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

http://www.lonelyplanet.com/destinationRedirector?openMap=true&ethylCobjId=5182

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