2020 Program

Implementing the National Framework. Where are the Gaps and How do we Address Them?

(April 21, 2020) Today, the CSPCP Board of Directors announced the cancellation of ALPM 2020. Given the risks to public health and the restrictions all of us are living with, it is clear that we will not be able to hold an in-person event. (…read the full message)

Refund of registration fees will be processed by mid-May.

Wednesday, May 27 – Pre-conference Workshops

10:00-16:00 Point of Care Ultrasound
Separate fee applies – more information
14:00-18:00 Telling Your Story Effectively: A Journalist’s Tips for Making a Compelling Case to Decision-makers and the Public
Separate fee applies – more information

Thursday, May 28

Speaker bios

09:30-11:30 National Academic Half Day for Residents Onlymore information
13:15-14:15 OPENING KEYNOTE – Kathryn Mannix
With the End in Mind: Reclaiming our Lost Wisdom
What has happened to the public understanding of dying? When life expectancy was shorter, medical interventions less potent and death at home a familiar event, there was widespread understanding of the process of dying. As medical advances have improved life-expectancy, with our sickest citizens often removed to hospital for more intensive care, that familiarity has been lost. There is widespread misunderstanding of what happens as we die, both amongst the public and also amongst healthcare professionals. Fear and taboo prevent family discussions, postpone advance care planning conversations and even cause colleagues to delay referral to palliative care services. Could we re-imagine dying? Can we restore public understanding both of our mortality and of the process of dying? By enabling people to know more about the process of dying, I believe we can help them to be less afraid and more engaged in living the last part of life well.

14:00-14:15 interaction with audience (Q&A, discussion)

Turning Words into Action: Implementing the Framework on Palliative Care in Canada
Moderator: Charlie Chen

This interactive two-part session will include a facilitated panel discussion on the Action Plan on Palliative Care – Building on the Framework on Palliative Care in Canada. Physicians will learn about ways they can participate in the implementation of the Framework in their local areas and engage in national initiatives. Discussion will include potential challenges, ways of addressing gaps, and identifying future directions with our panel of experts.In Part 1, Speakers will share their positions and then engage with the audience.

Paul Adams – personal story of palliative journey and challenges navigating the system
Deborah Dudgeon – update on competencies and outcome measurements to improve care
Venetia Lawless (Health Canada) – update on the National Framework and Action Plan
Denise Marshall – compassionate communities and public health approach to palliative care

1515-1545 – Interaction with audience (Q&A, moderated discussion)

15:45-16:00 Break
Turning Words into Action: Implementing the Framework on Palliative Care in Canada
Prepare to roll up your sleeves put on your thinking cap. Part II will be 100% action oriented. Through personal reflection, small group discussion, and interaction with the expert panel, participants will jointly look at challenges, gaps, options, and future directions.
17:30-18:00 Awards Presentations (part I)
18:00-20:00 Welcome Reception with Exhibitors

Friday, May 29

07:30-08:00 Continental Breakfast, Poster Viewing and Exhibits
08:00-09:00 Residents’ Presentations (this session is not accredited)
09:00-10:00 KEYNOTE – Hsien Seow
Early Palliative Care Everywhere: How to Move the Mountain
Increased access to palliative care is everyone’s business, but how do we succeed in achieving this goal? The Canadian Society of Palliative Care Physicians has been a national champion for increased access to palliative care. However, by some measures, the progress for change has been slow; at times it can feel like trying to move a mountain. We need to focus on strategies to overcome inertia in the system in order to have access to palliative care at the population-level. Dr. Hsien Seow, Canada Research Chair in Palliative Care and Health System Innovation, will explore potential strategies and the roles palliative care specialists can play in helping to build a better system. He will look at who needs to be engaged and discuss engagement strategies to help move the mountain that is adopting a palliative care approach.09:35-10:00 interaction with audience (Q&A, discussion)
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)
11:25-11:45: Interaction with audience (Q&A, discussion)
Workshop 1 Kathryn Mannix
An Approach to Understanding Suffering in Palliative Care

