What does Public Health have to do with Palliative Care?

by Dr. Denise Marshall - Pallium Canada

Today, every area of healthcare has a public health agenda. That is, every area of healthcare except palliative care. Palliative care would benefit from a public health approach by developing a wider community context in which palliative care services can make their contributions. A public health approach takes the responsibility of palliative care from a few highly trained specialists to a community that considers it “everybody’s business.”

Public Health Palliative Care is also known as Health Promoting Palliative Care (HPPC) and was developed as a social movement. The underlying philosophy behind HPPC is the Ottawa Charter for Health Promotion that was established in 1986, including 5 core principles:

• Building public policies that support health
• Creating supportive environments
• Strengthening community action
• Developing personal skills
• Reorienting health services

HPPC places emphasis on community development and partnerships across all sectors to empower communities, instead of emphasizing the responsibilities of health services as the primary advocate of change. This framework supports those with life limiting illnesses and their families by encouraging, sustaining and resourcing community capacity. The framework also provides opportunities to enhance access to palliative services, which is particularly relevant in Canada where only 16 to 30% of Canadians have access to good quality palliative care.

Compassionate Communities (CC) and Conceptual Clarity 

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The Compassionate Cities/Communities model is a theory of practice for HPPC. In fact, HPPC projects are typically described as “Compassionate Communities” projects. The CC model attempts to bridge the gaps between the realities of widespread “experience” of distressing death and “practice.” Previously, these gaps have neglected the social needs of dying or simply ignored it. These gaps include:

• Inadequate and inequitable access to integrated, high quality palliative care
• Inadequate support for caregivers
• Limited and inequitable service capacity across all care settings
• Lack of clear accountability for the delivery of palliative care
• Lack of system integration

To address these gaps, the CC model emphasizes reforms to the way palliative care is conceptualized, organized and delivered. It treats palliative and end-of-life care as a community responsibility and creates partnerships between the community and services.

Compassionate Communities Projects in Action 

Where do we turn for support of the CC model? What are the next steps to make the CC model a reality in our community? Illuminating and learning about existing international and “made in Canada” CC projects is a great start. Notable CC projects include:

• Hospice Friendly Hospitals, Ireland
• Frailty index – A global clinical measure of fitness and frailty in elderly people
• Compassionate watch – i.e. Neighbourhood watch
• Death education elementary schools/hospice partnerships
• Spiritual companions
• Integration of formal and informal care networks
• LTC pubs/beer coasters
• Caregiver Day
• Airport posters
• Die-alogues: Conversations on Life and Death, Thunder Bay

Pallium Canada and Mobilizing your Compassionate Community

Pallium Canada’s professional development opportunities, clinical decision-support tools and e-Learning Essential Approaches to Palliative and End-of-Life care (LEAP) courseware and LEAP Facilitator Training sessions. The LEAP courseware is designed for a generalist-level interprofessional audience - primarily physicians, nurses, pharmacists and social workers. Pallium Canada’s Guiding Principles are to promote interprofessional care, translate and diffuse knowledge, promote active learning, and connect community to local palliative care resources. LEAP is increasing service capacity across care settings through tailor-made, setting-based curriculum, including: LEAP Core, LEAP Mini, LEAP Mini Oncology, LEAP Paramedic, LEAP Long-Term Care, and Taking Ownership.

Learning Resources

Learning resources are intended to bridge existing gaps, increase capacity and enhance access to palliative care. Pallium Canada is increasing capacity and enhancing access to palliative care through the Pallium Canada’s professional development opportunities, clinical decision-support tools and e-Learning resources are intended to bridge existing gaps, increase capacity and enhance access to palliative care. Pallium Canada is increasing capacity and enhancing access to palliative care through the Learning Essential Approaches to Palliative and End-of-Life care (LEAP) courseware and LEAP Facilitator Training sessions. The LEAP courseware is designed for a generalist-level interprofessional audience - primarily physicians, nurses, pharmacists and social workers. Pallium Canada’s Guiding Principles are to promote interprofessional care, translate and diffuse knowledge, promote active learning, and connect community to local palliative care resources. LEAP is increasing service capacity across care settings through tailor-made, setting-based curriculum, including: LEAP Core, LEAP Mini, LEAP Mini Oncology, LEAP Paramedic, LEAP Long-Term Care, and Taking Ownership.












  


On October 28^th, 2015 Pallium Canada is taking our palliative care initiatives one step further with our Symposium entitled “Mobilizing YOUR Compassionate Community!” Hosted at the Westin Ottawa Hotel, the Symposium will engage participants to adapt, apply, and mobilize the international Compassionate Communities model to Canadian realities. We will learn about the movement, illuminate “made in Canada” CC projects, network with like-minded visionaries, and begin to develop a blueprint to build and support the CC movement in Canada. 


What: #hpm chat on Twitter
When: Wed 9/23/2015 - 9p ET/ 6p PT
Host: Dr. Denise Marshall - Pallium Canada

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