2018 Program

The Road to Universal Palliative Care

Wednesday, May 30 | Pre-conference Workshop

08:00-12:00 or
Point of Care Ultrasound Workshop
$425 per participant
George Brown College, 51 Dockside Drive, TorontoHands on workshop using task trainers and ultrasound machines on:Identification of Pleural Effusion and Abdominal Free Fluid
How to perform an Ultrasound Guided Paracentesis and Thoracentesis.

Instruction on U/S machine use (holding the probe, adjusting settings/positioning etc)
How to landmark for both procedures
How to position patients and move the probe around
Guidance of needle for procedure while holding probe
Image review and Case Based Discussion
Future uses for Ultrasound in Palliative Care

Workshop Leaders:
James Downar, University of Toronto
Frank Myslik, Western University and University of Ottawa

Thursday, May 31

This Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 14.75 Mainpro+ credits.
This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, and approved by the University of Calgary Office of Continuing Medical Education. You may claim up to a maximum of 14.25 hours.


13:15-14:30 OPENING KEYNOTE – Neil MacDonald
History of Palliative Care in Canada
Canada is one of the first nations to embrace palliative care. Many Canadians, notably Bal Mount, have inspired other countries to develop their own programs. Our history is rich in successful enterprises, albeit there are a  few areas where our progress lagged. A celebration of our accomplishments, and a consideration of how we may advance our field will be offered. One hopes that this session will stimulate reflection and discussion.
14:30-17:30 CSPCP Special Session
Compassion Satisfaction and Resilience: How to Thrive in Palliative Care
Co-moderators: Monica Branigan and Alan Taniguchi

  • Define compassion satisfaction and resilience in palliative care
  • Identify practical ways to achieve compassion satisfaction and resilience in palliative care
  • Develop a personal approach to achieving compassion satisfaction and resilience in practice
PART I (14:30-15:45)
How Resilience Works: Individual and System Aspects
Anthony Back
15:45-16:00 Networking Break
PART II (16:00-17:30)
Panel Discussion
Anthony Back
Monica Branigan
John Scott
Alan Taniguchi
17:30 Welcome Reception in the Exhibit Hall

