Providing Ex Exce cellent and and Com ompassio ionate Car are - - PowerPoint PPT Presentation

Eugene Dufour Hospice Palliative Care Consultant – Bereavement Specialist – Trauma Therapist Phone: 519-476-2116 Email: edufour@tcc.on.ca

Providing Ex Exce cellent and and Com

• mpassio

ionate Car are to Our ur Clie lients, The heir Fam amili lies, Our ur Coworkers s an and Our urselves Du During the COVID – 19 19 Pan andemic.

Str trugg gglin ling Wi With th Mean anin ing and nd Pur urpose dur durin ing A Pand ndemic ic

• Supporting people as they question meaning in purpose

during a pandemic.

• Supporting our coworkers as they struggle with the theme of

meaning and purpose

• Supporting ourselves as we question our own view of

meaning and purpose.

• Reviewing the Compassion Fatigue Test

https://www.compassionfatigue.org/pages/selftest.html

Respondin ing To

• A Pand

ndemic

• 1. Do the things you are good at first.
• 2. Create a team.
• 3. Start planning for the future now.
• 4. Plan to provide long term trauma support.
• 5. Follow trauma informed principles and practices.
• 6. Long term plan for front line workers.
• 7. Buy in from all sectors.

Ass ssumptiv tive Wor

• rld

ld Basic ic Ass ssumptio tions

According to Dr. Ronnie Janoff-Bulman people generally hold three fundamental assumptions about the world that are built and confirmed

• ver years of experience:

1. The world is benevolent, 2. The world is meaningful, and 3. I am worthy. These are tacit assumptions that serve as a basis of our well-being and our guides in navigating daily life. Together these assumptions provide us with a sense of relative invulnerability that enables us to awake each morning and face the day.

As Assumptiv tive Worl

• rld:

The assumptive world is an organized schema reflecting all that a person assumes to be true about the world and the self

• n the basis of previous experiences; it refers to

the assumptions,

• r beliefs,

that ground, secure, and orient people, that give a sense of reality, meaning, or purpose to life.

Th The e La Ladder r of

• f As

Assumptions

Mi Missi sion

• n

The AIDS Bereavement and Resiliency Program of Ontario (ABRPO) collaborates with organizations to build worker, agency and community resiliency in the face of AIDS-related multiple loss and transition.

Gu Guidi ding ng Pr Princ ncipl ples es We understand that with the changing nature of HIV/AIDS, agency personnel and AIDS-impacted communities are relating to an illness associated with unpredictability, uncertainty and anticipatory grief, in addition to the pre-existing legacy of multiple losses. We believe e that t our work must t be:

• Grounded in solid theory
• Shaped by the experience of the people we work with
• Linked to people’s broader life experiences
• Framed within a context of equity and inclusion
• Trusting of everyone’s unique capacity to survive, thrive and make meaning

Emot

• tion
• nal

al First Aid

• 1. Supportive techniques include reassuring people:
• that the emotional expression they are experiencing is natural and normal,
• that we are comfortable being with them through this process.
• 2. The condition of support is this: do not try to help a person to express an

emotion that you yourself are not able to express comfortably.

• 3. Basically we have a short-term contract with the person: we want to support

him/her through this emotional expression process without deepening the experience.

• 4. It is non-judgmental, peer support. We offer acceptance and permission with
• ur words, gestures, facial expressions and touch (with permission).

Emot

• tion
• nal

al First Aid - EFA

• 5. The peer providing the support has responsibility to both the person

receiving the aid, and to the environment, keeping both the person and those around feeling safe.

• 6. There is no attempt in Emotional First Aid to deepen the emotions, to

give advice or to direct someone. There is a major difference between EFA and therapeutic facilitation (which works on a clear and defined contract, either short- or long-term, which involves a mandate to redirect, deepen, initiate, prohibit, facilitate

• r give advice).

Therapists and facilitators have education, training, personal therapy and supervision that enables them to work with someone else’s issues and stay grounded and clear.

Death of a Child

• 4 and 5 year old's at a pool party
• 14 year old babysitter went with them
• 14 year babysitter drowns
• children and parents witness the resuscitation

Communi nication n Core e Compe peten ency – Le Level els s of Disc scloser ser The skill of self-awareness is applied in communication by the following four steps which are ‘nested’, meaning that each builds on the previous. Each step promotes authenticity in our words in order to support competent communication of personal experience into relating with

• thers.

