The EPECO TM Education in Palliative and Endoflife

The EPEC-O TM Education in Palliative and End-of-life Care - Oncology Project The EPEC-O Curriculum is produced by the EPECTM Project with major funding provided by NCI, with supplemental funding provided by the Lance Armstrong Foundation.

E P E C EPEC - Oncology Education in Palliative and End-of-life Care - Oncology O Plenary 3 Charting the Future

Overall message Palliative care can be integrated into comprehensive cancer care

Objectives l List the important themes from the curriculum l Identify challenges to integration l Reflect on need for personal support

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EPEC-O themes l l Relief of suffering is part of comprehensive cancer care Palliative care knowledge is now extensive l Role of families l Teamwork l Oncologist as patient advocate

Relief of suffering l 4 dimensions Physical Psychological Social Spiritual l Expected by patients, families

Palliative care l l Not the absence of care More powerful than ever in the history of medicine A positive, humanistic philosophy Technically sophisticated area of expertise

Families. . . l Cancer involves the whole family l Comprehensive care involves The chance to be close to family, friends Family / proxy assistance with decisions Good communication

. . . Families l None of this is possible without good symptom management

Teamwork. . . l l The whole person has cancer, not just his / her physiology No one person can meet all the needs

. . . Teamwork l Teamwork usually includes Oncologists Nurses Social workers Chaplains Others l Palliative care can be integrated into mainstream practice

Advocacy l l l Professional duty to patient care Professional duty to ensure availability of services Personal desire to be able to receive care that relieves suffering and improves quality of life

Challenges to integration l Institutional l Regulations l Reimbursement l Attitudes

Oncologists’ personal support needs. . . l l l Patients are asking us to do better Find a forum for candid discussion of experiences Transference is powerful; personal comfort is important

. . . Oncologists’ personal support needs l l Professional distance, empathic closeness must balance Know yourself

E P E C O Summary Palliative care can be integrated into comprehensive cancer care