Using a model derived from Cognitive Behaviour Therapy (CBT) theory and practice, we will consider the physical and emotional components of suffering, whether of patients, family members or professionals. Participants will practice developing a shared model of understanding with a patient (in pairs or triads), experiencing the role of ‘helper’ and of ‘patient.’ CBT skills of ‘curious questioning’ will be modeled and with an opportunity for experiential learning for all participants. Skills are transferable for working with patients, family members, peer support or supporting other team members or trainees)
Workshop 2 Jose Pereira, Hun Je Park
Top Palliative Care Articles from 2019
Workshop 3 Barbara Connolly, Teneille Gofton
Clinical Pearls for Symptom Management in Advanced Parkinsonism
Parkinsonism is a common feature of neurodegenerative disease. People living with both typical (idiopathic Parkinson disease) and atypical forms of parkinsonism (ie. multiple system atrophy, progressive supranuclear palsy) have complex palliative care needs that vary throughout the disease trajectory. This interactive workshop will provide an overview of the recently published Canadian Guideline for Parkinson disease as it pertains to symptom management in the advanced stages of Parkinson disease, will discuss the differences and similarities between typical and atypical parkinsonism and will explore time points along the disease trajectory amenable to palliative care intervention.
Workshop 4 Hsein Seow, Samantha Winemaker
Building CAPACITI in primary care: Exploring the mentorship and coaching role of palliative care specialists
This workshop is focused on exploring skills to build capacity in primary care providers to provide early palliative care. It will describe a quality improvement intervention, called CAPACITI, which aims to operationalize early palliative care among primary care teams working in the home and community. Each team in the intervention is paired with a palliative care specialist mentor. Using case examples, this workshop will explore tips to be an effective mentor and coach to primary care physicians and teams. This workshop is targeted to both those who identify as a palliative care specialist and those who mostly identify as a primary care physician.
Workshop 5 Kirsten Wentlandt
Congestive Heart Failure: A Palliative Medicine Review of the Disease, its Therapies and Drug Interactions

