2 3 4YOUR CARE Supporting more patients and families at home

YOUR WAY Managing Pain Caused By Cancer

Palliative and Supportive Care is holistic care for patients and their families when they are facing a life-limiting illness. It gives people relief from the symptoms and stress of a serious illness like cancer and helps improve quality of life for both the patient and the family.

Palliative Care is delivered by specially-trained physicians, nurses and other specialists who work together with a patient’s health care team to provide further expertise, clinical management and support. It’s appropriate at any age and at any stage in a serious illness. It’s often part of other curative treatments.

In Central East Region, our Palliative Care teams work with the Central East Local Health Integration Network, local hospitals, the Central East Community Access Centre and other community partners to provide Palliative Care to people in hospital, in clinic-like settings and often even in the home itself.

YOUR EXPERTS Meet our Regional Palliative Care Lead Dr. Edward Osborne

Team CancerMeet Dr. Edward Osborne, Our Regional Palliative Care Lead YOUR EXPERTS

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Dr. Osborne obtained his medical degree from the University of Toronto after completing his Master’s degree in cancer research at Queen’s University in Kingston. He completed his residency at the Scarborough General Hospital and a fellowship with the College of Family Physicians of Canada (CFPC). His family practice is in Bowmanville where he is also Medical Director at Glenhill Strathaven Nursing Home. He recently has been awarded a Certificate of Added Competence in Palliative Care by the CFPC.

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ISSUE 7 SUMMER 2016

THE ONTARIO PALLIATIVE CARE NETWORK In March, the Ministry of Health and Long-Term Care announced the creation of a new Ontario Palliative Care Network (OPCN) to improve how Palliative Care is delivered and organized across the Province

This initiative aligns with the Ministry’s strategy to make greater patient choice in Palliative and end-of-life care a priority as highlighted in its Patients First: A Roadmap to Strengthen Home and Community Care.

The OPCN is an organized partnership of community stakeholders, health service providers and health systems planners responsible for the development of a coordinated, standardized approach for the delivery of palliative care services in the province. It is accountable to the Ministry of Health and Long-Term Care.

Q: What do you enjoy about your role as Regional Palliative Care Lead for both the Central East Regional Cancer Program and the Central East Local Health Integration Network?

I enjoy that it gives me the opportunity to work with such compassionate people to make patients and families comfortable in a difficult time. I also really appreciate being able to share best practices and provide support, training and education to Palliative Care providers across the region.

Q: What are your goals for Palliative Care in Central East Region?I would like to see the day when every patient in Central East Region is comfortable discussing an advance care plan which includes end of life plans and feels supported in a decision to die comfortably in the location of their choice when that time comes.

Queen’s University and Lakeridge Health recently announced the creation of the Dr. Gillian Gilchrist Research Chair in Palliative Care.

The Research Chair was created by a $2.5 million endowment donated by Dr. Hak-Ming Chiu, a Medical Oncologist at the DRCC and his wife Debbie, a retired oncology nurse (pictured middle and right). It honours the work of Dr. Gillian Gilchrist (pictured far left) who founded the Palliative Care program at Lakeridge Health in 1981.

A research chair is a professor who is a leading expert in their field who helps pioneer new and important areas of research for universities. It is the first fully-funded academic research chair in Palliative Care at a community hospital in Canada.

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Radiation Therapy has been used to treat cancer since the early 1900s but more recently, it has also been used to help manage pain caused by cancer.

Using Radiation Therapy as a Palliative Care tool is a growing area of focus for cancer centres across Ontario.

“When we look at the data, there is a lot of variation all over the Province in who is using radiation in this way. And the further you go away from a cancer centre, the numbers are even less,” explains Dr. Medhat El-Mallah, Radiation Clinical Lead for the Central East Regional Cancer Centre and a Radiation Oncologist at the Durham Regional Cancer Centre (DRCC).

Dr. El-Mallah is working with the regional cancer program’s Primary Care and Palliative Care Leads to raise physician awareness about the benefits Radiation Therapy can provide to patients with advanced and late-stage cancer.

“The main benefit is pain control,” says Dr. El-Mallah. “But Radiation Therapy can also help provide relief from things like airway obstruction, spinal cord compression and bleeding. It really is another tool for palliation.”

