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Schools and Colleges

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Workplaces and Trade Unions

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Places of Worship

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Hospices and Nursing Homes

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Museums and Art Galleries

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City wide Memorial Event

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Incentive Schemes and Awards

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Homeless and Prison Community

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Become a Compassionate Friend or Champion

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Deliver a Compassionate Network

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Promoting and Celebrating

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Inclusive Policies and Practices

A Compassionate City

A compassionate city is a community that recognises that care for one another at times of crisis and loss is not simply a task solely for health and social services but is everyone’s responsibility.

In a compassionate city, we all stand to benefit.

At a conference in Plymouth earlier this year, schools, places of worship, GP surgeries, solicitors and charities – and many other organisations and groups from across the community – called for our city to have an End of Life (EoL) Compassionate City Network.

We’re pleased that Plymouth now has such a network, with over 40 individuals and organisations already signed up to work towards the key objectives of the EoL Compassionate City Charter formally adopted by Plymouth City Council.

Who are Public Health Palliative Care International (PHPCI)?

A public health approach to end of life care, views the community as an equal partner in the long and complex task of providing quality healthcare at the end of life.  All members of this association hold this principle to be true and commit their respective organizations to this value and vision of end of life care

Next Steps

This website provides a focal point for information on aspirations, activities and actions towards the aims of the charter, and a city-wide steering group will monitor our collective progress.

Together, we’re making big strides towards turning aspiration into action, but this is just the beginning.

Join us in giving a voice to everyone affected by death, dying, bereavement and loss and creating a city that does not shy away from their needs.

Our schools / colleges will have annually reviewed policies or guidance documents for dying, death, loss and care as part of the Healthy Child Quality Mark.

Schools and Colleges

Our schools will develop a policy position that sets out the school’s ethos towards death and dying and have procedures in place for staff to follow.

This objective seeks to ensure that those children, young people and the wider school community who have dying parents/loved ones and who are experiencing loss and bereavement, feel supported in schools by the school and their peers.

One in 29 children is affected by death, loss and bereavement (roughly one per classroom), and it is important that these children receive support to prevent from developing mental health issues. Teachers have told us that often these children need somewhere in school to talk about these issues as they feel they cannot talk about them at home for fear of upsetting the adults and family members.

What can schools/ colleges do?

Become a compassionate school that meets the following criteria;

  • Death and loss will not be a taboo subject in schools and settings. Through a whole school approach, including teaching and learning opportunities, children will become more resilient to the impact of death and dying and develop into emotionally mature adults.

  • Staff have access to training and can demonstrate an understanding of the schools policy on how to inform and support pupils and/or colleagues about a death or disclosure of a terminal illness.

  • PSHE (Personal, Social, Health and Economic) and Citizenship curriculum provides teaching and learning opportunities that enable pupils to build resilience and develop an understanding of bereavement, death and dying.

  • Schools will have a compassionate buddies, friends and champions scheme that will enable participants to recognise signs and behaviours associated with grief; understand what support can be offered to staff/students if they have been bereaved; understand supportive literature and recognise safe places to talk; recognise how and where to signpost for support, especially in school holidays; know what do in the case of a crisis or disaster situation and know how to deal with media interest surrounding a death and designating two/three members of staff to act as media co-ordinators.

  • Children will have access to bereavement ‘time out cards’ and stickers which alert teachers to the fact that the student’s work may be affected as they try to cope with their situation.

  • Monitoring and evaluation: schools identify a member of SLT to oversee quality assurance procedures and practice.

Our workplaces will have annually reviewed policies or guidance documents.

There will be a city wide award for compassionate organisations as part of the cities well being charter.

Workplaces and Trade Unions

Our workplaces will have annually reviewed policies or guidance documents. There will be a city wide award for compassionate organisations as part of the cities well being charter.

The aim of these charter objectives is to promote compassionate employers throughout the city ensuring that all those who work in an organisation who are who experiencing loss; death and bereavement feel supported by their employers. At any time, one in 10 employees are likely to be affected by loss, death and bereavement.

Grief and caring for someone who is dying, impacts hugely on the health and well being on the employee. 89% of people believe employers should allow flexible working for those caring for a dying relative. Having a compassionate and flexible approach from an employer can make a huge difference to that persons wellbeing and helps employers recruit and retain their workforce as they are recognised as a compassionate employer.

What can employers/ organisations do?

Sign up to become a recognised compassionate organisation by meeting the following criteria;

  • Training and having Compassionate Friends and Champions in the organisation that feel confident in talking to those who are experiencing death, loss and bereavement, so the person affected does not feel alone and feels they have someone to talk to.

  • The organisation will have policies and procedures that compassionately support employees affected by death, loss and bereavement e.g flexible working, individual tailored compassionate leave policies that take into account the persons circumstances rather than blanket policies.