This talk will review HF and current targeted therapies including their effects on symptoms, hospital admission rates, exercise performance, HRQL, and survival. Pharmacological interactions with, and precautions related to commonly used palliative care medications are also reviewed. The goal of this review is to equip palliative care clinicians with information to make evidence-based decisions while managing the balance between optimal disease management and patient quality of life.
Workshop 6 a
Repeats at 15:15Max of 30 participants
Stephen Liben
Skills for Life: Building Resilience & Mindful Self-Compassion
Understanding (e.g. the importance of being resilient) is not enough. We must both understand and do something about it – both for ourselves and in our capacity to promote change in the less than helpful healthcare system. Being more balanced and resilient should not be left to happenstance – It is a choice, involving teachable and learnable skills. This 100% experiential participatory workshop is based on the McGill Whole Person Care “Mindful Medical Practice” course that has been taught over the past 5 years at the undergraduate, postgraduate and CME levels. Participants will engage in contemplative practices (aka brief meditations), as well as small-group narrative and structured dyad work. The concept of clinical resilience building and the role of mindful self-compassion will not only be examined, but most importantly the skills to build these capacities will be practiced in the workshop.
Workshop 6 b
Does not repeat in PM
Amit Arya, Aveksha Ellaurie
Aging in Place: Development of a Shared Care Consultative Model of Palliative care in Long-Term Care Facilities
The proportion of Canadian deaths occurring in long-term care (LTC) facilities has been increasing in the past 2 decades and is expected to reach 39% of residents per year by 2020. These are individuals frequently facing advanced life-limiting illnesses including dementia, heart failure, lung disease and cancer. Yet as of 2018, it is estimated that only 6% of Canadian LTC residents received formalized palliative care in the last year of life. A recent study found that only 25% of LTC residents had completed an advanced directive prior to their most recent hospital admission, and 38% had recurrent hospital visits. Alarmingly, 21% of LTC residents who died in acute care were hospitalized primarily for palliative care. There is reasonable evidence in the literature to suggest that specialist palliative care services for patients in LTC improve health outcomes and reduce system costs. Hence, in 2018, the William Osler Health System and the Central West Palliative Care Network initiated a shared care, consultative palliative care in LTC pilot program which to date has provided 111 visits to over 90 patients with life-limiting illness. The program has focused on patients with complex symptoms, existential distress, and undifferentiated goals of care. This interactive workshop will examine relevant literature and involve multiple small group case discussions, highlighting the challenges and benefits of working in the LTC setting. The workshop will aid participants in development of a palliative care consult service in LTC, including a discussion on the successes and lessons learned from the ongoing pilot project.
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
13:55-14:15: Interaction with audience (Q&A, discussion)
14:15-15:15 Health/Networking Break, Poster Viewing and Exhibits
15:15-16:30 WORKSHOP SESSION III – Choice of 6 Workshops (non-repeating)
16:10-16:30: Interaction with audience (Q&A, discussion)
Workshop 1 Dave Henderson, Anne Boyle
CSPCP Staffing Model – How does this thing work?
This workshop will explore a model to help develop a staffing plan for a specialist palliative care program. It is recommended that core competencies and understanding of a palliative approach to care be developed in all practice settings for all disciplines. In order to improve access to high quality palliative care, the National Framework for Palliative Care in Canada outlines the need for an integrated model of specialist and primary palliative care. However, we know that <15% of Canadians have access to specialist palliative care. Our staffing model serves as a tool to enable communities to both plan and advocate for the necessary resources to staff specialist palliative care teams. Calculating staffing needs for specialist palliative care services is complex, and there is little published evidence to suggest best practice. Staffing needs are often dependent on factors such as patient demographics, access to primary care, competency levels, models of care, and geography, to name a few. Recognizing these challenges, the CSPCP has developed a model based on a review of international literature, expert opinion from Canadian palliative care medical directors and feedback from key stakeholder groups. The model theorizes as a standard, a specialist palliative care team that provides care in an advisory-consultant-educational-coaching role alongside shared care with all primary care clinicians. The model embraces a team approach to care and recognizes that the numbers of palliative care physicians, nurses and social workers are all interdependent. In this workshop we will describe the CSPCP staffing model. Participants will then work to use the model in a practical, interactive experience to calculate the staffing needs for various communities. We will also facilitate discussion on how to use this as an advocacy tool for developing/maintaining programs in the participants own regions.
Workshop 2 Catherine Courteau, Laurence Laneuville
Narrative medicine in palliative care: Allowing ourselves to be moved by patients’ stories
