Post on 17-Mar-2018
transcript
engaging communities
using an asset-based approach
STARTING FROM SCRATCH
Presented by
Mary Matthiesen & Lisa Deal
Mission Hospice & Home Care San Mateo County, CA, USA
we’re all
in this
together
hospices have extensive expertise
and community connections
around end of life awareness and
care,
yet can find themselves isolated
as solely 'end of life' providers in
a community.
we
often
feel
like
we’re
alone
Communities have the capacity
to engage and reach
the healthy,
aging,
advocates
How can we begin to engage with
the wider, healthy community to
aid efforts to raise awareness and
become engaged when most still
aren’t holding conversations,
have myths about hospice and
palliative care and fear opening
this wider conversation?
What is our role?
Not everyone
is as excited
as we are….
GOALS OF SESSION
• Understand the background and process undertaken to engage interest and participation in wider awareness, education and compassionate community initiatives in our community.
• Identify the key themes identified by communities-now internationally- as essential to reach and engage the wider community.
• Apply a mini-process to consider how you might apply similar approaches in your area.
• Share in a discussion of lessons learned and still learning to improve such approaches in the future.
Truly building community
partnerships takes time.
Yet catalyzing, creating, and
laying a foundation for longer
term partnerships & projects can
follow a simple process.
PREMISE
BACKGROUND
BMJ SUPPORTIVE & PALLIATIVE CARE JOURNAL
JAN 2016
International Observatory on End of Life Care
BACKGROUND
MISSION HOSPICE & HOME CARE
LISA DEAL, SC.D., M.SC., M.P.H., M.N., B.S.N.
CHIEF CLINICAL OFFICER
MARY MATTHIESEN COMMUNITY ENGAGEMENT & EDUCATION DIRECTOR
Advanced Care – skilled nursing and medical social work for homebound patients who are not ready for hospice.
Transitions – social work, nurse consultation, and volunteer support for patients who may be in between our other programs.
Hospice – Compassionate, personalized palliative and medical care, along with emotional and spiritual support for terminally ill patients and their loved ones.
Mission House – intensive, round-the-clock hospice care for the last few weeks of life.
Mission Hospice & Home Care our continuum of care
MISSION HOSPICE & HOME CARE IT’S ABOUT LIFE
We believe that death is a human experience that
touches every one of us, and that we each deserve
care at the end of life that is aligned with our
beliefs, wishes and values.
As one of the only independent, nonprofit hospices
serving the San Mateo County area, we are in a
unique position to partner with other agencies to raise
awareness about these important issues.
It’s about life!
STARTING FROM
SCRATCH
Is there interest in
becoming a more
compassionate
community for those facing serious
illness, death and
bereavement?
Is there interest in working
together?
SO HOW DID WE START?
….................SO HOW COULD YOU START?
AN ASSET-BASED PROCESS
o What is it?
o The Steps We Took
o Your Mini-Experience
ASSET-BASED APPROACH
IS OUR COMMUNITY
FULL OF “ASSETS”?
OR
FULL OF “DEFICITS?”
“ASSET-BASED” APPROACH 6 TYPES OF COMMUNITY ASSETS
• Talents and skills of our people
• Community groups and networks
• Government and non-government agencies
• Physical assets: Land/property/buildings/equipment
• Economic assets: Productivity of individuals, consumer spending, local business assets
• Stories, heritage and local identity: values.
• www.abcdinstitute.org
THE PROCESS
Mission Hospice & Home Care seed-funded a Community Engagement & Education Director to lead the process.
Moving
Into Action
Follow- Up
Session
Planning
& Initial
Leader
Outreach
Facilitated
Community
Meeting
Asset-
Based
Summary
Report
Community
-Led Action
Plan with
Priorities
VIEW YOUR COMMUNITY
AS BEING FULL OF ‘ASSETS’
• Who serves the public?
• What agencies serve people facing
end of life issues?
• Who has the greatest trust?
• Who has the greatest reach?
LIST 10-30
THINK OUTSIDE OF THE BOX
WHO DO YOU INVITE?
1 Lead Organization (Mission Hospice & Home Care)
invited
30 community representatives delivering services locally
(healthcare, aging, social care, care homes, rotary/service associations,
schools, funeral, carers groups, local government, bereavement
support, churches, faith groups, University, etc.)
to a Facilitated ½ day (rural)
or 2X 2 hour (Suburban/City)
Community Partnership Event
and a Follow-Up 2 hour Session
The Process
IS THERE INTEREST IN BECOMING A MORE COMPASSIONATE
COMMUNITY FOR THOSE FACING SERIOUS ILLNESS,
DEATH AND BEREAVEMENT?
