Tag Archives: Macmillan Professionals

Bwyd, canser a diwedd oes: rôl dietegydd lliniarol Macmillan

Pan ddechreuais ar fy swydd fel dietegydd gyda Macmillan yn y tîm gofal lliniarol arbenigol natalie-potter-cropped doeddwn i ddim wir yn siŵr beth i’w ddisgwyl na beth oedd gofal lliniarol yn y bôn, ond roeddwn i’n gwybod ei bod hi’n mynd i fod yn swydd ‘arbennig’.

Felly beth mae Dietegydd gofal lliniarol yn ei wneud mewn gwirionedd?

  • Mae pobl yn cael eu cyfeirio ataf i’n bennaf oherwydd eu bod nhw wedi colli archwaeth at fwyd ac am eu bod yn colli pwysau.  Oherwydd effeithiau canser ar y corff, yn enwedig pan fydd yn y cyfnod olaf, mae’n amhosibl magu pwysau eto.  Mae colli archwaeth at fwyd yn cyd-fynd â hyn yn aml.
  • Fel dietegydd allaf i ddim newid y broses gorfforol hon ond mae llawer o bethau y gallaf eu gwneud i gynorthwyo cleifion a’u gofalwyr yn y maes anodd hwn, sy’n aml yn un emosiynol.
  • Gyda fy nghydweithwyr nyrsio a meddygol, rwy’n gweithio i wella symptomau eraill a all effeithio ar gymeriant bwyd a diod. Er enghraifft, teimlo’n sâl neu broblemau treulio eraill.

Mae iechyd y geg yn bwysig iawn; os oes gan rywun geg dost neu sych, gall bwyd flasu’n ofnadwy a gall bwyta fod yn boenus.  Mae llawer o gleifion yn colli’r gallu i flasu unrhyw beth, mae cleifion yn aml yn dweud bod bwyd yn, ‘blasu fel cardfwrdd’ felly mae bwyta’n ddiflas ac yn anodd. Rwy’n gallu argymell fitaminau penodol gan y gall hyn fod oherwydd diffyg, a hefyd rwy’n rhoi cyngor ar fwydydd addas.

  • Rwy’n rhoi cyngor arbenigol yn rhan o dîm ar symptomau gastroberfeddol mwy cymhleth gan fod gen i flynyddoedd o brofiad clinigol yn y meysydd hyn o’m gwaith mewn swyddi blaenorol.
  • Rwy’n rhoi cyngor ar wella cyfansoddiad pa bynnag faeth y mae cleifion yn gallu ei gymryd, er enghraifft drwy roi cyngor syml am atgyfnerthu bwyd neu am fwyta dewisiadau mwy syml. Mae llawer o bobl yn ofni bwydydd braster uchel, uchel mewn calorïau oherwydd y negeseuon bwyta’n iach sydd o’n cwmpas i gyd ond yn yr achos hwn bydden nhw’n hynod briodol.
  • Hefyd rwy’n argymell ychwanegion maethol ar bresgripsiwn er mwyn rhoi maeth ar ffurf sy’n gallu cael ei dioddef ar y pryd hwnnw ac er mwyn gwella’r maeth sy’n cael ei gymryd yn gyffredinol.
  • Yn bennaf oll rwy’n teimlo mai’r peth pwysicaf rwy’ wedi’i ddarganfod yw’r effaith seicolegol sylweddol y gall colli archwaeth a cholli pwysau ei chael ar glaf a’i anwyliaid. Mae’r rhan hon o’u clefyd yn eu hatgoffa’n weledol o’r salwch ei hun ac mae’n achosi ystod eang o emosiynau. Gall y rhain gynnwys galar a cholled na fydd hoff ddilledyn byth yn fitio neu na allan nhw wisgo eu modrwy briodas eto, yr ofn fod y salwch yn mynd rhagddo, trallod, rhwystredigaeth a dicter nad yw’r person yn gallu bwyta a mwynhau bwyd fel roedden nhw’n arfer ei wneud.
  • Mae bwyd yn mynegi cariad ac mae’n rhan o’r broses o ofalu.  Mewn cyfnod o ymyriadau meddygol dwys, dyna’r cyfan y mae teuluoedd yn teimlo y gallan nhw ei wneud dros eu hanwyliaid. Yn aml mae perthnasau’n gallu teimlo ymdeimlad enfawr o golled os yw’r rôl hon yn cael ei cholli.
  • Dydy llawer o bobl ddim yn sylweddoli bod colli pwysau a cholli archwaeth yn symptom o’r canser ei hun a’i fod y tu hwnt i reolaeth y person – rhywbeth rydyn ni fel gweithwyr proffesiynol yn ei gymryd yn ganiataol. Weithiau mae esbonio hyn yn unig, er ei fod yn gysyniad anodd, yn gallu achosi rhyddhad mawr i’r cleifion a’r gofalwyr. Gall gael gwared ar wrthdaro adeg bwyd fel y gall pobl dreulio eu hamser gwerthfawr gyda’i gilydd mewn heddwch ac nid yn dadlau ynghylch faint i’w fwyta a’i yfed.

Yn wir, mae bod yn ddietegydd gofal lliniarol yn swydd arbennig; mae’n tynnu ar fy sgiliau personol, clinigol a seicolegol i gyd ac yn fy ngyrru i geisio gwella’r hyn sy’n bosibl i glaf a’r teulu ar adeg anodd.
Rwy’n ystyried fy mod i’n ffodus iawn, oherwydd y gefnogaeth barhaus rwy’n ei chael gan Macmillan a’r cyfleoedd rwyf wedi’u cael, yn enwedig wrth weithio gyda thîm gwych hynod arbenigol a’r fraint o weithio yn y gymuned rydym yn ei gwasanaethu.

Byddem wrth ein boddau’n clywed eich sylwadau am y blog yma.

