Transcript Public Health & End of Life Care

Public Health & End of Life Care
Professor Allan Kellehear
University of Bath
The Australian Experience
1998 Est. of the PCU, School of Public
Health, La Trobe University, Melb.
 To re-align a bedside care view of end
of life care with all other existing and
broader health service approaches
 Expanding both (1) the approach; and
(2) the target populations
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Expand & align
with other health services approaches
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FROM: direct service, clinical and
institutional approaches
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TO: community, health promotion and
partnership approaches
Expand target population
Go beyond illness esp cancer
 Include the aged
 Include the well and the ill
 Include carers and family
 Include schools, workplaces, business,
unions and places of worship
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Conceptual & Practice Emphasis
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Prevention
Harm reduction
Health & death education
Participatory relations
Community development
Service partnerships
Ecological emphasis (not simply info and
awareness)
Some examples
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Poster campaigns
Trivial Pursuit/World café nights
Positive grieving art exhibition
Annual emergencies services round table
Public forum on death & loss
Review of local policy and planning
Annual short story competition
Annual Peacetime Remembrance day
Suicide aftermath pamphlets
More examples
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Compassionate Watch programme
School and workplace plans for death & loss
Palliative care for beginners
Compassionate book club
Building/architecture prize for caring designs
World spirituality show day
Academic prizes for dissertations on DDL&C
Animal companion remembrance day (involve vets)
Beer mats, book marks, etc
What did success look like?
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Greater participation in end of life care from
all non-health sectors (eg A.C.T ‘garden of
loss and reflection’)
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Increase in active partnerships between
public health, aged care, bereavement care
and palliative care services around DDL&C
What did success look like?
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Greater recognition of the common
experiences of DDLC from previously
disconnected groups - cancer, HIV,
aged, youth, children
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New local policy developments around
DDLC from schools, councils, unions,
workplaces
What did success look like?
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A greater ‘sense’ of normalisation
around DDLC (eg beer mats, book
marks, etc)
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Increase in community involvement and
experience in DDLC (eg Sydney home
care, neighborhood watch, world café,
memorial days, etc)
Evidence - thine thorny chestnut
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Does not define the limits of action
Tests and trials crucial to collection
Check record of health promotion evidence HIV, dietary ed, drug & alc, bullying,
neighborhood watch, anti-smoking, cancer ed
Poor evidence? - palliative care, counseling,
history of medicine, WMD, God…
Need for evidence must not overtake equal
need for perspective in policy & practice
Further Reading
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A. Kellehear (2005) Compassionate Cities:
Public health and end of life care. London,
Routledge
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A. Kellehear & B. Young (2007) Resilient
Communities. In B. Monroe & D. Oliviere
(eds) Resilience in Palliative Care:
Achievement in Adversity. Oxford, Oxford
University Press.