The Question
WHAT DO YOU DO
ONCE THEY’RE IN THE ROOM?
YOUR EXPERIENCE APPLYING AN ASSET-BASED TEMPLATE
“ASSETS TEMPLATE”
WHAT’S WORKING?
Individual
• Gifts/stories/experience
Organizational
• Skills, networks,
buildings, newsletters
Community
• Organizations,
associations, events
= REACH
SKILLED CARE/ILLNESS/DEATH
COMMUNITY OUTREACH AND EDUCATION
WEBSITES
INFO MEETINGS/COFFEES
NEWSLETTERS
SPACE
BAY AREA ROOMS FOR HOLDING MEETINGS
COMPASSIONATE AND HELPING CAN VOLUNTEERS
EDUCATION BY PROFESSIONALS
GOOD MODEL FOR COMMUNITY SUPPORT
NEWSLETTER AND WEBSITE
MEETING SPACE
HEALTHCARE PROFESSIONALS
FUNERAL SERVICES AND MEMORIAL GARDENS
PASTORAL CARE, STEPHEN MINISTRY (LAY) W/ CLERGY
POLST LECTURES
PSYCHOLOGIST VISITS
VOLUNTEERS
COMMUNITY GROUPS AND NETWORKS
SOME OF OUR
COMMUNITY
STRENGTHS
THAT COULD
HELP OTHERS
FACING
EXPEIRENCES
OF DEATH,
DYING, or
BEREAVEMENT
QUOTES FROM FIRST SESSIONS
“Somehow, though we know we’re all
aging, death and dying weren’t part
of any of our strategies.”
-Community Leader
“How can we support our clients and
community if we don’t know what
services exist? Of course we need to
work together.”
- Community Leader
CALL TO ACTION
What 3 things will you do as a result of today
– Personally?
– Professionally?
– Organizationally or in your community?
THE PROCESS
Mission Hospice & Home Care seed-funded a Community Engagement & Education Director to lead the process.
Moving
Into Action
Follow- Up
Session
Planning
& Initial
Leader
Outreach
Facilitated
Community
Meeting
Asset-
Based
Summary
Report
Community
-Led Action
Plan with
Priorities
SAMPLE FROM SUMMARY
INFORMATION/RESOURCES
• Templates for conversation-like living will
• Information more widely available-what resources exist
• Resource guide for residents re: Advance Directives, Bereavement, Caregiver support
• (Stanford) Letter project
• Discussions about goals of care especially around aggressive/curative treatment vs. comfort symptoms
• Ritual, faith, framework for journeying through death & dying
• Educate about signs of decline that indicate life limiting illness
• Staff needs more time/resources to help support families/patients/residents
• Communicate people’s stories
• Identifying and articulating stories and local identity
SAMPLE FROM SUMMARY: OUTREACH/AWARENESS
• Increase awareness of need for discussion
• Understanding better people’s beliefs regarding prognosis, death, dying process.
• Openness to discuss dying
• Start this (EOL) awareness in Sequoia Village
• Take it to all the villages
• Host a death café
• Somehow participating in normalizing the conversation i.e., EOL
• Move EOL discussions upstream
• Move to a public health perspective vs. death =end /failure to empower/close of life journey
• Somehow reduce the taboo about death
• Constant communication
• National ministry project to ACP-public health initiative.
• More of these presentations in the community (include faith-based organizations)
• Drawing on other culture’s practices (e.g. Dia de los Muertos) as a way to break down emotional barriers to the discussion.
• City proclamations of a special day.
• Health fair -positive conclusion.
• Meet your neighbor
• Week long celebration similar to Dia de los Muertos
• Death cafes
• Movie series
• Engagement & Education through local associations
• Engagement & Education through faith based organizations
• Engaging communities, neighbors looking out for neighbors re: the England model.
• Neighborhood watch program for dementia and other illnesses
• The Stanford Letter Project
• Churches in Menlo making a commitment to letter project
• Small groups discussing end of life issues.
• Have discussion on end of life with family members.
• Begin discussion on end of life options for those living with dementia
• Research; educate colleagues at work.
