The International Journal of Whole Person Care
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Psychedelic medicines for existential distress associated with life-threatening illnesses
Get PDFThis presentation will review the history of scientific research into the use of psychedelic medicines for the treatment of existential distress due to life-threatening illnesses, it will then outline the current state of affairs in North America, and conclude with exploring the implications it will have on the future of palliative care.
Despite the significant advances in the field of palliative care with regards to symptom management, and pain control in particular, we have yet to devise an effective treatment strategy for individuals facing the existential distress associated with the inevitable reality of facing death. Psychedelic-assisted therapy, which involves the use of various psychoactive substances in the right set and setting to experience an altered state of consciousness, could serve as a powerful tool to alleviate the anxiety that many face after receiving a life-threatening diagnosis.
 
Humanity. A medical student's reflections on the healer role
Get PDFDetailing the moving story of his interactions with a patient and her significant other, Ahmed Imcaoudene's Goodwin Prize-winning essay on the Healer Role was selected for presentation in McGill University's Physicianship curriculum. It was also read at the 4th International Congress on Whole Person Care on October 22nd, 2021, introducing profound discussions on compassion in healthcare
Introduction of GRACE program required for COVID-19 disaster - especially for exhausted healthcare workers
Get PDFThe global pandemic of COVID-19 has exhausted many citizens around the world, especially health care workers. In times like these, mindfulness and compassion are necessary to heal many people. GRACE is a program that healthcare professionals can easily use in clinical practice. This program was developed by Roshi Joan Halifax, Ph.D., a Buddhist teacher, Zen priest, anthropologist, Cynda Rushton, the Bunting Chair of Ethics at Johns Hopkins University, and Professor Tony Back, a palliative care physician and medical oncologist at the University of Washington to prevent burnout among medical professionals.
G.R.A.C.E. was developed in response to the deficit of compassion in the world today. The G.R.A.C.E. process includes the following five steps. G: Gathering attention and Grounding, R: Recalling intention, A: Attuning to self and other, C: Considering what will serve, E: Engaging and ending. G.R.A.C.E. is a tool for anyone, especially those in leadership roles or helping professions, such as medical workers, teachers, human rights workers, and more.
In Japan, we invited three of the developers to hold training sessions since 2015. We held an annual conference every year, and monthly study sessions, in Tokyo and Osaka. Currently, we are planning to translate the online course developed in the US into Japanese and use it for training.
In this presentation, we will report on the spread of G.R.A.C.E. in Japan, along with an overview of G.R.A.C.E
The use of digital tablets eases the way to compassionate care during the COVID-19 pandemic
Get PDFObjective: A patient communication program was implemented as a response to hospitals visiting restrictive policies during the COVID-19 pandemic. The aim of the program was to facilitate communication between patients and families, mainly through the use of digital tablets; thus program performance was evaluated by selecting the number of calls performed, the average call time, and the percentage of patients that used the program more than once.
Methods: A communication service for hospitalized patients who did not have access to a personal electronic device or were unable to use their electronic device was launched at different MUHC hospitals. A dedicated team of re-deployed employees was available to help patients connect with their loved ones using a hospital tablet or telephone.
Results: A total of 806 calls were performed between April and November 2020. Eighty one percent of the calls were performed during the non-visitors policy implementation, being video calls preferred over phone calls. The average call time was 15 min, 34% of the patients had a video call with their loved one more than once and 40% of the calls were performed in the intensive care unit.
Conclusion: The patient communication program can be described as a new delivery model of compassionate care. It was effective, helped reduce patients’ isolation and met the needs of family members and caregivers during the hospital non-visitors policy directed by the Ministère de la Santé et des Services Sociaux de Québec during the Covid-19 pandemic.
 
How to think about pain with the whole person in mind
Get PDFToo often, pain is reduced to a simple symptom of illness or injury – a puzzle piece to fit into the differential diagnostic jigsaw. Pain reports that fit the emerging pathoanatomical picture are validated and treated accordingly. But many reports don’t fit this picture, and the widespread stigma associated with persistent pain is most commonly directed toward these individuals, whose symptoms aren’t well explained by known pain mechanisms. A root problem is not seeing the person in pain or the suffering they experience.
This presentation aims to help participants develop a more comprehensive perspective on pain that better integrates its complexities within clinical practice. Participants will be introduced to the Multi-modal Assessment model of Pain (MAP; Wideman et al, Clinical Journal of Pain 2019; 35(3): 212). MAP offers a novel framework to understand the fundamentally subjective natures of pain and suffering and how they can be best addressed within clinical practice. MAP aims to help clinicians view pain, first and foremost, as an experience (like sadness), which may or may not correspond to specific pathology or diagnostic criteria (like clinical depression). MAP aims to facilitate a more compassionate approach to pain management by providing a rationale for why all reported pain should be validated, even when poorly understood. Viewing pain in this manner helps highlight the central importance of listening to patients’ narrative reports, trying to understand the meaning and context for their experiences of pain and using this understanding to help alleviate suffering
The use of portraiture to foster humanistic care
Get PDFIt has been said that a picture says a thousand words, that art should speak for itself. Within the social sciences, there is recognition that images are not merely illustrations, but “texts” that can be read, studied and interpreted in different ways: they are visual narratives. When we look at a work of art, we respond with our own thoughts, feelings and ideas about what it communicates.
