conference program at-a-glance sunday, april 23, 2017 · conference program at-a-glance sunday,...

CONFERENCE PROGRAM AT-A-GLANCE SUNDAY, APRIL 23, 2017

Times

8:00 - 9:30 am Registration, Continental Breakfast

Exhibitor Showcase Opens

9:30 - 10:45 am Welcome Remarks and Opening Presentation: The Patient and Caregiver Voice in Improving Access to Hospice Palliative Care

10:45 - 11:00 am Stretch Break

11:00 - 11:45 am June Callwood Awards Ceremony

11:45 - 1:00 pm Luncheon Buffet & Exhibitor Showcase

1:00 - 2:15 pm CONCURRENT WORKSHOP SESSIONS - SERIES 100

Session # Stream Session Title and Speaker(s)

101 LDP The “How To’s” for Building Primary Care Palliative Care Capacity within our Systems of Care; An Experiential Workshop based on 20 Years of “Lessons Learned”

Dr. Denise Marshall, Dr. Jeff Myers

102 LDP Community Access to Palliative Care via Inter-Professional Teams Intervention (CAPACITi)

Dr. Hsien Seow, Dr. Daryl Bainbridge

103 LDP Health Care Consent, Advance Care Planning, and Goals of Care: The Challenge to Get it Right (Part 1)

Judith A. Wahl, Tara Walton

104 LDP Improving End-of-Life Care in First Nations, Inuit and Métis (FNIM) Communities - Beliefs, Myths, Practices and Protocols that Make a Difference in Care

Audrey Logan, Dr. Mark Tomen, Mona Stonefish

105 CLN Using an eLearning Module to Teach Goals of Care Conversations (Part 1)

Dr. Leah Steinberg, Dr. Ciara Whelan 106 CLN Mixology: A Primer on Medications Used to Manage Advanced Heart and Lung Disease,

their Contribution to Improving Quality of Life, and Drug Interactions with Common Palliative Care Medications (Part 1)

Dr. Kirsten Wentlandt, Dr. Ebru Kaya, Dr. Erin O’Connor, Andrea Weiss, Sandra Porter, Derek Leong

107 CLN Medical Assistance in Dying (MAID) and Hospice – A Conflict of Values or an Opportunity for Whole Person Care

Dr. Andrew Mai, Lisa Shishis 108 PSBCT Wishes Philosophy

Julie Premo

109 PSBCT Pathways Grief Support Program: How to Make a Difference When Death is Part of a Family’s Story

Lori Ives-Baine, Norah Shaughnessy

110 VOL Helping Hospice Palliative Care Volunteers Deal with Unusual End-of-Life Phenomena

Dr. Stephen Claxton-Oldfield, Jane Claxton-Oldfield

111 LDP Innovation and Collaboration; Improving Access to Care in a Small, Rural Residential Hospice

Kerri-Anne Wilson, Lynn Park

SUNDAY, APRIL 23, 2017

Times

2:15 – 2:45 pm Refreshment Break

Exhibitor Showcase and Posters

2:45 – 4:00 pm CONCURRENT WORKSHOP SESSIONS - SERIES 200


201 LDP Five Great Ideas to Extend Hospice Services Farther into the Community: The Results of a Co-Design Exercise at Hospice Georgian Triangle

Dr. Paul Holyoke, Karen Oikonen, Kelly Borg

202 LDP A Day in the Life of the Palliative Pain & Symptom Management Consultant (PPSMC): Partnering to Capacity Build Expertise in the Delivery of High Quality Palliative & End of Life Care

Amy Archer, Tracey Human

203 LDP Health Care Consent, Advance Care Planning, and Goals of Care: The Challenge to Get it Right (Part 2)

The Health Care Consent Advance Care Planning Community of Practice Leadership Team, Hospice Palliative Care Ontario

204 LDP Affirm and Repeat – Telling Your Story and Winning Support

Jennifer Mossop

205 CLN Using an eLearning Module to Teach Goals of Care Conversations (Part 2)

Dr. Leah Steinberg, Dr. Ciara Whelan

206 CLN Mixology: A Primer on Medications Used to Manage Advanced Heart and Lung Disease, their Contribution to Improving Quality of Life, and Drug Interactions with Common Palliative Care Medications (Part 2)

Dr. Kirsten Wentlandt, Dr. Ebru Kaya, Dr. Erin O’Connor, Andrea Weiss, Sandra Porter, Derek Leong

207 CLN Medical Aid in Dying: A Practical Training for Physicians, NPs and Allied Health

Dr. Narges Khoshnood, Dr. Joshua Wales, Dr. Sarah Kawaguchi

208 PSBCT Clinician Suffering: A Paradigm Shift for Palliative Care Providers

Maxxine Rattner, Dr. Joan Berzoff

209 PSBCT Games, Cookies and Creativity: Addressing the Needs of Children When Caring for Adults

Megan Sloan, Kath Murray, Kathryn (Katt) Brooks

210 VOL Volunteers Supporting Innovative Compassionate Care in our Community

Teresa Harris, Kathy Stewart, Teneal Childs

211 LDP Partnerships and Passion - Building a Sustainable and Successful Hospice Program

Michelle O’Rourke

4:15 – 5:15 pm The Carmelita Lawlor Lectureship in Palliative Care

Making a Difference: Social Innovation and Impact in End of Life Care. Recipient: Shirlee Sharkey (Lecture open to non-conference participants)

5:30 – 8:00 pm OMA Section on Palliative Medicine AGM (Meeting Open to OMA Member Physicians Only)

6:00 – 7:00 pm RNAO, Palliative Care Nurses Interest Group (PCNIG) AGM

7:00 – 8:30 pm HPCO’s Compassionate Communities - Community of Practice (CoP) Information Session

FREE EVENING

MONDAY, APRIL 24, 2017

Times

7:15 am Early Bird Continental Breakfast Available

7:30 - 8:45 am Registration & Continental Breakfast


Oral Paper Presentations: Series 1, 2, 3, 4

8:50 - 9:15 am Welcome Remarks

9:15 - 10:15 am Plenary Panel Presentation: The Ontario Palliative Care Network: Improving Access to High Quality Hospice Palliative Care

10:15 - 10:45 am Refreshment Break


10:45 am - 12:00 pm CONCURRENT WORKSHOP SESSIONS - SERIES 300


301 LDP Rebranding Death: How to Change your Community's Perception on Death and Dying

Lee Rendell

302 LDP Compassionate City Charter in Canada

Pamela Blackwood, Karen Candy, Bonnie Tomkins

303 LDP Start where You Are: Building a Fundraising Plan

John Andresen

304 LDP Engaging the General Public in Advance Care Planning Conversations Where They Live, Work and Pray

Jessica Hutchison, Lynn Weimer

305 CLN Blending Quality and Compassion---Caring for Those with End Stage Heart Disease and Stroke

Dr. Brian Berger

306 CLN Improving Delirium Management at End of Life: Reflection, Education and Management in Residential Hospice

Rebecca Ellerson, Dr. Deb Harrold

307 CLN iEPECO: Advancing Palliative Care Through Standardized Online Education

Dr. Jiahui Wong, Susan Blacker, Dr. Paul Daeninck

308 PSBCT Death Cafes: Igniting the Public to Talk about Death, But Not in Bereavement Groups

Linda Hochstetler

309 PSBCT When is Close Too Close? Caring for Patients whom we Know Personally

Dr. Jennifer Shapiro

310 VOL Training Standards for Direct-Service Community Hospice Volunteers

Annalise Stenekes

311 CLN A Review of Palliative Sedation Therapy (PST) in a Residential Hospice

Lynn Varga, Wendy Beitel, Francis Zavarise

12:00 - 1:15 pm

Luncheon Buffet & Exhibitor Showcase

Awards Presentation

MONDAY, APRIL 24, 2017

Times

1:15 – 2:45 pm Plenary Session: HIT (Healthcare, Innovation, Technology) Talks

Across the Continuum: An Innovative Approach to Person and Family- Centred Care - C. Elizabeth Dougherty

Let's Take Care of Us, Healthcare Providers in the Palliative Care Field – Nadine Persaud

Entertain, Educate, and Entrall: Applied Theatre in Palliative and End-of-Life Care – Keri-Lyn Durant

2:45 – 3:15 pm Refreshment Break, Exhibitor Showcase & Posters

Exhibitor Showcase - Last Chance to Visit with Exhibitors

Posters

3:15 – 4:30 pm CONCURRENT WORKSHOP SESSIONS - SERIES 400


401 LDP Partnering for Change in Palliative Care in Ontario; Update from the Clinical Advisory Council of the Ontario Palliative Care Network

Tara Walton, Dr. Ahmed Jakda, Melody Boyd

402 LDP When Hospices and Hospitals Team-Up! How a Community Based Hospice Program and Palliative Care Unit at a Hospital Joined Forces to Provide Exceptional Quality Hospice Care to Patients!

Amanda Maragos, Karina Wulf

403 LDP Building Your Donor Base

John Andresen

404 LDP Co-Designing Hospice Palliative Care: Deep Engagement with Family Members, Hospice Staff, Healthcare Providers and Community Members

Karen Oikonen, Dr. Paul Holyoke, Kelly Borg, Susan Paterino

405 CLN Cancelled – Replacement to be Announced

406 CLN Advanced Heart Failure and Palliative Care: Lessons Learned from a Collaboration

Dr. Leah Steinberg

407 CLN Health Care Provider Comfort with Quality of Life Feeds for Patients with Dysphagia

Peter Allatt, Phoebe Smith Chen, Joyce Lai

408 PSBCT Understanding and Overcoming Compassion Fatigue: Moving Towards Compassion Satisfaction

Cher Curshen

409 PSBCT Legacy Boxes in Pediatric Care; When and How

Julie Schelter, Irena Razanas

410 LDP Patients will Experience Seamless Care: Innovations in Communication and Collaboration

Dr. Russell Goldman, Dr. Amna Husain, Catherine Prestwich, Meredith Muscat

411 CLN Cannabinoid Therapies: What's All the "Buzz" About?

Dr. Vincent Maida

6:00 – 7:00 pm

Pre-Dinner Reception

7:00 – 11:00 pm Banquet Dinner and Entertainment

Awards Presentation

TUESDAY, APRIL 25, 2017

Times

7:15 am Early Bird Continental Breakfast

7:30 - 8:45 am Registration & Continental Breakfast

Posters

Oral Paper Presentations: Series 5, 6, 7, 8

9:00 -10:00 am Welcome Remarks & Keynote Presentation: Reframing the Social Determinants of Health: Towards Palliative Care Equity in our Communities

Dr. Naheed Dosani

10:00 - 10:30 am Refreshment Break

Last Chance for Posters and Hotel Check-out

10:30 – 11:45 am CONCURRENT WORKSHOP SESSIONS - SERIES 500


501 LDP Planned Giving for Pennies: How to Jumpstart Your Bequest Program

Kimberley MacKenzie

502 LDP Integrated Succession Planning for Non-Profit Corporations

Linda Fairburn

503 LDP The Palliative Care Future: Defining Quality and Our Role in It

Dr. Ahmed Jakda, Melody Boyd, Lisa Ye

504 LDP Developing a Palliative Care Program in a Rural Hospital: The Journey So Far

Chiamaka Odunukwe

505 CLN Medication Deprescription and Increasing Comfort Medication Use in Patients with Advanced Medical Illness

Rachel Whitty, Sandra Porter, Kiran Battu, Dr. James Downar

506 CLN Improving Communication About Goals of Care with Hospitalized Patients Who Have Serious Illness: A Canadian, Multi-Centre Program of Research

Marilyn Swinton, Sandra Andreychuk, Tasnim Sinuff, Carol Mantle, Dr. John You, Peter Allatt

507 CLN Having the Hard Conversations

Sheila Mahoney

508 PSBCT H.U.G.S. Helping Children Understand Grief Sessions Training & Workshop

Christine Dernederlanden

509 PSBCT "The Sick Mannes Salve": Contemplative Traditions and End of Life Care

Dr. Mary Wallis

510 VOL How to Conduct an Antineoplastic Drug Risk Assessment in the Workplace

Carolyn Cuthbertson

11:45 - 1:00 pm Luncheon Buffet

Best Oral Paper and Poster Presentations

1:00 - 2:00 pm Closing Keynote Presentation: Laughter is the Best Medicine

Deborah Kimmett

2:00 - 2:15 pm Closing Remarks, Draw Prizes, Adjournment

WORKSHOP STREAMS The workshop sessions have been scheduled into the program agenda by streams, so that conference participants can easily zero in on sessions most relevant to their discipline or practice. These are only guidelines to help you choose from the 54 concurrent workshops being offered.

