Michael Connors Director of Services 34 years helping people to - - PowerPoint PPT Presentation

Michael Connors Director of Services

34 years helping people to live well with the impact of cancer

Understanding the patient experience Penny Brohn Whole Person Model

Emotions Body Mind Spirit WHOLE PERSON AFFECTED BY CANCER

26 bedroom centre Residential courses in living well with cancer Day clinic for personalised specialist services

All our services are free of charge

National Living Well Services

Living Well Courses

National Centre

Prostate Cancer UK Living Well Courses Cancer Partners UK Health & Wellbeing Clinics Bowel Cancer UK Living Well Services Prostate Cancer UK Living Well Pathway Services

(Health & Wellbeing Clinics and Living Well Courses)

Telephone Support

Taking Action to Improve Outcomes (March 2013)

What is the report designed to do?

• informs the direction of survivorship work in England to 2015
• support commissioners, providers and others to take the actions

necessary to drive improved survivorship outcomes

• set out what has been learnt about survivorship, including people’s

needs, their experience of care, and the impact cancer and treatment has upon their lives

• describe interventions that have been tested, and are ready to

spread across England to improve survivors’ outcomes

(http://www.ncsi.org.uk/)

Living beyond cancer potentially with consequences Living with cancer either incurable or further diagnosis

The Penny Brohn Integrated Care Pathway of Services

Diagnosis

Patient Cancer Journey PBCC Pathway of Support

Treatment Treatment ends Pre Treatment Clinic Treatment Support Clinic Health & Wellbeing Clinic Living Well Course Follow up services Follow on services

National Living Well Services

Living Well Courses

National Centre

Prostate Cancer UK Living Well Courses Cancer Partners UK Health & Wellbeing Clinics Bowel Cancer UK Living Well Services Prostate Cancer UK Living Well Pathway Services

(Health & Wellbeing Clinics and Living Well Courses)

Telephone Support

Living Well Study

Service Evaluation of ‘Liv iving W Well w with ith t the I Impact o

• f C

Cancer’ Courses

In collaboration with the University of Westminster

The immediate Impact:

• Concerns were immediately addressed and

statistically and clinically significant changes recorded

• Wellbeing significantly improved
• Health Related Quality of Life immediately improved

– Statistically significant improvements; total score – Statistically significant improvements; emotional, functional and spiritual wellbeing.

Long term impact:

• Concerns and Health Related Quality of Life continue

to improve

• Improvements in diet at 6 week follow up
• Barriers to sustaining change identified
• Improved confidence to communicate with medical

professionals

• Clients who returned to PBCC for more support had

bigger improvements in their Health Related Quality of Life at the 12 month follow up

Service Evaluation of ‘Liv iving W Well w with ith t the I Impact o

• f C

Cancer’ Courses

In collaboration with the University of Westminster

The Penny Brohn Whole Person Approach

WHO definition of health “a state of complete physical, mental and social well-being and not merely the absence

• f disease or infirmity.” (WHO

Constitution 1948)

What do we mean by a Whole Person Health?

BMJ re-definition of health “the ability to adapt and to self manage” = the resilience or capacity to cope and maintain and restore

• ne’s integrity, equilibrium,

and sense of wellbeing (Huber

et al BMJ 2011)

What do we mean by a Whole Person Health?

Understanding the experience Penny Brohn Whole Person Model

Emotions Body Mind Spirit WHOLE PERSON AFFECTED BY CANCER

Living beyond cancer potentially with consequences Living with cancer either incurable or further diagnosis

The Penny Brohn Integrated Care Pathway of Services

Diagnosis

Patient Cancer Journey PBCC Pathway of Support

Treatment Treatment ends Pre Treatment Clinic Treatment Support Clinic Health & Wellbeing Clinic Living Well Course Follow up services Follow on services

Understanding the experience Penny Brohn Whole Person Model

Social isolation Change in appetite/taste/digestion Reduced physical activity Change in body image Lack of sleep and energy Insecurity about job or home Reduced finances Problems with dependents Feeling out of control Difficult decisions to make Feeling stressed Worries about dying Stuck at home/ in hospital Reduced access to sunshine and places I love Anger Sadness/Grief Hopelessness Fear Sexual difficulties Isolation/lack of communication Difficulties asking for/getting support Identity crisis Worries about mortality What’s the point? Crisis of faith

Emotions Body Mind Spirit WHOLE PERSON AFFECTED BY CANCER

People don’t know what to say Travel insurance Weight loss or gain through treatment Treatment side effects Pain

Understanding the experience – client/patient as expert Penny Brohn Health and Wellbeing Wheel

Whole person Emotions Mind Body Spirit 2 4 6 2 4 6

Understanding the experience Penny Brohn Whole Person Model

Emotions Body Mind Spirit WHOLE PERSON AFFECTED BY CANCER

Body

Learning about healthy eating and cooking Appropriate physical activity Breathing techniques for relaxation Managing sleep problems Conventional and complementary symptom control Hospital-based cancer treatment

Supporting resilience with physical interventions

Penny Brohn Healthy Eating Plate

Based on WCRF/AICR Guidelines

Anti-inflammatory, Unprocessed, Low GI,

instead of ……

Men with cancer who exercise regularly have HALF the chance of dying in the next 20yrs Regular physical activity can reduce many of the side effects of cancer and its treatment e.g.

• fatigue
• bone thinning
• weight gain
• hot flushes and erectile

dysfunction

• anxiety and depression

Supporting resilience with activity

Managing your Relaxation and Stress Responses

Getting the balance right can support your immune system and health

Lifting your Spirits

Group activities to build social networks – clubs, choir, support group Learning about healthy eating and cooking Appropriate physical activity Breathing techniques for relaxation Managing sleep problems Financial advice/support Signposting to sources of practical support Good work/life balance Mindfulness, relaxation & imagery training Knowledge about cancer and the immune system Stress management techniques Support for more shared decision making Access to green spaces Sunshine Acknowledging emotions Getting emotional support Restoring hopefulness Finding acceptance Connecting or reconnecting with loved ones Relationship counselling Giving and receiving Stillness Creativity Laughter Connecting with joy and purpose

Emotions Body Mind Spirit OPTIMAL RESILIENCE

Letting go of fear Conventional and complementary symptom control

Penny Brohn Whole Person Model A menu of possible interventions to build resilience

Hospital-based cancer treatment

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