In Chapter 8 of his book Compassionate Cities, Allan Kellehear describes a number of initiatives that might support health promoting palliative care. He writes:
“These activities are offered as a guide and illustration of what some communities or activists might consider by way of public health actions that encourage communities to take a greater role in the care of their people living with life-threatening illness and loss... to stimulate readers to thinking of their own possibilities, or indeed even to experiment with some of the suggestions in their own communities.”
Some of Kellehear’s suggestions may be useful in providing inspiration or ideas to members of Good Life, Good Death, Good Grief:
Poster campaign: for example posters giving advice on how to comfort a grieving person.
Annual emergency services round table for paramedics, police, fire fighters and other emergency workers who deal with sudden death on an everyday basis in the community.
An annual “round table” could be an opportunity for them to discuss organisational ways that recognise and support the special stresses and satisfactions of their work.
Neighbourhood watch programmes: building on existing crime-watch programmes, neighbours can be encouraged to observe and reflect on the health, age-frailty or sudden death of their neighbours.
Offers to feed pets while neighbours are away, or in respite care, are examples. A simple but regular offer of help after bereavement can be helpful.
Short story competition covering issues related to death, dying and loss: the winners and runners-up can be published in the local newspaper, helping readers to gain an insight into some of these issues, providing a substantial basis for community empathy and support, and providing a normalising and comforting way for people to express themselves.
School and workplace plans for death and loss: many schools but few workplaces have plans to deal with the sudden death of staff, students and workers. Where such plans do not exist they should be developed.
Building/architecture prize for carers: seldom are affordable homes designed so that certain rooms can convert easily into “granny flats”; or bathrooms and kitchens designed for disabled as well as able-bodied use.
An annual building and architecture prize may well encourage those members of the community for whom building and designing is a life passion to rethink the problem of living design in the face of ageing and serious illness for public, private and domestic use.
Trivial Pursuit nights: for example a night exploring world consolation words and rites can be informative and stimulate people’s ideas about how they might respond to another’s grief.
Positive grieving art exhibition: encouraging schools or communities to design art to give expression to the positive aspects of grieving.
Public forum on compassion and loss: these can bring together people who have interest, time and commitment to these ideas, and a coalition of these interests can be formed from the initial interest that such a forum might generate.
A forum can also raise awareness and educate people, and can be a useful venue for a public debate about compassionate care.
Review of local policy and planning: most local governments have policies or planning models for public health, disasters and community services, but what about compassionate policies that support those living with life-threatening illness and loss? Local councils could be asked what these policies are.
Annual peacetime Remembrance Day: although many countries war veterans have an annual day to march and remember their dead, few places have an annual peacetime Remembrance Day.
Marching groups could walk together holding photos of their loved ones and may carry banners representing different suburbs, ethnic groups, ages or experiences of loss.
Walk-a-mile-with-me Week: communities could set aside one week every year to assist people to understand the joys and burden of care.
For example, aged care facilities might open their doors and ask members of the public to accompany or assist staff in caring for the elderly for one week; workplaces might sponsor lunchtime talks; newspapers might run special features.
Mortality network: a network of experts from funeral, grief or palliative care can be organised and advertised to visit schools, workplaces or community groups to speak to people about particular aspects of death, dying or loss. This can supply information, provide comfort, and can facilitate discussion.
Mobile death education unit: a mobile unit could be used for one or two education officers to visit schools and factories to impart practical information about death, dying and loss.
It could carry poster displays, photographs and research information. It could act as a mobile library of books and video material. Games, group exercises and role plays could be facilitated, as well as referrals and educational information about local services.
Annual veterans' Remembrance Day: An important obstacle to compassion is the ability to identify with the troubles of another person or group.
An ongoing community programme of reconciliation with former enemies around the universal social, personal and spiritual problem of loss during national days of remembrance is a worthy and therapeutic public health task, as well as a contribution to the prevention of further wars.
‘Speak my language (of Experience)’ programmes: Three or four times a year eight people could gather together to compare and contrast their experiences of living with a life-threatening illness or living with loss.
The idea is to select an experience – caring or coping – and choose two groups on the basis of social or cultural difference (eg four Christians speak about living with loss with four Muslims living with loss).
These group discussions of comparing and contrasting allow community members to learn about the differences within their own community but also the similarities of experience.
Such programmes can create a broader camaraderie and support within the community by encouraging new networks based on existential/circumstantial identification.
‘Volumes of Compassion’ book club: members of such a book club would read books that cover issues such as death, dying, loss, dispossession, abuse, as well as spiritual books with existential reflections and arguments, world religions, humanism and parapsychology. A book is chosen, read by the group, and then discussed.
The role of loss in the social history of the local community: local histories often emphasise their own local heroes and events, and when loss becomes a theme it is treated as a temporary setback or a tragedy.
The enduring nature of loss, its influence on decision-making of many people, including the elite as well as the poor of any community, and the constructive building power of loss is seldom the framework or even major section in social history.
Local governments, local historians or local community members could add to their local knowledge about themselves and their histories by re-examining, perhaps even rewriting their own histories to reflect and analyse the role of loss in their own life and times, and those of their ancestors.
Death and loss are not only tragic and sad experiences but also sources of motivation, hope and creativity in people.
Educational incentives for research into community support structures: Local government and/or the local grief or palliative care agency can offer incentives to universities and colleges to encourage their students to examine possible community support structures for death, dying and loss. For example prizes (a trophy is inexpensive to buy) for Best Student Essay or Best Thesis.
World spirituality show day: once a year it could be useful to ask the community’s religious adherents to ask their senior clerics to participate in promoting themselves to their local community.
Few people will not benefit from knowing more about how religion acts as a living experience in the lives of so many of their community
‘Light up a Life’ is a series of community events that are open to all and take place around the UK during the Christmas period.
The events are organised by independent hospices to help families and friends to come together to remember and celebrate the lives of loved ones.
Every Light up a Life event is different, but for most a vital part is the opportunity to dedicate a message in memory of a loved one, either by lighting a candle, hanging a message on a tree, recording the name of someone special in a book of remembrance or reading it aloud.
For most hospices, Light up a Life is one of their best-loved and most meaningful events, attracting hundreds of local people year after year. It represents a time to be comforted and to share hope with others.
NHS Dumfries & Galloway have developed a bereavement tool for use by the community based primary health care team to identify those who may require ‘extra’ support following bereavement.
It is designed to prevent some people from being visited too many times while others are not visited at all, and to clarify who in the ‘team’ is supporting and referring on to other agencies or methods of support where required.