LDP Leadership/Systems/Integration

Hospice Executive Directors

Program Administrators

Policy Makers

CLN Research, Scientific/Advanced Clinical Practice

Palliative Care and Family Physicians

Nurses, Case Managers, Care Coordinators

Advance Palliative Care Practitioners

Other Care Providers

PSBCT Psychosocial, Spiritual, Bereavement, Complementary Therapy

Social Workers

Pastoral and Spiritual Care Workers

Practitioners Providing Complementary Modalities

Anyone Interested in the Psychosocial Aspects of Palliative Care

VOL Volunteer Management

Volunteer Managers

Volunteer Coordinators

101 The “How To’s” for Building Primary Care Palliative Care Capacity within our Systems of Care; An Experiental Workshop Based on 20 Years of “Lessons Learned” Dr. Denise Marshall, B.Sc., MD, CCFP (PC) FCFP, Associate Professor, Division of Palliative Care, Department of Family Medicine, McMaster University; Medical Director , Niagara West Palliative Care Team and McNally House Hospice, Hamilton, ON Dr. Jeff Myers, MD, MSEd, CCFP(PC), Head & Associate Professor, Division of Palliative Care, Faculty of Medicine, University of Toronto Head, Division of Palliative Care, Sunnybrook Health Sciences Professor, Toronto, ON A critical success factor for improving the quality of end of life care of any population is the recognition by palliative care clinicians of our role in leading systems change. To meaningfully address the needs of any community, clinicians must look beyond direct care provided to patients and families and expand their focus to include building primary palliative care capacity. To effectively address issues of access, equity, and sustainability, every palliative care clinician has a social responsibility to become “system integrators” and change the way “business” is done. Requisite skills include integrating collaborative/ shared models of care delivery, co-planning beyond the level of a palliative care team and developing true cross-sectorial partnerships that are jointly responsible and accountable for quality, evaluation and performance. The workshop target audience includes palliative care clinicians who have moderate/ advanced experience in systems leadership. Learn about the challenges, lessons learned and resultant practical approaches developed in various community settings. The workshop format will be case-based drawing from the experience of two seasoned clinical leaders from two regions in Ontario. A facilitated discussion will explore strategies that can be applied across settings and systems from the perspectives of geography, organizations, clinicians as well as patients and families. Particular emphasis will be placed on partnerships, primary care, and community services including hospice. Learning Objectives:

1. Discuss what being a “palliative care systems integrator” means to front line clinicians; 2. Gain an appreciation for, and “compare and contrast” various components/considerations of

primary palliative care capacity building; 3. Learn about the challenges, lessons learned and resultant practical approaches developed in

various community settings. Workshop Stream: Leadership/Systems/Integration

102 Community Access to Palliative Care via Interprofessional Teams intervention (CAPACITi) Workshop Dr. Hsien Seow, Associate Professor, McMaster University, Hamilton, ON Dr. Darryl Bainbridge, Senior Research Coordinator, McMaster University, Hamilton, ON

CONCURRENT WORKSHOP DESCRIPTIONS – SERIES 100

Sunday, April 23, 2017 Time: 1:00 ‐ 2:15 pm

Interprofessional collaboration in which nurses, physicians, personal support workers, and other healthcare providers work together is critical for providing patient-centred palliative care in the community. Role clarity, open communication, interdependence, mentorship, and other qualities of provider cohesion are indicative of well-functioning, effective, palliative care programs. Although standardized curriculum exists to improve the clinical competency of healthcare professionals in providing palliative care, there is little in the way of training to help these individuals develop their team building skills or explore opportunities to strengthen relationships with other providers in their community. Dr. Seow and his team have developed a workshop intervention to assist community healthcare providers strengthen their own interprofessional palliative care capacity. Design of the workshop exercises was informed through a synthesis of existing literature and tools on team building and input from a broad cross section of palliative care providers and experts. The workshop will be fully interactive, with attendees participating in the session activities in reflection of their own practice community and fellow providers who work there. The goal of the workshop is to provide participants with ideas of how to engage other providers, including primary care physicians, in their daily work and strengthen professional relationships. Learning Objectives:

1. To share the findings of an exhaustive review of the key steps and proven activities to strengthening collaborative palliative care practice in the community;

2. To participate in team building activities to hone these skills in reflection of one’s own community of practice;

3. To contribute to the refinement and improved utility of the workshop exercises as part of a team-building curriculum that can be used in any community.

Workshop Stream: Leadership/Systems/Integration

103 Health Care Consent, Advance Care Planning, and Goals of Care: The Challenge to Get It Right

(Part 1) Judith A. Wahl, Executive Director and Barrister and Solicitor, Advocacy Centre for the Elderly, Toronto, ON

Tara Walton, MPH, Family/Caregiver Representative, Ontario Palliative Care Network, Toronto, ON

The demand for pre-planning by patients about future health care decisions has dramatically increased, particularly for end-of-life care. There is considerable variability in the components of the pre-planning process, such as advance care planning (ACP) conversations, and/or goals of care (GOC) discussions, as well as potential documentation of the outcomes of either or both Ensuring compliance with Ontario law and meeting the legislated professional obligations for all health practitioners, and accredited health organizations (e.g., hospitals, long term care homes, community agencies) is vital to reducing the risk of complaints and legal liability.



This two-part workshop will offer participants a review and highlights from the findings on the 2016 Law Commission of Ontario report, “Health Care Consent, Advance Care Planning, And Goals of Care Practice

Tools: The Challenge to Get It Right” for the Improving the Last Stages of Life project. The session will also provide critical information to assist in understanding the current climate and practice challenges and opportunities moving forward; it will include activities to support increased efficacy in screening for and making changes to HCC and ACP materials, processes and activities. Participants will increase their knowledge of the linkages between HCC, ACP and GoC, learn to screen for Ontario reflective language and practice, and gain information on potential Ontario supports available when making the commitment to change.

Learning Objectives: 1. To understand and appreciate the current climate and practice challenges in Ontario; 2. To build knowledge about HCC and ACP within an Ontario legal framework and the system and

supports to improve compliance; 3. To have an opportunity to engage in reflect and screening focusing on required changes need to

HCC, ACP and GoC.


104 Improving End-of-Life Care in FNIM Communities - Beliefs, Myths, Practices and Protocols that

Make a Difference in Care Audrey Logan, Aboriginal Navigator, Windsor Regional Hospital, Windsor Regional Cancer Program, Windsor, ON Dr. Mark Tomen, Physicain, Erie St. Clair Aboriginal Cancer Lead, Chatham, ON Mona Stonefish, Elder with ESC Regional Cancer Centre's Aboriginal Program, Erie St. Clair Regional Cancer Centre, Windsor, ON Every person, every culture, and every journey has a story. This adage holds particularly true for anyone working with First Nations, Inuit and Métis (FNIM) peoples at End-of-Life where the need for care is increasing. Communities are diverse and the provision of culturally appropriate care is critical. This workshop will be led by a Traditional Knowledge Keeper, Aboriginal Navigator and Physician with years of experience in palliative care. This intermediate level workshop is designed for health care providers (HCPs) who support FNIM peoples at end of life (EOL). The session will support and empower HCPs working with FNIM people by providing them with:

An understanding of the need for respect of FNIM practices and protocols;

The ability to identify and differentiate between truths and myths about FNIM peoples and their communities;

Insight into Traditional beliefs of First Nation (FN) peoples about death and dying and the implications for EOL care;



The experience of participating in a traditional ceremony to aid in understanding of cultural practices.

This workshop will open and close with a FN ceremony. The session will be devoted to teaching through story telling. There will be information shared to facilitate the understanding and respect for the FN traditional belief system surrounding end of life. Case scenarios will be used to aid in the understanding of best practices. Participants will depart the workshop with basic skills including knowledge of how to build relationships and capacity in FNIM communities. Learning Objectives:

1. Provide HCPs with insight into Traditional beliefs of First Nations peoples about death and dying and the implications for EOL care;

2. Develop an understanding of the need for respect of FNIM protocols and practices; 3. Strengthen the ability to differentiate between myths and truths about FNIM peoples and their

communities. Workshop Stream: Leadership/Systems/Integration

105 Using an eLearning Module to Teach Goals of Care Conversations (Part 1) Dr. Leah Steinberg, MD, MA, CCFP, Mount Sinai Hospital, Toronto, ON Dr. Ciara Whelan, MD, Mount Sinai Hospital, Toronto, ON There are no standard guidelines or recommendations for conducting goals of care conversations with patients who have advanced illness. Through literature review, expert input and formal feedback sessions, a new eLearning tool was developed to teach learners fundamentals and advanced skills in conducting goals of care conversations. Three patient scenarios and video materials were developed to demonstrate the skills taught in the module. Several skills are focused on in the learning module: using reflection and motivational interviewing skills to promote your understanding of your patient; skills in asking your patient about values and goals and skills in determining recommendations and plans. This eLearning module has undergone usability testing within the University of Toronto General Internal Medicine program and is planned for use by the Mount Sinai Hospital General Internal Medicine residents. In this workshop, the eLearning module will be demonstrated in real time, as a tool to both advance learner's comfort and skill in leading goals of care conversations and to engage the participant in using the module for education in their own setting. In this workshop format, time will be allocated to practicing the skills taught in the eLearning module. Learning Objectives:

1. Participants will improve their skill and comfort in leading goals of care converations by observing, reflecting on and practicing specific communication skills such as offering reflections;



2. Participants will learn about the process of developing eLearning modules; 3. Participants will engage in discussion about how to teach these skills in their own environment.

Workshop Stream: Research/ Scientific/Advanced Clinical Practice

106 Mixology: A Primer on Medications Used to Manage Advanced Heart and Lung Disease, their

Contribution to Improving Quality of Life, and Drug Interactions with Common Palliative Care Medications (Part 1)

Dr. Kirsten Wentlandt, MD, University Health Network, Toronto, ON Dr. Ebru Kay, MB BS (UK), MRCP (UK), Assistant Professor, Department of Medicine, University of Toronto, Palliative Care Physician, Site Lead, Toronto General Hospital Palliative Care Team, Toronto, ON Dr. Erin O’Connor, MSc MD FRCPC, Lecturer, University of Toronto, Department of Medicine, Divisions of Emergency Medicine and Palliative Medicine, University Health Network, Toronto, ON Dr. Andrea Weiss, MD, University Health Network, Toronto, ON Sandra Porter, BScPhm, RPh, CRE., Clinical Pharmacist, General Internal Medicine, Toronto General Hospital, Adjunct Lecturer, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON Derek Leong, RPh, BScPhm, ACPR, Clinical Pharmacist, General Internal Medicine, Toronto General

Hospital, Toronto, ON

This workshop will review common medications used to manage advanced heart and lung disease and highlight their ability to support quality of life and symptom management. We will also review the possible drug interactions between these disease specific medications and those commonly used in palliative care. Specific conditions covered in this workshop include: heart failure, COPD, interstitial lung disease and pulmonary hypertension. The session will be 2.5 hours long spread over 2 workshop sessions. Learning Objectives:

1. Review advanced heart and lung disease; specifically heart failure, COPD, interstitial lung disease and pulmonary hypertension;

2. Review common medications used to manage advanced heart and lung disease and outline those that support quality of life and symptom management;

3. Evaluate the possible drug interactions between disease specific medications and those commonly used in palliative care.


