1. home based palliative care
eastern palliative care
and
Peninsula Hospice Service
Yvonne Sherring-Howard
AUTHOR: Yvonne Sherring-Howard, Senior Art Therapist, Eastern Palliative Care, Melbourne, Australia & Peninsula Hospice Service, Melbourne, Australia
ACKNOWLEDGEMENTS: Thanks and gratitude to Bev Armstrong, Felicity Podger and Lyn Hayes, visionaries of home based Palliative Care Art Therapy and thank you to all participating / contributing clients and staff - Management, Clinical & Corporate & volunteers.
REFERENCES: 1
Electronically retrieved 05/12/2008 http://www.jkp.com/catalogue/book.php/isbn/9781853026775; 2
ANZATA: The Australian and New Zealand Art Therapy Association - http://www.anzata.org/mambo/;
3
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991 Summer;7(2):6–9
Phone: 9783 6177
www.peninsulahospice.com.au
Phone: 1300 130 813
www.eastpallcare.asn.au
‘MEDICAL’ ART THERAPY IN TWO SETTINGS
Establishing Contemporary ‘Medical’ Art Therapy
in Community Palliative CareINTERDISCIPLINARY CARE
The person facing terminal illness requires the best from their community and its facilities.
While medical care remains a primary focus of palliative care, the expansion of whole-person care approaches have resulted in the development of multidisciplinary care
teams. The inclusion of Art Therapy in such teams means palliative care clients and their families are advantaged with additional communication, symptom management
and illness adaptation options.
‘MEDICAL’ ART THERAPY “is defined as the use of drawings, art expression and imagery with individuals who are physically
ill or disabled, or are undergoing aggressive medical treatment such as surgery or chemotherapy.” 1
Both the Peninsula Hospice Service and Eastern Palliative Care employ field experienced and ANZATA2
recognised, registered Art Therapists with both Fine Art and
Master of Art Therapy tertiary education, and ‘Art As Therapy’ and ‘Art In Therapy’ palliative care field experience.
ESAS:3
1 Pain
2 Tiredness
3 Nausea
4 Depression
5 Anxiety
6 Drowsiness
7 Appetite
8 Wellbeing
9 Shortness of
Breath
10 Complexity of Care
‘MEDICAL’ ART THERAPY TOOLS
Communication...
• Concretising— abstract feelings into tangible form
• Mark making—mobilising expression
• Objects / Images—non-verbal communication
Pain / symptom assessment and support...
• Colour breath work—visualisation / sensory play
• Concretising symptoms / pain—image construction
• Symptom / pain narratives—journal / digital / cards
Illness adaptation / Bereavement support...
• QOL options—life interest / inspiration / release
• Artistic skills (aesthetic / expressive Mastery)
• Life review—visual narratives / legacy creation
“I’ll keep using the Art Therapy visits for more than one thing; its time for me… about making sense of my life, my disease … about being inspired…. [its] useful to
help me get my head around ... relationships and the changes ahead…. I’d love to give painting a try ... [I] always wanted to learn” - Name withheld PHS Client
Art + Therapy
(images / making + counselling / psychology)
= Art Therapy
Artist, Aya Nahas
PENINSULA HOSPICE SERVICE (PHS) ART THERAPY PILOT YEAR
96 Clients /families receiving Art Therapy & 90 Art Therapy ed. attendees
In 2003 Victoria’s Peninsula Hospice Service set about defining home-based
Palliative ‘Medical’ Art Therapy with client’s living at home.
PHS ‘MEDICAL’ ART THERAPY TODAY...
After six years one therapist continues to work two days a week
• Client / family home visits
• Studio Art Therapy for clients
• Co-facilitated Carers Programs
• Palliative Care Art Therapy education for staff, volunteers & community
• Collaborative ‘Palliative Care Week’ Client Art Therapy exhibits
EASTERN PALLIAITIVE CARE (EPC) ART THERAPY PILOT YEAR
Three palliative care teams / geographical sites
66 Clients /families receiving Art Therapy & 113 Art Therapy ed. attendees
In 2007, Melbourne’s Eastern Palliative Care piloted Palliative Care ‘Medical’
Art Therapy as a Complementary Therapy.
EPC ‘MEDICAL’ ART THERAPY TODAY...
After two years there are now two therapists, each working three days a week
• Client / family home visits (including bereavement)
• Guest clinician at Bereavement ‘Talking Through Grief’ Groups
• Palliative care Art Therapy education for staff, volunteers & community
• Collaborative ‘Palliative Care Week’ Client Art Therapy exhibits
REFERRAL INDICATORS
OTHER:
Fear / Stress
(anger, relaxation / communication)
Art Media
(expressive / creative / artistic / Artist)
Enjoyment, Expression
(fun/ emotional awareness / release)
Processing Disease
(Illness adaptation, treatments client,
carer, family, children –relationships)
Grief, Loss
(ambivalence, hopelessness,
demoralisation)
Quality of Life [QOL] (Life purpose, Identity)
Stimulation (Curiosity, interest, inspiration)
Metaphoric Symptom Descriptions
(concretisation)