Celebrating our Macmillan professionals

Last week, on Wednesday 27 January, we held a celebration event for some of our fabulous Macmillan professionals at the Norwegian Church in Cardiff Bay.

The event was an opportunity to recognise and say “thank you” to some of our longer serving Macmillan professionals, as well as a chance to catch up with friends.

Fourteen Macmillan Professionals were presented with a long service recognition award at the event.

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From left to right: Helen Tyler, Llinos Pink, Karen Kirwan, Mel Lewis,Carolyn Faulkner, Rhian Jones, Carol Davies, Andrea Byrne, Jane Hart, Sarah Morgan, Mark Rogers, Alison Doherty, Sian Lewis, Sian Hughes and Andrea Rich

These are the Macmillan professionals who received the award:

Helen Tyler – Macmillan Therapy Services Manager – Velindre Cancer Centre

Carol Davies – Macmillan Breast Care CNS – Neath Port Talbot Hospital

Alison Doherty – Macmillan Occupational Therapist – Princess of Wales Hospital

Carolyn Faulkner – Macmillan Head & Neck CNS – Morriston Hospital

Sian Hughes – Macmillan Palliative Care CNS – University Hospital Wales

Jane Hart – Macmillan Lead Cancer Nurse – Royal Gwent Hospital

Rhian Jones – Macmillan Lead Cancer Nurse – Singleton Hospital

Karen Kirwan – Macmillan Community Nurse – Pontypridd Hospital

Mel Lewis – Macmillan Palliative Care Lead Nurse – University Hospital Wales

Sian Lewis – Macmillan Clinical Lead Dietitian (and Macmillan Cymru Wales blogger!)– Velindre Cancer Centre

Sarah Morgan – Macmillan Lung Cancer CNS – Glangwili Hospital

Llinos Pink – Macmillan Palliative Care CNS – University Hospital Wales

Andrea Rich – Macmillan Palliative Care CNS – Llandough Hospital

Mark Rogers – Macmillan Consultant in Cancer Genetics – University Hospital Wales

Helen Tyler, also received the prestigious Henry Garnett Award. This is awarded to Mac professionals who have worked beyond their core role to promote and support Macmillan.

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Helen Tyler received Henry Garnett Award from Andrea Byrne.

Vaughan Gething, deputy minister for health, addressed the audience at the start of the night praising the hard work of Mac professionals in Wales. He also took the opportunity to chat with some of our professionals.

As well as presenting the awards to our Macmillan Professionals, ITV Wales news presenter Andrea Byrne made a very touching and personal speech about the role that Macmillan has played in her life.

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The long service recognition award was created by Ewenny Pottery

You can view more images from the event on our Facebook page

 

 

Dathlu ein Gweithwyr Proffesiynol Macmillan

Ddydd Mercher 27 Ionawr, cynhalion ni ddigwyddiad dathlu i rai gweithwyr proffesiynol Macmillan gwych yn yr Eglwys Norwyaidd ym Mae Caerdydd.

Roedd y digwyddiad yn gyfle i gydnabod rhai gweithwyr proffesiynol Macmillan sydd wedi rhoi’r gwasanaeth hwyaf, ac i ddweud “diolch yn fawr” wrthyn nhw, yn ogystal â bod yn siawns i gael sgwrs â ffrindiau.

Cyflwynwyd gwobr cydnabod gwasanaeth hir i 14 o Weithwyr Proffesiynol Macmillan yn y digwyddiad.

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© WALES NEWS SERVICE

(O’r chwith i’r dde: Helen Tyler, Llinos Pink, Karen Kirwan, Mel Lewis, Carolyn Faulkner, Rhian Jones, Carol Davies, Andrea Byrne, Jane Hart, Sarah Morgan, Mark Rogers, Alison Doherty, Sian Lewis, Sian Hughes ac Andrea Rich)

Dyma weithwyr proffesiynol Macmillan a dderbyniodd y wobr:

Helen Tyler – Rheolwr Gwasanaethau Therapi Macmillan – Canolfan Ganser Felindre

Carol Davies – Nyrs Glinigol Arbenigol Gofal y Fron Macmillan – Ysbyty Castell-nedd Port Talbot

Alison Doherty – Therapydd Galwedigaethol Macmillan – Ysbyty Tywysoges Cymru

Carolyn Faulkner – Nyrs Glinigol Arbenigol y Pen a’r Gwddf Macmillan  – Ysbyty Treforys

Sian Hughes – Nyrs Glinigol Arbenigol Gofal Lliniarol Macmillan – Ysbyty Athrofaol Cymru

Jane Hart – Nyrs Ganser Arweiniol Macmillan – Ysbyty Brenhinol Gwent

Rhian Jones – Nyrs Ganser Arweiniol Macmillan – Ysbyty Singleton

Karen Kirwan – Nyrs Gymunedol Macmillan – Ysbyty Pontypridd

Mel Lewis – Nyrs Glinigol Arbenigol Gofal Lliniarol Macmillan – Ysbyty Athrofaol Cymru

Sian Lewis – Dietegydd Arweiniol Clinigol Macmillan (a bogiwr Macmillan Cymru!)– Canolfan Ganser Felindre

Sarah Morgan – Nyrs Glinigol Arbenigol Canser yr Ysgyfaint Macmillan – Ysbyty Glangwili

Llinos Pink – Nyrs Glinigol Arbenigol Gofal Lliniarol Macmillan – Ysbyty Athrofaol Cymru

Andrea Rich – Nyrs Glinigol Arbenigol Gofal Lliniarol Macmillan – Ysbyty Llandochau

Mark Rogers – Ymgynghorydd Macmillan mewn Geneteg Canser – Ysbyty Athrofaol Cymru

Hefyd derbyniodd Helen Tyler Wobr fawreddog Henry Garnett. Rhoddir hon i weithwyr iechyd Macmillan sydd wedi gweithio’r tu hwnt i’w rôl gofal er mwyn hyrwyddo a chynorthwyo Macmillan.

