1. Multidisciplinary Team & Symptom Control December 2014 1

2. Dear Doctor Inability to catch his breath “COPD CVA IHD Hospital follow up: Not required” Referral to hospice for assessment, and support for his wife Lives with wife, no home help Every night he suffers a panic attack 2

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6. Exploring the Dynamics of Interdisciplinary Pall Care Teams in providing psycho-social care: “Everyone thinks that Everybody can do it, but they can’t”. O'Connor, Moira, and Colleen Fisher. Journal of Palliative Medicine 14.2 (2011): 191-196. Lack of clear role boundaries Strategies for maintenance of role boundaries Claiming access to specialist knowledge etc Minimizing the knowledge of others 6

7. Who? 7

8. All hospices will employ / contract Nurses Doctors Cultural Liaison Social Work Counselling Spiritual Care Educators Volunteer Services 8

9. All hospices will provide / have access to…. Specialist Medical Occupational Therapy Physiotherapy Clinical Pharmacist Speech Language Therapy Dietician 9

10. All hospices could offer…. Music therapy Art therapy Massage therapy Aroma Therapy 10

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12. How? 12

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16. Leadership Bands BEERS / Hospice values Creativity – the pros and cons Training / Professional Development Bringing expertise in Pushing expertise out 16

17. From the Team… More energy and better colour Energy conservation Techniques for getting into bed Hand held fan Simple breathing techniques Discharge back to GP and Cardiac failure nurse Completed ambulance plan and emergency medication Much improved on m-Eslon 17

18. Resources http://www.physio-pedia.com Google ‘the role of physiotherapy in palliative care http://www.physio-pedia.com http://primarypsychiatry.com/psychotherapy -in-the-palliative-care-setting/ http://primarypsychiatry.com/psychotherapy -in-the-palliative-care-setting/ http://www.nzaot.com/downloads/contribut e/NZAOTOccupationalTherapyandEndofLifePa lliativeCarePositionStatement2013final.pdf http://www.nzaot.com/downloads/contribut e/NZAOTOccupationalTherapyandEndofLifePa lliativeCarePositionStatement2013final.pdf 18

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20. References Crawford G Price S 2003 Team working: palliative care as a model of interdisciplinary care MJA 179 S32-34 O’Connor M, Fisher C, Guilfoyle A 2006 Interdisciplinary teams in palliative care: a critical reflection I J Pal N 12;3 pp132-137 Higginson 2010 What is the evidence that palliative care teams improve outcomes for cancer patients & their families? Ca J 16:5; 423-435 Exploring the Dynamics of Interdisciplinary Pall Care Teams in providing psycho-social care: “Everyone thinks that Everybody can do it, but they can’t”. O'Connor, Moira, and Colleen Fisher. Journal of Palliative Medicine 14.2 (2011): 191-196. Optimising the role and value of the interdisciplinary team: providing person-centred end of life care. 2013 National End of Life Care Programme www.endoflifecare.nhs.ukwww.endoflifecare.nhs.uk 20

21. Questions…… 21