107 Medical Assistance in Dying (MAID) and Hospice – A Conflict of Values or an Opportunity for Whole Person Care Dr. Andrew Mai, MD CCFP (PC), University of Ottawa, Ottawa, ON



Lisa Shishis, RN, Ottawa, ON Medical Assistance in Dying (MAID) is now a reality in Canada. We at Hospice Care Ottawa struggled with how to address this issue from a policy perspective and also with how to respect the rights and beliefs of patients volunteers, doctors and staff. Rather than take a hard line for or against MAID, we sought to find a middle road. We feel that hospice is in a perfect position for leadership in providing palliative and end-of-life care to patients whose suffering has led them to request MAID. The importance of not abandoning these patients cannot be overstated. This workshop will target the more advanced learners among residential hospice staff and policy makers. Making use of case studies we will explore our experience in caring for a patient at HCO who had requested MAID. This assisted us in forming our policy. Participants will be expected to share their own experiences and opinions around MAID in a small group setting. At the end of this workshop, participants will be able to approach the issue of MAID with a more nuanced understanding of the potential benefits of caring for patients at hospice who may be requesting MAID. It is hoped that this understanding will lead to development of policy, education and practice in residential hospice that will allow for whole person care of these patients. Finally, participants in this workshop will form the nucleus of a MAID and hospice support network in Ontario. Learning Objectives:

1. Network; 2. Find support from other hospices in Ontario that are struggling with these same issues.


108 Wishes Philosophy Julie Premo, Support Services Manager, ARCH Hospice, Sault Ste. Marie, ON Wishes are a fundamental component of the day-to-day operations of hospice. As the focus shifts from quantity to quality one may begin to see that in the end-of-life there is a beautiful space. In this space the focus shifts and the notion of being alive or dead is quite shifted as those in hospice are so very much alive. What an individuals wants for and strives from becomes altered and often so crystal clear. And here is where we find the wishes philosophy. Our team of exceptional volunteers and staff come together to fulfill wishes. A wish for a favourite meal, a wedding renewal, time to hold your grandbaby, to see a Monarch butterfly, to pass outside at one with nature, to hear bagpipes at your window, to spend time outside with live horses or to celebrate your birthday one last time. No matter the wish we find a way, a creative solution to make the wish a reality for those we serve. In the presentation the goal is to inspire others to do the same by sharing our experiences through video and storytelling. For quite simply those we serve are teachers for what matters in the end is often what should matter the most anyways.



Learning Objectives:

1. Wishes Philosophy; 2. Inspire Others to Live Fully; 3. Quality over Quantity.

Workshop Stream: Psychosocial/Spiritual/Bereavement/Complementary Therapy

109 Pathways Grief Support Program : How to Make a Difference When Death is Part of a Family’s Story Lori Ives-Baine, RN, BScN, MN (CPB), The Hospital for Sick Children, Toronto, ON Norah Shaughnessy, BAH, MSW, RSW, The Hospital for Sick Children, Toronto, ON Paediatric palliative care is an area of health care that frightens many. At SickKids Hospital, the Pathways Grief Support Program, which is housed with the Paediatric Advanced Care Team offers grief support to families and staff in anticipation of and after the deaths of babies, children and teens. This program is offered to all families whose child has died in hospital or out of hospital if the child was ever a patient at SickKids. The range of deaths that we support is vast: sudden death (suicide or car accidents), cancer, heart defects, genetic and metabolic diagnoses- the list goes on. Regardless of the cause of death, all of these families need tremendous grief support. Over the past three years, Pathways has grown into a robust, multi-faceted program. Components of the program include: quarterly personalized mailings, quarterly family education events, bi-monthly coffee drop-ins, legacy building and phone-call check-ins. We have also built a user-friendly website where parents can go to learn about resources in their community, as well as gain access to valuable online resources. We also provide informal and formal support to staff around anticipated deaths, moral distress, and deaths on their units.This 1.15 hr presentation will provide information, a program summary and a review of the current data on impact of this program, now in its’ 4th year of expansion. The continually evolving website will be reviewed along with the benefits to all who take part in the programming. Learning Objectives:

1. Participants will be able to express 3 benefits of a comprehensive bereavement service in care of clients’ families in their organization;

2. Participants will be able to define outcome measures that will show the growth of the program; 3. Participants will be able to learn and identify grief support resources across the province that

have been verified for use with their specific populations. Workshop Stream: Psychosocial/Spiritual/Bereavement/Complementary Therapy



110 Helping Hospice Palliative Care Volunteers Deal with Unusual End-of-Life Phenomen Dr. Stephen Claxton-Oldfield, PhD, CT, Hospice Palliative Care Volunteerism Lab, Associate Professor,

Psychology, Mount Allison University, Chair, Tantramar Hospice Palliative Care Organization, Sackville, NB

Jane Claxton-Oldfield, MN, Mount Allison University, Sackville, NB As people who work closely with the dying and their families, hospice volunteers may have personally witnessed or have had patients or patient's family members tell them about unusual occurrences happening shortly before, at the time of, or shortly after a patient's death. These end-of-life phenomena (EOLP) (e.g., deathbed visions, synchronistic events, terminal lucidity) are a part of, and most often have a positive influence on, the dying process (e.g., are a source of comfort to dying patients and their families). The goals of this workshop include: 1) Helping volunteers learn more about these EOLP so that they are comfortable talking about these phenomena with their patients and patients' family members who report them; 2) Normalizing and validating EOLP by looking at data showing how common they are (e.g., Claxton-Oldfield & Dunnett, 2016); and 3) Discussing training needs around EOLP for volunteers. We may not know why these EOLP happen, but what we do know is that they happen and volunteers need to feel comfortable in having conversations about these experiences with their patients and patients' family members who report them. Learning Objectives:

1. Giving volunteers the skills to talk about unusual end-of-life phenomena (EOLP) with their patients and patients' family members who report them);

2. Normalizing and validating EOLP; 3. The need for training around EOLP.

Workshop Stream: Volunteer Management

111 Innovation and Collaboration; Improving Access to Care in a Small, Rural Residential Hospice Kerri-Anne Wilson, RN, BScN, The Bridge Hospice, Warkworth, ON Lynn Park, Regional Director, Saint Elizabeth Research Centre, Saint Elizabeth Health Care, Markham, ON The Bridge Hospice is a 3-bed residential hospice located in rural south eastern Ontario. Envisioned, funded and built by the community over seven years, the small hospice opened in 2013. The original service model was volunteer-based; qualified volunteers provided around the clock care for residents and families, with CCAC support for regular visits by nurses and PSWs. A limited number of volunteers restricted capacity to serve, so the hospice south opportunities to expand and enhance care provision. In 2015, TBH entered a 5-year partnership with Saint Elizabeth, an organization that shared its passion for rural palliative care. The partnership initially provided visiting designated palliative nurses and 24/7 onsite PSWs with an expanded scope of practice specific to end-of-life care. With greatly enhanced service capacity, TBH admission rates have nearly doubled since the partnership, and the hospice is



often at capacity. Volunteers continue to serve and integrate seamlessly with the professional healthcare staff as our model of care continues to evolve. Most recently, we have added an RPN to supplement the PSW overnight shift to address the more complex needs of our residents. This has increased safety and security and reduce the need to the call the on-call RN. As we continue to grow in our partnership, our admission rates and level of care continue to rise. Together our teams enable consistency in care; provide families with a welcoming and supportive home-like environment; and improve access to exceptional end of life care, demonstrating that together you can make amazing things happen. Learning Objectives:

1. Participants will develop a better understanding of the uniqueness of a 3-bed, rural residential hospice;

2. Participants will identify strategic opportunities to integrate and collaborate to best meet the palliative needs of individuals and families living in rural Ontario;

3. Participants will engage in open discussions on innovation, strategy and integration related to residential hospice.


201 Five Great Ideas to Extend Hospice Services Farther into the Community: The Results of a Co- Design Exercise at Hospice Georgian Triangle Dr. Paul Holyoke, PhD, Saint Elizabeth Research Centre, Saint Elizabeth Health Care; Markham, ON Karen Oikonen, BID, M.Des, Saint Elizabeth Research Centre, Saint Elizabeth Health Care; Markham, ON

Kelly Borg, Psychodynamic Counsellor (UK qualified), Executive Director, Hospice Georgian Triangle, Collingwood, ON Hospice Georgian Triangle had a vision to extent its services into the community, through digital and other means, so that more rural patients and families might benefit from what the Hospice could offer when they choose a home death. Hospice Georgian Triangle and the Saint Elizabeth Research Centre partnered to use co-design methodology to guide the process of moving from the vision to concrete ideas and then to action. The 5 projects that emerged from the co-design process included: (1) developing a name for services to be offered to community members with life-limiting disease diagnoses before they are ready to access “palliative” or “hospice” services; (2) defining that set of services; (3) developing a more expansive Self-Care Kit to include resources and plans to respond to concerns including but beyond pain management; (4) developing a communications tool to enable patients and family caregivers and healthcare workers to share information about the journey toward death; and, (5) developing an online ‘end-of-life experience’ to help people understand the kinds of choices and decisions they may encounter as they journey toward death.





In this workshop, we will describe how the co-design process worked and who was involved, and how we narrowed a very large list of potential ideas to an essential 5. We will provide details of the 5 projects and how co-design processes have continued to evolve the ideas and bring them to reality. In an interactive segment of the workshop, we will encourage and facilitate discussion about the five projects. Learning Objectives:

1. Workshop participants will learn about 5 important ideas for extending hospice services into the community;

2. Workshop participants will learn about the value, and challenges, of engaging people in a collaborative and creative process and the implications of engagement;

3. Workshop participants will have the opportunity to discuss the 5 projects, contribute their ideas, and discover how the ideas could be relevant to their own work.


202 A Day in the Life of the Palliative Pain & Symptom Management Consultant (PPSMC): Partnering to Capacity Build Expertise in the Delivery of High Quality Palliative & End of Life Care Amy Archer, RN, BSCN, Palliative Pain and Symptom Management Consultant (PPSMC), Durham Service, Lead, Palliative Care Consultants Network, Whitby, ON Tracey Human, RN, CHPCN(C), Director, Palliative Pain and Symptom Management Consultant (PPSMC), Toronto Service, Chair, Palliative Care Consultants Network, Ajax, ON This workshop will refresh the intended audience on the benefit of PPSMC engagement in a creative presentation on A Day In the Life of a PPSMC. The session will include the PPSMC grass roots to system level 24 year history to present; inclusion as 1 of the 4 initiatives in Ontario’s End of Life Care Strategy (2004-2008) through to contributing stakeholder in the report Advancing High Quality, High Value Palliative Care in Ontario: Declaration of Partnership and Commitment to Action and its specific directives to PPSMCs; our role framework; mandate and our future vision for PPSMC in the evolving palliative landscape.The session will illustrate Who we support; What we do; How we partner; How we build capacity; How we measure; Lessons learned and relationships working with mandated targets CCAC; CCAC contracted providers; LTCH sector; CSS; Primary Care. The goal will be a stimulation driver to galvanize attendees envisioning benefit of PPSMC utilization from organization specific to system level. Benefits of leveraging the rich repository of the PPSMC history, combined experience and expertise garnered over decades of capacity building across care sectors for all life-limiting diagnoses and ages, paediatric to elderly, and the trans-disciplinary providers who care for them. Practical implications will be to inform local, regional and provincial palliative care stakeholders what change we can effect together when integration with PPSMCs are strengthened. “To move upwards you do so alone, to move further we do so together.”




1. Understanding of PPSMC role, history; accountabilities and deliverables; 2. Benefits of PPSMC engagement; 3. Vision for PPSMC in an evolving landscape of regional programs.


