From the President’s Desk

Dear Friends,

Unfortunate issues are looming over us in the past few months. Considering the extreme difficult scenario, IAPC central council (CC) had to take certain unprecedented decisions. The central council held on 11th July 2020 decided to postpone the Annual Conference, AGM, and election to the vacancies of office bearers of IAPC to October 2021. Details are given in this Newsletter. Resolution to postpone Annual conference, AGM, and election was passed unanimously in the CC meeting held on 11th July at 5.30 PM through zoom.

But despite the adverse circumstances I feel  proud that with the help of the Faculty in Palliative care,the central council of IAPC,  members and staff, and with the support of partner organisations,  we have made significant progress in our activities and launched new initiatives.

Last week, on 24th,25th, and 26th  of July, IAPC could successfully organise online contact classes for Certificate Course in Essentials of Palliative Care with the participation of 291 candidates form different regions of India. My sincere thanks to the faculty members, who made this program a great success, and congratulations to the IAPC team for conducting a well organised program. We got feedback from candidates expressing their satisfaction and it is truly a motivation  for us. Even though all of us were working from different parts of the country, and the faculty for each session joined from their own place to take classes, as a team we could work together and  deliver a well organised contact session of 3 days duration with the help of technology.  At the end we could  realise that the program  offered candidates the feel of a live classroom.

The IAPC Academy launched by the end of June 2020 with an aim to provide the much needed advanced training in Palliative Medicine for doctors practicing Palliative Medicine in India is an important milestone. These lectures being organized on Mondays from 6.30 AM to 7.30 AM provide the participants a fresh start at the beginning of a week.

We could also finalise the curriculum of  the training program in palliative care for physiotherapists, pharmacists, and councilors. The training program will be launched soon.

The formation of a task force for ethics in health care to help IAPC in this area was discussed in the last CC meeting and the suggestion was approved.

Regular updates on all the activities of IAPC including the videos of IAPC academy lectures are available on IAPC website. We could also start  a Resource section on the website to make available  important documents and guidelines.

A big thanks to Cipla Palliative Care and AIDS Foundation for their Immense contribution to IAPC.

On behalf of Indian Association of Palliative Care, I express our gratitude to CIPLA Palliative Care and AIDS Foundation for their immense contributions in developing Palliative care across India. The CIPLA Foundation has always remained in the forefront to support the activities of Indian Association of Palliative care. They are the major sponsors of the Annual Conference of Indian Association of Palliative care and has been helping the academic program of IAPC – the Certificate Course in Essentials of Palliative Care -by financially supporting the printing of TEXTBOOK FOR CCEPC.

A total of 5000 books have been printed with the financial aid of CIPLA Foundation. Another area of contribution is the training for nurses in End of Life Care. It is a fact that for Non-profit organizations like IAPC, one of the important success factor to carry forward its activities is reliable support by likeminded organizations. Once again expressing our sincere gratitude for the support the CIPLA FOUNDATION offers to IAPC.

Dr. Sushma Bhatnagar
President
IAPC


IAPC Academy

Online Training In Palliative Medicine

Enthusiastic Participants; Overwhelming Response!

Nowadays, the Palliative Care Physicians in India are habituated to begin their week with the re-charging sessions, which happens early morning every Monday. The overwhelming response from participants shows that they were in need of an advanced training program that boosts their motivation, satisfies their quench for advanced learning, provides the answers for their queries, and that imparts a clear vision in their long and tough journey. Moreover, this program created a sense of togetherness and a feel of getting solid support in their difficult task of providing relief to the most suffering patients in a country where many of their fellow beings die in extreme distress. IAPC ACADEMY, the online training program, which began with the inspiring and brilliant talk by Dr. M R Rajagopal, who is known as the father of Palliative Care, has been proved as a much-awaited initiative. Most of the participants, more than a hundred of them, join the one-hour session every Monday at least 15 minutes before the session actually starts. The session is from 6:30 AM to 7:30 AM

Four lectures were held in July. Dr. Nandini Vallath (Approach to prescribing strong opioids for pain management), Dr. Seema Mishra (Approach to an adult patient presenting with opioid toxicities), Dr. Sushma Bhatnagar (Approach to a patient with cancer pain needing interventions), and Dr. Jayita Deodhar (Approach to a cancer patient with substance abuse disorder) were the faculty for the sessions.

