Health Sciences

Palliative Care Unit

Practice Guidelines for Health Promoting Palliative Care

By Allan Kellehear, Gail Bateman, Bruce Rumbold. 

1) (i) Extend the activities or complement existing support groups with additional adult learning groups:

• a) Should be small groups (5-7 people maximum)
• b) Should have weekly reading material
• c) Readings should cover one’s own health care and life changes but be flexible to the needs of the group
• d) There should be some component of death education
• e) Learning groups should run for a limited number of weeks (eg, 6-8 weeks)
• f) Ideally learning groups should be for patients only but if this is not possible or desirable at all times then a specific number of sessions should be put aside for carers only and patients only. These can be some part of any program where joint sessions are the main feature.
• Two small group programs a year recommended

And/or

(ii) Offer opportunities for one-on-one patient information sessions with a health educator about life-changes, health maintenance and death education needs.

2) Demonstrated evidence of Death Education for:

• a) Patients
• b) Staff (including Volunteers)
• c) Caregivers
• d) Community (talks, publications, and contributions to media)

NB: ‘Death education’ should not be interpreted to mean information about the agency’s services. The content of death education

is directed specifically at changing attitudes toward death, dying and loss and/or addressing ignorance in these areas.

At least two of the above.

3) Demonstrated evidence of Education in Social Approaches to Care for:

• a) Staff (including Volunteers) [in-service education and higher education]
• b) Caregivers [in-service]
• c) Community (talks, publications, and contributions to media)

NB: ‘Social education’ means teaching people to view the experience of living with a life-threatening illness in terms of social alterations, eg, work, church, friendships, sexual relations. Other issues of importance may be topics such as stigma and discrimination, unexpected popularity, living with loss, or communication and support difficulties.

At least two of the above

4) Demonstrated evidence of non-clinical partnerships:

With the aim of understanding prevention, harm-minimisation, early intervention, community development, participatory health care, health ecology, and the Ottawa Charter.

• a) Membership of Health Promotion / Public Health Associations
• b) Regular meetings with Community Health Agencies
• c) Annual attendance at a public health conference by some staff/volunteers Schools

At least (a) and one other activity

5) Education Resource Material

NB: The resource collection should contain client AND professional material. In this way the reading material should cater for patient, family and staff needs.

• a) Death Education Literature/audio-visuals. These might include books and articles of grief and loss and also near-death experiences and visions, spiritual issues in death and dying, world culture and customs in death and dying, sociology of death and dying, first person accounts of living with life-threatening illness and caring for those people.
• b) Complimentary Therapy Literature/ audiovisuals. These might include, for example, books on Reiki, therapeutic touch, massage, aromatherapy, and meditation. These topics are relevant for symptom control and quality of experience.
• c) Health Promotion Literature/ audiovisuals. Much of this literature is for staff development. These might include literature on health promoting palliative care, health promoting environments, health education, sexual health, and community development.
• d) Spirituality Literature/audiovisuals. These might include literature about a range of reflective and meditative (anecdotes, quotations, poems, etc) literature for clients; and for staff in spiritual and pastoral care in palliative care settings.

A library containing these items should be in evidence. These might include books and copies and collections of journal articles.

6) Social Research

• a) Evidence of partnerships in research devoted to social issues in palliative care
• b) Staff reading groups or journal clubs devoted to social, cultural and spiritual research topics
• c) Actual social research activities
• d) Encouraging staff toward future education in welfare studies, public health, social sciences, humanities, or legal and political studies.

7) Policy

Evidence of regular submissions to:

• a) Local Members (MPs)
• b) Government committees of inquiry
• c) Department Of Human Services
• d) Local councils
• e) Peak bodies (eg: PCV)

These submissions should describe agency activities, staff and client needs

8) Staffing Profile

• a) Employment of socially trained professionals, especially social workers and pastoral care workers
• b) Access to a health promotion and/or health educator worker
• c) A staff profile that resembles the cultural and social profile of the community in which it serves

The annual report should be able to identify what proportion of funding was devoted to these staff issues, services, and consultancies.

9) Evidence of Health Promoting Settings

• a) Minimisation of impact of clinical settings
• b) Environments that recognise and enhance individual identity
• c) Environments that provide opportunities for community access and participation
• d) Environments that provide genuine opportunities for health improvements (relief of distress - emotional, physical, social and spiritual, physical mobility, sense of wellbeing, etc.)

10) Demonstrated Community Development Program

• a) Provides regular partnered and cooperative activities
• b) With local government
• c) With local media
• d) With local schools, workplaces and churches
• e) With local community sporting, service and political groups
• f) Raising awareness about death, dying, loss and caring

These guidelines are meant to be read in conjunction with the theory and philosophy of Health Promoting Palliative Care (Kellehear 1999) available from Oxford University Press Australia.

© Palliative Care Unit, La Trobe University Melbourne, 2003

Copies of this document are available from: La Trobe University Palliative Care Unit, La Trobe University (City Campus) 215 Franklin Street Melbourne , Victoria 3000

All comments, criticism and additions are most welcome.

Email: palled@latrobe.edu.au
Tel: (03) 9285 5259
Fax: (03) 9285 5111
Web: www.latrobe.edu.au/publichealth

© Copyright Palliative Care Unit, La Trobe University , Melbourne 2003.