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Derbyniodd Helen Tyler Wobr Henry Garnett oddi wrth Andrea Byrne © WALES NEWS SERVICE

Anerchodd Vaughan Gething, y Dirprwy Weinidog dros Iechyd, y gynulleidfa ar ddechrau’r noson gan ganmol gwaith caled gweithwyr iechyd proffesiynol Macmillan yng Nghymru. Hefyd manteisiodd ar y cyfle i sgwrsio â rhai o’n gweithwyr proffesiynol.

Yn ogystal â chyflwyno’r gwobrau i Weithwyr Proffesiynol Macmillan, gwnaeth Andrea Byrne, cyflwynydd newyddion ITV Cymru araith deimladwy a phersonol iawn am y rhan y mae Macmillan wedi chwarae yn ei bywyd.

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Cafodd y wobr cydnabod gwasanaeth hir ei chreu gan Grochendy Ewinni

Cewch weld rhagor o luniau o’r digwyddiad ar ein tudalen Facebook

I was ‘delighted and terrified’ to be asked to be a Macmillan nurse

Macmillan Ambassador Lynne Tanner MBE, reveals that she was just 25 years old when her own mother died from cancer.  In this blog, Lynne reflects on her ten years as a community Macmillan nurse, and how attitudes and approaches have evolved to “make life more bearable for people diagnosed with a life threatening illness.”

LYNN FotoWhen I was 25 years old my mother died. She died from something I had not then heard of before… cancer. Little did I know then the effect that her death and her cause of death would have so much bearing on the rest of my life.

My mother haemorrhaged and died in my arms as the district nurse knocked on the front door for the first time. Some years later when I became a district nurse the same thing happened again only this time I was the nurse comforting a distraught daughter.

After my mother died I went to work in the local cottage hospital as an auxiliary nurse to “get it out of my system”. The matron at the cottage hospital persuaded me to do my training and after qualifying and gaining experience, I went back to the same cottage hospital. In those days palliative care consisted of keeping the patients asleep for most of the time with “Brompton’s” mixture, a combination of alcohol and morphine.

GP funding came into being and our local surgery asked me if I would go to work for them as a district nurse. I jumped at the chance, and very soon realised that the community was my “niche”, especially nursing  “the terminals”- as patients who had a non-curative illness were labelled.

One day our locality manager sent for me and asked me to “act up” to a community Macmillan post. I was delighted and terrified at the same time but I had the support of Macmillan and my husband! After six months the post was found to be feasible and was advertised. I applied and to my amazement got the post.

The information that flowed from Macmillan was invaluable. Additionally, we had the weekend seminars – these were brilliant. Apart from the information given there was the support of other Macmillan nurses. You felt you were not on your own.

My “ Mac”  team consisted of two other nurses. Together we covered the whole county and had each other to exchange information. St. Michaels Hospice was within the county and we were fortunate in having their support referring patients to each other, thus ensuring continuity of palliative care.

As a Macmillan nurse I could apply for Macmillan grants. When you are diagnosed with a non-curative illness the last thing you need to worry about is money. Unfortunately washing machines break down, microwave ovens cease to work or simply the fact that you have lost so much weight that your clothes no longer fit and your battered self-esteem takes another blow. The grants really made such a difference to the patients’ lives. Not huge amounts of money but enough to take the worry out of basic living.

We also had the use of several reclining chairs which we could “loan out” to patients. Working in partnership with Soldiers, Sailors and Airmens Families Association (SSAFA) also proved beneficial to our joint patients. There was also the opportunity, to send patients and their carers away for the weekend to hotels by the sea.

Referrals were made from the consultant oncologist in Cheltenham, GP’s or in fact anyone who needed our help. I met on a regular basis with the GP and district nurses, the information exchange proving beneficial to both patients and staff.

Symptom control was the main reason for referral but spiritual care was also requested, helping patients to become at ease with themselves and their families.  Families themselves I know gained support from being able to air their worries to another person.

Patients found comfort in the fact that the Macmillan nurse was always there to take them through their cancer journey. A patient once told me that he found it so helpful to have the same nurse to talk to, whereas in hospitals there were a stream of different nurses, all trying to be kind but he missed the rapport of having the same nurse.

I spent ten years as a community Macmillan nurse and am now a Macmillan Ambassador. The input of Macmillan through its nurses cannot and should not be underestimated.

Macmillan is the gift to make life more bearable for people diagnosed with a life threatening illness.

For information or support from Macmillan, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit www.macmillan.org.uk.

 

Dietitian Sian Lewis on the special challenges of helping head and neck cancer patients

I qualified as a dietitian in 1993 and have worked as a Macmillan Sian Lewis blog sizeSpecialist Oncology Dietitian since 1999. In 2007 I took up the position as Macmillan Clinical Lead Dietitian at Velindre Cancer Centre. With this I not only manage a team of three but also provide a clinical dietetic service to patients who have head and neck cancer.

As clinical lead I have to ensure that the dietetic team is providing a service to all patients attending the cancer centre – making sure that they have access to the right nutritional information and that their dietary needs are being met. We see patients throughout the cancer centre; inpatients, day cases, out patients and radiotherapy patients. The cancer centre has a long corridor and I walk many steps a day seeing my patients.

A huge part of the role nowadays is to identify future developments for the team that are not only in line with the cancer centre’s vision but national documents such as the Cancer Delivery Plan. As more people are living with cancer we are now looking at services to help people manage the consequences of treatment and meet the goals that matter to them. We also provide healthy living programmes, working with other therapists such as physiotherapy and occupational therapy, to give patients the knowledge and skills to self manage their own health.

