Lecture notes for this 8 week U3A Melbourne course.
The course outline is available here.
The timetable (based on participants feedback on possible topics) is also available.
Week 1: Topics – Improving communication between consumers / patients and their health care providers. Assessing the risks, benefits and costs of interventions.
Week 2: Topics – Screening to detect cancer, e.g. Bowel (Faecal occult blood test, Colonoscopy), Prostate (PSA test), Breast (mammography).
Week 3: Topics – Cancer treatment, (surgery, chemotherapy, radiotherapy, etc.).
I’ve also posted a new decision aid for breast cancer screening devised by colleagues at the University of Sydney, Centre for Medical Psychology & Evidence-based Decision-making (CeMPED). They have recently reported a randomised controlled trial of its use to support informed decision making.
See also an article in “The Age”, May 6, 2015, “Breast cancer screening harming hundreds of women a year: Surgeon“.
Week 4: Topic – Intensive care (cardiopulmonary resuscitation, etc).
Week 5: Topics (Dr Rodney Syme, Dying with Dignity) – Medical treatment Act 1988; Enduring Power of Attorney (Medical Treatment); Refusal of medical treatment; Advance Healthcare Directive; Palliative care (Victoria).
Additional resources (week 5):
- MyValues: a set of specially constructed statements designed to help you identify, consider and communicate your wishes about the medical treatment you would want in the later stages of life (a not-for-profit service operated by Barwon Health, funded by The Victorian Department of Health).
- An example of a completed Advance Healthcare Directive (from Dying with Dignity).
- Video (Ted Talk): Prepare for a good end of life.
Week 6: Topics (Dr Rodney Syme, Dying with Dignity) – Dementia and end of life decision making. Resources mentioned:
- Alzheimer’s Australia (Web site)
- Mini-Mental State Examination (Form)
- Advance Healthcare Directive – Alzheimer’s Disease (and other dementias)
Additional resources (week 6):
- NEJM: Unanimity on Death with Dignity — Legalizing Physician-Assisted Dying in Canada
- Death with Dignity Canada: Canada Legalizes Physician-Assisted Dying
Week 7: Topics – Unnecessary antibiotics (minimising antibiotic resistance), Polypharmacy (multiple medication) and deprescribing, Antipsychotics in dementia, Home medicine reviews, Consumer Medicine Information (CMI), Shared electronic health record.
Also, Ray suggested the following resources:
- The Victorian Office of the Public Advocate: Take Control – a kit for making powers of attorney and guardianship. It provides clear information about powers of attorney and guardianship, step by step instructions, and a complete set of all the forms you may need.
- The Guardian Weekly UK news 22.05.15: Doctors move to end culture of giving ‘too much medicine’.
- Health experts warn of antibiotics immunity amid concerns of overuse
- Australian Antimicrobial Resistance Strategy 2015-2019
Week 8: Keeping Healthy -Topics:
- Immunisation: Influenza, Pneumococcal and Herpes zoster vaccine; also diphtheria-tetanus-whooping cough booster shots.
- Minimising the risk of: Coronary heart disease, heart attacks and stroke, Cancer, Falls and fractures, Depression and Dementia.
- Coping with:Osteoarthritis.
- Healthy eating and exercise; Motivation.