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Abstracts WA50

WE CAN’T DO IT ALONE: HOSPICES AND SCHOOLS WORKING TOGETHER TO EDUCATE AND SUPPORT CHILDREN AROUND DEATH, DYING AND BEREAVEMENT

Sally Paul, Helen Quinn. Strathclyde University, UK 10.1136/bmjspcare-2015-000906.50

Background Educating and supporting children around death, dying and bereavement, in schools, frequently relies on the individual interest and expertise of staff (Rowling 2003). Moves to develop such work of ten results in one off projects led by external agencies. Support and education is therefore ad hoc and unequitable. A research study was undertaken between a hospice and school to develop practice in this area from a health promotion perspective. This presentation discusses the design and implementation of two practice innovations arising from this process. Aim The innovations aimed to introduce and educate children on issues related to loss and change, whilst simultaneously ensure that school staff have the skills and confidence to support individual experiences within the school setting. This was from a harm education and early intervention standpoint. Method Collaborative inquiry, within an action research methodology, was used to advance the innovations. This involved school and hospice staff working together to design and facilitate the activities. Results A programme of activities for children aged 5 to 11 (the resilience project) was designed and integrated throughout the curriculum. This is currently being piloted. A bereavement training programme was designed and facilitated to all school staff. Evaluations reported an increase in confidence around supporting bereavement issues. Conclusion The process highlighted that combing the skills and expertise of hospice and school staff was essential in developing sustainable activities, appropriate to the setting. The role of the hospice in engaging with communities to collaboratively develop education and support around death, dying and bereavement was emphasised. REFERENCE 1

Rowling, L. Grief in school communities: effective support strategies. Buckingham and Philadelphia: Open University Press, 2003.

OA51

CARING COMMUNITY IN LIVING AND DYING – ENGAGING COMMUNITIES THROUGH PARTICIPATORY RESEARCH, AN AUSTRIAN CASE STUDY

1

Klaus Wegleitner, 1Patrick Schuchter, 2Sonja Prieth. 1Institute of Palliative Care and Organisational Ethics/Faculty of Interdisciplinary Studies/IFF Vienna/Alpen-Adria University Klagenfurt, Wien, Graz; 2Tyrolean Hospice Association, Austria

10.1136/bmjspcare-2015-000906.51

Background The development in hospice and palliative care in German-speaking Europe is focused on improving professional practice and specialised palliative care services. The project was developed to foster the paradigmatic shift from professional – and institution – centred end-of-life care to community-based approaches in current end-of-life care in Austria. Aim The project aims to strengthen networks and solidarity in endof-life care, moreover to foster self-help resources of older people and family caregivers. Local initiatives and projects in diverse community contexts should be developed and supported. The process should raise awareness within the local population about existential questions concerning vulnerability, frailty, dying, death, loss and grief. Method The project follows a multi-level participatory research (Minkler, Wallerstein 2003) and community development A16

(Kellehear 2005) approach. Phase 1: Describing, analysing and appreciating local care culture. Phase 2: Strengthening local networks and self-help resources. Phase 3: Supporting implementation and sustainability. Results The participatory research process was based on the dense narratives, micro-stories and care actions of people concerned in order to put these in relation to, and expand it with the different perspectives of the “circles of care” (Abel et al. 2013). Thus existential and care experiences were shared and common knowledge of local care cultures and resources was generated. REFERENCES 1 2 3

Minkler M, Wallerstein N, eds. Community based participatory research for health. San Francisco: Jossey-Bass, 2003. Kellehear, A. Compassionate cities. London: Routledge, 2005. Abel J, Walter T, Carey L, Rosenberg J, Noonan K, Horsfall D, Leonard R, Rumbold B, Morris D. Circles of care: should community development redefine the practice of palliative care? BMJ Support Palliat Care 2013:3:383–388.

Conclusion The stakeholders succeeded in building relationships of trust and in forming “care culture working groups” in various spheres of the community. As this is an ongoing project the challenges of social and cultural sustainability should be discussed in order to get the citizens involved to an even greater extent in gaining ‘ownership’ of and control over the caring community as an ongoing cultural process offering solidarity and compassion in living and dying.

OA52

“ETHICS FROM THE BOTTOM UP”: PROMOTING NETWORKS AND PARTICIPATION THROUGH SHARED STORIES OF CARE

Patrick Schuchter, Andreas Heller. Faculty of Interdisciplinary Studies IFF Wien/Vienna, Institute of Palliative Care and Organisational Ethics, Alpen-Adria University Klagenfurt, Wien, Graz, Austria 10.1136/bmjspcare-2015-000906.52

Background The "basic action" in creating compassionate communities is to create settings where people effectively have the opportunity to develop concerns and compassion for each other. The project “ethics from the bottom up” (in Bad Bentheim, Lower Saxony, Germany) brings together the relatives of old and dying people, professionals from healthcare organisations and people from other living and working contexts in order to share their sorrows and care experiences. Aim Current methods and concepts of applied and organised ethical deliberation (or ethics "consultation") are not qualified and able to fulfil the requirements of ethical questions in the field of health promotion and health promoting palliative care. The predominant model of ethical deliberation in healthcare settings, the clinical ethics consultation, is designed for the specific orientation needs of curative medicine. The analogous step from medicine to health promotion, from professional palliative care to compassionate communities has not been carried out in ethics. By promoting a compassionate community through shared narratives of care and concern, a paradigmatic shift from clinical ethics to “communal” ethics is put into action. Method Participatory action research design. Ethical approach based on narrative and care ethics. Results We observe a new and simple way to bring relatives into communication with each other and with professional and (specialised) health services and to discuss the fundamental questions of human life. This is one way of initiating the democratisation of care, of finding support in the challenges of weakness and dying. SPCare 2015;5(Suppl 1):A1–A32

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OA51 Caring community in living and dying − engaging communities through participatory research, an austrian case study Klaus Wegleitner, Patrick Schuchter and Sonja Prieth BMJ Support Palliat Care 2015 5: A16

doi: 10.1136/bmjspcare-2015-000906.51 Updated information and services can be found at: http://spcare.bmj.com/content/5/Suppl_1/A16.2

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OA51 Caring community in living and dying - engaging communities through participatory research, an austrian case study.

The development in hospice and palliative care in German-speaking Europe is focused on improving professional practice and specialised palliative care...
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