During the 2018 Columbia University Narrative Palliative Care: A Basic Narrative Medicine Workshop, Dr. Charon reminded us that narrative medicine and palliative care share a lot in common, namely an openness to be moved by patients’ stories. Our own experiences have confirmed the many parallels between the two fields. Our workshop is divided into three parts. First, we briefly review what is narrative medicine and possible applications in palliative care, namely the use of patients’ personal narratives in care such as dignity therapy. We follow by presenting narrative medicine experiences we were actively involved in the last few years such as the creation of a reading club and reading module as part of the Physician Apprenticeship Course for medical students at McGill University, the development of writing workshops with health care professionals in a Montreal hospital and the participation in writing series for cancer patients in Vancouver. We have found death and dying to be a common theme in reading choices and writing topics in all our initiatives, reflecting an unmet need for a space to discuss this topic among medical trainees, physicians and patients. Our goal here is to discuss how narrative medicine can bridge this gap. Lastly, we go into action by exploring different techniques of narrative medicine with the participants. By allowing participants to experience projects we have developed and implemented, we hope to facilitate the integration of narrative medicine into participants’ own practices.
Workshop 3 Caroline McAllister, Subhra Mohapatra
Opioid Continuous Subcutaneous Infusions – How to Establish A Consensus Guideline
As patients approach end of life 70% or more will require injectable pain medications. Frequent subcutaneous injections are laborious for patients and families alike. Unfortunately there are no clinical or evidence based guidelines to indicate when a continuous subcutaneous infusion of opioid pain medications is preferred to intermittent subcutaneous injection. In this workshop we will examine contraindications of continuous subcutaneous opioid infusions and factors that lead clinicians to chose this treatment. We hope to demonstrate that when a set of factors is examined in a consistent approach that a “consensus” can be reached among participants in their decisions initiate opioid subcutaneous infusions, thus providing a “consensus” guideline/approach for them to disseminate to their colleagues.
Workshop 4 Allison Crombeen, Glen Maddison
Improving the quality of life and death in Long Term Care (LTC): A palliative care collaboration within LTC
Residents in LTC homes are frail and have comorbid conditions that render them to be at risk for death; however, access to palliative care in LTC can be inconsistent. The need to have detailed advanced care planning discussions is critical in this population to ensure the care they receive aligns with their goals. In this workshop, we will describe our year long collaboration with a LTC home wherein we provided consultation to residents, education to the nursing staff and collaboration with the LTC nurse practitioners with the goal of improving palliative care in LTC and reducing transfers to hospital at EOL. Our consultations included a detailed advanced care planning discussion during which we described common scenarios that could lead to death for LTC residents, such as acute respiratory illnesses, swallowing difficulties and hip fractures, as well as possible management choices, such as transfer to hospital or management in LTC. We provided end of life care for residents who requested not to be hospitalized, including patients who chose non-operative management of hip fractures. We supported the nursing staff by providing 24/7 access to our team to ensure proper symptom management as a means of knowledge translation. We will present data that demonstrates that our project reduced transfers to acute care, increased the quality of death in LTC and lead to improved staff satisfaction. This intervention has the potential to improve access to palliative care in LTC, while also improving the ability of frontline LTC providers to provide comprehensive palliative care.
Workshop 5
Repeat of AM workshopMax of 30 participants
Stephen Liben
Skills for Life: Building Resilience & Mindful Self-Compassion
Understanding (e.g. the importance of being resilient) is not enough. We must both understand and do something about it – both for ourselves and in our capacity to promote change in the less than helpful healthcare system. Being more balanced and resilient should not be left to happenstance – It is a choice, involving teachable and learnable skills. This 100% experiential participatory workshop is based on the McGill Whole Person Care “Mindful Medical Practice” course that has been taught over the past 5 years at the undergraduate, postgraduate and CME levels. Participants will engage in contemplative practices (aka brief meditations), as well as small-group narrative and structured dyad work. The concept of clinical resilience building and the role of mindful self-compassion will not only be examined, but most importantly the skills to build these capacities will be practiced in the workshop.
Workshop 6 Megan Doherty, Stephanie Van Zanten
Talking the Talk: Enhancing Communication in the Care of Children with Serious illnesses
For children with serious illnesses, exploring a family’s values, priorities and goals of care and incorporating these into treatment plans and recommendations. This session will present a systematic approach to conversations in the setting of serious illness or complex health conditions. There will be a focus on practical tools, approaches and principles that can be integrated into routine palliative care practice, using the Pediatric Adaptation of the Serious Illness Conversation Guide.
16:30-17:45 CSPCP Annual General Meeting

