Karin Tancock, Professional Adviser for Older People and Long Term Conditions, talks about our roles as occupational therapists and compassionate communities.
Compassionate Communities – What is our role?
As the Professional Adviser for Older People and Long Term Conditions, I monitor policies and guidelines relevant to my area of practice. The Public Health Approaches to End of Life Care Toolkit was released last September and the Department of Health is currently committed to a set of actions related to end of life care.
Reading around the strategy and action plan led me to reflect on my responsibility as an occupational therapist and my role as a member of my community. In this blog I try to capture my thoughts and hope this prompts further reflection and discussion amongst its readership.
What is a compassionate community?
The Public Health Approaches to End of Life is an England only initiative but subscribes to the compassionate communities model. A compassionate community offers its inhabitants access to shared care and supportive experiences, interactions and communication around end of life. To read more about the end of life toolkit visit the NCPC website.
Our role within a compassionate community
Whilst reading around the materials I tried to consider my role as a citizen- as a member of my community. To explore personal responsibility it is important to reflect on what our communities’ mean to us. What communities do we feel part of- the local community, our neighbourhood, the occupational therapy community? I have had a vague idea for a while that visiting a Death Café would be an interesting experience and so I used the toolkit as a prompt to attend a local event.
A Death Café is a group where people meet to drink tea and coffee and discuss death. It is not a grief support session and there are no objectives or set themes. There was a broad range of people, some had experienced bereavement from an early age and others worked in palliative care or funeral services or with community groups. I left the meeting with questions floating around my mind: How do I react and behave towards friends, neighbours, and colleague’s bereavements or illness? Why do I keep promising myself I will write a living will but I have yet to get round to it? If I did die would my family know what to do for my funeral and am I confident that I know what they would like at theirs? What beliefs would guide my advanced care plan? Would I get my first tattoo- do not resuscitate- across my chest and if so when and in what circumstances?
The visit inspired me to start talking. “You know I went to this Death Café…” has given me an opening gambit to find out other peoples’ thoughts and to share mine. I have resolved to openly talk about death and dying- something I now realise I had subconsciously labelled a ‘work’ subject and not for home life. I hope to be more sensitive and listen to others – no longer responding jokingly or dismissively with “Oh you have plenty of years yet” -when an older relative makes a comment about “after I am gone”.
How does personal responsibility link in with professional responsibility?
In practice I have always felt very strongly that people should be open about death and dying, particularly working with older people that have often experienced a series of losses. With many of the principles of being compassionate we would automatically respond that ‘of course we do this’ but how often are we preoccupied with completing the tasks within our role or the pressure of time? It is at this point we may not read signs that someone needs to talk or needs our support to explore what their diagnosis or age means to them.
Ultimately, the lesson for me is that we need to be open to conversations about death and dying. If we listen carefully and read a person’s body language, we can quickly pick up the language someone is comfortable with and be guided in our approach. The skills we have learnt through practice serves us well within our personal life and by taking risks – broaching the subject – we may model to others and influence the groups we live in to be more open and compassionate.