1. Siriraj Palliative Care Center

2. Palliative Care Committee Faculty of Medicine Siriraj Hospital Palliative Care Executive Board Palliative Care Working Committee Departments Siriraj Hospital Faculty of Medicine Siriraj Hospital Units/Divisions Department of Nursing

3. Palliative Care in Siriraj Hospital  Siriraj Palliative Care Center  Pediatric Palliative Care Center  Outpatient service Pain clinic Pain clinic Chemotherapy center Chemotherapy center Radiotherapy clinic Radiotherapy clinic  Inpatient service Apply Palliative Care Guideline to every clinical departments Apply Palliative Care Guideline to every clinical departments Spiritual support program in unit/ward Spiritual support program in unit/ward

4. Palliative Care in Siriraj Hospital  Primary Care Team / community care (PCU)  Palliative Home Care / Continuing Care  Volunteer program

5. Our Team Hospital – Based Team  Attending physicians  Residents  Palliative care team consultant  Staff Nurses  Registered nurses  Nurse assistants  Others health care professional (psychologists, social workers, physical therapists, etc.)  Volunteers Primary Care Team / community care (PCU)  General practioners (GP) and family physicians  Primary care nurses

6. The Focus of Development 1.Palliative Care Guideline 2.Training and education for the trainers and providers

7. Palliative Care Guideline

9. Training and Education for the Trainers and Providers StaffPain and Symptoms control Counseling technique Spiritual support Complimentary and others needed skill Physicians Based on Buddhist concept Residents Based on Buddhist concept Nurses Based on Buddhist concept Other staffs and volunteers Massage, Art or music therapy

10. Siriraj Palliative Care Day 2010

11. Palliative Care Conference  On the third Wednesday, every 2-3 months  The chance for our staffs to share the ideas and experiences by using case study method. Operating Performance in 2010 There are 32 attendants in January There are 25 attendants in March There are 42 attendants in May

12. Palliative Care Website  http://www1.si.mahidol.ac.th/palliative

13. Our Services

14. Activities of the Clinic

15. Overall Operation in 2010  The number of patients from Jan – Aug Total number of patients = 76  Total number of new patients = 39 and total number of dead patients = 37  Home care 45 times  50 cases of the patient and family consult through the phone

16. Overall Operation in 2010  Patients and families follow up by phone 187 times  Bereavement care 37 cases  Follow up patients’ family by phone after the patient pass away 37 cases  Attend a funeral ceremony 1 case  Pick a patient up to visit her son at Thonburi jail (Patient’s last wish)

17. Palliative care service satisfaction among Patients  “I feel good, I have never found a doctor talking with me and my family for long period before and nobody give 24 hrs contact number, so I have more time to tell what I still want to do and able to ask for consult. It makes me feel secure and confident to take care of myself after I go back from the hospital.”

18.  “I feel like I still have someone, my family and I are not alone because I have the palliative care team visit my home and call me to follow up case. Now I have the team to consult and give advice.”  “I have never seen the service like this before, I am very impressed.” Palliative care service satisfaction among Patients

19. Activities and Projects for Palliative Care Patients Projects for Caring in End of Life Patient  Counseling for Patient and Family Project  Good Death Project (every wards)  Renal Failure Palliative Care  9 C End of Life Care  Body Comfort and Happy Mind  The Pathway of Relieving in Cancer Terminal Illness Patient

20. Projects for Counseling and Group Support  Cheerful and Happiness Project (Every Ward in Medicine Nursing)  The Development of Caring for Children with Cancer by giving psychological support and educate the parent  Counseling Service for Cancer Patient and Family  Family Support  Patient and Family Counseling

21. Projects and Activities  “Hospital like Home” for patients

22. Buddhist activities Spiritual Activities Alms giving to monks once a week Offering dedication to Buddhist monks every year

23.  Inherit Thai Tradition and Culture

24. Dharma Multimedia in Wards, e.g. Books, VDO, CD Information and medias

25. End of Life Care Nursing care team condoles with the family and asks for permission to put flower garland on patient’s chest

26. Bereavement Care Card and flowers

27. Bereavement care Warm line/call Bereavement care project Nurses have follow-up call for 3 times and record the information from the family to assess the needs and daily life after patient’s death.

28. Volunteer Program

29. Meditation for Mind Healing

30. Home Care: Home Visit Primary care nurse