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A Public Health Approach to Improving End-of-Life Care

In recognition of National Public Health Week, we are spotlighting an innovative public-health approach to improving end-of-life care, the Compassionate Communities (CC) model. Originating in Australia and now utilized in multiple countries, including the United Kingdom and Canada, CC models create bridges between health systems and local communities to transform palliative and end-of-life care experiences beyond the four walls of the hospital. The model is gaining interest in the United States and even among C-TAC members, such as The Peaceful Presence Project. The CC model works to transform conversations and practices around death, dying, and end-of-life care among community members and organizations. The CC focus on community-based services aligns with C-TAC’s policy and advocacy efforts aimed at improving access to care and services at home for people living with serious illnesses.

Implementing a CC model aims to transform end-of-life care in the following ways:

  1. Conversations around death, dying, and bereavement would be normalized and productive.
  2. Expectations around death and dying will change among community members, including how death will be managed.
  3. Palliative care will be repositioned to support community-based health and social care for people at the end of life and their families.

This can be done through partnerships between health systems and community-based organizations as well as targeted outreach efforts to change perceptions around death and dying. Along with the repositioning of palliative care, CC models take a holistic approach to improving end-of-life care experiences. Compassionate Communities often utilize death doulas to facilitate tough conversations, connect individuals to needed services, and holistically support people at the end of life. C-TAC member, The Peaceful Presence Project, is a collective of end-of-life doulas whose work is substantially informed by the ethics and vision of the compassionate communities model of care.

Continuum of compassionate palliative care in Canada, from Compassionate Communities in Canada: it is everyone’s responsibility.

Elizabeth Johnson is the Executive Director at The Peaceful Presence Project and shared with us how compassionate communities models can benefit public health on a community level:

“Prioritizing [informal care relationships], while also working to promote higher levels of death literacy, means that communities can begin to benefit from an informed and resilient ‘mutual care’ approach that encourages people to be more resourced and advocate for higher quality and more equitable end-of-life care experiences.”

Johnson highlights the way that compassionate communities prioritize non-medical needs to ensure there is the quality end of life care, stating, “because this model works from the perspective that death is a social event with a medical component, it informs where and how people can feel empowered to give and seek out quality and community-centered support.” End-of-life doulas are widely utilized in compassionate communities models around the world due to their unique position to bridge health and social systems on an individual level for people at the end of life. For more information on end-of-life doulas and The Peaceful Presence Project, click here.

The integration between healthcare and community-based social services that encompasses compassionate communities models exemplifies modern public health efforts to address population health as a product of multiple social factors influenced by the communities in which people live, work, and play. This year’s National Public Health Week theme is ‘Public Health is Where You Are’ and the CC model embodies this vision.

C-TAC continues to advocate to improve care for people living with serious illnesses, especially as it pertains to increasing access to community-based services. To read more about these efforts, check out our national policy agenda here.

Written by Andrew Lozano – C-TAC Communications Specialist