As for my clinical work I have for the last nine years specialised in head and neck cancer. Many patients who have head and neck cancer have difficulty eating during the treatment. I attend all the radiotherapy review clinics with the consultant, review radiographer, clinical nurse specialist and speech and language therapist. It’s very intensive treatment that involves the patient receiving radiotherapy every day for six weeks. Many find it difficult to keep their weight up so my aim is to provide them with simple and practical dietary advice to help them maintain their weight. In most instances we need to give food fortification advice, oral nutritional supplements but some patient find they need extra help and have a feeding tube for a short period. I get to review the patients every week, sometimes more, so as you can imagine I get to know each patient and their family well. I really enjoy that part of my role and like to feel that I have helped in some way improve their experience.

As I work closely with the review radiographers we input into the introductory evenings for patients just about to start radiotherapy. On a monthly basis I give a short 5 minute talk to raise the awareness of good nutrition during radiotherapy and answer any questions to help patients feel better prepared for their treatment.

Over the years I have held various committee roles for the British Dietetic Association Specialist Oncology Group. Presently I am the chair of the group. I enjoy being part of the committee as not only does it help me with my own professional career but I feel that I am more aware of best practices and national documents that will help me locally in ensuring I give the best care and support to my patients. Currently the group is working on developing an oncology specific outcome tool for dietitians to use to show the effectiveness of their work. Future plans include developing information for thyroid patients who require a low iodine diet.

I feel it’s very important as a Macmillan healthcare professional to establish and maintain strong links with Macmillan. I am a member of the Macmillan Allied Health Professional Forum and have worked on the Eat Well Feel Good Toolkit with Jill Scott. This led to me being awarded a role of honour by the BDA – an achievement I feel very privileged to have received. I have also been part of the working group who worked on the production of a set of ‘Top Ten Tips’ resources on nutrition for the different stages of cancer: During cancer treatment; Post-treatment and recovery; Advanced cancer/ End of Life; Living with and Beyond Cancer.

So as you can my life as a Macmillan Clinical Lead Dietitian is very varied and is not only face to face clinical work. Over the years I have provided dietetic care for some lovely patients and meeting them makes my job so rewarding.

Twitter: @SLewisRD

Y dietegydd Sian Lewis ar yr heriau arbennig o gynorthwyo cleifion canser y pen a’r gwddf

Cymhwysais fel dietegydd yn 1993 ac rwyf wedi gweithio fel Dietegydd Oncoleg Arbenigol Macmillan ers 1999. Yn 2007 dechreuais fySian Lewis blog size swydd fel Dietegydd Arweiniol Clinigol Macmillan yng Nghanolfan Ganser Felindre. Gyda hyn rwyf nid yn unig yn rheoli tîm o dri ond hefyd yn rhoi gwasanaeth dietegol clinigol i gleifion sydd â chanser y pen a’r gwddf.

Fel arweinydd clinigol rhaid imi sicrhau bod y tîm dietegol yn darparu gwasanaeth i bob claf sy’n mynychu’r ganolfan ganser – sicrhau bod mynediad ganddyn nhw i’r wybodaeth faethol gywir a bod eu hanghenion dietegol yn cael eu cwrdd. Rydym yn gweld cleifion drwy’r ganolfan ganser i gyd; cleifion mewnol, achosion dydd, cleifion allanol a chleifion radiotherapi. Mae coridor hir gan y ganolfan ganser ac rwy’n cerdded llawer o gamau’r dydd yn gweld fy nghleifion.

Rhan enfawr o’r rôl y dyddiau hyn yw adnabod datblygiadau’r dyfodol i’r tîm, rhai sydd nid yn unig yn unol â gweledigaeth y ganolfan ganser ond hefyd â dogfennau cenedlaethol fel y Cynllun Cyflawni ar gyfer Canser. Wrth i fwy o bobl fyw gyda chanser rydym bellach yn edrych ar wasanaethau i helpu pobl i reoli canlyniadau’r driniaeth a chwrdd â’r amcanion sy’n bwysig iddyn nhw. Hefyd rydym yn darparu rhaglenni byw’n iach, gan weithio gyda therapyddion eraill fel ffisiotherapi a therapi galwedigaethol, i roi’r wybodaeth a’r sgiliau i gleifion hunanreoli eu hiechyd eu hunain.

O ran fy ngwaith clinigol rwyf wedi arbenigo ar ganser y pen a’r gwddf am y naw mlynedd diwethaf. Mae llawer o gleifion sydd â chanser y pen a’r gwddf yn cael anhawster bwyta yn ystod y driniaeth. Rwy’n mynychu pob un o’r clinigau adolygu radiotherapi gyda’r ymgynghorydd, radiograffydd adolygu, nyrs glinigol arbenigol a’r therapydd lleferydd ac iaith. Mae’n driniaeth ddwys iawn sy’n golygu bod y claf yn cael radiotherapi bob diwrnod am chwe wythnos. Mae llawer yn ei chael hi’n anodd cadw eu pwysau felly fy nod yw rhoi cyngor dietegol syml ac ymarferol iddyn nhw i’w helpu i gynnal eu pwysau. Fel arfer mae angen inni roi cyngor atgyfnerthu bwyd, atodiadau maethol trwy’r genau ond mae rhai cleifion yn gweld bod angen help ychwanegol arnyn nhw ac maent yn cael tiwb bwydo am gyfnod byr. Rwy’n cael adolygu’r cleifion bob wythnos, weithiau’n amlach, felly fel y gallwch ddychmygu rwy’n dod i adnabod pob claf a’u teuluoedd yn dda. Rwyf wir yn mwynhau’r rhan honno o fy rôl ac yn hoffi teimlo fy mod wedi helpu mewn rhyw ffordd i wella eu profiad.

