This episode features Dr Bridget Candy (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK).

A systematic review of effectiveness data on aromatherapy, massage and reflexology in palliative care drew inconclusive conclusions. A systematic review of qualitative evidences shows palliative care patients highly value complementary therapy.

None of the aromatherapy, massage or reflexology trials included all key delivery components as outlined by palliative care patients. The five quality of life scales used in the trials failed to capture the range of perceived benefits from the complementary therapies and many included inappropriate or redundant items. This novel but simple method of integrating synthesised qualitative and quantitative reviews through matrices allows the reasons for inconclusive trial evidence to be explored.

This synthesis has highlighted a need for fully powered, robust trials of aromatherapy, massage and reflexology that are conducted with the key components described by people with palliative care needs. Outcome measures should be appropriate to capture the range of potential benefits highlighted by people with palliative needs. In the meantime, complementary therapies should continue to be offered as part of palliative care.

This episode features Dr Katie Ekberg (School of Early Childhood and Inclusive Education, Queensland University of Technology, Australia) and Dr Anthony Herbert (School of Early Childhood and Inclusive Education, Queensland University of Technology, Australia).

The urgency of caring for children with complex and serious conditions ensures that care must continue during the Coronavirus Disease 2019 (COVID-19) pandemic.

As yet, guidelines for communication with families about the COVID-19 pandemic are not based on direct observational evidence of actual communication practices within palliative care during the pandemic. The current study provides evidence of the pervasive relevance of communication about the COVID-19 pandemic during clinician-family paediatric palliative care consultations.There was a pervasive relevance of serious and non-serious talk about the pandemic.
Topics typical of standard paediatric palliative care consultations often led to discussion of the pandemic, including medical discussions and psychosocial and lifestyle discussions.Clinicians (55%) and parents (45%) initiated talk about the pandemic.

Clinicians should expect and be prepared for the pervasiveness of talk about the COVID-19 pandemic within standard paediatric palliative care consultations, so that they can be flexible in how they respond to families.
Future guidelines should consider the pervasive and varied ways that conversations about a pandemic are raised within and across routine consultations.

This episode features Dr Yakubu Salifu (International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK).

Caring for a family member with advanced prostate cancer in the home presents practical and emotional challenges, especially in resource-poor contexts, where there are increasing palliative cases without adequate palliative care institutions.
The study explored palliative and end-of-life care experiences of family caregivers and patients living at home in a resource-poor context in Ghana.

Men with advanced prostate cancer face complex issues, including lack of access to professional care and a lack of resources for homecare.  Family caregivers do not have easy access to professional support; they often have limited knowledge of disease progression. Patients have inadequate access to medication and other practical resources for homecare. Caregivers may be overburdened and perform the role of the patient’s ‘doctor’ at home-assessing patient’s symptoms, administering drugs, and providing hands-on care.
In resource-poor contexts, there are significant challenges associated with home caregiver support. This study revealed the scale of challenges family caregivers, who lack basic training on aspects of caring, face in providing home care unsupported by healthcare professionals.