He points out much work has been done to increase access to Radiation Therapy in Central East Region in recent years, with the opening of a second radiation treatment centre in Peterborough in 2013.

DRCC radiation oncologists also help cover the distances for patients and their families by holding regular consultation and follow-up visits at every hospital in our region. And in 2015, the DRCC created a new Clinical Specialist Radiation Therapist role that has reduced wait times for treatment for palliative patients.

To learn more about this type of Radiation Therapy and if may be right for your patient, Primary Care and Palliative Care physicians can contact the DRCC at 905-576-8711 and ask for the on-call Radiation Oncologist.

Supporting a Patient’s Right to Choose YOUR CARE

Managing Pain Caused By Cancer YOUR WAY

DID YOU KNOW...

In the Central East region, there is an Aboriginal Patient Navigator who can help Aboriginal patients to navigate the cancer system, including accessing Palliative and Supportive Care.

Kathy Macleod-Beaver can provide support before, during and after cancer appointments, provide information about resources and supports that can help at home, connect individuals with spiritual and cultural supports, provide information about cancer screening, and help with advance care planning.

Kathy also offers Sharing Circles at Hearth Place Cancer Support Centre. The Sharing Circle uses aboriginal approaches to holistic health and wellness. For more information, contact 905-576-8711, ext. 2554.

Cancer Care Ontario has created 10 guides for patients and caregivers which provide tips and resources to help them manage symptoms frequently experienced by cancer patients. These symptoms include fatigue, nausea and vomiting, constipation, diarrhea, pain, depression,anxiety, shortness of breath, mouth problems and loss of appetite.

The guides can be found electronically at www.cancercare.on.ca/symptoms in PDF format. They can be printed directly from the website, and are available in both single pages and booklet format.

HOW TO MANAGE YOUR SYMPTOMS - GUIDES FOR PATIENTS

WHAT IS LEAP?

The Learning Essential Approaches to Palliative and End of Life Care (LEAP) course is standardized education and training developed by the Pallium Canada, a national organization created to improve the quality of hospice and palliative care services.

The Central East LHIN offers LEAP courses for physicians, nurse practitioners, nurses and other health care professionals at no cost. Courses are accredited and taught by local Palliative Care experts.

Pallium Canada has also developed specialized LEAP courses for health care professionals who work in oncology as well as in long-term care facilities. For more information about LEAP courses available in our region, contact Jenny Greensmith at jenny.greensmith@lhins.on.ca.

HOW DO YOU KNOW SOMEONE IS READY FOR PALLIATIVE CARE?

It’s often been associated with those who are dying, but Palliative Care is much more than end-of-life care. It can be for people at all stages of disease.

Palliative Care gives people with serious illness relief from symptoms such as pain, shortness of breath, fatigue, nausea and depression.

When Palliative Care is introduced early in the cancer journey, families are given more time to focus on their quality of life today as well as plan ahead for the future.

“It’s also a time for patients to reflect on their values and wishes, and to let others know what kind of health and personal care they would want in the future if they became incapable of consenting to or refusing treatment or other care,” says Dr. Edward Osborne, Regional Palliative Care Lead for the Central East Regional Cancer Program and Central East LHIN.

“As healthcare providers, it’s our role to help people and their families feel comfortable having these difficult yet important conversations,” he adds.

Information and resources about advance care planning for patients, families and health care providers is available at www.advancecareplanning.ca.

Palliative Care Community Teams (PCCTs) are interdisciplinary teams funded by the Central East LHIN with the goal of supporting patients and families to live well and die safely and confidently in the setting of their choice – whether that is in hospital or at home.

In Central East, there are currently PCCTs in Scarborough, the City of Kawartha Lakes and Haliburton County. PCCTs help support patient choice, access to services and the delivery of high quality Palliative Care in a way that meets the special needs of each community.

The Central East LHIN has plans to introduce three more PCCTs in the future in our region -- in Peterborough, Durham Region and Northumberland County.

To find out more or to make a referral contact:

• In Scarborough, the Community Hospice Program at Scarborough Centre for Healthy Communities at 416-847-4111 or visit www.schontario.ca.

• In the City of Kawartha Lakes, Community Care City of Kawartha Lakes at 705-879-4123 or visit www.ccckl.ca.

• In Haliburton County, Haliburton Highlands Health Services at (705) 457-2941 ext.2930 or www.hhhs.ca.