Saturday, May 30

07:30-08:00 Continental Breakfast and Poster Viewing
08:00-09:15 CSPCP Members’ Showcase (this session is not accredited)
09:30-10:45 WORKSHOP SESSION IV – Choice of 6 Workshops
10:25-10:45: Interaction with audience (Q&A, discussion)
Workshop 1a
Different topic for session V
Dave Lysecki, Gregorio Zunia-Villanueva
Pediatric Palliative Care in Practice

The Framework establishes that all Canadians, regardless of age, require equitable access to palliative care. And yet, there are a limited number of practitioners and institutions with experience in comfort in delivering a palliative approach to children. This workshop is for individuals looking to explore or deepen their understanding of the provision of palliative care to children. The workshop will use cases to demonstrate how we all have a role to play in supporting children with palliative needs.
Workshop 2 Amy Montour, Michael Anderson
How Accessible is Palliative Care for Indigenous People?
Workshop 3 Erynn Shaw, Marissa Slaven
Cannabis and the Palliative Care Patient
Cannabis has a long history of therapeutic applications, and with legalization patients receiving palliative care have demonstrated a growing interested in it’s potential for symptom management. It is becoming increasingly important to understand the available evidence and balance this with management of refractory symptoms, patient preferences, and palliative patient’s rights to access experimental treatments. This workshop will provide an overview of medical cannabis for symptom management in palliative care patients, with a focus on oncology.
Workshop 4 Carlos Centeno
Undergraduate and Creative Medical Training in Palliative Care
In the competitive context of undergraduate medical education, creativity and a little spirit of adventure are needed to innovate and overcome difficulties. On occasion, students may receive conflicting inputs in their training that undermine the main message of palliative care. In not a few other cases, it is not possible to find clinical rotation time to expose the student to the clinical practice of palliative care, but it is possible to design educational activities that otherwise expose the student to the patient’s experience and compassionate practice. This seminar is designed so that all those related to the teaching of palliative care in undergraduate can share experiences and get new ideas of immediate application with which to renew their own training programs.
Workshop 5 Jessica Simon, Aynharan Sinnarajah
How can we implement early, systematic integrated palliative care for advanced cancer patients? Learning from the PaCES project
A key role for advanced palliative care providers is to improve the quality of care and patient/family experience but implementing best evidence into practice is not easy. The American Society of Clinical Oncology guidelines recommend palliative care involvement within 8 weeks of advanced cancer diagnosis, but commonly patients only access palliative care in the final few months of life. The Palliative Care Early and Systematic (PaCES) knowledge translation project has adapted and implemented evidence-based practices for delivering early and systematic Palliative Care (PC) at the health system level for patients with advanced colorectal cancer. Using the PaCES project as a case study, this hands-on workshop will walk you through the “Knowledge-to-Action cycle” and you’ll learn how this framework can guide your own projects to implement evidence into practice. We will explore key steps and challenges in developing clinical improvement, like securing project funding, engaging stakeholders, developing an implementation plan adapted to local contexts, assessing readiness and avoiding change fatigue, evaluating and sustaining change. You will be encouraged to share your own challenges and successes in implementing change. We aim to leave you with renewed enthusiasm in your role as a change agent for “Implementing the Framework on Palliative Care in Canada”.
Workshop 6 Denise Marshall, Erin Gallagher
Our Place in Public Health Palliative Care; The Role for Physician Leaders and Advocates
Public Health Palliative Care has gained traction internationally as more than a “movement”. it is now seen as one of the most important levers to shift societal care closer to the goal of “a good death for all”. In this workshop we will update one another on the core concepts underpinning a PHPC approach, and review the emerging theories, outcomes and research surrounding various aspects of PHPC programs, initiatives and activities around Canada and the world. Most importantly, we will, both individually and collectively, move forward as physician leaders and advocates in ‘next step” , logical, practical application of PHPC in our work and our lives.
10:45-11:15 Networking/Health Break and Poster Viewing
11:15-12:30 WORKSHOP SESSION V – Choice of 6 Workshops
Repeat of Session IV
12:10-12:30: Interaction with audience (Q&A, discussion)
Workshop 1b

Different pediatric topic from session IV

Dave Lysecki, Kevin Weingarten
Pediatric Palliative Care in Review

This workshop will review the practice of pediatric palliative care. After an overview of the field and its evolution, the group will work in depth through example cases to gain a deeper understanding of the patients, the care, the practice, the models, the evidence, the guidelines, and the philosophies of pediatric palliative care.
12:30-13:00 Buffet Lunch
13:00-13:15 Awards Presentations (part II)
13:15-14:15 KEYNOTE – Carlos Centeno
Global Experiences and International Good Practices to Develop a Palliative Care National Framework
It is urgent to study how palliative care can be integrated at all levels of a health system and even in the society considering that to develop of palliative care specialized services is only a link of the chain of a good palliative care practice. Some indicators new have been proved useful to draw the European perspective of the integration of palliative care in pediatric, primary care, oncology, cardiology, long term facilities, and in a societal level. Through research performed in Europe and also in Low- and Middle-Income Countries (LMIC) and presented in the format of Palliative Care Atlas, it is possible to identify experiences and good practices in Palliative Care that could inspire more integration and improvements in the Framework on Palliative Care in Canada.14:00-14:15 interaction with audience (Q&A, discussion)