203 Health Care Consent, Advance Care Planning, and Goals of Care: The Challenge to Get It Right (Part 2 – Continued from Session 103) The Health Care Consent Advance Care Planning Community of Practices Leadership Team, Hospice Palliative Care Ontario

The demand for pre-planning by patients about future health care decisions has dramatically increased, particularly for end-of-life care. There is considerable variability in the components of the pre-planning process, such as advance care planning (ACP) conversations, and/or goals of care (GOC) discussions, as well as potential documentation of the outcomes of either or both Ensuring compliance with Ontario law and meeting the legislated professional obligations for all health practitioners, and accredited health organizations (e.g., hospitals, long term care homes, community agencies) is vital to reducing the risk of complaints and legal liability.

This two-part workshop will offer participants a review and highlights from the findings on the 2016 Law Commission of Ontario report, “Health Care Consent, Advance Care Planning, And Goals of Care Practice Tools: The Challenge to Get It Right” for the Improving the Last Stages of Life project. The session will also provide critical information to assist in understanding the current climate and practice challenges and opportunities moving forward; it will include activities to support increased efficacy in screening for and making changes to HCC and ACP materials, processes and activities. Participants will increase their knowledge of the linkages between HCC, ACP and GoC, learn to screen for Ontario reflective language and practice, and gain information on potential Ontario supports available when making the commitment to change.

Learning Objectives: 1. To understand and appreciate the current climate and practice challenges in Ontario; 2. To build knowledge about HCC and ACP within an Ontario legal framework and the system and

supports to improve compliance; 3. To have an opportunity to engage in reflect and screening focusing on required changes need to

HCC, ACP and GoC.




204 Affirm and Repeat – Telling Your Story and Winning Support Jennifer Mossop It’s all communications. If we can’t tell our story effectively, no one will understand who we are or what we do. Developing and executing a strategic communications plan is critical to helping you win support from your community, decision makers, partners, and donors. We’ll look at the key elements of communications plans and how to repurpose your messages and materials for all communications opportunities, creating a cohesive and compelling story. Working in concert with your key partners to deliver a strong message and engaging narrative, builds trust and wins support. Learning Objectives:

1. The basics of developing a strategic communications plan; 2. About communications opportunities; 3. Staying focused on the end game.


205 Using an eLearning Module to Teach Goals of Care Conversations (Part 2 – Contiued from Session 105) Dr. Leah Steinberg, MD, MA, CCFP, Mount Sinai Hospital, Toronto, ON Dr. Ciara Whelan, MD, Mount Sinai Hospital, Toronto, ON There are no standard guidelines or recommendations for conducting goals of care conversations with patients who have advanced illness. Through literature review, expert input and formal feedback sessions, a new eLearning tool was developed to teach learners fundamentals and advanced skills in conducting goals of care conversations. Three patient scenarios and video materials were developed to demonstrate the skills taught in the module. Several skills are focused on in the learning module: using reflection and motivational interviewing skills to promote your understanding of your patient; skills in asking your patient about values and goals and skills in determining recommendations and plans. This eLearning module has undergone usability testing within the University of Toronto General Internal Medicine program and is planned for use by the Mount Sinai Hospital General Internal Medicine residents. In this workshop, the eLearning module will be demonstrated in real time, as a tool to both advance learner's comfort and skill in leading goals of care conversations and to engage the participant in using



the module for education in their own setting. In this workshop format, time will be allocated to practicing the skills taught in the eLearning module. Learning Objectives:

1. Participants will improve their skill and comfort in leading goals of care converations by observing, reflecting on and practicing specific communication skills such as offering reflections;

2. Participants will learn about the process of developing eLearning modules; 3. Participants will engage in discussion about how to teach these skills in their own environment.


206 Mixology: A Primer on Medications Used to Manage Advanced Heart and Lung Disease, their

Contribution to Improving Quality of Life, and Drug Interactions with Common Palliative Care Medications (Part 2 - Continued from Session 106)

Dr. Kirsten Wentlandt, MD, University Health Network, Toronto, ON Dr. Ebru Kay, MB BS (UK), MRCP (UK), Assistant Professor, Department of Medicine, University of Toronto, Palliative Care Physician, Site Lead, Toronto General Hospital Palliative Care Team, Toronto, ON Dr. Erin O’Connor, MSc MD FRCPC, Lecturer, University of Toronto, Department of Medicine, Divisions of Emergency Medicine and Palliative Medicine, University Health Network, Toronto, ON Dr. Andrea Weiss, MD, University Health Network, Toronto, ON Derek Leong, RPh, BScPhm, ACPR, Clinical Pharmacist, General Internal Medicine, Toronto General

Hospital, Toronto, ON

This workshop will review common medications used to manage advanced heart and lung disease and highlight their ability to support quality of life and symptom management. We will also review the possible drug interactions between these disease specific medications and those commonly used in palliative care. Specific conditions covered in this workshop include: heart failure, COPD, interstitial lung disease and pulmonary hypertension. The session will be 2.5 hours long spread over 2 workshop sessions. Learning Objectives:

1. Review advanced heart and lung disease; specifically heart failure, COPD, interstitial lung disease and pulmonary hypertension;

2. Review common medications used to manage advanced heart and lung disease and outline those that support quality of life and symptom management;

3. Evaluate the possible drug interactions between disease specific medications and those commonly used in palliative care.




207 Medical Aid in Dying: A Practical Training for Physicians, NPs and Allied Health Dr. Narges Khoshnood, B.Sc, MD, CCFP(PC), Assistant Professor, Division of Palliative Care, Department of Family Medicine, Temmy Latner Centre for Palliative Care, Mount Sinai Hospital, Toronto, ON Dr. Joshua Wales, MD, CCFP, Physician, Temmy Latner Centre for Palliative Care, Physician, Casey House, Toronto, ON Dr. Sarah Kawaguchi, MD, Palliative Care Physician, Mount Sinai Hospital, Lecturer, Lead of the Assessment Committee for the Palliative Medicine Residency Program, University of Toronto, Toronto, ON Medical assistance in dying (MAID) was decriminalized in Canada as a result of the Supreme Court of Canada's Carter ruling in February 2015, and the passing of Bill 52 in Quebec. MAiD occurs when an authorized health-care provider provides or administers medication that intentionally brings about a person’s death, at that person’s request. This procedure is only available to eligible patients. The goal of MAiD workshop is to provide information on medical assistance in dying that may be of interest to all practising physicians, nurse practitioners and allied health so they can (1) understand what is involved, (2) advise their patients and (3) make an informed decision about whether they should include this in their practice. Participants will gain knowledge on how to respond to a request for MAiD, how to explore suffering or the wish to hasten death. This workshop will include advanced practical training for physicians and nurse practitioners who are considering offering medical assistance in dying to their patients. There are unique clinical and organizational considerations involved with providing MAID to individuals. During this workshop presenters will discuss the approach of their institution in the development of an operational framework for medically assisted dying in the context of the delivery, administration and management of MAiD. Furthermore, the presenters will share their actual clinical experience with providing MAiD in the community and institutional setting with opportunities for lots of interactive discussions and dialogues. Learning Objectives:

1. How to explore suffering and wish to hasten death, how to assess patients for eligibility and capacity;

2. How to develop an operational framework for MAiD in the context of the delivery in your institution;

3. How to organize a MAiD procedure including ordering and administering medications, working with allied health.


208 Clinician Suffering: A Paradigm Shift for Palliative Care Providers Maxxine Rattner, MSW, RSW, MA Public Policy, Post-Graduate Certificate in End-of-Life Care for Social Work, Staff Social Worker, Kensington Hospice, Toronto, ON



Dr. Joan Berzoff, MSW, EdD, Professor, Author, Smith College School for Social Work, Northampton, MASS The prevention and relief of suffering is the primary aim of palliative care, described as an “obligation” (Cassell, 1982; Sacks & Nelson, 2007) and “duty” (WHO, 2014) for clinicians. This session will introduce a new conceptual and clinical framework that acknowledges that there is intrinsic psychosocial suffering at end of life –- loss, feeling burdensome, loneliness, death anxiety and worry for family –- which may be resistant to relief, despite clinicians’ best efforts. This new framework pinpoints a profound ethical and clinical tension in palliative care: the paradox of the expectation that we can relieve suffering, and our inability to necessarily do so. It also runs counter to the common adage that palliative care providers can and must “replac[e] suffering with joy” or meaning for dying patients (Witt Sherman, 2015. p. 477). While there may indeed be meaning and joy at end of life, it is possible that there may be no meaning to be found, and the pressure to make meaning may work to increase suffering for patients, families and clinicians. That some suffering endures indicates neither poor quality of care, nor of clinician inadequacy, but rather that dying is intrinsically hard (Rattner & Berzoff, 2016). Currently, little clinical guidance exists on how clinicians can work with psychosocial suffering that persists at end of life, and this workshop will help to fill this gap. This workshop will have an interactive lecture format, including clinical examples from presenters and participants. Learning Objectives:

1. To identify and describe five forms of intrinsic suffering at end of life; 2. To identify clinician barriers to addressing suffering in end-of-life care, including the concept of

‘clinician suffering’; 3. To identify how rethinking suffering at end of life, and our inability to necessarily bring its relief,

signals a paradigm shift for the discipline of palliative care. Workshop Stream: Psychosocial/Spiritual/Bereavement/Complementary Therapy

209 Games, Cookies and Creativity: Addressing the Needs of Children when Caring for Adults Megan Sloan, RN, RPN, BScN, Pediatric Palliative Care Nurse, Roger Neilson House, Ottawa, ON Kath Murray, RN, MA, CHPCN(C), FT, Hospice Palliative Care Nurse, thanatologist, educator, writer, Life and Death Matters, Saanichton, BC Kathryn (Katt) Brooks, RRT, BA, Registered Recreation Therapist, Roger Neilson House, Ottawa, ON Kids know. Kids have questions. Kids want to participate. However, members of the health care team may be anxious about how best to engage and or address the needs of kids. In this session we will play games, eat Care Planning Cookies and explore creative strategies designed to create a safe environment for kids to participate in conversations about loss, grief and dying. Participants will create a treasure chest of strategies that can be used in the adult care settings to help adults help their children participate in conversations and care. Participants will be able to appreciate how creative strategies that facilitate learning and conversations with children can be used in the adult care settings.




1. Identify that there are children involved in the lives of many of the adults that we care for and ways to best support them;

2. Explore creative strategies to remove barriers, and help children participate in conversations and care when their loved one is dying;

3. Create a treasure chest of games and practical resources to support kids and their adults in conversations and care.


210 Volunteers Supporting Innovative Compassionate Care in our Community Teresa Harris, BSW, RSW, Hospice Simcoe, Barrie, ON Kathy Stewart, Certified Volunteer Resource Manager, Hospice Simcoe, Barrie, ON Teneal Childs, MSW, RSW, Community Care Coordinator & Volunteer Coordinator, Hospice Simcoe, Barrie, ON Advancing High Quality, High Value Palliative Care in Ontario: A Declaration of Partnership and Commitment to Action(2011), makes a compelling case for the need to maximize volunteer support in order to provide optimal care to clients and their families in the community. The document states "the most appropriate and sustainable system includes support for informal caregivers and volunteers" while keeping the client and family at the center of care. With the increased needs of clients and the changing demographics of today's volunteer, we have had to adapt our programs and services to find creative, innovative and flexible ways to serve our community. Hospice Simcoe offers community based programs that give clients diverse options while providing volunteers with fulfilling, engaging and empowering opportunities to share their time. While examining traditional roles we will discuss how to change and re-work service offerings to retain volunteers and to foster compassionate community involvement. The change in the volunteer demographics has led us to re-examine how we engage this highly valued resource in the traditional roles such as home visiting and bereavement and to meet the new needs of family volunteers, episodic, students and highly skilled volunteers. The changes have compelled us to look to the greater community to help meet the needs of current volunteers and clients. The authors will present an interactive workshop with concrete and practical ideas presented to use in your own unique hospice settings. Learning Objectives:

1. Workshop participants will be able to formulate a logical plan for developing and exploring innovative program ideas;

2. To create a learning opportunity through discussion with volunteer leaders with similar interests and unique perspectives for shared learning;

3. To increase awareness and understanding of best practices in volunteer engagement with a comprehensive view of services from diagnosis through to bereavement.