Gan fy mod yn gweithio’n agos gyda’r radiograffyddion adolygu rydym yn cyfrannu i’r nosweithiau rhagarweiniol i gleifion sydd ar fin dechrau radiotherapi. Bob mis rwy’n rhoi sgwrs fer 5 munud i godi ymwybyddiaeth am faeth da yn ystod radiotherapi ac i ateb unrhyw gwestiynau i helpu cleifion i deimlo eu bod wedi’u paratoi’n well at eu triniaeth.

Dros y blynyddoedd rwyf wedi bod â sawl swydd ar bwyllgor Grŵp Oncoleg Arbenigol y Gymdeithas Ddieteg Brydeinig. Ar hyn o bryd fi yw cadeirydd y grŵp. Rwy’n mwynhau bod yn rhan o’r pwyllgor oherwydd nid yn unig y mae’n fy helpu gyda fy ngyrfa broffesiynol fy hun ond rwy’n teimlo fy mod yn fwy ymwybodol o’r arferion gorau a’r dogfennau cenedlaethol a fydd yn fy helpu’n lleol o ran sicrhau fy mod yn rhoi’r gofal a’r cymorth gorau i’m cleifion. Ar hyn o bryd mae’r grŵp yn gweithio ar ddatblygu adnodd canlyniadau penodol oncoleg i ddietegwyr ei ddangos i ddangos effeithiolrwydd eu gwaith. Mae cynlluniau’r dyfodol yn cynnwys datblygu gwybodaeth i gleifion thyroid y mae arnyn nhw angen diet isel mewn ïodin.

Rwy’n teimlo ei bod hi’n bwysig iawn fel gweithiwr iechyd proffesiynol Macmillan i sefydlu a chynnal cysylltiadau cryf â Macmillan. Rwy’n aelod o Fforwm Proffesiynol Macmillan Allied Health ac rwyf wedi gweithio ar Adnodd Bwyta’n Dda Teimlo’n Dda gyda Jill Scott. O ganlyniad cefais fy ngwobrwyo â rôl anrhydedd gan y Gymdeithas Ddieteg Brydeinig – roedd hyn yn fraint fawr imi. Hefyd rwyf wedi bod yn rhan o’r gweithgor a fu’n gweithio ar gynhyrchu set o adnoddau  ‘Deg Awgrym Gorau’ am faeth ar gyfer gwahanol gamau canser: Yn ystod triniaeth ganser; Ar ôl y driniaeth ac wrth wella; Canser datblygedig / Diwedd Bywyd; Byw gyda Chanser a’r Tu Hwnt iddo.

Felly fel y gallwch weld mae fy mywyd fel Dietegydd Arweiniol Clinigol Macmillan yn amrywiol iawn ac nid gwaith clinigol wyneb yn wyneb ydyw’n unig. Dros y blynyddoedd rwyf wedi rhoi gofal dieteg i gleifion hyfryd ac mae cwrdd â nhw’n rhoi boddhad enfawr imi yn fy swydd.

Twitter: @SLewisRD

Improving outcomes for people living with and beyond cancer

michelle_lloyd-cropped-lightenedMichelle Lloyd has worked within the NHS for 25 years. Here she explains what her role as a Macmillan Person-Centred Care Project Manager involves, and why it is her most rewarding role to date.

Hi, My name is Michelle Lloyd and I am the Macmillan Person-Centred Care Project Manager within Cwm Taf University Health Board.

I have been in post since April 2015. It is such a valuable role.  It’s really busy with so many exciting areas.  I am almost in my 25th year of working within the NHS and I can honestly say that this is the most rewarding role I have undertaken!  I feel lucky here within Cwm Taf UHB to be part of the Patient Care and Safety Team.

I report directly to the Assistant Director of Nursing who is also the Lead for Cancer Nursing. My placement within the nursing structure has been so valuable as it gives me direct access to our wonderful Specialist Cancer Nurses and Acute Oncology Nurses who are of paramount importance in implementing Person-Centred Care here within Cwm Taf UHB.

I am very grateful for the support of Alun Tandy, Macmillan Development Manager and the support given by Gillian Knight, Macmillan Lead Nurse/South Wales Cancer Network who is a key source of advice and support to me and many of our Specialist Cancer Nurses.

I really have great access to senior cancer services staff including the Lead Cancer Clinician, Mr Sandeep Berry who I work closely with.  Being an integrated member of the Cancer Services Structure has enabled me to raise the profile of person-centred care in such an effective way.

Macmillan Cancer Support define person-centred care as “ensuring that the needs of the person living with cancer are always at the heart of how services are planned, not the needs of the service providers”.

One way, adopted within Cwm Taf UHB of embedding person-centred care is through the Macmillan Recovery Package. The package details a series of key interventions which, when delivered together, can greatly improve outcomes for people living with and beyond cancer.  It is Central to Macmillan Cancer Support’s objective of achieving it’s ‘9 Outcomes’:

macmillan 9 outcomes

Cancer is moving from a disease where mortality was often the norm to one where more people can expect to live healthy and active lives for many years after their treatment is over.  This presents the NHS with new challenges particularly around ensuring that patient’s needs are holistically assessed and met via a Care Plan and that patients receive accurate information which helps with self-management.

The Recovery Package is made up of the following elements:

  • A Holistic Needs Assessment (HNA) and care planning at key points of the care pathway.
  • A Treatment Summary completed at the end of each acute treatment phase and sent to the patient and the GP.
  • A Cancer Care Review completed by the GP or practice nurse to discuss the person’s needs. The review should happen within six months of the GP practice being notified that the person has a cancer diagnosis, but this should be the start of an ongoing conversation required across the cancer care pathway.

Significant progress has already been made towards the implementation of the Macmillan Recovery Package here within Cwm Taf UHB especially in implementing Holistic Needs Assessment and Care Plans.  The Holistic Needs Assessment addresses the physical, emotional, practical, spiritual, psychological, social and financial needs of cancer patients helping to ensure that that the care delivered is person-centred.

