STOP/START/CHANGE! Developing your End-of-Life Care Hilary Smyth Regional Development Officer (Mid West) Residential Care
Part of the Changing Minds Programme
Post Inspections!
Our Vision: A Community of Care Centres committed to continually developing quality End of Life Care
Three levels of engagement Building Excellence Growing Excellence Strengthening Excellence
Building Excellence Published resources, online E bulletin, E Webinars EOL Resources Discounted education Growing Excellence All above + 2 onsite/offsite workshops Developing Vision Facilitating CEOL Review Development Officer Support Strengthening Excellence All above+ 4 onsite workshops Change Management cycle with EOL projects
Dealing with End of Life Issues
Give sorrow words; the grief that does not speak knits up the overwrought heart and bids its break (Macbeth)
How comfortable are we with caring for someone who is dying?
How comfortable are we with caring for someone who is dying? Do we feel unskilled? Do we find it difficult to handle emotions of others? Do we fear blame? Is it difficult to confront our own feelings & fears about death? Can we say I don t know? Are we worried about causing distress? Are we afraid of expressing our own emotions How do we cope with the loss of a resident? (Buckman 1998, Fallowfield 2010)
Our Modern World Social denial of death
How do we define good End of Life Care?
Framework for good EOLC (I.H.F., 2014) 1. I will be assured of excellence in the care provided to me by the staff and teams who care for me, who will respect me for being me, and place me in the centre of all decisions about my care. 2. I will be prepared for what lies ahead 3. I will have choice, where possible, in my preferred place of care and have the supports I need for good end of life. 4. I will have dignity and comfort in my care as death approaches. 5. I will know that my family and those important to me will be supported and cared for after my death
STOP- START- CONTINUE- CHANGE
Mike Morrison 2008 STOP- START- CONTINUE- CHANGE STOP What are we doing that is not working? (Something we should STOP) START What should we put in place to improve our service (Something we should START) CONTINUE CHANGE What is working well and should be continued? (Something we should CONTINUE) What is working well to some extent and would benefit form minor changes? (Something we should CHANGE)
How do you, and your organisation, support residents choice and control in their daily lives? STOP What are we doing that is not working? (Something we should STOP) START What should we put in place to improve our service (Something we should START) CONTINUE CHANGE What is working well and should be continued? (Something we should CONTINUE) What is working well to some extent and would benefit form minor changes? (Something we should CHANGE)
How do you promote dignity & comfort in the last days of life? STOP What are we doing that is not working? (Something we should STOP) START What should we put in place to improve our service (Something we should START) CONTINUE CHANGE What is working well and should be continued? (Something we should CONTINUE) What is working well to some extent and would benefit form minor changes? (Something we should CHANGE) Mike Morrison 2008
How do you acknowledge, support & include family in care before and after death? STOP What are we doing that is not working? (Something we should STOP) START What should we put in place to improve our service (Something we should START) CONTINUE CHANGE What is working well and should be continued? (Something we should CONTINUE) What is working well to some extent and would benefit form minor changes? (Something we should CHANGE) Mike Morrison 2008
How do you support ALL your staff with the losses of caring? STOP What are we doing that is not working? (Something we should STOP) START What should we put in place to improve our service (Something we should START) CONTINUE CHANGE What is working well and should be continued? (Something we should CONTINUE) What is working well to some extent and would benefit form minor changes? (Something we should CHANGE) Mike Morrison 2008
St Itas Privacy and dignity of the resident and family Symptom control If it was you If it was someone close to you Respect for the known wishes of the resident Holistic approach to care
St Poster Itas St Itas
St. Ita s Vision for End-of-Life Care We work very hard to ensure St Ita s is a comfortable and personal space for you to live life. Towards the end of your life we will endeavour to get to know and respect all your wishes, through open and honest communication and discussions in a sensitive manner. Your values, hopes, wishes and needs will guide us in caring for you. Family and loved ones dear to you are also important to us, and will include them in discussions and care, if that is your wish. We will strive to provide private and comfortable surroundings for you, and to ensure you are comfortable and free from pain, not only physically but emotionally and spiritually. We endeavour to care for all needs equally to provide holistic care and we do this by working as a team and using the support of team members should they be needed such as Specialist Palliative Care.
Where do we go from here?
Our Vision Feedback on our care Improve our care
CEOL Reviews Bereaved Surveys
Change Management Projects
No one can go back and start a new beginning but anyone can start today and make a new ending (Maria Robinson)
Thank You CEOL Group, St Ita s Hospital, Newcastlewest, Co. Limerick
Thank you ajourneyofchange@hospicefoundation.ie (01) 6793188 Anna De Siun: National Coordinator Hilary Smyth (Mid West) Aoife O Neill (Dublin) Una Cronin (South) Jacinta Kelly (North West)