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1 Example title for notes and handouts
1 April 2017 Strengthening palliative care through health promotion Bruce Rumbold, Palliative Care Unit, School of Public Health, La Trobe University, Victoria Example footer for notes and handouts



4 Downstream and Upstream
Clinical services Individual focus Specific problem-solving Expert interventions Biological science perspectives dominant Public health Community focus Network analysis Culture change Social science perspectives dominant

5 Health Promotion Preventive strategies Harm-minimisation strategies
Early interventions Community development Participatory/partnership relationships Ecological approach to health & safety

6 Public Health & Palliative Care
Public health approaches: Health promoting palliative care Compassionate communities Need health promoting palliative care services to facilitate and contribute to compassionate communities Need to locate end of life care outside the health services for genuine and sustainable community change to take place.

7 The tiered approach Fitch, M
The tiered approach Fitch, M. (2000) Supportive care for cancer patients, Hospital Quarterly 3: 39-46 ALL PEOPLE MANY SOME FEW The step-up approach with increasing specialisation or intensity for more complex needs Respectful and dignity conserving care Good communication and information Screening for need. Link with self-help and peer support programs Access practical assistance Participate in psycho-educational groups Behavioural interventions eg relaxation . Specialist care for identified issues eg depression, anxiety, relationship problems and more complex physical or social issues. Intensive or comprehensive care for acute or complex and multi-factorial psychological and social problems.

8 Conceptualising Health Promoting Palliative Care
SERVICE REORIENTATION GOAL: A HEALTH PROMOTING PALLIATIVE CARE SERVICE Develop personal skills Create supportive environments Strengthen community action Build public policy

9 Community café conversations on death, dying, loss and care
Café to Go Community café conversations on death, dying, loss and care Could holding a café in your community be a possibility?

10 Strengthening Palliative Care in Victoria through Health Promotion
Examples of successful implementation that encourage community conversations Book and journal club discussions on publications like Tuesdays with Morrie or The Spare Room Café Conversations in local communities Movie nights that address death and dying with discussion afterwards such as The Bucket List or Tulip Consortium logo Strengthening Palliative Care in Victoria through Health Promotion 10

11 Do you belong to other groups in your community?
Be brave and look for opportunities to use ideas such as these as a way to encourage people to talk about life and loss Multicultural club

12 Key components of project
Coordination/leadership A designated, appropriately-skilled person/group accountable to palliative care services and community Consultation A resource group of interested people from various community sectors Support Local expertise, La Trobe University PCU Proven strategies and resources

13 Terms of the partnership: The checklist Require at least one of 1-4, all of 5-7
Prevention Harm-minimisation Early interventions Changing settings or environment Participatory/partnership Sustainable Evaluated

14 What else could be done? Seek partners to organise: Plant a Tree and Remember Mum on Mothers Day event A Community Christmas Tree of Remembrance Community information sessions EG: Coping with Christmas Living with grief Living with Life threatening illness How to Care, What to Say …………the list goes on Invite community kitchen facilitators, physical fitness group leaders, school peer support leaders, youth group leaders….

15 What else could be done? Reflective place at the cemetery
Support program for carers Death education in schools Eg: Café conversations Visiting an elderly friend in aged care program Loss and grief art show Memory boxes

16 Project findings to date
LEADERSHIP ROLE for palliative care services in initiating end of life discussions in local communities NON- THREATENING approach that draws on people’s experiences and questions is effective in initiating end of life discussions DIVERSE rewarding PARTNERSHIPS Requires a LONG TERM COMMITMENT; continuing attention rather than occasional promotions PC VOLUNTEERS are key AMBASSADORS in linking palliative care services with local community structures and needs.

17 Larger issues to be addressed
Governance: locating end of life care policy – more than a health issue The shameful death and social exclusion

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