Health Promoting Palliative Care What has health promotion got to do with death, dying

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Health Promoting Palliative CareWhat has health
promotion got to do with death, dying grief ?

• Helen Corbett
• Health Promoting Palliative Care Coordinator
• Contact helen.corbett_at_nh.org.au or phone [phone]

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Project Partners

• Members of the North West Metropolitan
  Palliative Care Consortium
• La Trobe University Palliative Care Unit
• Department of Human Services

Acknowledgements Barbara Young (Hume Region
HPPC Coordinator) Dr. Colleen Nordstrom
(LaTrobe University) Sue Salau (Palliative Care
Victoria) those people whose photographs appear
in the presentation
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Some alarming statistics

• We have a 25 chance of developing hypertension
  during our life
• We are about 5 times more likely to have a stroke
  if we smoke
• We have a 30 chance of developing some form of
  cancer in later life
• We have a 100 chance of dying at some stage in
  our life!!

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The great majority of people who are living with
cancer and other life limiting or terminal
diseases spend their time with families, work
mates and friends, outside of any formal health
care system. Many people feel unprepared when
such illnesses befall them or others. In many of
our local communities we need to relearn the old
ways of caring for one another those persons
who are dying and those left behind (Kellehear
2005).
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Ottawa Charter Health Promotion - 1986

• In promoting health we should ..
• Build public policies that support health
• Create supportive environments
• Strengthen community action
• Develop personal skills
• Reorient health services

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Public health perspective

• Health is more than just the absence of disease
• Health is created in communities that attend
  to the richness of human experience
• Health is socially determined a healthy
  environment is a fundamental requirement
• Strategies to address health needs involve much
  more than simply providing health services

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Public health strategies include

• Prevention strategies
• Harm minimisation strategies
• Early interventions
• Community development strategies
• Ecological approach to health safety

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Public health questions for Palliative Care

• How can we support good deaths minimise harm
  from the ensuing grief?
• How can the knowledge that has been accumulated
  by palliative care programs become more available
  to the community?
• How can end-of life issues become more a part of
  life (than just the end!)?

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• Principal 7 of the DHS
• Strengthening Palliative Care Policy 2004-09
• People with a life-threatening illness and their
  carers and families are supported by
• their communities

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Health promoting palliative care is about

• Building on the communitys ability to help care
  for those with a life threatening illness as
  neighbours, family and friends
• Reminding the community of the place of dying and
  death as a part of life

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People living with a life threatening illness
look to others for support as they travel their
journey
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A health promotion perspective

• Clinical health care attends to downstream
  factors (what is happening at the moment)
• Public health attends to the upstream factors
  that have influenced what is happening downstream
  and it seeks to minimise harm from downstream

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Dying to know Bringing death to life (2007)
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Dying to know Bringing death to life (2007)
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We are going down this track because

• Local communities are where most people want to
  remain connected when they are dying
• Services arent enough on their own and cant
  provide all that people need

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Where are the signs directing us to go this way?

• Successful community and public education about
  palliative care means more people expect this
  care how can existing professional services
  maximise physical, social, emotional, cultural
  and spiritual support in a resource limited
  environment?

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Where are the signs directing us to go this way?

• Palliative care is more than purely clinical,
  end stage, bedside care for people dying or
  grieving earlier referrals and mainstreaming is
  now Australian Policy

• Increasing ageing population will put further
  demands on palliative resources into the future

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End of life issues as health concerns

• Current system is problem focussed
• Very individualised
• Professionalised
• Episodic

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Some of the perceived and real barriers to
implementing health promoting palliative care by
health or palliative care staff

• Limited resources available to commit to
  sustainable strategies
• Constraints of current position descriptions
  (including time) to include health
  promotion/community development work in roles
• Feeling of pressure to have to organise yet
  another thing

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Examples of successful implementation

• Reflective spaces
• Support programs for carers
• Death education for schools
• World Café conversations on death and dying
• Creative arts responses
• Book journal club discussions on publications
  like Tuesdays with Morrie

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Examples of successful implementation

• Community information sessions on issues like
  taking control or Coping with special
  occasions
• Staff education around how to care, what to
  say or cultural issues around death and dying

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With what resources would you like the ill person
and their family to arrive downstream in our care?

• What sort of resources might produce such ideal
  people?