Abstract
BackgroundA compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity. In this project, we piloted one such capacity-building model in which volunteers and a nurse partnered to provide navigation support beginning in the early palliative phase for adults living in community. The goal was to improve quality of life by developing independence, engagement, and community connections.MethodsVolunteers received navigation training through a three-day workshop and then conducted in-home visits with clients living with advanced chronic illness over one year. A nurse navigator provided education and mentorship. Mixed method evaluation data was collected from clients, volunteer navigators, the nurse navigator, and other stakeholders.ResultsSeven volunteers were partnered with 18 clients. Over the one-year pilot, the volunteer navigators conducted visits in home or by phone every two to three weeks. Volunteers were skilled and resourceful in building connections and facilitating engagement. Although it took time to learn the navigator role, volunteers felt well-prepared and found the role satisfying and meaningful. Clients and family rated the service as highly important to their care because of how the volunteer helped to make the difficult experiences of aging and advanced chronic illness more livable. Significant benefits cited by clients were making good decisions for both now and in the future; having a surrogate social safety net; supporting engagement with life; and ultimately, transforming the experience of living with illness. Overall the program was perceived to be well-designed by stakeholders and meeting an important need in the community. Sustainability, however, was a concern expressed by both clients and volunteers.ConclusionsVolunteers providing supportive navigation services during the early phase of palliative care is a feasible way to foster a compassionate community approach to care for an aging population. The program is now being implemented by hospice societies in diverse communities across Canada.
Highlights
A compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity
The public health approach to palliative care has various understandings in the literature [9], the project reported in this paper builds upon the approach that recognizes the essential nature of social support to overall well-being [10], and the relevance of health promotion strategies for those on a palliative trajectory [11, 12]
After the volunteers received navigation training, the nurse navigator matched the client with a volunteer and a joint visit was conducted by the nurse and volunteer navigator
Summary
A compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity. The public health approach to palliative care has various understandings in the literature [9], the project reported in this paper builds upon the approach that recognizes the essential nature of social support to overall well-being [10], and the relevance of health promotion strategies for those on a palliative trajectory [11, 12]. This social support, public health approach requires strategic partnerships between governments, communities, and services to develop important social capital, which is characterized by relationships of trust, empathy, and cooperation. Healthy communities coordinate efforts to improve these essential partnerships; compassionate communities work to ensure that those most vulnerable benefit from broad-based support in accordance with their specialized needs [13]
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