211 Partnerships and Passion - Building a Sustainable and Successful Hospice Program Michelle O’Rouke, RN MA, Integrated Program Coordinator, Palliative/Oncology, Chatham-Kent Hospice/Chatham-Kent Health Alliance, Chatham, ON Chatham-Kent Hospice, a new ten-bed residential hospice opened in April 2016. The entire community rallied to make this happen, from dream to business plan to completion. Keeping the costs sustainable for a largely rural, economically distressed municipality was important. Partnerships with a non-profit retirement home, a large acute care hospital, and a local agency providing bereavement and palliative care visiting services helped to make Chatham-Kent Hospice happen. This model could easily be replicated in other locales, and could help similar communities develop a cost efficient program. The workshop will focus on the steps taken to design this model, as well as an overview of how Chatham-Kent pulled together the necessary groups and resources to raise the capital, design the building, develop the programs and resources and open for occupancy in less than three years. We will also explore the ongoing advantages of these partnerships from a resident and family perspective to a financial perspective as experienced during the first year of operation. Learning Objectives:

1. To present an overview of the Chatham-Kent Hospice project, including the development of partnerships, with the legal and practical implications involved;

2. To interactively discuss challenges, issues and possibilities in establishing partnerships with other organizations to make residential hospice care affordable and successful;

3. To examine the first year of operation, including how the partnerships were able to support excellent care, ease resident and family transition and provide for financial sustainability.


301 Rebranding Death: How to Change your Community's Perception on Death and Dying Lee Rendell, Manager of Fund Development, Marketing Specialist, ARCH Hospice, Sault Ste. Marie, ON Theresa Mudge, MHA CHE, Executive Director, ARCH Hospice, Sault Ste. Marie, ON

Death has a bad rap. We don’t openly discuss it, essential end-of-life discussions do not consistently occur, and it blocks patients and families from timely access to quality, comfortable end-of-life care. This advanced level workshop deals with the deepest rooted barrier we face to provide palliative care: the negative public perception of death and dying. We will walk workshop attendees through our




Monday, April 24, 2017 Time: 10:45 – 12:00 pm

experience rebranding death in our community. By sharing the techniques used in our highly successful "grey" event and other advocacy initiatives, we’ll provide attendees with the tools and know-how to improve palliative care in your community.

This interactive, hands-on training session includes an exploration of the barriers to palliative care, a keynote speaker, audio-visuals, and a viewing of our "grey" event documentary. We will then work together to create a marketing plan as well as the best practices in creating and implementing "grey" in your community. This global, grass-roots initiative complements projects such as "Death Cafes", "The Conversation Project" methodology, the "Before I Die" community boards, and the "Zen Hospice Project" concepts.

Learning Objectives: 1. Specific learning outcomes include marketing basics and comprehensive applications to

palliative care; 2. The skills to engage your community in meaningful discussions on death and dying; 3. As well as a resource set and implementation knowledge to host your own "grey" event.


302 Compassionate City Charter in Canada Pamela Blackwood, Executive Director, Sessional Professor, McNally House Hospice, Grimsby, ON Karen Candy, MA, Executive Director, Carpenter Hospice, Burlington, ON Bonnie Tomkins, BPH, Community Health Coordinator, Carpenter Hospice, Burlington, ON In this workshop, participants will be introduced to why palliative care is everyone’s business, the Compassionate City Charter (3C); why a Public Health approach is important, and how to create buy in from key community stakeholders including Board of Directors, politicians and community partners. Participants will also learn about important success factors as well as lessons learned from two communities currently pursuing the Charter. Through round table discussions, participants will receive a working document that will allow them to identify key stakeholders and champions and prioritize next steps for their own community. This document will be the initial work plan for starting a Compassionate City Charter in their area. Other supporting tools will be highlighted and available as take away. Participants of this workshop will walk away with a better understanding of this international initiative, and why a Public Health approach makes sense. Participants will have practical tools on how to roll it out, gain buy-in from their community, as well as examples of success stories and pitfalls. This workshop is designed for leaders or community citizens who are passionate about palliative care and are looking for an initiative that will support their community.




1. Why to start the Compassionate City Charter; 2. How to gain key stakeholder buy-in; 3. Leave with a initial workplan.


303 Start Where You Are: Building a Fundraising Plan John Andresen, CFRE, Director of Development, Renascent Foundation; Toronto, ON How to start building a successful, sustainable plan aligned with overall strategy when you have no time and no budget! This session is meant to provide anyone who needs to run a fundraising program a clear and direct approach to create a fundraising plan quickly. You will learn a straightforward approach to developing goals and strategies get sample process documents and templates to enable your own plan creation. Learning Objectives:

1. Identifying your needs and assets; 2. Setting goals and creating strategy; 3. Creating and actionable plan.


304 Engaging the General Public in Advance Care Planning Conversations Where They Live, Work and Pray Jessica Hutchison, B.Sc., MA, Hospice of Waterloo Region, Kitchener, ON Lynn Weimer, Hospice of Waterloo Region, Kitchener, ON Conversations Worth Having is a unique 3-year government funded Advance Care Planning (ACP) program, hosted by Hospice Waterloo Region, in partnership with Hospice Wellington, with the goal of engaging the general public, community professionals (e.g., lawyers) and health care providers in building Waterloo-Wellington’s understanding/capacity for correct ACP conversations. Increasing the general public’s awareness and understanding of ACP is essential in order to ensure people are equipped with the knowledge and skills to correctly identify their Substitute Decision Maker, and to ensure that Substitute Decision Makers fully understand their roles/responsibilities in giving or refusing health care consent for another person. The project’s community outreach strategy seeks to engage people where they “live, work and pray”. This workshop will highlight the unique strategies of engagement such as: highly trained volunteers delivering ACP presentations across the region (where



people live), Corporate Wellness Initiatives (where people work), and the development of an Interfaith Committee and community-wide interfaith engagement campaign (where people pray). The workshop will also present on the innovative Community Estate Planning Project, which is a collaborative pro-bono legal clinic offered to low income individuals to complete their Will, Powers of Attorney for Property and Personal Care. Presenters will include staff and volunteers from Conversations Worth Having. Workshop participants will learn how to develop and implement these strategies and initiatives in their own communities and will be provided with the opportunity to further their understanding of engaging and educating the general public in correct ACP conversations. Resources and tools will also be provided. Learning Objectives:

1. Increased understanding of how to engage general public in Advance Care Planning; 2. Strategies on how to design and implement community engagement strategies; 3. Increased understanding of tools and resources available.


305 Blending Quality and Compassion---Caring for Those with End Stage Heart Disease and Stroke Dr. Brian Berger, M.D., C.C.F.P (PC), F.C.F.P, Cert Am Board Hospice and Palliative Medicine, Mackenzie Hospital, Richmond Hill, ON End stage cardiac disease and strokes offer a palliative care challenge. In a medical environment filled with newer and more invasive medical and surgical interventional therapies the nuances of terminal care and quality comfort care may be neglected or not requested. This situation can be improved with palliative care exposure earlier. Are certain drugs really needed? What are good communication cues to consider? These are all questions to be pondered in this workshop. Learning Objectives:

1. To grasp the difference and similarities between palliative care in cardiac disease and strke vs cancer;

2. To evaluate the drug therapies for cardiac disease and stroke and determine if they are needed when there is a palliative trajectory;

3. To highlight the importance of compassionate communication in this population. Workshop Stream: Research/ Scientific/Advanced Clinical Practice

306 Improving Delirium Management at End of Life: Reflection, Education and Management in Residential Hospice Rebecca Ellerson, RN, BSc, BScN, CON(C), CHPCN(C), Hospice Huntsville, Huntsville, ON



Dr. Deb Harrold, MD, CCFP(PC), OPCN Physician Lead for NSM, Hospice Huntsville, HOPE Huntsville, Huntsville, ON Although delirium has a very high prevalence at end-of-life, it is dramatically under-identified and under-treated by health care professionals. This workshop will focus on the experiences of the staff at Algonquin Grace Residential Hospice in Huntsville, ON in identifying, managing and preventing delirium. A chart review was conducted to identify the areas we could most improve and our staff team was surveyed to ascertain their perceived skill level and confidence in recognizing and managing delirium. A clinical workshop highlighted these areas to our team and introduced several new tools to improve our skill set in identifying, critically analyzing and communicating about delirium. In particular, The Gear Model of Delirium Management helps to focus staff on managing both the underlying causes and the treatment of the delirium symptoms simultaneously, just as gears need to turn together to function well. Participants in this workshop will receive an overview of the literature on delirium at end of life, a review of our experience learning about delirium management at Algonquin Grace and information about the tools we utilize and the Gear Model of Delirium Management. The intended audience is any individual hoping to learn more about how to manage delirium at end of life and learn about the experiences of one residential hospice team. Learning Objectives:

1. Participants in this workshop will receive an overview of the literature on delirium at end of life; 2. A review of our experience learning about delirium management at Algonquin Grace; 3. Information about the tools we utilize and the Gear Model of Delirium Management.


307 iEPECO: Advancing Palliative Care Through Standardized Online Education Dr. Jiahui Wong, PhD, de Souza Institute, University of Health Network, Toronto, ON Susan Blacker, MSW, RSW, St. Michaels Hospital, Toronto, ON Dr. Paul Daeninck, MD, MSc, FRCPC, Cancer Care Manitoba, Winnipeg Regional Health Authority Palliative Care Program, Winnipeg, MA This workshop describes a new online curriculum on hospice palliative care. The online course, iEPEC-O, is based on the "Education in Palliative and End of Life Care-Oncology" (EPEC -O) curriculum originally developed by a team of clinicians at Northwestern University in partnership with the National Cancer Institute in USA. The curriculum had been updated and adapted for the Canadian landscape by the Canadian Partnership Against Cancer. This online course is led by three interprofessional EPEC-O educators in Canada. It builds on the original comprehensive curriculum and incorporated recommendations from “The Way Forward” report on



person centred approaches. iEPEC-O enhances learning outcomes by leveraging powerful online graphic illustration, interactive activities and audio-visual demonstration of core palliative care competencies. The workshop presentation will include didactic teaching and interactive activities. We will demonstrate iEPEC-O modules including: evidence based comprehensive symptom assessment and management; a culturally sensitive approach in communication; working with patients and families in setting goals of care; and case illustrations on psychosocial aspects of end of life care. This workshop is suitable for clinicians with intermediate level of knowledge in hospice palliative care. At the end of the workshop, participants will obtain a solid understanding of the online learning process, appreciate learner- controlled experience and pace, as well as obtaining clinical tools and decision support that can be immediately applied to day-to-day practice. Learning Objectives:

1. Expand the learner’s knowledge in evidence-based symptom management; 2. Describe holistic person-centred approach in end of life care; 3. Apply principles of interprofessional team based care.


