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Palliative Care for Neurological Patients
By John Robson
Through the efforts of Dr. Balfour Mount, MNI Advisory Board member Kappy
Flanders and others, McGill University is an international leader in
palliative care, an essential element in the health care continuum. This
effort has focused largely on terminally ill cancer patients and the
management of intractable pain. But patients with incurable neurological
conditions are a rapidly growing segment of the population. In 21st century
Canada, it is estimated that 30% of people over age 80 will ultimately
require palliative care because of progressive neurological disease.
In addition to pain, these patients exhibit a constellation of symptoms
such as seizures, paralysis, and personality changes that burden current
palliative care programs. Consequently, these individuals are usually
treated on a case-by-case basis outside the dedicated palliative care
facilities. Caring for such patients and alleviating their suffering during
the critical period at the very end of life, when symptoms and disabilities
are worst and when fear and anxiety surge, challenges families and health
care professionals. Developing effective palliative care for these patients
and their families requires an integrated approach designed to manage
symptoms and provide assistance with important end of life decisions that
must be faced.
In response to the growing need, the Montreal Neurological Institute and
Hospital will create the first Neuro-Palliative Care Centre in North
America, dedicated to patients with terminal illnesses of the nervous
system. This clinical care and research facility will develop and deliver
specialized supportive treatments for patients who are at the end of life.
The Neuro-Palliative Care Centre will have a clinical mission: to provide
comfort and support for patients dying from neurological diseases, and to
help those who are losing a loved one. Professional staff will create an
environment to maximize the dignity and quality of life for these patients.
The setting will be home-like and nurturing, and have the clinical
infrastructure required to deliver appropriate medical care for these
special patients. Staff will be carefully selected and trained for this
The Neuro-Palliative Care Centre will have a research mission: to define
and develop evidence-based treatments and best practices to care for
patients with symptoms particular to diseases of the nervous system.
The Neuro-Palliative Care Centre will have a training mission: to educate
caregivers in other hospital-based and community-based palliative care
facilities on caring for the neurological patients and families who come to
them for help.
To fully realize the goals of the Neuro-Palliative Care Centre, space will
be renovated on the 4th floor of the Neuro to create a state-of-the-art,
self-contained, 8-bed unit for patient care, family support and research.
The Centre will be designed to provide neurological patients and their
families with a specialized supportive environment and the best possible
resources for alleviating suffering while preserving dignity at life’s end.
The Neuro-Palliative Care Centre will serve as a research and training
resource that will become a model for centres world-wide, and will augment
the place of McGill and the MUHC as pioneers in the field of palliative
Dr. John Robson is the Associate Director, Scientific Affairs. Comments may
be directed to him at
Recent News & Events
John Robson, Associate Director, Scientific Affairs, has been named
Associate Dean for the Faculty at the Faculty of Medicine. John will join
Rich Levin, McGill’s Vice-Principal for Health Affairs and Dean of the
Faculty of Medicine, and will be responsible for faculty recruitment,
promotion, retention and other academic matters. In his note to the Neuro,
John said, “The decision to leave the Neuro was not an easy one. I have
thoroughly enjoyed my tenure here and there are exciting times ahead. The
North Wing construction is underway; we are about to launch a capital
campaign; and the federal government is sending us $15M along with an
acknowledgement that this is truly a special place! However, in the end the
opportunity to do something new - to move into a larger domain with a new
set of challenges - was too attractive for me.”
John served the Neuro for almost 10 years and took a central role in hiring
20 faculty members, adding 30,000 square feet of space, renovating clinical
and research areas, and raising our success rates in CIHR grant
competitions to be consistently twice the national average or better. John
celebrated the reintegration of the Institute and Hospital and lauds his
colleagues at the Neuro for the excellence, dedication, collegiality and
pride that permeates the Neuro. John is very pleased to remain part of the
McGill University community and assures us the the Neuro will have another
friend and advocate in the Dean’s office.
Colleagues and friends are welcome to toast John at a reception on May 9 at
4:30 pm in the Neuro’s de Grandpré Communications Centre.
Special Welcome to Former Fellows
We are proud of our former fellows who trained at the Neuro and are now
dispersed in successful careers around the world. Under the leadership of
Eva and Fred Andermann, Bill Feindel and George Karpati, we are reaching
out to strengthen our ties with more than 1400 former fellows. Welcome to
those of you receiving the MNI Bulletin for the first time.
The Neuro community mourns the sudden death of neuropsychologist Laughlin
Taylor on April 7. Mr. Taylor came to the Neuro to assist Brenda Milner in
1957 and completed a Master of Science in psychology at McGill in 1961.
Over more than 50 years at the Neuro, he contributed significantly to
research and to the clinical assessment of patients. In 1973, Mr Taylor was
named the Head of the Clinical Neuropsychology Department at the Neuro and
in 2001, he was honoured by the University of Lethbridge with the Doctor of
Science, honoris causa. Known as a dedicated patient advocate, Mr. Taylor
spent innumerable hours with patients and their families to help them
understand and adapt to brain disorders, and worked with public agencies to
explain the behavioral challenges for people with brain injuries.