This creates greater visibility of our whole self as we relate with others and strengthens the integrity of relating within groups. Each step is based in taking ownership for our own experience and perception of a situation by using I-statements.

Communi nication n Core e Compe peten ency – Le Level els s of Self f Disc scloser ser

• 1. One’s capacity to be aware of one’s own inner experiences as they

relate to reality beyond oneself.

“I am aware of what is going on for me – at all levels – as I relate to this situation.”

• 2. One’s willingness to risk expressing one’s awareness to others.

“I am able to risk telling it like it is.”

• 3. The skill to express oneself without discounting the other person,

blocking communication or harming the relationships.

“I have solid communication skills that enable me to speak with deep honesty AND remain connected to others.”

Communi nication n Core e Compe peten ency – Le Level els s of Disc scloser ser

• 4. A willingness to use one’s voice to help the group interpret the meaning
• f events in a way that creates alignment on objectives and strategies, and

helps build mutual trust and cooperation.

“I can see how the various elements in this conversation can be linked to the

• verall work we are doing as an agency. The differences can help us be stronger

and more effective.”

“Life is change; Gro Growth th is op

• pti

tional; Choose wisely.”

Karen Kaise ser Clar ark

Bracketing ng

• 1. Bracketing is a process where a person notices an issue that is contributing

to feelings of sadness, fear or anger, and they temporarily put aside the issue, so that they can pay attention to the present situation.

• 2. It is important that we recognize and take care of these ‘emotional triggers’.
• 3. We must have the intention of returning to remove the brackets

(unbracket), which means that we then experience our own feelings and reactions at a time that is more suitable, convenient or appropriate. The stages below describe the behaviours, which are abbreviated to help to remember them: Acknowledge, Identify/Internal, Make, Breathe (AIMB).

Ackno nowledg edge, e, Iden entify fy/Inter erna nal, Ma Make, e, Brea eathe he (AIMB).

• 1. Ack

cknowled edge that there is an issue that needs bracketing. “I am feeling sad/angry/etc. at what I am hearing…”

• 2. Ide

dentify what part of your own story is being triggered. “This is reminding me about…”

• 3. Continue Intern

ernal Dialogue – “I am not going to relate to this experience right now; I will remain focused on the person in front of me.”

• 4. Make a contract with yourself to later remove the brackets and access

personal supports (informal or formal). “When can I look at these feelings and what or who will support me to do that?”

• 5. Brea

reathe, bend your knees, look around!

Emot Emotio ional l First t Aid – EF EFA

• 7. Bracketing is a crucial skill to develop before administering Emotional

First Aid. Being close to someone who is having big emotions can often be triggering.

• 8. Get support for yourself to unbracket and debrief the experience, either

informally or formally.

Due Duel l Proc

• cess of
• f Grie

Grief

HPCO Slide Masters Suffering Spirituality Beliefs

Life meaning and purpose

The Trinity Model – Lorraine Wright Spirituality, Suffering, and Illness – Ideas for Healing

The e Eigh ght Rs of Traum uma Recover ery Spiritua ual Crisi sis s – Surviving ng Traum auma to the e Soul ul – J.

• J. Mc

McBride de

Risking Revealing Responding Releasing Reflecting Rebuilding Resurrecting Reconciling Recovery

NEW COVID-19 RESOURCES

COVID-19 SPECIFIC CONVERSATION GUIDES:

• Proactive Goals of Care (GOC) conversations
• GOC conversations for a person with mild/mod COVID-19
• GOC conversation for a person with severe COVID-19
• Phone conversations with families of a dying person

OTHER COVID RESOURCES:

• Palliative symptom management suggested order set for LTC
• Advance Care Planning guides for patients and SDM
• Sample letter from LTC facilities to families and residents

ALWAYS AVAILABLE:

• Advance Care Planning, Goals of Care and Consent resources for

healthcare providers (conversation guides, e-learning modules)

• Person-Centred Decision-Making Toolkit

https://www.hpco.ca/