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4/4/2014 Learning Objectives Describe the difference between palliative care and hospice care Joan Olson, MA, BCC Explain some of the spiritual tasks at the end of life NACC National Conference St. Louis, MO Articulate your


  1. 4/4/2014 Learning Objectives  Describe the difference between palliative care and • hospice care Joan Olson, MA, BCC Explain some of the spiritual tasks at the end of life • NACC National Conference St. Louis, MO Articulate your wishes, hopes and fears as you • May 17, 2014 contemplate your own death Palliative Care What is it?   Provides relief from symptoms Integrates psychological and spiritual aspects of care What is it? • Uses a team approach to address the needs of patients and families How is it used? • Offers support for patients and their families Is used in conjunction with other therapies that intend Who gets it? • to prolong life Intends to neither hasten nor postpone death 1

  2. 4/4/2014 How is it used? Who gets it?   In the clinic to address ongoing symptom • management, goals of care, advance care planning Anyone with a complex, serious, life-limiting illness is appropriate for palliative care In the hospital to address ongoing symptom • management, to determine goals of care, advance care planning and to provide emotional, psychological and spiritual support Spiritual Care within Palliative Care  “Good quality care occurs when patients are able to express what is holy to them, gives them meaning and helps them transcend their suffering, even if not necessarily relieving it.” Christina Puchalski Making Health Care Whole 2

  3. 4/4/2014 Hospice Care  The Lady and the What is it? • Reaper How is it used? • Who gets it? • What is it? How is it used?   Two doctors must agree on prognosis Six Months or less • • Home care, residential hospice or facility Pain and symptom management • • Support for families to give them confidence in the Holistic care • • care of their loved one Patient and family as unit • Additional care and support at facility • Self-determined life closure • Medicare benefit • 3

  4. 4/4/2014 Who gets it? The Four Gifts   Thank you • Anyone with an illness whose prognosis is less than • I’m sorry six months • Must continue to show decline I love you • • Barriers to receiving hospice Goodbye • • Spiritual Pain from The Sacred Art of Living and Dying  It takes two to speak the truth – Meaning Pain one to speak and another to hear. • Forgiveness Pain • Henry David Thoreau Relatedness Pain • Hopelessness Pain • 4

  5. 4/4/2014 Meaning Pain Forgiveness Pain That which promotes motivation The ‘common cold’ of spiritual pain and happiness Lack of forgiveness of ourselves and others Making sense of illness and death can make us sick What hopes/fears do I have Willingness to let go for our own sake for the next life? from The Sacred Art of Living and Dying from The Sacred Art of Living and Dying Hopelessness Pain Relatedness Pain Hope = Our human capacity to imagine How are my relationships with what could be life-giving those I care about? Failure to thrive How is my relationship with God? ‘Terminal illness’ of spiritual pain from The Sacred Art of Living and Dying from The Sacred Art of Living and Dying 5

  6. 4/4/2014 Remedies for Meaning Pain Remedies for Forgiveness Pain Communion with nature Prayer of Gratitude Logotherapy Confession Life Review Release Rituals Dreams/Journaling Twelve Step Processes Asking Sacred Questions from The Sacred Art of Living and Dying from The Sacred Art of Living and Dying Remedies for Hopelessness Pain Remedies for Relatedness Pain Energy Therapies Grief Therapy Music Therapy Mingling of Breaths Anointing/Massage/Aroma Metta: Lovingkindness Meditation Sacred Ritual Examen from The Sacred Art of Living and Dying from The Sacred Art of Living and Dying 6

  7. 4/4/2014 Spiritual Health Assessment Healing Through Self Awareness Based on ‘Healing the Four Dimensions of Spiritual Pain’ In the classical Sacred Art of Living and Dying tradition It’s about how you live! If you want to die happily, Die before you die, learn to live. so that when you die, you do not die. If you want to live happily, learn to die. Egyptian Book of the Dead Latin Proverb 7

  8. 4/4/2014 Be at peace with your own soul. Enter eagerly into the treasure house You are healed of a suffering that is inside you. The ladder leading to the Kingdom is hidden within your soul. only by experiencing it to the full. Dive into yourself, and in your soul you will discover the stairs Marcel Proust by which to ascend. Isaac of Ninevah. Exercises  8

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