Friday, June 1

07:30-08:00 Continental Breakfast, Poster Viewing and Exhibits
08:00-09:00 Residents’ Presentations
09:00-10:00 KEYNOTE – Amy Montour
Palliative Care and Indigenous Populations
Currently, the palliative care journey for Indigenous people living in Canada is an experience not well understood by health care providers or health care systems. While Indigenous people have many of the same palliative care needs as non-Indigenous people, their lives are affected by additional layers of cultural and sociopolitical complexity. This session will introduce learners to the Indigenous Social Determinants of Health and describe how they impact the palliative care journey. The concept of “Relationship” will also be introduced as a tool to improve the Indigenous patient and family experience of palliative care
10:00-10:30 Health/Networking Break, Poster Viewing and Exhibits
10:30-11:45 WORKSHOP SESSION I – Choice of 6 Workshops (repeated in PM)
Workshop 1 Neil MacDonald
Topic: Pathophysiology and Management of the  Anorexia-Cachexia Syndrome
The ACS bedevils the quality of life of patients across the broad spectrum of advanced chronic illnesses and is a major cause of debility and dependence upon others. Until recently this syndrome has been regarded as an irreversible process. Indeed, aside from therapies for anorexia, some of which actually increase cachexia, clinical trials on single therapies have not been successful. Today, a better understanding of the Syndrome’s pathophysiology, and an appreciation for the need for a multimodal approach to this complex problem, evidence of successful management is emerging.
Workshop 2 Amy Montour, Joanna Vautour, Cara Bablitz
An Indigenous “Circle of Palliative Care”: Exploring Culturally Appropriate Care With a Multi-Disciplinary Team of Indigenous Health Care Providers
There has been an increasing awareness in our society of Indigenous Knowledge utilization in the health care of Indigenous peoples. The Truth and Reconciliation Commission Calls to Action on Health made clear recommendations to acknowledge the value of traditional healing practices and to increase the number of Indigenous health professionals. Indigenous people often choose to use traditional healing practices in harmony with western medicine and are requesting space to conduct healing and end-of-life ceremonies in all health care settings. Western health care providers are beginning to recognize that building relationships are fundamental to working effectively with Indigenous patients and their families. However, in the provision of holistic palliative care it is also essential to build relationships and foster collaboration among Indigenous and non-Indigenous health care providers, including Healers and Elders. This workshop is intended for Indigenous and non-Indigenous health care providers who are interested in exploring how each of their roles bring unique gifts that complete the Circle of Palliative Care.
Workshop 3 Russell Goldman
Home Palliative Care
There continues to be strong interest in home care and in particular home palliative care from patients, clinicians, planners and policy makers at  the regional, provincial and national levels.  In this workshop, we will take advantage of the Pan-Canadian  membership of the CSPCP to discuss innovations,  successes and failures in the provision of home palliative care.  We will utilize innovations from the Toronto area  in home ultrasound, virtual communication and home diuresis as a springboard to a discussion about opportunities to collaborate and spread innovation.  We will also focus on the challenges of rethinking home palliative care as patient populations  shift from cancer as the primary diagnosis to patients with non-cancer diagnoses. Registrants for this workshop who wish to share some of their innovations, successes and failures are encouraged to contact the workshop moderator, Dr. Russell Goldman  to be included in the program (contact information will be share with participants).
Workshop 4 Amna Husain, Sarina Isenberg
Top Practice Changing Articles of 2017
In an interactive format, Dr. Husain and Dr. Isenberg will present and analyze 5 potentially practice-changing articles of 2017.  Articles will be primarily chosen for methodological rigour and relevance to clinical practice. We will discuss as a group, the methods and quality of the studies, and debate how they apply to our palliative care practice.
Workshop 5 Camilla Zimmermann
Early Integration of Palliative Care, Evidence, Barriers, Pitfalls
There is increasing evidence for the benefit of early palliative care for patients and their families, particularly in advanced cancer. Following this evidence, there has been increasing acknowledgement of the importance of early, collaborative care and guidelines have been published to encourage early integration. However, most patients still get referred to palliative care services late in the course of illness. In this workshop, we will review the evidence for early palliative care integration and discuss barriers to its implementation. We will draw on trials-based, survey and qualitative research, as well as on the experience of participants. Participants will be encouraged to discuss barriers and pitfalls related to early integration that they face in their daily practice, and to propose innovative solutions. Together we will discuss ways to improve palliative care integration and potential models for early palliative care integration in various practice settings.
Workshop 6 Kerstin de Wit
Anticoagulation in Palliative Care
This workshop will cover commonly encountered problems around anticoagulation in palliative patients.This includes anticoagulation in cancer patients, patients with renal failure and patients with a high bleeding risk.
11:45-13:00 Networking Lunch, Poster Viewing and Exhibits
13:00-14:15 WORKSHOP SESSION II – Choice of 6 Workshops
Repeat of Session I
14:15-15:15 Health/Networking Break, Exhibits
Poster Presentations and Judging
15:15-16:30 WORKSHOP SESSION III – Choice of 5 Workshops (non-repeating)
Workshop 1 Gillian Fyles, Doris Barwich
Serious Illness Care – How to Have More, Earlier and Better Conversations
In this workshop we will introduce the evidence base for the Serious Illness Conversation Guide (SICG), along with patient/family tools and system change strategies, developed and tested by Ariadne Labs-Harvard Medical School to address the above gaps. We will focus on skills development using the Guide through role play and structured feedback. We will review how to identify triggers for the conversation, develop a reminder system, document in the medical record, and integrate patient and family resources. Emotional engagement will occur through reflective exercises and we will share lessons learned from our work in British Columbia. With the palliative approach to care becoming more recognized as an integral part of our practice the use of this Guide is relevant to all palliative care providers.Reflective discussion will be encouraged to explore how the Program could be implemented within the participant’s clinical practice
Workshop 2 Jessica Simon, Chandra Thomas, Michael Slawnych, Tara Lohmann
Strategies That Work for Early Palliation in Chronic Disease
This workshop, co-facilitated by Cardiologist Dr. Michael Slawnych, Nephrologist Dr. Chandra Thomas  and Respirologist Dr. Tara Lohmann, will offer gems and practical strategies for integrating both a palliative approach and specialist palliative medicine into chronic disease management.  Each facilitator has completed extra palliative care training and established palliative-focused clinics within their specialty.  This is a case-based interactive workshop that will address some of the common challenges faced when incorporating palliative care into chronic disease management including de-prescribing and managing advanced interventions (eg. cardiac devices, dialysis, noninvasive ventilatory support) in the last years of life.  We will also share our strategies for changing the practice and attitudes of specialist colleagues about providing palliative care in the face of prognostic uncertainty.
Workshop 3 Giovanna Sirianni, Irene Ying, Giulia Perri
Prognostication Tools in Palliative Medicine: A Case-based, Hands-on Workshop
Estimated prognosis is a critical piece of information for patients with life-limiting illness as they discuss goals of care and advanced care planning. Despite the importance of prognostication for decision-making and future planning, clinicians often feel poorly prepared and ill equipped to estimate prognosis. This workshop will explore clinical tools available to guide estimates of prognosis in the cancer and non-cancer setting. The presenters will also explore the limitations and inherent challenges of determining prognosis. This interactive workshop will engage participants in the use of various clinical tools as applied to cases of patients with life-limiting illness. These tools could be easily incorporated into a clinic visit, long term care, inpatient or palliative care unit setting. Participants are encouraged to bring their laptops or tablets as various online tools will be employed during the case discussions.
Workshop 4 Glen Maddison
Use of Elastomeric Subcutaneous Infusers
Continuous Subcutaneous Infusers are used every day in our 10 bed Hospice and in patient Palliative Care Unit. This presentation will explain the advantages of this device over more expensive computer assisted devices (CADD) and how they can be used in all settings including the home and long term care. The session will describe how useful these devices are for pain crises, delirium, bowel obstructions and palliative sedation.
Workshop 5 Great Ideas and in the Works
Megan Doherty
Palliative Care in Humanitarian Crises

