General Practitioners - palliAGED
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The Advance Project – supporting a team approach to advance care planning and palliative care in everyday general practice

A guest blog post by Professor Josephine Clayton, Senior Staff Specialist Physician in Palliative Medicine, HammondCare and Professor of Palliative Care, University of Sydney and Associate Professor Joel Rhee, General Practitioner and Associate Professor of General Practice, HammondCare Centre for Positive Ageing and Care, University of Wollongong

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General practices provide ongoing care for a large number of patients with chronic, progressive, and eventually fatal illnesses, and so have an essential role in providing palliative care to patients and their families. Professor Josephine Clayton, Senior Staff Specialist Physician in Palliative Medicine and Associate Professor Joel Rhee, General Practitioner, discusses the Advance Project and how it aims to support general practices with the tools to identify people early who might need a palliative approach to their care and enables general practice teams to thoroughly assess the persons’ symptoms, concerns and priorities as well as the needs of their carers.

General practitioner clinical decision making for patients with life-limiting illness: does the presence of complex multimorbidity make a difference?

A guest blog post by Raechel Damarell, PhD Candidate, College of Nursing and Health Sciences, Flinders University

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As the Australian population ages, general practitioners are increasingly required to manage patients burdened by multiple chronic conditions, or 'multimorbidity'. Raechel Damarell, PhD Candidate at Flinders University discusses her PhD topic to investigate if the presence of complex multimorbidity influences the clinical decision making of general practitioners for patients with a life-limiting illness.

Taking time to talk

A blog post from Professor Jennifer Tieman, CareSearch Director, College of Nursing and Health Sciences, Flinders University

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National Advance Care Planning Week is an annual initiative by Advance Care Planning Australia that encourages all Australians, regardless of their age or health status, to make their future health care preferences known. Jennifer Tieman Director of CareSearch discusses the importance of advance care planning and the need to start more conversations about death and dying.

palliAGEDgp: equipping GPs in rural and remote areas to deliver quality palliative care

A blog post by Professor Jennifer Tieman, CareSearch Director, Matthew Flinders Fellow, College of Nursing and Health Sciences, Flinders University

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General Practitioners (GPs), especially those in rural areas, face challenges when delivering palliative care for older Australians. Jennifer Tieman, CareSearch Director at Flinders University discusses how palliAGEDgp, an evidence-based and easy-to-access smartphone app, has been helping thousands of doctors support our elderly who are faced with life-limiting illness.

Why the Palliative Care Service Development Guidelines are important and what were the biggest changes from the previous guidelines

A guest blog post by Jane Fischer, President of Palliative Care Australia, Calvary Health Care Bethlehem

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In 2017 Palliative Care Australia undertook a review and update of the reference documents A Guide to Palliative Care Service Development: A population based approach and Palliative Care Service Provision in Australia: A planning guide. Together these key reference documents have provided a framework for the ongoing development of palliative care policy within the health care system for the last fifteen years.
 

Three things to do about health professionals’ knowledge of end of life law

A guest blog post by Professors Ben White and Lindy Willmott, Directors, Australian Centre for Health Law Research, Faculty of Law, QUT

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Health professionals need to know the law that governs withholding and withdrawing life-sustaining treatment. Law is not at the centre of the clinical encounter, but it is part of the regulatory framework that governs these decisions. Failure to know and follow the law puts health professionals and their patients at risk. But we know there are gaps in health professionals’ legal knowledge in this area and this is not surprising either, given how complex and difficult this field of law is.

 

Now there is specialised support and training for Australian GP nurses to provide better care at a very difficult time

A guest blog post by Associate Professor Josephine Clayton, Specialist Physician in Palliative Medicine at HammondCare’s Greenwich Hospital in Sydney, Associate Professor of Palliative Care at the University of Sydney and Director of the Advance Project

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As a young doctor I spent some time working in a palliative care hospital in the early 90’s.  It was such a privilege to be working with people at end of life - with the opportunity to make a difference to quality of life and well-being of patients, and their family members. That experience made me decide to devote my career to Palliative Medicine.
 
I had some experiences at that time that stayed with me.
 
I had a patient, Marion, who had been a school principal. Marion had suffered a severe stroke. She had survived but was very incapacitated, confined to bed and unable to communicate. She was being kept alive, surviving on a feeding tube, and facing a life of care and dependence. Her specialist was very committed to her survival.

 

‘What is needed to improve care planning for people living with dementia?’

A guest blog post from Tim Luckett PhD, Senior Research Fellow, University of Technology Sydney and Ingrid Duff, Research Assistant, Centre for Cardiovascular and Chronic Care

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During National Palliative Care Week, the University of Technology Sydney (UTS) hosted a forum on dementia care planning facilitated by the Director of The Centre for Cardiovascular and Chronic Care, Faculty of Health, Professor Jane Phillips. Imelda Gilmore, an Alzheimer’s Australia NSW Dementia Advocate and wife of a person with dementia, opened the forum by highlighting the importance of “getting the word out to have conversations about end of life early on”. A recurring theme at the forum was the need for care decisions to be person-centred and focused on what the person with dementia would have wanted were they able to speak for themselves, rather than the wishes of surrogate decision-makers. Lynn Chenoweth (Professor of Nursing at the Centre for Healthy Brain Ageing, The University of New South Wales) defined person-centredness as respecting the person with dementia’s “values, beliefs, history, likes and dislikes … all of the things that make them unique”.

Four easy steps to help GPs use the palliative care resources on CareSearch

A guest blog post from Dr Christine Sanderson, Staff Specialist, Neringah Community Palliative Care Service, NSW

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CareSearch is an online resource for palliative care. It has evidence-based resources for both clinicians and for patients, and their families and friends. As it is now a very large repository of evidence-based information, I would like to point you to four of the best sections for GPs to start off in.

These sections include the GP Hub, the Clinical Evidence pages, the Finding and Using Evidence pages, and the Education pages. You can also find information specially written for your patients in the Patients, Carers, and Families section. 

Assessing and managing chronic breathlessness

A guest blog post from Professor of Palliative Care David Currow

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Chronic breathlessness is highly prevalent across the community. One in 100 Australians have significant impairment of their activities of daily living and one in 300 people are housebound because of breathlessness.

Chronic breathlessness is systematically under-recognised by health professionals. When taking a history about breathlessness, the question ‘are you breathless?’ is not going to elicit the problem nor its magnitude. ‘What do you have to avoid in order to minimise breathlessness?’ is a far more important question, or this can also be phrased as ‘what have you given up in order not to be breathless?’ With these questions, we start to get a picture of the net impact of breathlessness on individual patients.

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