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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.

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Public Health & End of Life Care

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  1. Public Health & End of Life Care Professor Allan Kellehear University of Bath

  2. 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

  3. Expand & align with other health services approaches • FROM: direct service, clinical and institutional approaches • TO: community, health promotion and partnership approaches

  4. 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

  5. Conceptual & Practice Emphasis • Prevention • Harm reduction • Health & death education • Participatory relations • Community development • Service partnerships • Ecological emphasis (not simply info and awareness)

  6. Some examples • 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

  7. More examples • 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

  8. What did success look like? • Greater participation in end of life care from all non-health sectors (eg A.C.T ‘garden of loss and reflection’) • Increase in active partnerships between public health, aged care, bereavement care and palliative care services around DDL&C

  9. What did success look like? • Greater recognition of the common experiences of DDLC from previously disconnected groups - cancer, HIV, aged, youth, children • New local policy developments around DDLC from schools, councils, unions, workplaces

  10. What did success look like? • A greater ‘sense’ of normalisation around DDLC (eg beer mats, book marks, etc) • Increase in community involvement and experience in DDLC (eg Sydney home care, neighborhood watch, world café, memorial days, etc)

  11. Evidence - thine thorny chestnut • 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

  12. Further Reading • A. Kellehear (2005) Compassionate Cities: Public health and end of life care. London, Routledge • A. Kellehear & B. Young (2007) Resilient Communities. In B. Monroe & D. Oliviere (eds) Resilience in Palliative Care: Achievement in Adversity. Oxford, Oxford University Press.

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