308 Death Cafes: Igniting the Public to Talk about Death, but not in Bereavement Groups Linda Hochstetler, MSW RSW, Social Worker, Education & Quality Lead, Bethel Hospice, Inglewood, ON The Death Cafe movement began in 2011, and since then there have been 3706 Death Cafes in 38 countries, with 294 in Canada alone. What is it that makes people want to gather over tea or coffee, or even a beer, and talk about death and dying? Join us as we share stories with you about what actually happens at a Death Cafe. The dialogue and stories that happen at these events is both inspiring and desperately needed for all Canadians. In Canada, more and more hospices are getting involved in the hosting of Death Cafes, as the structure and philosophy of the Death Cafe movement seems consistent with other hospice palliative care public education events. This workshop will contrast and compare Death Cafe ideology with hospice palliative care principles. In doing so, we will demonstrate that the Death Cafe movement is indeed advancing hospice palliative care principles using unique and creative formats for reaching the many generations of Canadians that seem to want to do death differently from the boomers before them. Conversations at a Death Cafe do not follow the usual structure of a bereavement group. It is not therapeutic, but it can be very healing. Death Cafe hosts are not allowed to lead people to any conclusion, product or course of action. It is a discussion group, not a grief support or counselling session. And this seems to be how Canadians want to talk about death today. Learning Objectives:

1. To understand the principles of the Death Cafe movement; 2. To be able to compare the death cafe movement with the hospice palliative care principles;



3. To have a better understanding of younger generations' ways of dealing with issues of death and dying.


309 When is Close Too Close? Caring for Patients whom we Know Personally Dr. Jennifer Shapiro, MD, MA, CCFP(PC), Lecturer University of Toronto, Temmy Latner Centre for Palliative Care, Toronto, ON Caring for patients at the end of life can be emotionally draining for many healthcare providers. More and more, as the population ages, such providers will be asked to care for patients, some of whom they might know socially, adding to the emotional strain. The College of Physicians and Surgeons of Ontario have a strict policy about caring for family members ot friends. But, this does not cover informal acquaintances, family friends, or colleagues. When is a social relationship too close to objectively provide end of life care? This workshop will use a case-based approach to review the unwitting complexity and emotional complications associated with caring for a colleague or a family friend. It will identify how the complexity might snowball depending on clinical circumstances, the patient's family dynamics, or the environment in which a patient is located. Finally, a bioethical framework will be presented to help healthcare providers determine if the relationship with a patient-colleague or acquaintance may affect the doctor-patient relationship, and by extension, the end-of-life care. Learning Objectives:

1. Review the CPSO Policy regarding the treatment of friends and family; 2. Outline a case complicated by a social relationship with the patient and family; 3. Use a bioethical framework to determine when a patient is "too close".


310 Training Standards for Direct-Service Community Hospice Volunteers Annalise Stenekes, Standards & Accreditation Coordinator, Hospice Palliative Care Ontario, Toronto, ON

Screening and training of volunteers is a critical component of ensuring a high standard of care and minimizing risk for a community hospice program. This workshop is intended for volunteer coordinators of any hospice service that relies on volunteers to provide direct service to clients or residents.

In this session, we will explore several components of the "volunteer training" issue. An overview of HPCO's recently launched online volunteer training program, and update on its usage, will be provided followed by a discussion on the standards and accreditation expectations related to volunteer training (and how these apply when online training is used). The workshop will also provide an opportunity to



review the standards on volunteer screening, training and support. Participants will provide input on the applicability of these existing standards to other hospice programs where volunteers provide direct service to a client (Day Hospice, Bereavement Support, Spiritual Care, etc).

The workshop will be facilitated by Annalise Stenekes, HPCO’s Standards & Accreditation Coordinator. She joined HPCO as a Project Manager in 2012 to facilitate the process of updating and expanding the Standards and Accreditation program. Annalise holds a Master of Social Work degree and has been involved with Visiting Hospice programs in various capacities (volunteer, case manager, executive director) since 2003. Annalise also lectures part-time at Lakehead University in Orillia where she lives with her family.

Learning Objectives: 1. Understand the current status of HPCO's online volunteer training program;

2. Understand how the existing standards apply when online training is used;

3. Become familiar with the standards/accreditation expectations related to volunteer training

overall;

4. Consider and share ideas regarding the applicability of these standards to other direct service

hospice programs.


311 A Review of Palliative Sedation Therapy (PST) in a Residential Hospice Lynn Varga, RN, BScN, MEd, Carpenter Hospice, Burlington, ON Wendy Beitel, RN, CHPCN(C), Carpenter Hospice, Burlington, ON Francis Zavarise, RN, CHPCN(C), Carpenter Hospice, Burlington, ON The administration of sedation to manage severe anxiety at the end of life is an important yet often misunderstood therapy. Now that MAID is an option for individuals facing end of life, it is even more important that the health care team is able to sensitively and accurately inform people of the palliative care options available to optimize comfort at the natural end of life. Extensive interdisciplinary collaboration is required to accurately assess the causes of anxiety, to explore values and hopes, to implement and evaluate strategies to improve comfort, and when necessary to obtain informed consent for an individualized patient and family centered approach to PST. At Carpenter Hospice we have developed tools which have helped us to standardize our PST process in order to optimize safety and the quality of care for the person and their family. In this workshop we will present 1. best practice approaches to PST 2. data describing our experience with PST in our residential hospice, 3. the tools we have developed 4. several examples of individualized plans of care used in the provision of PST at our hospice. Sharing our outcomes and the learnings we have experienced with PST is directly relevant to all palliative care environments and our presentation will offer insight and enable participants to reflect on their own experiences.




1. Describe the rationale and various approaches to palliative sedation therapy; 2. Identify strategies for interdisciplinary communication and collaboration; 3. Articulate strategies to form a patient and family centered plan of care for palliative sedation

therapy. Workshop Stream: Research/ Scientific/Advanced Clinical Practice

401 Partnering for Change in Palliative Care in Ontario; Update from the Clinical Advisory Council of the Ontario Palliative Care Network

Tara Walton, MPH, Family/Caregiver Representative, Ontario Palliative Care Network, Toronto, ON Dr. Ahmed Jakada, MD, CCFP (PC), Ontario Palliative Care Network, Toronto, ON Melody Boyd, BScN, MSc, MN, Provincial Clinical Co Lead, Ontario Palliative Care Network, Meaford, ON Officially launched in March 2016, The Ontario Palliative Care Network (OPCN) is a partnership of community stakeholders, health service providers and health systems planners who are developing a coordinated, standardized approach for delivering hospice palliative care services in the province. The OPCN introduces a new governance structure for hospice palliative care directly accountable to the Ministry of Health and Long-Term care, under the joint leadership of the Local Health Integration Networks (LHINs), Cancer Care Ontario, Health Quality Ontario, and the Quality Hospice Palliative Care Coalition of Ontario. Clinical advice for the OPCN is provided by the Clinical Advisory Council (CAC), a group that is multidisciplinary in nature and keeps patient and family needs as the center of its purpose. Formalized in the Fall of 2016, the CAC is responsible for providing recommendations for clinical improvement of hospice palliative care in Ontario, as well as clinical implications of policy. This session will focus on sharing the progress of the CAC to date, and providing an overview of future focus areas. Importantly, we will use this as an opportunity to engage the broader palliative care community, and seek feedback and advice to inform the prioritization of future deliverables. Learning Objective:

1. Describe how multidisciplinary clinical partnerships will be used to support change in palliative care.






402 When Hospices and Hospitals Team-Up! How a Community Based Hospice Program and Palliative Care Unit at a Hospital Joined Forces to Provide Exceptional Quality Hospice Care to Patients! Amanda Maragos, Manager of Volunteer Services, Philip Aziz Centre for Hospice Care, Toronto, ON Karina Wulf, Palliative Care Specialist, Michael Garron Hospital, Toronto, ON How a Community Based Hospice Program and Palliative Care Unit at a Hospital joined forces to provide exceptional quality hospice care to patients! In the spring of 2016, Philip Aziz Centre (a Toronto Community-Based Hospice) and Michael Garron Hospital (formerly known as Toronto East General Hospital) collaborated to create a pilot project that would allow PAC (Philip Aziz Centre) volunteers to support patients at the hospital. Upon successful completion, the project has gone from pilot to program – we’re going to tell you how so you can do the same!The vision was simple; instead of the hospital using their own volunteers, why not have professional, suitable, reliable, experienced, well trained and pre-screened Hospice Palliative Care Volunteers do client care shifts exclusively on a Palliative Care Unit of a hospital. This would add a whole new depth of care for patients and families there. These volunteers offer a level of expertise and knowledge that only hospice care volunteers (who have completed the HPCO 30 hour training program) can share. Learn how the whole circle of care at the hospital came together as a team, the construction process of the project, benefits, challenges, and how to implement similar programming in your hospice or hospital.At a time where the LHIN is asking to see the best use of resources and streamlining of service delivery though community partnership, this concept of seamless 360 degree care has never come at a better time. Join us to learn more! Learning Objectives:

1. Learn how this type of programming benefits both the hospice and hospital; 2. Participants will understand how to implement community partnership projects between

hospitals and hospices; 3. Discover why this kind of strategy in care is so important today.


403 Building Your Donor Base John Andresen, CFRE, Director of Development, Renascent Foundation; Toronto, ON A solid donor base is the key to developing a sustainable fundraising revenue stream. Acquiring new donors can be one of the most stressful and expensive parts of every fundraising plan. Large or small, every charity needs a healthy donor base as a basis for any fundraising. In this discussion, you will learn what to do to keep your database growing year over year. The importance of communications and



donor care. Included will be an overview of direct marketing, peer- to-peer, online as well as other channels for donor engagement. Learning Objectives:

1. Checking the foundations: how to perform a quick audit to determine if your donor base is healthy;

2. Acquisitions and renewals and upgrades - where to place your efforts; 3. The good and the bad of Memberships.


404 Co-Designing Hospice Palliative Care: Deep Engagement with Family Members, Hospice Staff, Healthcare Providers and Community Members Karen Oikonen, BID, M.Des, Saint Elizabeth Research Centre, Saint Elizabeth Health Care; Markham, ON Dr. Paul Holyoke, PhD, Saint Elizabeth Research Centre, Saint Elizabeth Health Care; Markham, ON

Kelly Borg, Psychodynamic Counsellor (UK qualified), Executive Director, Hospice Georgian Triangle, Collingwood, ON Susan Paterino, Executive Director, Hospice Vaughn, Vaughn, ON The Ministry of Health and Long-Term Care provincial strategy aspires to put ‘Patients First’ however there is not a strong history of developing services for patients and families WITH patients and families. The Saint Elizabeth Research Centre partnered with each of Hospice Georgian Triangle and Hospice Vaughan to use co-design methodology to guide the process of developing services and facilities from problem framing to developing ideas to translating to reality. Co-design goes well beyond the “informing” and “consulting” forms of patient and family engagement. It involves a wide variety of stakeholders -- bereaved family members, hospice staff, nurses, doctors, PSWs, navigators, spiritual care providers, architects, and community members – while holding firm to the idea of person and family members being at the centre. The co-design is highly process-driven, potentially leading to outcomes that the stakeholders may not have even considered prior to the process. As such, it requires a commitment to deep listening and attentiveness, but ultimately, leads to a wider commitment to a vision and results that will more closely meet the needs and expectations of the patients and families – and the other stakeholders. In this workshop, we will provide the principles and general approach of co-design, and provide some perspectives on the co-design experience from two hospice organizations. Then, we will enter into a dialogue with workshop participants about co-design and how it works, and how it might benefit future work participants will be undertaking in their own hospice palliative care work. Learning Objectives:

1. Workshop participants will learn about the co-design process as methodology as well as particular techniques within the process;



2. Workshop participants will learn about the value, and challenges, of engaging people in a collaborative and creative process and the implications of engagement;

3. Workshop participants will have the opportunity to view initial outcomes (prototypes) from the process and provide feedback.


405 Cancelled – Replacement to be Announced

406 Advanced Heart Failure and Palliative Care: Lessons Learned from a Collaboration Dr. Leah Steinberg, MD, MA, CCFP, Mount Sinai Hospital, Toronto, ON Patients with advanced heart failure represent a population that is significant in number, health system utilization, and symptom burden. In 2000, patients with HF accounted for the second highest number of hospital days in Canada. Over a three-year span in Ontario, there were 78,642 emergency department (ED) visits for HF, of which 27,184 were repeat visits. The condition is responsible for a high burden of hospitalization for symptoms and is associated with high mortality and morbidity. To address this patient and system burden we developed a collaborative model of symptom management and home-based care for patients with advanced heart failure. The ‘HeartFull’ model integrates specialist cardiology care, primary care, and specialist home-based interdisciplinary teams. To facilitate care, we developed education modules, care pathways and therapeutic guidelines for diuresis in the home. Evaluation of the program shows good patient and caregiver satisfaction with the program, no increases in symptom burden from transitioning care to the home environment and fewer hospitalizations than prior to enrolling in the program. In this workshop, I will review the management of heart failure for patients wishing care at home, with a focus on symptom management including IV diuresis. I will present the clinical tools we developed including a home diuresis protocol. In addition, I will discuss communication skills to engage patients in discussion about advance care planning specific to heart failure such as ICD deactivation. Participants will actively engage, and work to incorporate the material into their environment. Learning Objectives:

1. Participants will review the basic pathophysiology of Heart Failure as it leads to the symptom burden in their patients;

2. Participants will discuss the challenges in palliating patients with advanced heart failure such as prognostication;

3. Participants will learn skills in palliating patients with advanced heart failure, both symptom management and skills in advance care planning.




