Her national perspective on changing issues in end-of-life care inspired the audience of almost 200 healthcare professionals. To ensure that your wishes will be carried out at the end of life, "...the best guarantee is to talk to your family about your wishes," Christopher said. "Dying is not a medical event, it is a social and community event." She explained that the caring conversation between loved ones about end of life "is not about fear and death-but rather it is about what is important in your life."
Two breakout sessions from the conference will lead to new projects in Oklahoma in the coming months. Becky Pruitt, ethicist with Mercy Health Systems, and Dr. Kevin Donovan, director of the Oklahoma Bioethics Center, led an all-day training for ethics committee members from across the state. Over a dozen of the participants volunteered to continue working on plans for an Oklahoma Alliance for Ethics Committees. "We believe members of ethics committees in Oklahoma's hospitals and long-term care facilities will welcome the opportunity to come together and share information and experiences," Pruitt said.
Invigorating and expanding Oklahoma's pain initiatives was the focus of another session led by Mary Bennett, from the American Alliance of Cancer Pain Initiatives, Madison, WI. Assisted by Oklahoma leaders in the field, the group discussed new JCAHO pain standards. A work group will meet again to continue this effort.
A panel on "Religious and Cultural Differences in Decisions at the End of Life" included presentations by a rabbi who is also a social worker, an Islamic imam who is also a medical doctor, and a Cheyenne-Arapahoe health educator who is a member of the Native American Church. Issues raised included how cultural beliefs about personal autonomy might affect how aggressively a person would pursue life sustaining treatment, or how some people might appear more fatalistic or willing to "give up" in comparison to dominant American values.
Jane Carney, panel facilitator, said "Although everyone recognized that this was just an opening to understanding different cultural perspectives, it was very successful in sensitizing participants to question their first view of decisions and behaviors of patients and families from different traditions."
Over 225 people gathered for the conference luncheon where the first annual Omega Award was presented. The NBA Oklahoma Christian Home, Edmond, won the award for innovations in end-of-life care. The award included a special commendation for the "Unsung Hero" of the facility, Felicia Moghbel-Far, L.P.N. The award application asked for nominations to recognize and honor a worker who delivered outstanding bedside care to residents at the end of life. Moghbel-Far said, "I look at this as a calling, not a career." Moghbel-Far loves to sing, and often sings favorite songs to residents as she cares for them.
Laura Cross, project director for OkABCD, said that the Alliance knows there are many facilities across Oklahoma that deliver outstanding care to terminally ill residents. "The award was designed to recognize this work and to honor the 'Unsung Heroes' who work at the bedside in licensed nursing facilities," she said. Standards for the award included attention to physical symptoms, pain management, and awareness of psychological and spiritual issues at the end of life.
Representatives from the honored facilities discussed their programs during an afternoon panel. At the Oklahoma Christian Home, a book is sometimes placed by the bedside of a dying resident so staff and other visitors can record their "good-byes." The facility has an ethics committee. Hospice care is often used, and nursing staff makes sure that a resident does not die alone. If no family can be present with the resident, staff will remain in the room.
The Oklahoma Alliance for Better Care of the Dying is a statewide partnership of organizations and individuals working to foster competent, comprehensive, and compassionate end-of-life care accessible to all Oklahomans. It has received one of twenty-three state grants from the Robert Wood Johnson Foundation's "Community-State Partnerships to Improve End-of-Life Care" initiative.
Linda Edmondson is Executive Director, Oklahoma Association for Healthcare Ethics and Project Manager, Oklahoma Alliance for Better Care of the Dying.
For more information, contact: Oklahoma Alliance for Better Care of the Dying, phone: 888 687-2280 or www. OkABCD.org