International perspective on Hospice UK’s annual conference

Categories: Education.

The conference was incredible.

It consisted of three days in Liverpool full of poster presentations, plenary lectures and parallel sessions centred around “the art and science of hospice care.” I was there for two days, Wednesday and Thursday, so as not too miss too many classes.

I felt like I was in a constant state of learning – I was learning a lot about hospice care just from the small talk before dinner and at coffee breaks!

Every presentation was full of insights and ideas that I had never considered before. I’m still trying to process everything I learned from the posters, presentations, and amazing people I met.

Music, dancing, happiness and tears

I could write pages on each session I attended, but I will do my best to summarise them all.

The first session I attended was ‘The arts and hospice care: leadership; improving communication training and compassionate care using arts based methods’. The speakers covered the unfortunately peripheral role that the arts play in hospice care and the reasons that the arts need to become more central.

I was struck by how one of the speakers compared music and medicine, saying that he thinks like a musician, in terms of flow and rubato, for example. I had always known there were parallels between music and medicine (ie discipline and creativity) but I had never thought about them in this way.

The next session I attended was a plenary talk, called ‘Dance Macabre’. The speaker, Professor Scott Murray, analysed the narrative of the three phases of illness with the trajectory of illness (and the multidimensional trajectory, which includes not only physical but also social, spiritual, and psychological highs and lows), all while comparing various trajectories to various types of dance.

He also discussed different types of service redesign, describing “disruptive” and “sustaining” innovation from both the inside and the outside of hospices.

Next, I was the room manager for a session on depression and happiness in palliative care. The first speaker in this session explored what happiness is and what the function of happiness is. He also explained that we don’t make it a focus in palliative care, although it certainly should be. He described a study exploring what makes people with cancer happy and how it changes throughout their illness.

One thing that really stuck with me was how we never ask other people what makes them happy, and how maybe people should begin doing this – especially doctors.

The second speaker in this session discussed depression and the role of antidepressants and day care in combating depression. She also discussed how physicians can recognise depression.

Being a room manager was actually quite fun. For the most part, I passed the microphone around during questions, but I also had to take a head count, post signs and let latecomers in to the talk.

On Wednesday night, I attended a conference dinner. I was worried about not knowing anyone, but I sat down at a random table and the conversation flowed easily, touching on everything from how many times we had cried that day to the great city of Chicago. We also heard a talk from David Pearl, which was quite interesting and inspiring.

Transition, empathy and death anxiety

My first session on Thursday, in which I was also a room manager, was on young adults and palliative care. I had never thought about the transition for young adults from paediatric hospices to adult hospices, but it is a very important consideration as there are large differences between the two, from workload to drug administration. The speakers discussed this problem and a few potential solutions.

I had always thought working in a children’s hospice would be very difficult, but one of the speakers pointed out that in a children’s hospice, no one is lonely, whereas in an adult hospice, almost everyone is lonely.

I then attended another plenary ‘Moving stories to provoke and challenge’. We watched three short videos, and then discussed some relevant topics that each video brought up. My favourite discussion point was “can you teach empathy?” One delegate responded with a very inspiring speech on compassion fatigue, and how doctors should not be just “surviving” from day to day.

One of the videos also focused on global health, which I was especially interested in. In this session, I was a roving mic, passing around the microphone to various people who wanted to contribute to the conversation.

I next attended a session on a collection of papers concerning volunteering. I learned of various volunteering programs that different hospices have and how important they are to the hospices. It was interesting to learn about all of the planning and pilot testing that goes into creating one of these programs, and it was inspiring to hear the success stories of them.

Finally, I attended the last plenary session given by Professor Sheldon Solomon, the author of the book I’m currently reading (The Worm at the Core). Prof Solomon discussed death anxiety, which brings together many philosophical, psychological and sociological theories but originally stems from Ernest Becker, and how death anxiety relates to hospice care. It was great to hear Prof Solomon speak – there was a lot in his talk to process, so I’m glad I have the book to continue exploring the topic!

Comparison between US and UK

All too soon, I was on a train back to London. A few themes stood out for me, personally, from the conference.

One of the main things I explored was the differences and similarities in hospice care between the US and the UK. This was mostly because the majority of my conversations with people centred around this, but a few of the talks I attended to also highlighted the comparison between the countries.

We discussed how physicians in the US are more aggressive than here (and I heard the term “palliative chemotherapy” for the first time), how in the US one needs a six-month or less prognosis to be eligible for hospice care but not in the UK, and the vast differences in insurance and fundraising for hospices.

Still, there are plenty of similarities, such as the emphasis on teamwork and volunteering.

I also felt that I learned much about the medical field in general, and how to be a good doctor – one insight was that the doctor should speak only 50% of the appointment, when many doctors speak for 90% or more.

Finally, I learned a great deal about the importance of the arts in medical care, specifically hospice care.

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