you will find more information about our membership categories, member benefits, valuable resources, and upcoming events you can attend for free. If you’d like to JOIN PALPRAC as a member, please visit https://bit.ly/3lmRtqV or contact us at firstname.lastname@example.org feel free to send a direct message on 📲WhatsApp +27827738467.
PALPRAC PalliCHATs till October 2022 are available PALRPAC Member portal or directly from our website – https://bit.ly/37gp6HI
Digital living-will start-up, Swansong, has recently launched in order to make the difficult conversations about illness, facing death, and planning a good life to the end easier.
First-to-market in South Africa, Swansong offers virtual, guided end-of-life conversations and planning with expert counsellors. Over two one-hour online video sessions, a counsellor helps a client discover, clarify and communicate what is important to them towards the end of their life, documenting all of it into a living will or advance care plan.
The Swansong Advance Care Plan is legally sound, and contains the client’s decisions around future medical care (the treatment they are prepared to receive and where they want to die – hospital, hospice or home), and the nomination of their healthcare proxy (someone who can legally make healthcare decisions on the client’s behalf if they can’t). It’s a comprehensive, personalised guide that gives peace of mind to the client, and their loved ones. It can also protect clients and their families from panicked end-of-life decisions that waste financial resources.
Swansong is the brainchild of South African women, Dr Linda Holding, a palliative care-trained doctor with 20 years of clinical risk management experience, and Shivani Ranchod, a healthcare actuary and academic.
“The recent COVID pandemic has shown us that being prepared for your death is more than simply having a Will in place which details how your finances and property will be split up. Too many people were dying in a way that they wouldn’t choose for themselves,” says Holding.
One of the most valuable gifts someone can offer to those they love is to embrace their mortality and be specific about the care they do or do not want to receive, and how they would prefer to die. By planning their end-of-life wishes ahead, they’ll unburden their family from making tough decisions when the time comes someday.
Says Holding: “To all healthcare practitioners caring for the elderly or ill, we’d say you have a critical role to play in nudging your patients to think through their individual end-of-life wishes. Your patients should certainly have an advance care plan in place. Perhaps you are comfortable to have this discussion with your patients, and ensure their wishes are documented and easily accessible. However, perhaps with the pressures of running a busy practice or care home, you may not be broaching this difficult topic with your patients as often as you like, and not having the conversation in sufficient detail, nor ensuring that it is captured in a legally sound document.
“This is where Swansong can assist, by having the difficult conversations with your patients about illness, facing death, and planning a good life to the end. We have specialist counsellors who facilitate the advance care planning process.”
Swansong Project Lead, Janine Rauch, says that international studies show that *92% of us say that talking about our end-of-life values is important, yet only 32% of us have actually done so. “It’s a challenging topic to contemplate, let alone plan and discuss,” says Rauch. “Working through and documenting an advance care plan with Swansong now, especially at an older age, is a good idea. Accidents happen. Illness and surgeries increase our risk of needing an advance care plan.
“Swansong wants to help everyone think about, talk about and document their wishes for care through the end of life, so that those wishes can be understood and respected. And we know that families of people who have had a written advance care plan in place are left feeling less guilty, uncertain and bereaved after a death. If doctors and care homes routinely invite Swansong to do planning with each patient and resident, those advance care plans will reduce stress, for everyone, in the end,” says Rauch.
*Source: The Conversation Project National Survey, 2018
Dr. Margie Venter PALPRAC Clinical Director enlightens us on how to inform your healthcare team on what matters most to you when facinga serious illness.
Going on any journey means planning ahead. Also a cancer journey. Planningfor what’s likely, but also for the what-ifs. I’ve often thought this to be a much more useful cancer metaphor, as opposed to the war one. Wars imply winnersand losers, and often destruction in its wake.
Journeys can be gentle strolls, even if sometimes long. Other times journeys are much more difficult hikes, up hills with only the short relief of a plateau from time to time. It can feel as though you never quite reach the top to appreciate the view. Sometimes there are unexpected hailstorms or a break in the clouds allowing the warmth of sunshine. Sometimes it would have been better to turn left. Either way, it helps to plan a little, knowing where you’re supposed to be going and what you should pack.
Clinical Director Dr. Margie Venter discusses Palliative Care on KykNet & Kie with Dr. Darren Green. Highlighting key misconceptions and important facts on Palliative Care, our multidisciplinary support, and our passion for Palliative Care within Southern Africa.