Megan Doherty
Experiences Implementing a Perinatal Palliative Care Program

Sarah Kawaguchi
Competence as Palliative Medicine Teachers in Competency-Based Medical Education (CBME)

Leah Norgrove
Journey Home: Working towards Cultural Safety in Palliative Care Services for Four First Nation Communities

Claire Slavin-Stewart
A Feasibility Study of Home-based Palliative Care Telemedicine in Rural Nova Scotia

16:30-17:45 CSPCP AGM
18:30-23:00 Awards & Social Evening
Arts and Letters Club (description)
14 Elm Street
$75 per ticket
Join us to celebrate this year’s awardees and to network with friends and colleagues.

Saturday, June 2

07:30-08:30 Continental Breakfast, Poster Viewing and Exhibits
08:45-10:00 KEYNOTE – Maxxine Rattner
Suffering and the Role of Palliative Care
While relieving suffering is the primary aim of palliative care (WHO, 2018), there is less acknowledgement of the psychosocial suffering we may not be able to relieve because dying is intrinsically hard. This presentation will share a conceptual framework for thinking about and approaching psychosocial suffering in the context of palliative and end-of-life care: intrinsic suffering. It will also reveal results from a pilot qualitative study that explored how palliative care clinicians navigate patients’ non-physical suffering in their day to day practice. The impact of the discipline’s call for suffering’s relief on the clinician will be queried, with the overarching aim of igniting dialogue.
10:00-10:30 Networking/Health Break, Poster Viewing and Exhibits
10:30-11:45 WORKSHOP SESSION IV – Choice of 6 Workshops (repeated in PM)
Exceptionally, Workshop 4 does not repeat in the afternoon.
Workshop 1 Fliss Murtagh
Use of Patient-level Point of Care Outcome Measures in Palliative Care: Practical Considerations
This is a practical workshop for clinicians and researchers to consider and explore Patient-level Point of Care Outcome measures in Palliative care; how these measures may help in routine clinical practice, what are the benefits and challenges, and practical ways forward for implementation and use.
Workshop 2 Maxxine Rattner
Acknowledging the Suffering of Palliative Care Providers
That palliative care providers themselves suffer is an under-acknowledged part of our work. Where it has been acknowledged, it is primarily described in relation to patient and family suffering — that is, because patients and families suffer, we do too. While this is certainly part of the experience, there may be more to it. Results from a recent study indicating the multi-faceted nature of clinician suffering will be shared in this workshop. Through clinical case examples and small and large group discussions, participants will have the opportunity to reflect on this personal and professional aspect of palliative care provision.
Workshop 3 Jenny Lau, Andrew Smith
Addictions and Palliative Care: How to assess and manage opioid use disorders, aberrant medication taking behaviors and overdose risk in patients receiving palliative care.
There is a widespread belief that addiction is rare in patients receiving palliative care. The palliative care population, however, is changing as palliative care is increasingly integrated in the care of patients with cancer and non-cancer illnesses. This workshop will draw on clinical experiences and principles in pain and addiction medicine, and adapt and apply them to palliative care. 
Workshop 4 10:30-11:45
Megan Doherty, Robin Williams, Christina Vadeboncoeur

Difficult Symptoms at End of Life in Pediatric Palliative Care
This workshop will provide practical clinical training about how to anticipate and provide palliative care at the end of life for children, with a particular focus on the situations which are commonly encountered in areas where access to specialized pediatric palliative care may be limited.
Workshop 4 13:00-14:15
Ahmed al-Awamer, Pamela Mosher, Norma D’Agostino

Palliative Care for Adolescents and Young Adults
This interactive workshop will provide the audience with an overview of Adolescent and Young Adults (AYA) cancer palliative and psychosocial needs and strategies to address this complex patient population needs.
Workshop 5 Alyssa Boyd, Anne Boyle
Continuous Palliative Sedation Therapy
This interactive, case based session will take participants through the definition, indication and options for Palliative Sedation Therapy.   We will review the medications used and how to initiate, maintain and titrate a sedation to the desired affect.  We will discuss common misconceptions about the intervention and explore ways to talk about it with families, patients and health care providers.  We will also discuss some of the ethical dilemmas of initiating a sedation for existential grief and how it differs from MAID.
Workshop 6 Ben Robert
Palliative Care in the Long Term Care Homes will be reviewed
11:45-13:00 Networking Lunch, Poster Viewing and Exhibits
13:00-14:15 WORKSHOP SESSION V – Choice of 6 Workshops
Repeat of Session IV
14:15-15:30 KEYNOTE – Fliss Murtagh
International Perspective on Different Models of Palliative Care; and Current Evidence on Effectiveness and Cost-effectiveness
Models of palliative care – defined as the configuration and availability of staff, resources, and interventions for any one palliative care service – are becoming increasingly diverse. New and innovative models of care are developing. This plenary will address the current state of the science internationally in relation to models of specialist palliative care; and provide an overview of the current evidence on effectiveness and cost-effectiveness of different models.