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UWI TODAY
– SUNDAY 6th JULY, 2014
Ravindra Maharaj is course coordinator for the MSc in Palliative Care Medicine. He is a UWI graduate who returned to Trinidad as an American Board-Certified Internist,
Geriatrician and Palliative Care physician. The UWI is reviewing applications for a new class to begin in September 2014.
Interested candidates can contact the School for Graduate Studies and Research on the first floor of the Lloyd Braithwaite Student Administration Building,
or E-mail:
or visit the website at
ENERGY
EW PROGRAMME
Palliative care is a relatively
new area in medicine.
It involves supporting the seriously ill and those who
are terminally ill and close to the end of life. As this
specialty is still gaining ground, the public may not be
familiar with the services it can provide.
Palliative care is frequently confused with hospice
care, which focuses more on end of life care. It should
be noted that while hospice care follows the same
philosophy, palliative care can be involved from the
point of diagnosis of a serious or life-threatening
illness.
Essentially, to palliate is to make something,
such as the systems of a disease, less severe without
removing the cause. This can involve a variety of
approaches because managing serious illness or even
the dying process is complex. Support may be required
in the physical, psychological, functional and spiritual
domains, and this is ideally provided by a team.
This team approach frequently includes nurses,
pharmacists, chaplains, social workers, physical
therapists and physicians to provide comprehensive
care plans. It goes beyond the traditional scenario,
where a doctormay recommend a series ofmedications
and treatments without addressing these other needs
of the patient and family.
Communication is a vital component of palliative
care. Frequently, medical treatment plans can be
difficult for many to understand. Palliative care teams
ensure that the medical team, patients and families
are on the same page. Quite often, emotions may run
high and it takes a great deal of training to manage the
situation in a sensitive but practical way.
Studies have shown that the majority of people
who are near the end of their lives experience
distressing symptoms, including pain and shortness of
breath. Palliative care teams provide plans and support
to mitigate these stressors so that the quality of life is
kept in focus even if expectations of time remaining
are short.
With an increasingly aging population, it is
expected that the demand for health care practitioners
familiar with caring for the elderly andmore vulnerable
will rise.
Prior to 2012, education in palliative care was
limited to a few lectures in the undergraduate medical
programme at the Faculty of Medical Sciences. There
were two charity-driven hospice centres and a few
physicians in the community who comforted the
dying, but there was no formalized service in the
public setting. Through the efforts of The UWI and
the Palliative Care Society of Trinidad and Tobago, a
Master’s degree programme was set up to train a variety
of health care practitioners to improve the knowledge
base and skillset locally.
Students were taught skills in communication,
planning, symptom recognition and management
which were complemented by lecturers from a
palliative care background, as well as speakers from
other fields, including leaders in nursing, social work,
religion and medicine.
We congratulate the graduating class of the MSc
in Palliative Care Medicine. This inaugural class has
completed the two-year part-time programme where
they learned about the principles of palliative care.
The class had a diverse background made up of health
professionals, including nurses, a radiotherapist, social
workers and doctors.
The class started in September 2012 with the
assistance of the late Professor Larry Librach, Canadian
pioneer of palliative care and his team from the
Temmy Latner Centre of Palliative Care. I joined the
programme as a lecturer in the first semester, keen to
take up the baton from the Canadians to be a point of
reference for these students.
Twelve students graduated in 2014, with two
achieving distinctions. Three students produced
research projects highlighting the burden of palliative
care in Trinidad and nine had clinical exposure to
palliative care delivery at homes, clinics, tertiary
centres and hospices. There is now a Palliative Care
clinic at the National Radiotherapy Centre in St. James
as well as plans for a public service in-patient hospice
facility.
When Every Moment Counts
Palliative care brings comfort to the last
B y R a v i n d r a M a h a r a j
Students from the first graduating class of the MSc in Palliative Care Medicine with course coordinator,
Ravindra Maharaj.
Photo: Dexter Superville