407 Health Care Provider Comfort with Quality of Life Feeds for Patients with Dysphagia Peter Allatt, MA, MHSc, CHE, Bioethicist, Sinai Health System Bridgepoint, Toronto, ON Phoebe Smith Chen, MA SLP, Reg. CASLPO MHSc, Michael Garron Hospital, Toronto, ON Joyce Lai, BSc, University of Toronto, Toronto, ON Ben Walmsley, BA, Queens University, Kingston, ON Background Rationale: Many palliative care patients experience dysphagia. Despite swallowing difficulties, some request oral intake. “Quality of life feeds” (QoLF) give a patient with dysphagia small amounts of food/drink for pleasure, taste sensation, oral sensation (mastication), companionship, or a sense of normalcy but are not intended for nutritional needs or caloric intake. Patients with dysphagia who receive QoLF are at increased risk of aspiration and/or choking, causing moral distress for some health care providers (HCP). Study Objectives: To identify the factors that affect HCP comfort with QoLF for patients with dysphagia and determine if there were differences between HCPs; to identify the criteria used to determine if a patient should receive QoLF. Methods: We conducted a mixed-methods pilot study using semi-structured focus groups or 1:1 interviews followed by a survey with five case vignettes in a complex continuing care/complex rehab hospital with a large palliative care unit.Results: Participants (n=23) were health care providers including physicians, nurses, speech language pathologists, dieticians, therapeutic recreation and meal time assistance volunteers. Participants ranged in degree and frequency of involvement in QoLF and were divided into 4 groups. HCP comfort level was associated with frequency and degree of involvement with QoLF. Prominent themes were risk, perceived incongruences with goals of care, conflict between HCP and patient’s family, and patient decision-making capacity. The concordance between QoLF and palliative care status was significant. Learning Objectives:

1. Review findings with focus on palliative care; 2. Engage attendees in discussion of case vignettes; 3. Benefits and burdens of QoLF, ways to approach requests.


408 Understanding and Overcoming Compassion Fatigue: Moving Towards Compassion Satisfaction Cher Curshen, Arts Therapist, Certified Trauma and Compassion Fatigue Specialist, Bigheart Integrative Arts Therapy Studio, Toronto, ON Listening professionals, whether staff or volunteers, bear witness to others' stress, trauma and suffering. It's therefore not a question of whether or not you will be hurt in the course of your



interactions with families and patients, but how you will handle it when it happens. This introductory workshop will provide an understanding of Compassion Fatigue, described by Charles Figley as ‘the cost of caring’ for others in emotional pain (Figley 1982), and will draw upon reflections as to how Compassion Fatigue may impact us both personally and in the work place. It will also begin to help you identify and develop strategies for resiliency and self-care moving towards compassion satisfaction, lowering the risk of burnout and fatigue. Learning of the use of assessment tools, practicing self awareness techniques and self care strategies, you will come away with experiential knowledge on how to find life/work balance and practical realistic changes that you can make to help yourself that are aimed at any practitioner working in frontline services and managers. Learning Objectives:

1. Identify compassion fatigue symptoms and learn the underlying causes; 2. Develop an understanding of resiliency and how Compassion Fatigue impacts you both

personally and professionally; 3. Learn methods to promote compassion satisfaction towards resiliency, self care and access

resources. Workshop Stream: Psychosocial/Spiritual/Bereavement/Complementary Therapy

409 Legacy Boxes in Pediatric Care; When and How Julie Schelter, Social Service Worker, Hospice of Waterloo Region, Kitchener, ON Irena Razanas, MSW, RSW, CPT, Hospice of Waterloo Region, Kitchener, ON In 2013 the Waterloo Wellington Pediatric HPC Committee championed a project to introduce families, who were living with a child who was seriously ill, to legacy building activities. Kits with instructions based on activities from the "legacy project.org" website and supplies were made available to visiting nurses and other professionals providing Hospice homecare. Julie Schelter and Irena Razanas, who worked with the team, to get this project off the ground and continue to support this endeavor will share what they learned. Legacy building activities provide families with concrete ways to support their mourning once the death has occurred and help reinforce family resiliency. Using legacy building boxes is a unique way of supporting interactions between professionals and families in the home and a comfortable way of supporting end of life conversations. Learning Objectives:

1. Identify the challeges associated with introducing the concept of legacy work to amilies where a child id dying giventhe dynamics of anticipatory grief as experienced by siblings and parents;

2. Learn how to introduce expressive play activities to parents and support typical questions that come up with siblings at end of life;

3. Know when to refer family members for additional professional support.




410 Patients will Experience Seamless Care: Innovations in Communication and Collaboration Dr. Russell Goldman, MD, MPH, CCFP, Temmy Latner Centre for Palliative Care, Toronto, ON Dr. Amna Husain, MD, MPH, CCFP, Temmy Latner Centre for Palliative Care, Toronto, ON Catherine Prestwich, RN, BScN, CHPCNc, Toronto-Central Community Care Access Centre, Toronto, ON Meredith Muscat, MN, RN(EC), Nurse Practitioner, Toronto Central Community Care Access Centre, Toronto, ON As the healthcare system faces increasing numbers of patients with chronic and complex needs, clinical collaboration and coordination of care needs to be improved. Our experience in home-based palliative care is that patients experience care that is fragmented, communication is often poor and information is not shared. During this workshop, we will provide two examples of cross-organizational and interdisciplinary initiatives in which we have been engaged to make patient care more seamless. One is a research program where we developed a secure online clinical communication system called LOOP that assembles the care team centred on the patient. The patient and caregiver are integral members of the team. The second is a pilot project where we developed a business model to allow our physicians and Toronto-Central CCAC colleagues to document joint medical records in our existing EMR. Care team members seamlessly exchange high-quality information about shared patients in a timely and secure manner, enhancing team collaboration and integration of care delivery. Both initiatives have encountered very similar barriers, for the reason that our system is not yet setup to support integrative solutions. These initiatives are a way to challenge ourselves, our organizations and the system itself to adapt and enable us to provide seamless care to our patients. Learning Objectives:

1. Hear and share experiences of using technology to securely share personal health information (PHI);

2. Identify common barriers to sharing PHI across organizations, settings, and interprofessionally; 3. Identify strategies for addressing barriers and promoting more coordinated care.


411 Cannabinoid Therapies: What's All the "Buzz" About? Dr. Vincent Maida, MD, MSc, BSc, CCFP (PC), FCFP, ABHPM, Associate Professor, University of Toronto, Toronto, ON The term cannabinoid is a collective term for a group of compounds that are either derived from the cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they may also have actions at other



receptors and sites. Patients with advanced incurable illness represent a cohort within healthcare that has some of the greatest unmet needs despite having access to a plethora of guideline driven disease modulating treatments and pain and symptom management options. Cannabinoid therapies are varied and versatile and may be offered as pharmaceuticals (Nabilone™ and Sativex™), dried botanicals (for smoking, vaporization, teas, or cooking), and cannabis infused oils (for ingestion, vaporization, cooking, or topical application). Cannabinoid therapies regimens may be creative and involve combinations of all of the aforementioned modalities. Basic scientific and clinical research on cannabinoids has been growing exponentially over the past few decades. Patients with malignant disease, at all points of their disease trajectory, may be candidates for cannabinoid therapies whether as monotherapies or as adjuvants. The most studied and established roles for cannabinoid therapies include pain, CINV, and anorexia. Moreover, given their breadth of activities, they may be used to concurrently optimize the management of multiple symptoms, thereby reducing overall polypharmacy. Utilizing cannabinoid therapies may be effective in improving QOL and possibly life extension by virtue of direct effects as well as improving compliance/adherence with disease modulating treatments such as chemotherapy and radiation therapy. Learning Objectives:

1. Discuss the scientific basis for cannabinoid therapies and their potential for disease modulation; 2. Integrate cannabinoids as effective agents for poly-symptom management in malignant and

non-malignant diseases; 3. Reflect on the range of cannabinoid products and their routes of administration.


501 Planned Giving for Pennies: How to Jumpstart your Bequest Program Kimberley MacKenzie, Kimberley MacKenzie & Associates, Toronto, ON Do you want to reveal legacy prospects in your donor file but you aren’t sure how to start? By sharing a true example of what she did to go from zero to 43 confirmed expected bequests in less than one year and raise millions of dollars, Kimberley will provide you with five concrete actions you can take today to boost your legacy program. This session is meant for anyone who has responsibility for a legacy program, in full or in part, and deliver the program off the side of their desk. Learning Objectives:

1. A clear action plan for your planned giving program; 2. More confidence to help start the legacy conversation with donors; 3. Understanding of how to integrate planned giving into your organization.




Tuesday, April 25, 2017 Time: 10:30 – 11:45 am

https://www.cagp-acpdp.org/sites/default/files/civicrm/persist/contribute/files/Kimberley%20MacKenzie%20Bio.pdf

https://www.cagp-acpdp.org/sites/default/files/civicrm/persist/contribute/files/Kimberley%20MacKenzie%20Bio.pdf


502 Integrated Succession Planning for Nonprofit Corporations Linda Fairburn, BIS MSOD, Make Things Happen Limited, Guelph, ON Failure to plan for succession has exposed a fatal flaw in nonprofits throughout North America. According to the 2013 survey by Ontario Nonprofit Network, 60% of leaders plan to leave their positions by 2018. Many agencies are anticipating their leaders' retirement and have the luxury of planning — but are they? Are board directors, HR or staff managers hiring today to meet the needs of tomorrow? Integrated Succession Planning will demystify the succession and replacement process, provide a catalyst to get the conversation going and tools to keep it growing. Learning Objectives:

1. Begin the dialogue about leadership transition and its impact on an organization; 2. Introduce a four-step process that will leads to succession readiness; 3. Explain succession and replacement planning as it relates to nonprofit corporations; 4. Provide an assessment tool to identify risk factors for CEO transition; 5. Review the common barriers to succession planning and provide tips on how to meet them head

on. Workshop Stream: Leadership/Systems/Integration

503 The Palliative Care Future: Defining Quality and Our Role In It Dr. Ahmed Jakada, MD, CCFP (PC), Ontario Palliative Care Network, Toronto, ON Melody Boyd, BScN, MSc, MN, Provincial Clinical Co Lead, Ontario Palliative Care Network, Meaford, ON Lee Fairclough, BSc, MRT, MHSc, Health Quality Ontario, Toronto, ON Lisa Ye, RN, MN, Health Quality Ontario, Toronto, ON Lacey Phillips, MAHSR, Health Quality Ontario, Toronto, ON

Tara Walton, MPH, Family/Caregiver Representative, Ontario Palliative Care Network, Toronto, ON

Quality is a key focus for the Ontario Palliative Care Network, embedded in each of the three mandates that guide our work. Equity, efficiency, safety, patient-centeredness, effectiveness and timeliness are the six defining elements of quality care. As we build a healthcare system that has a plan for palliative care, we need to understand what we mean by quality and how we are to achieve it. Many organizations use quality as a necessary benchmark of success, but the healthcare system has been slow to move towards systemic quality improvement that can transform our system. This process is ongoing. The purpose of this session will be to understand and define quality, discuss the current state of quality in palliative care, and explore areas of implementation that can be achieved at the local level. We will also introduce ongoing work to create a provincial Palliative Care Quality Standard – a go-



to resource containing a set of evidence-based, measurable statements that describe what high-quality care should look like in Ontario. Regional leaders, directors, and all in involved in the delivery of palliative care are encouraged to attend.

