Download The Importance of Resilience in End of Life Care

The Importance of Resilience
in End of Life Care
Jenny Downes Social Worker Hammondcare
Each year around 58 million people die world wide, with more
than half aged 60 years and older. (Gomes and Higginson,
2008) Increasingly people are dying at an old age, as a result
of chronic illness and in a hospital or institutional setting.
Chronic illness makes up more than 70% of Australia’s
disease burden and is expected to continue
to grow. (PCA, 2010)
Society Resilience
The American Psychological Association
defines resilience as ‘the process
of
Neighbourhood Reilience
adapting well in the face of adversity,
trauma, tragedy, threats or even significant
sources of stress.’ Resilience is an
important quality to be developed in
people facing a chronic and life limiting
illness. It is a multidimensional construct
and can be defined on multiple levels (fig 1)
and in different areas of life. (fig 2)
Community
Resilience
Neighbourhood
Reilience
Family/Househ
old Resilience
Individual
Resilience
Financial
Resilience
Psycholog
ical
Resilience
Cultural
Resilience
Areas of
Resilience in
later life
Environm
ental
Resilience
Physical
Resilience
Social
Resilience
Braeside Hospital is a 72 bed
Wild et al 2013, fig 1 (top) Contextual and
hospital situated in South West collective scales of resilience in later life
Sydney in an area that is poor fig 2 (bottom) Different areas of life of
socioeconomically, has a large resilience for old age populations.
number of recent migrants, high unemployment and a high
proportion of families on welfare. 60% of the population in the
Fairfield area speak a language other than English at home.
(SWSLHD Annual Report 2007/08) The palliative care unit at
Braeside Hospital encompasses a 20 bed inpatient unit, an
outpatient clinic and community service.
The Importance of Resilience
in End of Life Care
Jenny Downes Social Worker Hammondcare
Challenges to developing Resilience
• Stressful life events
• Illness
• War and Trauma
• Financial Strain
• Poverty
• Lack of social support
• Language/cultural barriers
• Lack of information/education
Theories used in building Resilience include
Strength Based Approach
• Focus on client’s strengths
• Affirms client’s resilience and capacities
•
•
•
•
Anti-oppressive Theory
Aims to challenge the dominant and
oppressive structures of society impacting
on one’s age, race and gender etc.
Biopsychosocial Approach
Biological factors (illness)
Psychological factors (personality)
Social factors (cultural, familial etc)
Physical
Bereavem
ent
End of Life
Issues
Spiritual
Patients
and
Carers
Psychologi
cal
Advanced
Care
Planning
Emotional
Social
Areas of need
Palliative Care Australia 2003
Examples of Building Resilience in Palliative Care
• Casework – Focus on holistic care
• Multidisciplinary Patient and Carer Education Sessions
• Carer Support Days held at Local Clubs
The Importance of Resilience
Poster Title
in End of Life Care
Author/s
Jenny Downes Social Worker Hammondcare
Topics included in Patient and Carer Sessions
•
Advanced Care Planning
•
End of Life Issues/Crisis Management
•
Energy Conservation
•
Look Good, Feel Better Workshop
•
Legal Issues
•
Medications and Nursing Issues
•
Physical Activity/Exercise
•
Spiritual Care
•
Grief and Loss Issues
•
Healthy Eating
•
Guided Meditation and Massage
•
Stress and Relaxation, Laughter Therapy
•
Art Therapy/Leisure
•
Music Therapy/Concert
Conclusion
Palliative Care ‘affirms life and regards dying as a normal
process’ and aims to enable patients to live as actively as
possible until death. (WHO) With the aging of the world’s
population and increasing chronic illness, the philosophy and
principles of palliative care such as holistic care and
maximizing quality of life assist in enabling patients and their
families in building the resilience needed to live their lives to the
fullest in the time they have left.
References
•
•
•
•
•
Gomes, B and Higginson, I. Where people die (1974-2030): past trends, future
projections and implications for care. Palliative Medicine. 2008:22; 33-41.
Healy, K. Social Work Theories in Context (2005) Great Britain: Palgrave
Macmillan.
Min,J., Yoon, S., Lee, C., Chae, J., Lee., C., Song, K. and Kim, T. (2013)
‘Psychological resilience contributes to low emotional distress in cancer patients.’
Support Care Cancer. Vol 21: 2469-2476.
Palliative Care Australia, ‘Health System Reform and Care at the End of Life: A
Guidance Document,’ May 2010.
Wild, K., J. L. Wiles and R.E.S. Allen. 2013. “Resilience: thoughts on the value of
the concept for critical gerontology.” Ageing and Society 33(special issue 1): 137–
158.