When we look at a portrait specifically, we are not just looking at a picture of an individual, we are looking at a picture of someone being looked at. It is a visual record of an interaction, as much as a likeness of the person. The artist-sitter relationship has much in common with the doctor patient relationship involving trust, attention, and an openness to ambiguity and creativity. As clinicians that are tired and feeling overwhelmed, we may objectify patients. Engaging with art can help hone our skills to consistently see the whole person. It provides freedom to sit with ambiguity and maintain curiosity and can help us become more flexible in our thinking, to hold multiple possibilities in mind at the same time. Viewing art in a group provides opportunities to understand and appreciate others’ perspectives.
Drawing on multiple portraiture projects related to pediatric epilepsy, youth mental health and dementia, this presentation will provide constructive ways in which portraiture can be used to foster humanistic, patient centred care, and to understand the power of distributed cognition
A student-run free clinic project: lessons in compassion, community, and courage
Get PDFFor 25 years, UC San Diego Student-Run Free Clinic Project has provided free high-quality care to underserved communities, while inspiring the next generation of health professionals. Free thorough ongoing care is provided in community settings to people who have nowhere to turn and do not qualify for access to care.
The clinic philosophy has four tenets: empowerment - creating environments where patients take charge of their lives and achieve wellbeing, a humanistic approach - embodying Rogerian principles of empathy, respect, and self-awareness, a transdisciplinary model, one where the patient and community are the teacher. This philosophy permeates the life of the clinic. These values are taught, modeled, expected, and observed in curricular components throughout the four years of medical school. 250 medical, 75 pharmacy, and 100 predental students are involved each year as well as students in law, social work, and acupuncture.
Students learn to be healers, artists, teachers as they become health professionals. At each clinic session student leaders gather the team in a large circle, and lead a sharing of recent stories and experiences reflecting the core tenets. All work is directly supervised by licensed clinicians, many of whom were once free clinic students. During the era of COVID, care became virtual. Promotors helped patients learn to use Zoom to receive care. Visit attendance increased to 100%. Our Spanish language empowerment group met online. The clinic already provided healthy food bags to patients at medical visits. Students and volunteers organized to deliver food and medication to people’s homes
Reflections on a journey, doing unfinished business, and homage to Balfour Mount
Get PDFAs a medical student at McGill in 1972, I was honored to meet Dr. Balfour Mount. He made it possible for me to accompany him to St. Christopher’s Hospice. We were 8 students from all over the world. Dr. Cicely Saunders felt the best way to learn to be with dying patients was to work as a nurse. So, in that summer of my third year of medical school, I did.
My career has gone on, first at Mc Gill and since 1987 at UC San Diego. I have been privileged to teach generations of students and faculty a humanistic empowering model of healthcare, seeing the patient as teacher. Our role is to create environments where people take charge of their lives and achieve wellbeing.
My first teacher in doing unfinished business was my father. I was 17. He was 72. He had a MI, called me and my mother into the CCU and said, “The last 25 years with you and Ellen have been the best years of my life. If I should die, I want to say thank you and goodbye.” Then he lived for 20 years and we got to know each other. Present at these moments in people’s lives, we can facilitate unfinished business, whether a mother with cancer, who wrote letters for the next 20 years of her daughter’s life, knowing she wouldn’t be there, a Somali family saying goodbye in the ICU to a loved one or my Dad, opening doors to the future
Online health promotion program and individualized health coaching for veteran wellbeing
Get PDFThe pandemic has highlighted the need for accessible and effective health promotion as Canadians are isolated from their communities during social distancing measures. A web-based health promotion program in which participants also received individualized email-based health coaching from medical students has been available during the pandemic to empower veterans and their family members to engage in healthy lifestyle change.
Health coaches’ email interactions with participants used techniques of motivational interviewing, including an empathetic style, statements of affirmation, and reflections. Open-ended questions were useful in gaining insight into the participant’s current lifestyle, including habits, challenges, and coping strategies. As services have transitioned online and individuals have become more isolated, the connection formed between online health coaches and individuals participating in the health promotion program became crucial in countering the mental and physical health repercussions of the pandemic.
In a preliminary analysis, we show that web-based health promotion with health coaching, for Canadian Veterans and their families, leads to significant weight loss, increased activity and improvement in wellbeing metrics such as sleep and stress.
The medical students acting as health coaches were able to gain a deeper understanding of the challenges involved in behaviour change, something that is seldom covered in detail in the medical school curricula. Medical students were also able to practice their motivational counseling skills surrounding lifestyle changes. Given the lack of available evidence for web-based health promotion that targets veterans and their families, these preliminary results appear promising, with longer-term follow-up planned for the next two years