  • Have a support pack made available to an employee that offers practical advice and support about their options and available support.

  • Customer facing organisations should review and ensure their policies and services meet the needs of customers that are affected by death, loss and bereavement to ensure they deliver a compassionate response that meets the aims and values of this charter.

Our places of worship will have at least one dedicated group for end of life.

Places of Worship

This charter objective recognises that faith is important to many people and that places of worship can be a great source of community support for those who are dying and those who are experiencing loss, death and bereavement.

What can places of worship do?

  • Have a compassionate network and co-ordinator that can practically support those who are dying and those who are experiencing loss, death and bereavement in their community.

  • Have faith members and volunteers who have received compassionate friends/ champions training so they feel more confident in talking about death, loss and bereavement.

  • Hold regular events and activities that support those who are experiencing loss, death and bereavement e.g holding ‘compassionate coffee’ events where people can come and seek support so they feel less isolated and lonely.

  • Hold events that are open to the public which openly talk about death and bereavement e.g. hold ‘Grave Talks’ which provide an open forum where people can come and talk or receive advice about any aspect of death, bereavement and loss, including making future plans.

  • Offering support for school children who are affected by death, loss and bereavement during school holidays.

  • Volunteer their venue for compassionate friends/network training and use these spaces to promote the charters aims.

Our city’s hospices and nursing homes will have a community development program involving local area citizens in end of life care activities and programmes.

Hospices and Nursing Homes

The aim of this charter objective is to ensure that the hospice can support the wider community to care for people at end of life. The majority of people who die in Plymouth do so in nursing and residential homes and it is important that staff in these settings have the confidence and skills in caring for dying people.

In addition, many people who are admitted to nursing and residential homes lose their friends and feel less connected with their communities. It is important that nursing and residential homes seek ways that residents can feel part of their local community and maintain their personal networks and friendships.

What can residential and nursing homes do?

  • Sign up to hospice Six Steps Programme which is a practical training and quality improvement programme that ensures the home has end of life (EOL) champions who can support others in the home to have the confidence skills to care for people at end of life. Each home is allocated a personal hospice EOL practice tutor.

  • Hold annual events during Dying Matters week in which residents and their families can openly talk about their future care wishes and be given advice and support.

  • Have community connectors, who with the homes activity co-ordinators get to know residents personal life stories so they can re-engage the resident with their interests and past networks e.g. reconnecting veterans, bringing pets into the home and helping someone paint.

  • Hold events that enable the home to engage with its local community, examples are inviting local schools and choirs into the home.

  • Access care home chaplains and other faith leaders who have received compassionate friends training to provide faith based support.

  • Attend the end of life care home link forum events.

Our city’s major museums and art galleries will hold annual exhibitions on the experiences of ageing, dying, death, loss or care. Our city will work with local social or print media to encourage an annual city-wide short story or art competition that helps raise awareness of ageing, dying, death, loss, or caring.

Museums and Art Galleries

The aim of this charter objective is to raise everyone’s awareness of death, dying, loss and bereavement issues. Ensuring Plymouth and its surrounding areas, does not shy away from the taboo subject of death, but talks openly about it, in order to create a city that is truly informed and compassionate towards those facing end of life, or experiencing loss and bereavement.

So what can the arts community do?

  • Create and support artistic events that get people talking about death, dying, loss and bereavement an example of this is the St Luke’s Elmer Trail showcasing 40 elephant sculptures painted by local artist will be placed across the city, getting everyone involved to talk about the elephant in the room.

  • Working with schools on activities to raise awareness of end of life issues and helping them to meet their compassionate schools award. An example of this is the University of Plymouth Drama department who will be using forum theatre to work with students to help them to hold conversations and support those experiencing loss and bereavement.

  • Create an annual city-wide short story or art competition that helps raise awareness of ageing, dying, death, loss, or caring.

  • Museums display arts and creativity to support displays/exhibitions around death, dying and loss in with dying matters week.

Our city will host an annual peacetime memorial parade representing the major sectors of human loss outside military campaigns – cancer, motor neuron disease, AIDS, child loss, suicide survivors, animal companion loss, widowhood, industrial and vehicle accidents, the loss of emergency workers and all end of life care personnel.

City Wide Memorial Event

This charter objective recognises that remembering loved ones is important and can be a great comfort to those who have lost someone they have loved or cared for.

People die in all sorts of circumstances, for all sorts of reasons and it is ensuring that all those who have lost loved ones, in whatever circumstances have an opportunity to remember their loved one in a dignified and compassionate way, with the collective support from others who share their sense of loss.

So what can the people do?

  • Join the end of life compassionate network to help create a memorial walk that is open to all.

  • Promote and support events that are memorial events that are held for certain communities e.g. St Andrews Church memorial service for people who have died from substance misuse.

  • Attend services of remembrance.

  • Undertake individual acts of remembrance and talk about the importance of this to friends and colleagues.