Learning Objectives: 1. Understand and define quality; 2. Discuss the current state of quality in palliative care, and explore areas of implementation that

can be achieved at the local level; 3. Introduce ongoing work to create a provincial Palliative Care Quality Standard – a go-to resource

containing a set of evidence-based, measurable statements that describe what high-quality care should look like in Ontario.


504 Developing a Palliaitve Care Program in a Rural Hospital: The Journey so Far Chiamaka Odunukwe, Nurse Practitioner (Adult), MN, Four Counties Health Services, Newbury, ON With the call to have more individual’s die at their place of choice, which is most often not in acute care settings, rural communities continue to face the limitations of access to care at End-of-Life at desired place of death. Some identified limitations are access to palliative services for home care, distance of hospice facilities from home and distance of hospitals with palliative care programs from home. At Four Counties Health Services (FCHS), these gaps in care were identified from numerous feedbacks from both patients and their families. To address the gap between optimal palliative care and individuals in the community, FCHS choose to convert one of its acute care rooms to a palliative suite. Knowing that palliative care is not just about a well furnished room, FCHS began to develop a palliative care program that aims to narrow the identified gap within the FCHS catchment communities. To achieve this, a palliative care committee was developed, with a sub-section of the committee as the working group. The committee reviewed the needs of the community, identified primary goals and resources required to develop a palliative care program that helps decrease the gap between individuals within the FCHS catchment communities and optimal palliative care. As the program continues to develop, it has encountered both successes and challenges in narrowing the gap between individuals living in rural settings and optimal palliative care. Learning Objectives:

1. To become familiar with the development of a palliative program in a rural acute care setting given various limitations that are unique to rural communities;

2. To identify ways of improving access to palliative care in rural settings; 3. To navigate and share ideas/possible solutions to challenges often faced by patients, families

and health care providers in the provision of palliative care in rural settings.




505 Medication Deprescription and Increasing Comfort Medication Use in Patients with Advanced Medical Illness Rachel Whitty, RPh, BScPhm, ACPR, University Helath Network, Toronto, ON Sandra Porter, RPh, BScPhm, University Health Network, Toronto, ON Kiran Battu, RPh, BScPhm, University Health Network, Toronto, ON Dr. James Downar, MDCM, MHSc, FRCPC, University Health Network, Toronto, ON Many people take medications to manage chronic illness or prevent complications. As patients develop serious and terminal illness, these medications are often continued even when they offer little or no benefit. In this workshop, we will review some of the important guidelines for medication deprescription in patients with advanced illness (e.g. Beers, STOPP, Choosing Wisely). In particular, we will use interactive case presentations to explore the deprescription of medications used for primary and secondary prevention (e.g. statins), modified targets for blood pressure and glycemic control, anticoagulants, vitamins/minerals and natural health products. We will also present our own experience with a MEdication RAtionalization (MERA) pilot project at our institution, including qualitative and quantitative findings that highlight barriers to deprescription. We will break into small groups to discuss how to overcome these barriers and discuss deprescription in different settings. We will conclude by presenting future approaches to automating the process of medication deprescription. Learning Objectives:

1. Be familiar with guidelines for medication deprescription in patients with advanced illness; 2. Have an approach to integrating routine medication deprescription into the clinical

environment; 3. Understand the barriers to deprescription among the seriously ill.


506 Improving Communication about Goals of Care with Hospitalized Patients who have Serious

Illness: A Canadian, Multi-Centre Program of Research Marilyn Swinton, MSc, Research Coordinator, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Sandra Andreychuk, RN (EC), MSc (Nursing), MHSc (Bioethics),Clinical Ethicist, Hamilton Heath Sciences, Hamilton, ON Tasnim Sinuff, MD, FRCPC, PhD, Associate Professor, Critical Care and Respirology, InterDepartmental



Division of Critical Care Medicine, University of Toronto, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre,Clinician Scientist, Sunnybrook Research Institute, Toronto, ON Carol Mantle, MScN, Research Nurse, Hamilton Heath Sciences, Hamilton, ON Dr. John You, MD MSc FRCPC, McMaster University, Hamilton, ON Peter Allatt, MA, MHSc, CHE, Bioethicist, Sinai Health System Bridgepoint, Toronto, ON Hospitalization presents an opportunity for clinicians and patients with serious illness to discuss goals of care. We will share findings from our experience developing, implementing, and evaluating a multi-faceted suite of tools to achieve more and better discussions about goals of care (GCD). Findings from our research program at 3 Canadian hospitals (Calgary, Hamilton, Montreal) inform this workshop. First, we will report gaps in current goals of care communication practices identified using process mapping. Next we will review preliminary evidence about 4 tools aimed at increasing patient/family preparedness and clinician competencies for GCD: [1] “What’s Important to Me: A Graphic Values History Tool”; [2] PREPARE, a values-based, patient-centered, advance care planning website; [3] A CPR Video Decision Aid; [4] the Serious Illness Conversation Guide, a structured communication tool to enhance clinician skills. In small groups, participants will review these tools and will be guided through exercises to create a plan for using these tools within their practice settings. In an interactive discussion participants will share in learning about implementing tools to enhance goals of care communication with patients who have serious illness and are approaching EOL. Learning Level: Intermediate. Learning Objectives:

1. Understand how process mapping can identify strategies to improve GCD; 2. Select communication tools to implement in their practice setting; 3. Create a plan to improve GCD within their practice setting.


507 Having the Hard Conversations Sheila Mahoney, BSc (Hon), Certified Copy Editor, Simcoe Health Advocates, Barrie, ON

Doctors and other healthcare providers need to be comfortable with and effective at having

conversations with patients and families about diagnosis, prognosis, palliative care, transition to end-of-

life care, and other challenging topics. This workshop looks at the following challenges • When is the

best time to share bad news with patients and their family members? • Where is the best place to have

the conversation? • How do you start the conversation? • How much time should it take? (And, how do

I find that time in my busy schedule?) Learning Level: Advanced. Training Methods: • Introductory

lecture • Shared experience • Role play Intended audience: Healthcare professionals responsible for

giving patients and their families bad news. Skills and/or knowledge gained: Communication skills



related to listening first to understand patient/family knowledge level and comprehension, and then

providing information at an appropriate level and avoiding jargon. SPIKES, a six-step protocol for

breaking bad news. Knowledge Applicability: This knowledge is applicable in any healthcare

environment where a healthcare provider needs to share bad news. It can also be used to review and

revise processes in any healthcare environment so that communication is more effective,

compassionate, and private.

Learning Objectives: 1. Language to effectively communicate upsetting information to patients and families; 2. Increased confidence and effectiveness in communicating with patients and families; 3. The knowledge required to update processes as necessary in the practice environment.


508 H.U.G.S. Helping Children Understand Grief Sessions Training & Workshop Christine Dernederlanden, Certified Trauma Service Specialist, Award Winning Author, Professional Coach member of ICF, Robert’s Press Canada’s Grief Resource Centre, St. Catharines, ON The award winning author Christine Dernederlanden C.T.S.S., C.T.R. for the first time is offering a training workshop developed for volunteers, professionals and individuals who wish to start a bereavement program. The program is guided by the H.U.G.S. manual. There are templates for photo copying; step-by-step instructions for art, craft and music therapy. The sessions can run consecutively or be used as stand-alone sessions. Included are caregiver’s page, journal, tips and common concerns. Participants will become confident leaders who are well organized; keeping caregivers well informed and involved in their loved ones grieving process. As leaders, participants will be given the tools to keep their own journal and thoughts of each bereavement program they facilitate. Caring for the caregiver is an essential part of becoming a confident, empathetic and compassionate leader. You are welcome to explore the pictures from various bereavement programs that Christine Dernederlanden, C.T.S.S., C.T.R. developed and facilitated. Recently Christine has trained The District School Board of Niagara (along with supplying each Youth Counsellor with a H.U.G.S. Grief Kit) and The Catholic District School Board of Niagara. Both boards are running H.U.G.S. programs at schools in need. Christine has a repertoire of clients from Hospices to Funeral Homes. The H.U.G.S. training is endorsed by the Association of Trauma and Stress Specialist www.atss.info. Niagara Fall Review For Kayla, "I don't have to keep all this stuff inside me any more. I can express my feelings about everything I'm going through and there's other people who have experienced the same thing." Learning Objectives:

1. Participants will become confident H.U.G.S. leaders with a variety of tools within the play therapy spectrum;

2. Learn to keep caregivers well informed and involved in their loved ones grieving process



3. Participants will be given the tools to keep their own journals and thoughts of each bereavement program they facilitate.


509 "The Sick Mannes Salve": Contemplative Traditions and End of Life Care Dr. Mary Wallis, BScN, MHSc, PhD, RN, Alberta Health Services, Calgary Zone, Calgary, AB Contemplative End-of-life Care (CEOLC) is an approach to the care of dying people based on insights from both eastern and western religious traditions. Recently, it has been given credibility by neurophysiological descriptions of how the brain “expresses” such values as compassion, lovingkindness, and equanimity. Contemplative practices have proven valuable to many caregivers, professionals and volunteers who attend the dying. Using examples first from European traditions, the workshop shows the development over centuries of the definitive themes and practices in contemporary CEOLC: the dyad of provider and recipient of care seen together within a larger whole; the emphasis on “caring for” as a spiritual exercise with all the clarity of thought that this requires; the willingness to embrace mystery, and to move toward rather than from pain and fear. It then looks at how contemplative care has been affected by such events as war, plague, religious and social movements, the rise of medical science, and influences from eastern cultures. The workshop will reconnect us with the people who long before us faced the same dilemmas in care of dying people as we do: hope, suffering, pain, fear and mystery. In doing so, we explore various ways to incorporate a contemplative approach into the way we support people who are dying. Contemplative care is at the same time a means of deep self-care and of providing richer care to our patients. Learning Objectives:

1. Insight into where the tradition of Contemplative Care came from, and how it is defined and practiced in 21st century end-of-life care;

2. Awareness of the basic neurophysiology behind the effectiveness of contemplative practices; 3. A practical understanding by means of group discussion and simple exercises in meditation,

and body awareness, of how contemplative care can create resilience in the caregiver as part of self-care, and also enhance the care we provide to dying people.


510 How to Conduct an Antineoplastic Drug Risk Assessment in the Workplace Carolyn Cuthbertson, MHSc, CRSP, Public Services Health & Safety Association, Toronto, ON



The 2014 World Cancer Report (produced by the International Agency for Research on Cancer (IARC)) estimated that cancer rates could increase to 22 million from 14 million in the next two decades thus an increased use of antineoplastic drugs is an inevitable result. Developing and implementing a comprehensive hazardous drugs exposure control program to address these hazards is of critical importance at this time. Exposure to workers may occur during the preparation and administration of the antineoplastic drug; handling excreta and wash water; disposal of wastes; support activities such as laundry, dishwashing and environmental cleaning; and any spill clean-up. This session provides basic information on antineoplastic drugs as well as an overview of which workers are at risk in the hospice palliative care sector. In addition, the speaker will provide practical guidance on completing PSHSA’s "How to Conduct an Antineoplastic Drug Risk Assessment" resource manual. The discussion will be interactive so participants can have an opportunity to provide feedback and share their ideas. Learning Objectives:

1. Gain an understanding of the relevant legislation, publications and guidelines related to antineoplastic drugs;

2. Become familiar with how to conduct your own antineoplastic drug risk assessment in the residential/community setting;

1. Learn about practical ways to ensure the health and safety of workers and volunteers in a hospice palliative care setting.




conference program at-a-glance sunday, april 23, 2017 · conference program at-a-glance sunday,...

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