Gwella canlyniadau i bobl yn byw gyda a thu hwnt i ganser

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Mae Michelle Lloyd wedi gweithio o fewn y GIG am 25 mlynedd. Yma eglura beth mae ei rôl fe Rheolwr Prosiect Gofal gyda’r Unigolyn yn Ganolbwynt yn ei olygu a pham mai hon yw’r rôl fwyaf boddhaol hyd yma.

Helô, Michelle Lloyd ydw i a fi yw Rheolwr Prosiect Gofal sy’n Canolbwyntio ar yr Unigolyn Macmillan ym Mwrdd Iechyd Prifysgol Cwm Taf.

Rwyf wedi bod yn y swydd ers mis Ebrill 2015, mae’n rôl mor werthfawr, mae’n brysur iawn gyda chymaint o feysydd gwaith diddorol ar y gweill.  Rwyf bron wedi treulio 25 mlynedd yn gweithio yn y GIG a gallaf ddweud yn onest mai dyma’r rôl fwyaf heriol imi ei gwneud erioed!

Rwy’n teimlo’n ffodus yma ym Mwrdd Iechyd Prifysgol Cwm Taf fy mod i’n rhan o’r Tîm Gofal a Diogelwch Cleifion, rwy’n adrodd yn uniongyrchol i’r Cyfarwyddwr Cynorthwyol Nyrsio sydd hefyd yn Arweinydd ar gyfer Nyrsio Canser. Mae fy lleoliad yn y strwythur nyrsio wedi bod mor werthfawr gan ei fod yn rhoi mynediad uniongyrchol imi i’n Nyrsys Canser Arbenigol gwych a Nyrsys Oncoleg Acíwt sy’n hynod o bwysig wrth weithredu Gofal sy’n Canolbwyntio ar y Person yma ym Mwrdd Iechyd Prifysgol Cwm Taf.

Rwy’n ddiolchgar iawn am gymorth Alun Tandy, Rheolwr Datblygu Macmillan ac am y cymorth a roddir gan Gillian Knight, Nyrs Arweiniol Macmillan/Rhwydwaith Canser De Cymru sy’n ffynhonnell cyngor a chymorth allweddol imi ac i nifer o’n Nyrsys Canser Arbenigol.

Mae gennyf fynediad gwych i uwch staff y gwasanaethau canser gan gynnwys Mr Sandeep Berry, y Clinigwr Canser Arweiniol yr wyf yn cydweithio’n agos ag ef.  Mae bod yn rhan wedi’i hintegreiddio o’r Strwythur Gwasanaethau Canser wedi fy ngalluogi i godi proffil Gofal Sy’n Canolbwyntio ar y Person mewn ffordd mor effeithiol.

Mae Cymorth Canser Macmillan yn diffinio gofal sy’n canolbwyntio ar y person fel gofal sy’n “sicrhau mai anghenion y person sy’n byw gyda chanser sydd bob amser wrth wraidd sut caiff gwasanaethau eu cynllunio, nid anghenion y darparwyr gwasanaeth.”

Un ffordd o wreiddio gofal sy’n canolbwyntio ar y person ym Mwrdd Iechyd Prifysgol Cwm Taf yw drwy Becyn Gwella Macmillan. Mae’r pecyn yn rhoi manylion cyfres o ymyriadau allweddol sydd, o’u cyflawni gyda’i gilydd, yn gallu gwella canlyniadau’n fawr i bobl sy’n byw gyda chanser a’r tu hwnt iddo.  Mae’n ganolog i nod Cymorth Canser Macmillan o gyflawni ei ‘9 Canlyniad’, sef:-

  • Cefais ddiagnosis cynnar
  • Rwy’n deall, felly rwy’n gwneud penderfyniadau da
  • Rwy’n cael y driniaeth a’r gofal sydd orau ar gyfer fy nghanser a’m bywyd
  • Mae’r rhai o’m cwmpas i’n cael cefnogaeth dda
  • Caf fy nhrin ag urddas a pharch
  • Rwy’n gwybod beth gallaf ei wneud i’m helpu fy hun a phwy arall a all fy helpu
  • Rwy’n gallu mwynhau bywyd
  • Rwy’n teimlo’n rhan o gymuned a chaf fy ysbrydoli i roi rhywbeth yn ôl
  • Rwyf eisiau marw’n dda.

Mae canser yn symud o fod yn afiechyd lle roedd marwolaeth yn arfer bod yn norm i un lle gall pobl ddisgwyl byw bywydau iach ac egnïol am nifer o flynyddoedd ar ôl i’w triniaeth ddod i ben.  Mae hyn yn rhoi heriau newydd i’r GIG, yn enwedig yn ymwneud â sicrhau bod anghenion cleifion yn cael eu hasesu’n gyfannol a’u cwrdd drwy Gynllun Gofal a bod cleifion yn cael gwybodaeth gywir sy’n helpu gyda hunanreoli.

Mae’r Pecyn Gwella’n cynnwys yr elfennau canlynol:-

  • Asesiad Anghenion Cyfannol (Holistic Needs Assessment (HNA)) a chynllunio gofal ar adegau allweddol o’r llwybr gofal.
  • Crynodeb o’r Driniaeth wedi’i gwblhau ar ddiwedd pob cam triniaeth acíwt ac wedi’i anfon at y claf a’r meddyg teulu.
  • Adolygiad Gofal Canser wedi’i gwblhau gan y meddyg teulu neu nyrs y practis i drafod anghenion yr unigolyn. Dylai’r adolygiad ddigwydd cyn pen chwe mis ar ôl i’r feddygfa gael gwybod bod y person wedi cael diagnosis canser, ond dylai hyn fod yn ddechrau sgwrs barhaus y mae ei hangen ar draws y llwybr gofal canser.

