Building a Stronger and More Inclusive Ontario Part 2: Understanding the link between

Age-Friendly and Compassionate Communities

May 31, 2018

Presented by: Julie Darnay, Manager of Partnerships and Communities of Practice, Denise Marshall BSc., MD, CCFP(PC), FCFP Medical Director, Niagara West Palliative Care Team and McNally House HospiceDeborah Sattler, Lead, Windsor Essex Compassion Care Community and

Polling Questions #1: Before we start

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Learn about the “Compassionate Community” movement

Theory

Learn about provincial and local resources, tools and opportunities

Gain insights on how Compassionate Communities complement Age-Friendly and Dementia-Friendly

Scale Up

Compassionate Communities in Action: Windsor-Essex experience

Practice

Objectives for Today

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Who We Are

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We are part of an International Movement that wants to improve the Quality of Life …

One PersonOne Neighborhood,

One Community, One Population … at a time

• 50% of Ontarians who die do not access palliative care

• Misperceptions about HPC• ‘healthy living’ has become ‘health services’• ‘good death’ has become ‘managed death’• The ‘social’ element in general, is missing

• Lack of availability of HPC services – large inequities

• 40% more deaths each year by 2020 that will contribute to a demandin palliative care. Relying solely on a formal system response to the predicted increase in demand for PC in the future will be challenging

• Caregiver burnout is a key contributor to trips to the emergency room in the last stages of life.

• 25% of seniors live alone and social isolation is linked to poor health and poor quality EOL care.

• Preventable waste and avoiding ED visits in the last month of life could save 11.1M/year for the Ontario Health Care system

Reality #1: Death, Dying and Loss

Reality #2: Most Care is Social

Meaningful life-long care as seen by the person within their environment

Reality #3: Social Isolation is Harmful

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Theory

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Our Response: Compassionate Communities

• Developing public health principles first alongside institutional priorities

• Working with the public health sector

• Employing collaborative models

• Mainstreaming death & dying as a ‘life and living’ issue – avoiding ghetto-ing mortality

Dr. Alan Kellehear

Public Health Approaches to End of Life Care

HPCO Slide Masters

Health Promoting Palliative Care

• Goes beyond illness- involves the well, and wellness

• Includes schools, workplaces, businesses, unions, places of worship, media, leisure groups, clubs etc

• Recognizes limits to service provision

• Restores end of life care to the wider public health sphere of policy, practice, and language

• Principle that end of life care is everyone’s responsibility

• Uses partnership and population based approaches

1. Schools – Will have guidance documents for dying, death, loss and care.

2. Workplaces – Will have guidance documents for dying, death, loss and care.

3. Trade Unions – Will have guidance documents for dying, death, loss and care.

4. Churches and Temples – Will have at least one dedicated group for End Of life (EOL) care.

5. Hospices and Nursing Homes – will have community development programs that focus on EOL care and will involve local area citizens.

6. Museums and Art Galleries – will hold exhibitions on the experience of ageing, dying, death and loss or care.

7. Our city will celebrate and highlight the most creative compassionate organization, event or individual(s) through an incentive scheme, for example a “Mayor’s Award.”

Compassionate City Charter

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7. Through various forms of media, our city will publicly showcase our local government policies, services, funding opportunities, partnerships, and public events that address our compassionate concerns. As well, all EOL services will be encouraged to share this material.

8. Our city will work with local social or print media to encourage an annual city-wide short story or art competition to raise awareness of ageing, dying, death, loss or caring.

9. All services and policies will demonstrate an understanding of how diversity shapes the experience of ageing, dying, death, loss and care.

10.We will encourage and support institutions for the homeless and the imprisoned to have support plans in place for EOL care.

11.Our city will establish and review these targets and goals in the first two years. Thereafter will add one new sector annually to our action plan.

Compassionate City Charter

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HPCO Slide Masters

Practice

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Working Together23 Sponsors; 100+ partnersIT’S A SOCIAL MOVEMENT

Improving Lives, Strengthening CommunityVision: “Working together to make ourselves, our citizens and our community more well”

Community Challenge Prove the difference we make: 500+ new members served each year Target of 5 to 10% year over year measurable improvement in population quality of life

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Collective Impact Approach

• Wellness Hubs and end of life programs in hospices and community centres

• Compassionate neighbourhoods

• 1ST Annual Shining the Light on Compassion Awards: MP, MPP, Mayors, Town Councillors

• Compassion choir,

• Short story, video and song contests, photo and art exhibits, reading events, neighbourhood quality of life challenge

• Community Dialogue series

• Education events and workshops

• Calling All Faith Leaders: Time to talk

• Initial conversations with schools, businesses and trade unions

• Public marketing and advertising, print, social media and radio coverage, and navigation to address “compassionate concerns”

CCC Community Events

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Scale Up

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Hospice Palliative Care Ontario is leading the new provincial strategy called

“Compassionate Communities”

to catalyze whole person care throughout the province of Ontario, to benefit patients, family caregivers, and the formal health care system.

