End-of-life care a sensitive issue

A
conference on end-of-life care held in Cayman last weekend explored a range of
sensitive, ethical questions on how to treat terminally ill and very elderly
patients.

Cayman
Islands HospiceCare held its second palliative care conference on Friday and
Saturday, 4 and 5 June, at which presenters from several renowned American and
Canadian institutions spoke.

Dr.
Virginia Hobday, medical director of Cayman Islands HospiceCare, said: “Some of
the presentations covered the practical, day-to-day health, the use of
medication and the diagnosis and treatment of different symptoms,” she said,
adding that other presentations dealt with more philosophical issues, such as
discussing at what point medical treatment for a patient should stop. It also
covered how to keep patients informed and in control.

About
125 people attended the conference.

One
speaker, Raul E. DeVelasco, director of clinical ethics with the University of
Miami Ethics Programmes, discussed medical futility, an emotive subject that
explores when and why to discontinue treatment. “Trying to define medical
futility was one of the discussions, it means different things to different
people,” Dr. Hobday said.

Medical
advances have meant that people are living longer and surviving with diseases
that would have cut their lives a lot shorter just a few years ago, such as
cancer and heart disease. Because of this, the issues of palliative and
end-of-life care are more important than ever, delegates were told.

Among
those who attended were medical students, whom Dr. Hobday was pleased to see.
“It’s good to get to them early before they get preconceived ideas,” she said,
adding that it was helpful for them, and for professionals who have been in the
medical health industry for years, to address issues such as “how to interact
with patients with kindness and compassion and spending time with them and
making them feel that they are cared about”.

She
was also happy to see such a diverse range of medical professionals at the
conference. “We had a mixture of professionals, doctors, nurses, physiotherapists,
councillors… and some lay people as well.”

Presenters
from Baptist Health South Florida; Johns Hopkins in Maryland; Suncoast Hospice,
St. Petersburg, Florida; and McGill

University,
Montreal, Canada spoke at the two-day event.

They
included Neil MacDonald, a medical oncologist and palliative care physician who
is the founding director of the McGill Cancer Nutrition Rehabilitation
Programme who discussed end-of-life nutrition, and Joan Christie, medical
director of Silver Team Suncoast Hospice, who gave a presentation on the last
hours of living.

Thinh
H. Tran, chief medical and quality officer and corporate vice president for
quality and patient safety at Baptist Health South Florida, covered the subject
of gaps in end-of-life care; Lynn Billing, nurse coordinator for the Harry J.
Duffey Pain and Palliative Care Service at The Kimmel Cancer Centre at Johns
Hopkins Hospital, gave a presentation on common physical symptoms” while her
colleague at the centre, physician leader Sydney Dy delivered a talk on no-pain
symptoms.

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