10 August 2023

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Hospice care fit for the future: a rehabilitative approach

Rehabilitative Palliative Care

Join us at our Multi-Professional Academy to see how you and your organisation can provide personalised end of life care for a steadily increasing number of older people.

If, like many health and social care professionals right now, you’re struggling to see quite how you and your organisation can provide personalised end of life care for a steadily increasing population of older people, you might very well want to join us for our annual Multi-Professional Academy event in October – which this year has an especially relevant and practical programme.

The challenges to health care systems across the world are ever growing. As medical care improves, people are living longer, frequently into late old age. Just like at every other stage of life, people approaching the end of life want to be treated as individuals and to enjoy as good a quality of life as possible. But the changing demographics are creating a serious challenge for all those working in healthcare, particularly for palliative care teams. This can lead to people feeling like they are in the ‘waiting room’ of death rather than living their lives.

Good palliative care enables a sharp focus on the individual and their level of function (physical, emotional and social). Effective and personalised goal setting can add value and quality to life, thereby improve wellbeing. Shrinking resources mean this formula for good care is becoming ever more challenging. Time pressures on staff are also leading to more transactional relationships with patients, in which care becomes task-oriented and algorithm led. As we lose sight of the individual, meaningful interactions fall by the wayside.

“It doesn’t matter if you have 5 minutes or 50 minutes, make them count.”

In a recent lecture, Max Chochinov, Professor of Psychiatry at the University of Manitoba, said: “It doesn’t matter if you have 5 minutes or 50 minutes, make them count.” This is a call to all professionals to make the most of each interaction we have, however big or small, we can still have the power to make sure the individual is heard and upheld as who they are.

What matters to you? is a movement that has been growing globally in recent years. It’s such a simple question to ask and one that enables us to put the person we’re supporting right at the centre of what we do. That’s why we celebrated What Matters To You Day here at St Christopher’s on 6 June, sharing the campaign’s key messages, asking the question and encouraging our staff and visitors to do the same.

What Matters to You

It’s important to realise this isn’t just a message for us as professionals. We should also be taking a moment to ask the people that matter to us, ‘what matters to you?’ We’ve also developed our new model of rehabilitative palliative care around this fundamental question, to include all our colleagues – making it relevant to all and everyone’s business, not just us physio and occupational therapists. That’s because this is something that we can all be getting involved in – supporting those around us to be the best that we can be.

This thinking isn’t new. The original model was formally published by Rebecca Tiberini and Heather Richardson in 2015 – Rehabilitative Palliative Care: Enabling People to Live Fully Until They Die. Any student of palliative care will know that the concept even pre-dates this, with its origins to be found in the work of St Christopher’s founder, Dame Cicely Saunders. “All the work of the professional team… is to enable the dying person to live until he dies, at his own maximal potential performing to the limit of his physical and mental capacity with control and independence whenever possible,” Dame Cicely wrote.

Some nursing colleagues will see similarities with the philosophy of the Lantern Model, understanding the importance of putting the person at the centre of everything we do as we strive to manage the needs of a growing population of older people with multiple co-morbidities.  

Keen to share this approach more widely, our Multi-Professional Academy Week will this year be dedicated to Rehabilitative Palliative Care. This annual event at St Christopher’s attracts people from all over the world who come and immerse themselves in what we do in an intensive five-day programme. The week is packed with workshops, presentations and practices. Participants also get the chance to witness care in action with our clinical teams.

Helena Talbot-Rice, our Rehabilitation and Wellbeing Consultant Lead, will provide attendees with a really solid grounding in, and exploration of, the model, how we can support people to be the best that they can be Throughout the week Helena and the team  will also work with peopleto think about how they can best apply the approach in their practice.

Among other highlights of the week, Heather Richardson, St Christopher’s Education, Research and End of Life Policy Lead, will facilitate sessions designed to inspire you to really grasp the wider context of the model and consider how you can influence and effect change, whatever your role. While Mary Hodgson, our Head of Community Action and Learning, and Libby Sallnow, Honorary Senior Clinical Lecturer at St Christopher’s, and co-author of The Lancet Commission on the Value of Death, will curate a discussion about the wider context of death, recognising its place as a social event.

In the current world economic climate, it’s more important than ever that we see death not as a failure of medical professionals, but a natural process supported by the people that matter most to us. By engaging with communities and reacquainting them with this process we enable people to talk about death, their death, and their wishes. We can then enable these wishes with health care interventions being the adjunct, not the main part of this story.

Rehabilitative Palliative Care

This Multi-Professional Academy will take you on a journey through all of these issues. It will challenge your thoughts, it will encourage you to challenge the processes in which you work and provide you with support and motivation to take your ideas back to your workplace and to make change, to make a real difference to the people that you support and the quality of their lives.

For more information about the Multi-Professional Academy, 9-13 October, and to secure your place, click here.

Gail Preston, Physiotherapist and Visiting Lecturer

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