Testimonials of some of the participants.

We are extremely grateful to the faculty members for these excellent lectures and truly appreciate the extra effort taken by all the participants in their busy Monday mornings to attend these sessions!

Videos of all the lectures are available on IAPC website. Those who missed the sessions, please visit Here

Please see the program schedule Here

Next session on Monday 3rd August, 2020 – 6:30 AM to 7:30 AM

Topic: Approach to a patient presenting with neurological weakness in a palliative care setting

Faculty: Dr. Roop Gursahani

Please register before 5 PM on 2nd August, Sunday, by sending an email to academyiapc@gamil.com expressing your interest to join the academic session.


Affected By COVID -19

We are Forced To Postpone IAPCON 2021

IAPC here by announce that due to the uncertainty posed by COVID-19 pandemic, it has been decided to postpone the Annual International Conference of IAPC to October 2021.

In the Last AGM of IAPC held in February 2020, in Guwahati, it was decided to organize the conference in Patna, Bihar in the month of February 2021. Assessing the situation, the central council meeting held on 11th July, decided to postpone the conference. The decision was unanimous.

Please see the resolution passed by the Central Council Here

But the scientific committee will go ahead with its preparations and abstract submission deadline will be announced soon.


AGM and Election

The annual General body meeting and election to the vacant posts also will be held in October 2021 at the conference venue. The decision was taken by the central committee meeting held on 11th July 2020 and it was pointed out that an online election and AGM will not be satisfactory.

Please see resolution Here


Certificate Course in Essentials of Palliative Care (CCEPC)

Online Session Held in July 2020

An online session of the Certificate Course in Essentials of Palliative Care was organized on 24th, 25th, and 26th July 2020. Through 16 course centres, 291 candidates were registered for the course.

It was the first attempt to conduct the course online for candidates registered at various centers . The centres found it difficult to organize class room sessions due to the increasing cases of COVID-19 pandemic. We feel satisfied that we could successfully deliver the program.

The points that we have identified as advantages of conducting the program online are:

  • IAPC could deliver a uniform course with lectures by the best faculty in India to all candidates registered form all over India through different course centres.
  • Candidates could attend the sessions from the comfort of their home.
  • The online sessions can be coordinated well and from the feedback of participants we could realize that they enjoyed the sessions.

The Time Frame for completion of Part B has been extended

Considering the current situation due to the COVID-19 pandemic, it has been decided to extend the period to complete part B of the IAPC Certificate Course. Part B can be completed within one and a half years of completion of Part A.


Now we realize

The advantages of Online teaching sessions!

Here, Dr. Mallika Tiruvadanan of Lakshmi Pain and Palliative Care Trust Shares her experience of organizing online sessions for CCEPC. Lakshmi Pain and Palliative Care Trust is the first course centre which organized CCEPC online in June 2020.

Read the experience shared by Dr. Mallika by following the link Here


Palliative Care for Patients

With Severe COVID-19

This article, published in BMJ (BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2710 – Published 14 July 2020) outlines the palliative approach to the management of patients with severe covid-19 in hospital and community settings, focusing on the management of distressing symptoms, planning ahead, communicating with patients and their families, and grief and bereavement. This article definitely help physicians treating serious covid-19 patients and those who practice palliative care.

Please follow this link below to get the full article:

Palliative care for patients with severe covid-19


After Four Decades

A New Definition for Pain

For the first time since 1979, IASP introduced a revised definition of pain, the result of a two-year process that the association hopes will lead to revised ways of assessing pain.

The definition is: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” and is expanded upon by the addition of six key Notes and the etymology of the word pain for further valuable context.

The revised definition was introduced in an article in the journal PAIN. Read it Here


The unfolding legacy of Cicely Saunders

15 years on

Dame Cicely Saunders

It was on 14th July 2005, Dame Cicely Saunders, the founder of modern hospice movement bid adieu to this world.

Prof. David Clerk, who got the opportunity to work very closely with Cicely Saunders, and who has written her biography, remembers Cicely on her 15th death anniversary.