Gwnaed cynnydd arwyddocaol yn barod tuag at weithredu Pecyn Gwella Macmillan yma ym Mwrdd Iechyd Prifysgol Cwm Taf yn enwedig o ran gweithredu Asesiadau Anghenion Cyfannol a Chynlluniau Gofal.  Mae’r Asesiad Anghenion Cyfannol yn rhoi sylw i anghenion Corfforol, Emosiynol, Ymarferol, Ysbrydol, Seicolegol, Cymdeithasol ac Ariannol cleifion canser sy’n helpu i sicrhau bod y gofal a roddir yn canolbwyntio ar yr unigolyn.

It’s time to challenge widespread beliefs about cancer

Sgroliwch i lawr ar gyfer y blog Cymraeg

Helen Tyler 001Helen Tyler, Macmillan Head of Therapies at Velindre Cancer Centre in Cardiff, believes that person-centred care should be “enabling, coordinated, dignified and respectful.” As survival rates for cancer improve, Helen argues that we should be using a variety of methods to encourage people affected by cancer to live as healthy and as active a life as possible- for as long as possible.

The dramatic improvements in survival rates mean that we need to challenge widespread beliefs about cancer.

Cancer is increasingly an illness which might be cured or which might have the characteristics of a long term or chronic condition that people can live with for many years.

For the increasing numbers of people living with and beyond cancer, their carers, and their families, it is very important that they have the support and services that they need to make adjustments to the changes which have occurred as a result of the disease or its treatment.

People affected by cancer should be able to reach their maximum potential and achieve the best possible quality of life. RS10366__T0C6722-hpr ALT

The vision of the Velindre Cancer Centre Therapies team (which includes physiotherapy, occupational therapy, dietetics, speech and language therapy, working in close collaboration with clinical psychology and complementary therapies), is to ensure that people living with and beyond cancer have a personalised holistic needs assessment at diagnosis.  This assessment should repeated at intervals during the cancer journey to gather and discuss information to understand what the person living with and beyond cancer knows, understands and needs.

A personalized holistic needs assessment should be focused on the whole person:

  • Physical
  • Practical
  • Emotional
  • Spiritual
  • Psychological
  • Social
  • Environmental
  • Financial

From this assessment, a co-productive, person-centred care plan is provided with relevant information to empower patients to manage their condition. Person-centred care should be enabling, coordinated, dignified and respectful

Ten Top Tips for patients affected by cancer to promote self-management

My ten top tips for patients affected by cancer to promote co-productive, supported, self-management are:

  1. Discuss your needs and develop a care plan
  2. Ask about a treatment summary
  3. Find your main contact
  4. Be aware of any post-treatment symptoms
  5. Get support with day to day concerns
  6. Talk about how you feel
  7. Try to lead a healthier life style
  8. Know what to look out for
  9. Be aware of your own health
  10. Share your experiences

Coordination across primary and secondary care and across health and social care is also necessary. There should also be a requirement for the routine use of patient reported outcome measures to monitor problems as defined by the patients.

During, and following cancer treatment, some people will be left with physical or psychological problems which affect their health and wellbeing. There are some very practical actions that can be taken to make a difference to people following cancer treatment.

Our vision is for people to be informed and prepared for the long term effects of living with and beyond cancer, and that health and care services are responsive to individual needs to ensure access to specialist care when needed. This may be achieved from:

Information, education or advice e.g.:

  • leaflets
  • top tips
  • use of media

Group treatment interventions e.g.:

Individual complex care e.g:

Our strategy is that people affected by cancer are supported to live as healthy and active a life as possible for as long as possible. For some, cancer can be an ‘acute illness’ which can be cured by initial treatment. Being ‘cured’ however does not mean one is necessary well.

Chronic consequences of treatment may need to be managed over months and years, consequences which often have a devastating impact on daily life. For those with advanced disease, we want to support them to have an active and independent life as possible.

If you’re living with or looking after someone with cancer and need information or support, call 0808 808 00 00 or visit www.macmillan.org.uk.

Macmillan Cancer Support in Wales believes that every person with cancer should have a holistic needs assessment undertaken using a validated tool. The outcomes from this discussion, and the actions agreed with the patient should be set out in a written care plan, a copy of which should be offered to the patient. Read more about our Manifesto calls.

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Mae’n bryd herio’r syniadau cyffredin am ganser

Mae Helen Tyler, Pennaeth Therapïau Macmillan yng Nghanolfan Canser Felindre yng Nghaerdydd, yn credu y dylai gofal sy’n canolbwyntio ar unigolion fod yn “galluogi, wedi’i gydlynu, yn urddasol ac yn parchu.” Wrth i’r cyfraddau goroesi ar gyfer canser wella, mae Helen yn dadlau y dylem fod yn defnyddio amrywiaeth o ddulliau i annog y rhai sydd wedi’u heffeithio gan ganser i fyw bywyd mor iach a phrysur ag sy’n bosibl – cyn hired ag sy’n bosibl.Helen Tyler 001

Gan fod cyfraddau goroesi wedi gwella’n syfrdanol, mae angen inni herio syniadau cyffredin am ganser. Yn fwyfwy, mae canser yn afiechyd a allai gael ei wella neu a allai fod â nodweddion cyflwr tymor hir neu gronig y gall pobl fyw gydag ef am nifer o flynyddoedd.

Felly mae’n bwysig iawn fod y nifer cynyddol o bobl sy’n byw gyda chanser a’r tu hwnt iddo, eu gofalwyr a’u teuluoedd yn cael y cymorth a’r gwasanaethau sydd eu hangen arnyn nhw i addasu’r newidiadau sydd wedi digwydd o ganlyniad i’r clefyd neu’r driniaeth, a hynny fel y gallant gyflawni eu potensial mwyaf posibl a chael yr ansawdd bywyd gorau posibl.