HPCO Compassionate Communities Provincial Strategy

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Ontario’s Approach

• Core components: • A charter to bring together all

levels of governments, business, community groups, grass-roots and service leaders

• A program for life-long care to address all aspects of well being

• A measurement tool to track individual and community progress

Taking a Health Promoting Palliative Care Approach

Expands our approach to health care to include the community as genuine partners – not simply as targets of our service provision

➢MOVING FROM: direct services, clinical, face-to-face, bedside, acute care, or institutional approaches

➢MOVING TO: community, health promotion, partnership, population based approaches

HPCO Slide Masters

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Compassionate Communities CoP

• Connect individuals across Ontario that are actively involved in a structured Compassionate Community project or interested in learning more

• Offers an infrastructure to support these individuals in sharing knowledge and information

• Offers a forum for building a broad network of Ontario communities committed to improving population health outcomes for aging and EOL

HPCO Provincial Project Management Office• Offering mentorship and coaching in project implementation, technology,

policy, research, incubator test site

Expert Leadership Team• Supports and advises on recommended Ontario approaches, tools,

resources, promotion, awareness, etc.

Project Members• begun community engagement and/or• identified a project sponsor and/or• secured resources or funding

General Membership• Open to any individuals interested in, considering or working in a

structured organization participating in a Compassionate Community/City initiative in Ontario

CC CoP Structure - Implementation

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Community Research Collaborative• Connects like-minded Ontario researchers and offers an

infrastructure to support these individuals in sharing knowledge and information

• Develops and shares research and evaluation approaches for adoption by existing and emerging CC implementation communities

• Involves 25+ Researchers

CC CoP Structure - Research

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Polling Questions #2: Join our research

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International Leadership

Public Health Palliative Care International

National Leadership

Pallium Canada

Provincial Leadership

Hospice Palliative Care Ontario

International, National, Provincial Alignment

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Common Goals and Principles

Overlapping Core

Characteristics, Goals & Vision

Value Of Persons' Lived

Experience, Wisdom, and Contributions

Broad Coalition of Stakeholders

Engaged

Global Reach & International

Support

Emphasizing Inclusion and Accessibility

Mechanisms of Promotion & Mentorship

Opportunities

Importance of Physical

Environment

Alzheimer Society of Saskatchewan,2017

Strengths and Evidence- based

Domains Age-friendly Dementia Friendly Compassionate Communities

Purpose In an age-friendly

community, the

policies, services and

structures related to

the physical and social

environment are

designed to help

seniors “age actively.”

The community is set

up to help seniors live

safely, enjoy good

health and stay

involved.

Dementia Friendly

community is a place

where people living with

dementia are understood,

respected and supported.

People will be aware of and

understand dementia, and

people living with

dementia will be included

and have choice and

control over their day-to-

day lives and level of

engagement.

Using a Healthy Communities

framework, the

Compassionate Community’s

movement ensures seniors

and people with life-altering

conditions and their

caregivers live well from

diagnosis to death.

The community is set up to

enable people of all ages to

actively participate

in community activities and

treats everyone with respect

and compassion, regardless

of their age, status or level or

type of disability, across their

lifespan.

Aligned Purposes

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LHIN AGE FRIENDLY

COMMUNITIES

DEMENTIA FRIENDLY

COMMUNITIES

COMPASSIONATE

COMMUNITIES

ERIE ST CLAIR XXX X

WATERLOO

WELLINGTON

XX X XX

HNHB XXXXXXX X XX

MISSISSAUGA HALTON XXX X

TORONTO CENTRAL X X XX

CENTRAL XXXX XX

SOUTH EAST XXXXXXXX XXX XX

SOUTH WEST XX

CHAMPLAIN XXXXXX XX X

NORTH SIMCOE

MUSKOKA

XXXXXX X

CENTRAL EAST XX

NORTH EAST XXXXXXXXXXX XX X

NORTH WEST XXXX X X

Common LHIN/Community Locations

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Opportunities to work together

• Work together as provincial and local coalitions on key and aligning messages attempting to change social norms and influence policy

• Align with education and workplace learning (engaged youth = future leaders)

• Build a network of Ontario learning communities committed to improving population health outcomes across the life-span (inclusive of healthy aging, dementia and EOL sub-groups)

• CREATE A MOVEMENT

Strategies to Move Forward

Enable

• Promote education

• Association and agency leadership

Mediate

• Support local adoption

• Engage local, regional and provincial leaders

Advocate

• Advocacy common messages

• Incorporating common messages into association/organizational policy

Discussion

Polling Questions #3: What’s Next

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Julie DarnayManager, Partnerships and Communities of Practice

1-800-349-3111 ext. 30

jdarnay@hpco.ca

Hospice Palliative Care Ontario

2 Carlton Street, Suite 707

Toronto, ON M5B 1J3

www.hpco.ca

Contact Information