Eulogizing Mr Taylor, Gabriel Leonard remarked on his love of children and
zest for life: recounted tales of Laughlin’s talents as a singer, dancer
and actor, and commented on his love of travel, nature, art, architecture,
film and fine wine. Condolences are offered to Mr Taylor’s children,
Malcolm and Laura, and to his many friends and colleagues.
Penfield lecture: Scott
Scott Johnson, founder and CEO of the Myelin Repair Foundation (MRF)
delivered the Wilder Penfield Lecture on April 26. Diagnosed with Multiple
Sclerosis (MS) at the age of 20, Mr Johnson had a successful business
career as an executive and entrepreneur. In 2002 he established the MRF to
accelerate the rate of discovery leading to treatments for MS, and
developed a unique model that blended the best practices in business with
those in academic scientific discovery. This initiative resulted in a
highly collaborative, cross-continental research group that has
dramatically advanced research on myelin, thus giving promise for new
treatments. Director Dave Colman’s lab studies myelin, the insulating
sheath on nerve fibers that speeds up nerve transmission, and is one of the
5 research labs in North America funded by MRF.
Thanks to all the faculty, staff, students, and special guests that
attended the lecture. It was great to see everyone there.
Newest MNI Podcast: A Look Inside a Child’s Brain
The largest, most comprehensive database of normal brain development will
soon be available to physicians and scientists around the world. Alan
Evans, who has coordinated the development of this pediatric brain
database, describes what the healthy brain looks like from birth to four
years. To view this MNI podcast, visit http://mnimedia.mcgill.ca/podcasts/
Please see the MNI calendar for the schedule of
lectures and events.
Neuropsychology Day will be May 7 in the Jeanne Timmins
Amphitheatre. All are welcome to view poster presentations by members of
the Neuropsychology / Cognitive Neuroscience Unit from 2-4 pm. At 4:30,
Lizabeth Romanski, from University of Rochester, will deliver the tenth
annual Brenda Milner Lecture in Cognitive Neuroscience, entitled Encoding
and integration of faces and voices in the frontal lobe.
The Neuroscience Nursing Awards ceremony will be May 8 at
2 pm in the Jeanne Timmins Amphitheatre. Please join us in recognizing the
On May 8, neurologist Gian Borasio, Chair of Palliative
Medicine at University of Munich, will deliver the 10th Annual Sandra
Goldberg Lecture, Palliative Care Isn't Just About Cancer, at 5:30 pm in
the Charles Martine Amphitheatre at McGill’s McIntyre Medical Sciences
Building. The lecture this year is sponsored by the MNI, the Council on
Palliative Care and the Goldberg family. A reception will follow the
On May 25, the public is welcome to Migrating Minds and
Methods - Trajectories of the Neurosciences in North-America after 1933 at
McGill’s Thomson House on McTavish. For more information, contact Frank
Stahnisch, Department of Social Studies of Medicine, 514-398-6933.
May 28, Daniel Dennett, MNI Advisory Board member, author
and philosopher, will deliver a lecture, From Animal to Human: The
evolution of human culture, in the MNI’s Jeanne Timmins Amphitheatre at 4
pm. His books, including Consciousness Explained and Darwin’s Dangerous
Idea have inspired substantial work in neuroscience and philosophy.
Dennett, Co-director of Tufts University Center for Cognitive Studies, will
receive an honorary Doctor of Science degree from McGill earlier that day.
North Wing Expansion
The Neuro’s new North Wing is moving right along. Daily blasting means that
excavation of rock is happening almost faster than seems possible and our
‘hole in the ground’ is getting bigger and bigger. Staff, students, and
patients and their families are being very understanding as we proceed with
this much needed expansion of facilities. Please contact Sandra McPherson
at Sandra McPherson or at
Fred Pennell with questions
about the project.
Congratulations to …
Fred and Eva Andermann on the birth of their first
grandchild, a girl, and to their daughter (new mom) Lisa Andermann who is
Assistant Professor, Department of Psychiatry at the University of Toronto.
Liam Durcan, neurologist and novelist, on the success of
his debut novel, García’s Heart, which is making waves with enthusiastic
reviews across Canada.
Thanks to …
Iris Biteen, Lucia Fabijan, Maria Mastracchio, Nancy
Wright and Deborah Radcliffe-Branch for
organizing the Building Blocks for Self Care training program attended by
volunteers and health care professionals who will become leaders of new
groups for patients with chronic diseases.
Director - David R. Colman, PhD
Senior Management - Mark Angle, MD; Tom Gevas; Marilyn Kaplow; Elizabeth
Kofron, PhD; Patricia O'Connor; John Robson, PhD; Catherine Rowe
MNI Bulletin Editors: Elizabeth Kofron, PhD & Sandra McPherson,
Please send any items for the MNI Bulletin to
Sandra McPherson or