OREGON HOSPICE AND PALLIATIVE CARE ORGANIZATION ENDOFLIFE DOULAS

OREGON HOSPICE AND PALLIATIVE CARE ORGANIZATION END-OF-LIFE DOULAS & HOSPICES PRESENTED BY: LYNNE DENNE' + PATTY BURGESS

OPTIONS AND OPPORTUNITIES INTEGRATING EOL DOULAS INTO HOSPICE AGENCIES COLLABORATIVE APPROACHES

LEARNING OBJECTIVES • Define the role of the EOL Doula • Understand how doulas may address aging crisis • Describe how hospices may utilize doulas • Share practice settings and integration opportunities

LYNNE DENNE` INTRODUCTION: PRESENTERS Coastal Home Health and Hospice Volunteer Coordinator and Trainer, Community Advocate/Educator End-of-Life Doula PATTY BURGESS Teaching Transitions, President of Possibility Online Hospice Volunteer Training Doing Death Differently End-of-Life Doula Training • Founding member of NEDA • Founding Member of the NHPCO EOL Doula Advisory Council

DOULAS AS NON-MEDICAL ANSWER TO AGING CRISIS • 76. 4 Million Baby Boomers Source: US Census Bureau • 9/10 people want to be cared for at home Source: 1996 Gallup Poll from NHPCO • U. S. shortage of up to 120, 000 physicians by Source: Complexity of Physician Supply and Demand - AAMC 2030 • By 2020 US will need 12 million new nurses Source: ANA American Nurses Association • 117, 000 million American will need assistance by 2020, yet the number of unpaid caregivers will be 45 million Source: Forbes, August 2018

WHAT'S THE BUZZ? Trending Emerging Profession Addressing the Silver Tsunami

NATIONAL INITIAVTIVES National End-of-Life Doula Alliance NHPCO End-of-life Doula Council

ROLE, SCOPE & MODEL Definitio EOL doulas n provide non-medical, [holistic], practical, emotional and spiritual support & companionship to the dying person and their loved ones, from advanced illness through death and post-death Practice Scope • Adjunctive support to the care team, not the lead • Does not give advice or provide medical care • Offers information, guidance, and community resources • Respecting values, upholding self-determination Non-Medical Doula Model • Presence and companionship • Comfort measures and practical support • Logistical support • Advocacy/Education

WE ALREADY DO THAT. . . WHY DO WE NEED DOULAS? STAFF TIME AND SERVICE LIMITATIONS REINFORCED EDUCATION FOR BETTER PATIENT COMPLIANCE HIGHER PERCEPTION OF CARE EARLY REFERRALS COST SAVINGS

CHALLENGES • Increasing complaints of hospice service failures • Doing more with less • Increased patient loads • Staff burnout • Underutilized volunteers OPPORTUNITIES EOL Doulas can positively impact all hospice departments: Marketing – Volunteer – Clinical – Finance

HOW? Filling Gaps. . . Bridge to the patient and the family Bridge to the family and hospice As A Bridge. . . Bridging the community and hospice

A COLLABORATIVE ENDEA VOR Marketing Clinical Finance Volunteer OPPORTUNITIES BY DEPARTMENT

MARKETING • Bridging early referral challenges • Doula program is a marketplace differentiator • Solidifying referral source relationships • Higher perception of care = more admissions

CLINICAL - Supportive Care • Lack of time for Nurses, Aides, Social Workers, Chaplains, Bereavement Coordinators (caseload) • Reinforcing family education • Extra set of eyes and ears • Minimizes burnout • Increases advocacy • Presence when staff it not available

FINANCE - Cost Savings • Increase in early referrals • Increased LOS • Potential head-count reduction • Per-head costs less for doulas • Staffing flexibility • Cost saving - fewer 911 calls • Reduced liability - inexpensive insurance

VOLUNTEER DEPARTMENT Working with EOL doulas can assist with: • Recruitment/Retention • Meeting the 5% rule • Increasing patient assignments • Availability of alternative modalities If an EOL doula program is considered or formed, it is usually managed from the Volunteer Department

MORE COVERAG E WAYS TO USE DOULAS • Extended vigil care • More coverage for last days = fewer 911 calls • Immediate Post-death visits BETT ER COM MUNICAT ION • Reinforcing family teaching • Pro-active family check in • Troubleshooting communication gaps, internal and externally GREATER PRESENCE • Doula on call • Tele-Doula • Continuity for pre-death, vigil and post-death c are NO COST MARKETING DOULAS AS COMMUNITY ADOVCATES FOR HOSPICE • Doulas host community events • Collateral materials drop-off to referral sources • Speaking - Educating

• Volunteer/ Community Doulas • Hired/Salaried (PT or FT) • Contracted (independent) • Retained (to be available) EOL Doula Integration Solutions and Strategies EOL DOULA INTEGRATION OPPORTUNITIES • Per-Diem • Job Share (shared with other hospices or referral sources) • On call (PRN) • Tech doula - email/text communication • Tele-Video doula

LYNNE DENNE' Crafting a doula position within a hospice WHAT Bridging gaps – time, communication, education Offer “high touch” with low cost service HOW On call need in rural community where we serve WHEN Available when nurse or other clinical team are not able to meet a more immediate need. Only filling in when clinical services are not required, Providing presence. WHY Satisfaction and perception of care increases when patients needs are met as soon as possible

One Doula’s Duties Responsibilities Hospice Setting Volunteer Referrals Body Disposition Resource Provider Notification of Death Pre. Admission Visit Member IDG EOL Doula Death Midwife Vigil & Respite Aid-in. Dying Resource Tuck-in Calls Reporting EOL Educator Field Support

NEXT STEPS? Q & A • What might the challenges and opportunities be for my organization? • How can a doula serve in my organization?

Lynne Denne’ Coastal Home Health and Hospice 541 -469 -0405 www. coastalhhh. org Patty Burgess Teaching Transitions – Doing Death Differently 267 -428 -6677 Online Volunteer Training - www. Teaching. Transitions. com Doula Training - www. Doing. Death. Differently. com