To read the article please follow this link below:

Listenening to Cicely – A small section of the last interview of Dam Cicely Saunders is available below:

It was the last recording made of her speaking by Prof. David Clerk. “Enjoy hearing Cicely in excellent spirits, despite the problems she was facing” – writes Prof. Clerk.


Book For This Month

ON DEATH & DYING by Elizabeth Kubler-Ross

8th July 2020 was the 94th birth anniversary of Dr. Elizabeth Kubler-Ross and the suggested book for the month is the 50th Anniversary Edition of ON DEATH & DYING.

The first edition was published in 1969 and even after 50 years it is the most sought after book on Death, Dying and Grief. In this remarkable book, Dr. Kübler-Ross first explored the now-famous five stages of death: denial and isolation, anger, bargaining, depression, and acceptance, through sample interviews and conversations.

Fifty years after its original publication, a commemorative edition of “On Death & Dying” has now been published with a new introduction and updated resources section.

Read the excerpt from the book Here


WHO Recommendations

Women with COVID-19 can Breast Feed

They should:

  • Wash hands with soap and water or use alcohol-based hand rub frequently.
  • Wear a medical mask during any contact with the baby.
  • Sneeze or cough into a tissue.
  • Routinely clean and disinfect surfaces touched.

At present, data are not sufficient to conclude vertical transmission of COVID-19 through breastfeeding. In infants, the risk of COVID-19 infection is low, the infection is typically mild or asymptomatic, while the consequences of not breastfeeding and separation between mother and child can be significant.

To read WHO recommendations on breast feeding, please follow the link Here


Medical Profession Excluded

From Consumer Protection Act

As per the Act, the removal of “healthcare” from the list of services means consumer can no longer approach a consumer court to address issues of medical negligence or file complaints against doctors there. However patients or their family members can approach higher courts for medical negligence.

But representatives of health care professionals express different views on this.

Read the related article Here

The copy of consumer protection act is available for download Here


ELNEC Training Workshop at Dayanand Medical College and Hospital

Ludhiana – A three day End of life Nursing Education Consortium (ELNEC) workshop for nurses was organized by Dayanand Medical College and Hospital (DMCH)


A Webinar for

Nurses on Palliative Care

A webinar for Nurses on – Palliative Care , an Update was held on 4th July 2020 from 11 AM to 12.30. The program was organized by Ministry of Health and Family Welfare in collaboration with ECHO India and DNIP Care, Delhi.


Worth Reading

  1. COVID-19 is pushing doctors to the brink. Medicine needs to recognize they’re human and need help
    “Doctors and nurses have always dealt with patients’ terminal illnesses and deaths, but with covid-19, these tragedies are coming in rapid-fire succession, and in the form of an illness we are still just beginning to understand. Covid-19 has presented an added emotional burden: Doctors and nurses have had to stand in for family members barred from hospitals for fear of spreading infection. Loss of control, failure and helplessness are all part of practicing medicine, though never before, at least in modern medicine, on this magnitude, for this prolonged duration and with so many confounding uncertainties.” – writes Esther Choo, an emergency physician and a professor of emergency medicine at Oregon Health & Science University, in the opinion page of The Washington Post: https://www.washingtonpost.com/opinions/2020/07/20/covid-19-is-pushing-doctors-brink-medicine-needs-recognize-theyre-human-need-help/
     
  2. Family conflict common during bereavement, study shows: https://medicalxpress.com/news/2020-07-family-conflict-common-bereavement.html
     
  3. COVID-19 Tips and Tools – a guide for people living with serious illness: https://getpalliativecare.org/whatis/disease-types/covid-19-and-palliative-care/covid-19-tips/
     
  4. COVID-19 Pandemic prompts changes to palliative care The unique challenges of COVID-19 require adjustments to the delivery of palliative care during the pandemic, according to an article in the Canadian Medical Association Journal. Read the article: https://www.healio.com/news/primary-care/20200420/covid19-pandemic-prompts-changes-to-palliative-care
     
  5. Palliative care amid COVID-19: ‘Be seen, heard and flexible’ https://www.healio.com/news/hematology-oncology/20200608/palliative-care-amid-covid19-be-seen-heard-and-flexible

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