Gweledigaeth tîm Therapïau Canolfan Ganser Felindre sy’n cynnwys Ffisiotherapi, Therapi Galwedigaethol, Dieteteg, Therapi Lleferydd ac Iaith, gan gydweithio’n agos â Seicoleg Glinigol a Therapïau Cyflenwol, yw sicrhau bod y rhai sy’n byw gyda chanser a’r tu hwnt iddo’n cael asesiad anghenion cyfannol wedi’i bersonoli adeg y diagnosis, a bod hynny’n cael ei ailadrodd bob hyn a hyn ar hyd eu taith ganser i gasglu a thrafod gwybodaeth er mwyn deall yr hyn y mae’r person sy’n byw gyda chanser a’r tu hwnt iddo’n ei wybod, ei ddeall a beth sydd ei angen arno.

Dylai ganolbwyntio ar y person cyfan:

  • Yn gorfforol
  • Yn ymarferol
  • Yn emosiynol
  • Yn ysbrydol
  • Yn seicolegol
  • Yn gymdeithasol
  • Yn amgylcheddol
  • Yn ariannol

O’r asesiad hwn, darperir cynllun gofal ar y cyd sy’n canolbwyntio ar yr unigolyn gyda gwybodaeth berthnasol fel y gall cleifion reoli eu cyflwr. Dylai gofal sy’n canolbwyntio ar yr unigolyn alluogi, dylai gael ei gydlynu, dylai fod yn urddasol ac yn dangos parch.

10 Awgrym Gwych ar gyfer cleifion er mwyn hyrwyddo hunanreoli ar y cyd, gyda chymorth:

  1. Trafodwch eich anghenion a datblygu cynllun gofal
  2. Gofynnwch am grynodeb o’r driniaeth
  3. Dewch o hyd i’ch prif berson cyswllt
  4. Byddwch yn ymwybodol o unrhyw symptomau ar ôl y driniaeth
  5. Gofynnwch am gymorth gyda phryderon o ddydd i ddydd
  6. Siaradwch am sut rydych chi’n teimlo
  7. Ceisiwch ddilyn ffordd o fyw iachach
  8. Dewch i wybod am beth y dylech chi gadw llygad
  9. Byddwch yn ymwybodol o’ch iechyd eich hun
  10. Rhannwch eich profiadau

 Mae angen cydlynu ar draws gofal cynradd ac uwchradd ac ar draws gofal iechyd a gofal cymdeithasol hefyd. Mae gofyn defnyddio fel mater o drefn fesurau canlyniadau y mae’r cleifion yn rhoi gwybod amdanyn nhw i fonitro problemau fel y’u diffiniwyd gan y cleifion.

RS10366__T0C6722-hpr ALTYn ystod triniaeth ganser ac ar ei ôl bydd rhai pobl â phroblemau corfforol neu seicolegol sy’n effeithio ar eu hiechyd a’u lles. Mae rhai camau ymarferol iawn y gellir eu gwneud i wneud gwahaniaeth i bobl ar ôl triniaeth ganser.

Ein gweledigaeth yw i bobl gael gwybodaeth am effeithiau tymor hir byw gyda chanser a’r tu hwnt iddo a’u bod yn barod amdanynt, a bod gwasanaethau iechyd a gofal yn ymateb i anghenion unigolion er mwyn sicrhau eu bod yn cael mynediad i ofal arbenigol pan fydd angen. Gall hyn fod ar ffurf:-

  • Gwybodaeth, addysgu neu gyngor, e.e.:
    • taflenni
    • awgrymiadau gwych
    • defnyddio’r cyfryngau
  • Ymyriadau triniaeth grŵp, e.e.:
    • rheoli blinder
    • rheoli pwysau
    • rheoli pryder
    • ymwybyddiaeth ofalgar (Mindfulness)
    • byw gydag ansicrwydd
    • rheoli gweithgarwch corfforol
    • adsefydlu galwedigaethol
  • Gofal cymhleth unigol, e.e.:
    • ffisiotherapi – symudedd, swyddogaeth, aciwbigo
    • therapi galwedigaethol – darparu cymhorthion ac addasiadau
    • dieteg – gofynion maethol a diet penodol
    • therapi Lleferydd ac Iaith – llyncu, cyfathrebu
    • therapi cyflenwol – Adweitheg (Reflexology), tylino’r corff

Ein strategaeth yw y dylai rhai sydd wedi’u heffeithio gan ganser gael cymorth i fyw bywyd mor iach ac egnïol ag sy’n bosibl gyhyd ag sy’n bosibl. I rai, gall canser fod yn ‘afiechyd acíwt’ y gellir ei wella drwy driniaeth gychwynnol. Ond dyw ‘cael eich gwella’ ddim yn golygu eich bod chi’n iach o angenrheidrwydd. Efallai bydd angen rheoli canlyniadau cronig triniaeth dros fisoedd a blynyddoedd, canlyniadau sy’n aml yn cael effaith ddinistriol ar fywyd bob dydd. Gyda’r rhai sydd â’r afiechyd wedi datblygu ymhellach, rydym eisiau eu cynorthwyo er mwyn iddyn nhw gael bywyd mor egnïol ac annibynnol ag sy’n bosibl.

Os ydych chi’n byw gyda rhywun sydd â chanser arno neu’n gofalu am rywun fel hyn, a bod arnoch angen gwybodaeth neu gymorth, ffoniwch 0808 808 00 00 neu ewch i  www.macmillan.org.uk.

Mae Cymorth Canser Macmillan  yng Nghymru’n credu y dylai pob un sydd â chanser gael asesiad anghenion cyfannol wedi’i wneud gan ddefnyddio adnodd wedi’i ddilysu. Dylai canlyniadau’r drafodaeth hon, a’r camau gweithredu y cytunwyd arnynt gyda’r claf gael eu gosod mewn cynllun gofal ysgrifenedig, a dylai’r claf gael cynnig copi ohono. Darllenwch ragor am y pethau y mae ein  Maniffesto yn galw amdanynt.
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