• Discuss with friends, neighbors in community
• Share with colleagues and church members
• Start a personal conversation in community
• Publicize organizations
• Communicate people’s stories
MOVING INTO ACTION
THE MAGIC WAND QUESTION
COMMUNITY-LED ENGAGEMENT PLANS
Hospice/Community
Lead
Chamber
Faith Groups
Family Care-giver
Alliance
Libraries
County
Aging & Adult
Peninsula
Volunteers
University (Chaplain/Research)
Senior & Retirement
Centers
Community Led Action
Plans
Information
Outreach/awareness
Education
Leadership
SAN MATEO COUNTY, USA (2 SITES)
**services discussed but not a direct aim of this group
COMMUNITY-LED ENGAGEMENT PLANS
Hospice Lead
Local Authority
Faith Groups
Age UK
CVS
PCT
Care Homes
Women’s Institute
Funeral Directors
Community Led Action
Plans
Information
Outreach
Education
Leadership
NORTHWEST ENGLAND (8 SITES)
MATTHIESEN ET AL
BMJ SUPPORTIVE & PALLIATIVE CARE JOURNAL, JAN 2016
Inspired leaders as partner allies
Personal Commitment to engage others
Collective Commitment to engage others
Tools to move momentum forward
Report of Identified Community Assets
Report of Community-Initiated Priorities
Foundation laid to further engage with communities
COMMUNITY OUTCOMES INCLUDE
STEPS TAKEN AS A RESULT
Local
Leadership:
Steering
Groups
Established
Key
projects
aligned
to action
plans
FIRST COMMUNITY-LED GOAL
“We want the people in our community to all have
had the conversation with their family, their doctor
and have completed their advance directive.”
Coastside Adult Day Health Center |
Family Caregiver Alliance |
Peninsula Volunteers, Inc. | Palo Alto
Medical Foundation |
San Mateo County Health System
Aging and Adult Services | Senior
Coastsiders | Seniors At Home |
Village of the Coastside | Villages of
San Mateo County
Community Partners Working Together
Goal: Awareness, Information, Education
Our coalition is dedicated to creating a more compassionate community
for people facing serious illness, death, and bereavement. We encourage
everyone to have conversations with their families and their doctors
and take charge of their advance health care planning.
OUTCOMES
Outcomes Outcomes
Outcom
es
• Increased Partnerships & Position
• Local Leadership
• Community-led Priorities
• Information & Resources
• Increased Public Reach
• Increased Skill and Resource Sharing
• Collaborative, Community-Based
Awareness-Raising
** Shift in Hospice Awareness
OUTCOMES TO DATE
Take Charge! 1000 Toolkits Distributed via partners in 6 mo’s
70 people attended first phase of workshops, held conversations, chose healthcare agents, % completed and witnessed ACP’s.
Access & Continuity of Care
Participants want follow-up! (Lesson learned for phase 2) Host senior center site achieved increase in new visitors (70%) On-site social worker referrals for f/u 1:1 support
Legal Aid/RN follow-up Additional community agency awareness/involvement: 70-strong initiative-social work navigators
Expanded opportunities for reach With Library System
With County Behavioral Health on health disparities and inclusion With Funders Residential Senior Center (initially didn’t participate) has now requested to lead a
new pilot with us
THE RIPPLE EFFECT
• Requested participation on panels
• Volunteers-Staff
• Mutual marketing of events
• Orgs took ‘EOL Care’ off the back shelf
• Key meetings in the County
– To lay foundation for Compassionate Community Partnership Projects
– To open diversity and equity discussions
– To discuss a county-wide initiative in partnership with Aging & Adult Services
• Partnership response to traumatic event & mental health collaboration
OUR ROLE in the BHAG Catalyst, Facilitator & Convener
Truly building community
partnerships takes time.
Yet catalyzing, creating, and
laying a foundation for longer
term partnerships & projects can
follow a simple process.
PREMISE
• Tremendous community interest
• Takes a lead to move forward-if not us, who?
• Continual clarity of our role: Convener/Facilitator-NOT OWNER
• Balance expectations & focus on assets
• Engaging community partners opens doors that otherwise
were closed or hard to open
• People want (and need) follow-up
• Community engagement takes commitment & time
• Be open to the unexpected
• Trust that the big vision happens in steps
LESSONS LEARNED & LEARNING
Mary Matthiesen, Community Engagement & Education Director,
mmatthiesen@missionhospice.org
Lisa Deal, Chief Clinical Officer,
ldeal@missionhospice.org
For more information contact
The reality is you’re never truly
starting from scratch If you engage communities using an asset-based approach
to view samples go to www.missionhospice.org