Dr. Paul Holyoke is the Director of the Saint Elizabeth Research Centre which has an applied health services research and evaluation portfolio focused on end of life care, person and family centred care, supports for caregivers, and integrated care and transitions. Paul has a PhD in health policy from the University of Toronto, a Master’s degree in public policy and administration from the London School of Economics, and a law degree from the University of Toronto.
Addressing spiritual needs at the end-of-life: a workshop on barriers and opportunities for changes in care at the individual, practice, and organization levels
Katherine is s a Research Associate with the Saint Elizabeth Research Centre, studying the needs of people, their caregivers, and health care providers to develop innovative solutions to improve health care experiences and more effective approaches to care. Her research work has focused on supporting conversations about dying and death, working with patients and family members through a co-design approach to improving supports during the end of life, chronic illness, and post-surgery experiences. Katherine’s previous areas of research work have included public health policy analysis, health equity, cross-sector and transdisciplinary partnerships in global health, cancer control strategy, quality control initiatives for radiation therapy, and government affairs in bio-pharmaceuticals. Katherine has a Master’s degree in Health Information Science from Western University and an Honours Bachelor of Arts in Health Studies and Political Science from McMaster University.
In best practices for end of life care, incorporating spiritual care is recognized as important and often, as essential. Despite this, health care organizations often do not embed spiritual care within their overall approach to practice, and spiritual care is often the first aspect of service to be reduced in the name of efficiency or cost-cutting. This is especially the case in secular healthcare settings without historical roots in spiritual practice. Given the stated importance of spiritual care but the reluctance to embrace it in secular settings, how can barriers be broken and opportunities seized? How can we provide for the specific spiritual needs of those nearing end-of-life and enable them to live their lives to the fullest up to the last moments of their life?
The overall goal of this interactive workshop is to engage participants in practical discussions on the challenges and opportunities in the provision of spiritual care at the individual, practice and organizational levels. The workshop will begin with a brief presentation on the research of Holyoke and Stephenson (2017) that identified, from the practices of spiritually-focused hospice programs across North America, nine organizational-level principles and practices to support spiritual care at the end-of-life.
Next, workshop facilitators will describe the following details about the second-stage qualitative study that identified barriers, opportunities and key processes for actually implementing the nine spiritual care principles at the organizational, practice, and individual levels in secular health care organizations: Focus groups were conducted with health care and spiritual care workers (n=55) in hospital, hospice, and home care settings in four Canadian cities. Framework analysis was applied by two independent researchers to analyze the data, who then, together, developed a working analytical framework. The resulting framework includes barriers, facilitators, and processes related to the following three categories and themes: 1) Place: identifying and creating elements that enable a sacred space (physical & imagined) in any setting for any person; 2) People: involvement and practices that support a holistic approach to care, including the spiritual; and 3) Time: investing time in and for spiritual care, often in stark contrast to systemic pressures for hurried, transactional care in the healthcare system.
Following these brief presentations, workshop participants will be asked to consider the application of the framework themes across the continuum of care and work together to brainstorm and discuss immediate, shorter term and longer term actions to improve and expand spiritual care at the end-of-life in accordance with the nine organizational-level principles and practices. Workshop facilitators will guide reflections on challenges and opportunities related to the actions identified, for example, asking participants to consider whether there is a need for additional financial and human resources.
At the end of this workshop, participants will be equipped with tools and ideas to apply the framework in their own organizations and practice areas to enhance the delivery of spiritual care at the end-of-life.