Introducing Amanda Dunnem. Welcome! Kath Murray 10/27/2017. Webinar for Hospice Aides National Hospice and Palliative Care Organization

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1 Webinar for Hospice Aides National Hospice and Palliative Care Organization Understanding the Common Patterns of Dying and Preparing to Care by Katherine Murray, RN, BSN, CHPCA(C), FT Life and Death Matters Illustrations by Joanne Thomson Introducing Amanda Dunnem NHPCO National Council of Hospice and Palliative Professionals CNA Section Leader circle.org Kath Murray Welcome! 1

2 Plan for today Describe the common patterns of decline, the effects of each decline on person and the family. Describe three ways that hospice and palliative care are responding to the needs of the dying person. Identify best practice interactions and ways of being that support the dying person and family. Patterns of Decline Four common patterns of dying Sudden death 10 % of deaths Heart attack Major stroke Car accident Other fatal accidents Steady decline < 20% of deaths More common for people dying with certain cancers decline often occurs in last 6 months The following patterns... Stuttering decline and Slow decline together account for approximately 70% of deaths. 2

3 Stuttering decline Slow decline Multiple periods of decline and recovery Organ failure, chronic disease e.g. COPD, CHF, kidney disease Periods of decline and recovery are more subtle Parkinson s dementias POLL What pattern of decline would you prefer for yourself? What is helpful? Sudden Steady Stuttering Slow Comments: Why? (type in the Chat Box to your left) Today. Describe the common patterns of decline, the effects of each decline on person and the family. Describe three ways that hospice and palliative care are responding to the needs of the dying person. Identify best practice interactions and ways of being that support the dying person and family. Hospice and Palliative care: Responding to the needs of the dying person and family 3

4 But who is less well served? Hospice and Palliative Care serve certain populations really well Elderly Children People with physical or developmental disabilities People with mental illnesses People who identify as LDBTQ People who are homeless, live in rural and remote areas... People with non cancer diagnosis People from other diverse and marginalized populations Others? All people who are living and dying with serious illness(es) deserve excellent care and can benefit from palliative care and hospice care. How are hospice and palliative care programs evolving to meet the needs? HPC programs are reaching out to care for people with non cancer diagnosis The symptom burden of living and dying with non cancer diagnosis is just as significant as for those living and dying with cancer. And HPC programs are reaching further. To meet the needs of ALL people living and dying with serious illness, in any care setting, in any community. Education to help ALL members of the Health Care Team to.. 4

5 A palliative approach Integrate a Palliative Approach Integrating the principles, practices and philosophy of HPC into the care of people with any life threatening illness, early in the disease process, across all care settings Who can integrate a palliative approach? The entire health care team When can a palliative approach be integrated? Early in the disease process, even from time of diagnosis Can Palliative Care be offered at the same time Can a palliative approach benefit people with dementia? A palliative approach can improve care for those dying with dementia, and can reduce the number of transfers to acute care 5

6 A palliative approach can be integrated in: Comments or Questions? Type them into the Chat Box on your left. Skilled Nursing Facilities Emergency departments Acute medical/surgical units Home and community care Plan for today Describe the common patterns of decline, the effects of each decline on person and the family. Describe three ways that hospice and palliative care are responding to the needs of the dying person. Identify best practice interactions and ways of being that support the dying person and family. You integrate a palliative approach when you: 1. Hold the dying person and family at the center of care 2. Gather information (page 52) 3. Consider the needs of the whole person 4. Provide physical and psychosocial support by implementing the care plan and individualizing comfort measures 5. Communicate and advocate for the dying person and family Best Practice Interactions Preparing to care Being real Expressing empathy Avoiding roadblocks to communication Offering a compassionate presence Supporting dignity Communicating Preparing for the journey 6

7 When you pack for a trip Pack light Consider: Where Who What Applying the idea of baggage to caregiving What is in your baggage? your beliefs your values your cultural practices your experiences your opinions your stereotypes Sort your baggage...regularly Journey with a light pack Comments or questions? Type them into the Chat Box on your left. 7

8 Be real Avoid communication roadblocks Communication roadblocks are phrases or responses that shut down communication Communication roadblocks Minimize the problem Offer false reassurances, praise, platitudes or sympathy Avoid the FIX IT TRAP In the Fix it Trap we only hear what needs fixing or what we can fix and sometimes people want to talk about those things that cannot be fixed Avoid the Fix It Trap because If we cannot fix someone, we may label them as troublesome or difficult We may label people whose problems we can fix as being good or compliant The truth is We cannot fix deep emotional and spiritual pain But we can... 8

9 Offer a compassionate presence in the presence of suffering A compassionate presence requires the inner disposition to go with others to the place where they are weak, vulnerable, lonely and broken Henri Nouwen Working with people in a crisis is similar to reading Braille, you need to feel your way, moment by moment Stephen Levine Being with Breathe paying attention to natural rhythm. Allow for silence Silence Silence is full of presence Silence makes room for whatever needs to happen trust that what needs to happen will happen Supporting dignity The way a person sees themselves is filtered by what they believe others see in them The person and family can judge their status in the health care system by the way you mirror their status 9

10 Support dignity Ask the dignity question What do I need to know about you as a person to give you the best care possible? Communication is the expression of a person s experiences and needs Communicating can bring change Hospice Aides can provide a safe place for communication... Encouraging communication with open ended questions Hm.. Can you tell me more? What is happening? Can you give me an example? What do you need right now? Comments or Questions? Type them into the Chat Box on your left. A tribute to you at base camp 10

11 Plan for today Describe the common patterns of decline, the effects of each decline on person and the family Describe three ways that hospice and palliative care are responding to the needs of the dying person? Identify best practice interactions and ways of being that support the dying person and family. Next week. Applying the principles of Hospice and Palliative Care in Practice: Increasing Physical Comfort for a Person Experiencing Pain My kath@lifeanddeathmatters.ca If you want to provide feedback, stories or experiences for the Webinar next week, then put the name of your hospice in the comments box or send us an by the end of the day today and we will follow up For more information Visit Contact Kath at kath@lifeanddeathmatters.ca Powerpoint Teaching Presentations to be used in conjunction with the text and workbook Essentials in Hospice and Palliative Care: A Resource for Nursing Assistants Publisher: Life and Death Matters, 2015 All Rights Reserved 11