Our city will create an incentives scheme to celebrate and highlight the most creative compassionate organisation, event and individual/s. The scheme will take the form of an annual award administered by a committee drawn from the end of life care sector. A Mayors Prize’ will recognise individual/s for that year who most exemplifies the city’s values of compassionate care for those at end of life.

Incentive Schemes and Awards

This charter objective recognises that to effect change the city leaders, organisations and individuals need to celebrate those members and organisations within our city and wider communities, who shine out as beacons of compassion for those affected by death, loss and bereavement.

It is hoped that new categories for end of life compassionate awards will be created in the existing award ceremonies e.g. Plymouth Herald City Award. This will share the learning and experiences of others and promote best practice and inspire compassionate acts throughout the city.

What can the city and surrounding areas do?

  • Seek to create new categories for end of life compassionate awards in their existing award ceremonies.

  • Create end of life compassionate awards in their own organisations and sectors e.g. schools, crematoriums, funeral directors, hospitals and care homes.

  • Recognise and nominate those individuals, organisations who are making a difference to those affected by death, loss and bereavement and who are fulfilling the charters aims.

  • Sponsor an end of life compassionate event or award.

Our city will publicly showcase, in print and in digital media, our local government policies, services, funding opportunities, partnerships, and public events that address ‘our compassionate concerns’ with living with ageing, life-threatening and life-limiting illness, loss, bereavement and long term caring. All end of life care-related services within the city limits will be encouraged to distribute this material in print or digitally, including veterinarians and funeral organisations.

Promoting and Celebrating a Compassionate City

This charter objective recognises how important it is to communicate the ambitions and progress of the Compassionate City Charter to a wide audience. To communicate the key message of having a compassionate response to those affected by death, loss and bereavement we need a variety of communication methods e.g. social media platforms.

We need to communicate three key messages:

  • Death happens to us all.

  • We need to talk about it.

  • We can all make a difference.

What can we all do?

  • Attend a Compassionate Friends session and make a pledge to make a difference and share your pledge on your social media platform or through conversations.

  • If you have received a helpful compassionate response at your time of loss or bereavement, share your personal story about this by telling friends and share across your social and digital media platforms.

  • If you have an initiative that is supportive to those who are experiencing death, loss and bereavement, share this on the Plymouth Compassionate City digital media platforms.

  • If you have a personal story that you feel may help others share this on the Plymouth Compassionate City digital media platforms.

  • Local libraries to promote end of life activities in their area.

  • If you have any funding opportunities to support end of life activities inform the End of Life Compassionate Network.

  • Join the Plymouth Compassionate Communities Facebook group

Our end of life services and policies will be inclusive and will address inequalities of access to end of life care. This includes those individuals who are homeless, in prison, live in rural locations or who are from BME, LGBTQ and Traveller communities; and those with cognitive, frailty and sensory issues.

 

 

Promoting Inclusive Policies and Practices

‘Dying is a universal part of life’s journey, and every individual will experience it in a different way. The importance of good care in the last years, months, days and hours of life cannot be overestimated – both for the person who is dying and for those who are important to them. In the majority of cases, health and care staff who provide care in the last days and hours of life in all settings, from hospices and care homes to hospital wards or at home, are committed and compassionate.

However, it is clear that the quality of care for some people at the end of their life is still not good enough. People with a diagnosis other than cancer, older people, people with dementia, people from equality groups and people who may be vulnerable because of their circumstances, do not always experience good care in the last phase of their life, because their needs are not always fully understood or considered’ (CQC Different Endings Report 2016 p3)

What can organisations do?

  • Look at your service provision and profile your service users to ensure it is meeting the needs of the whole population and identify any gaps.

  • Engage and listen to the needs of marginalised groups that are not accessing the services they need. Listen to their personal stories and find out about any barriers, invite them to work in partnership to address any barriers to make services more accessible.

  • Ensure your service is aware of the needs of those with a disability or sensory impairment and be mindful of their communication needs and make information accessible.

  • Ensure organisational policies, literature, images and online presence is inclusive, to ensure that all sections of the population can identify with the service and know it is a service for them.

  • Ensure your workforce is aware of the end of life needs of various groups.

  • Promote the use of equality, diversity and inclusive champions in your organisation.

  • Ensure that there is good end of life care for all, regardless of diagnosis.

The homeless and the imprisoned have support plans in place for end of life care and loss and bereavement.

Homeless and Prison Community

This objective seeks to ensure that those who are homeless and those who are imprisoned have access to good end of life care, which includes end of life plans and support for those who are experiencing loss, death and bereavement.

We know that the average age of death among people known to be homeless is around 40 to 44 years old with cardiac disease, liver failure, cancer and respiratory diseases such as pneumonia being among the main reported causes of death. Advanced liver disease is the most common cause of death and often the last weeks of life are frequently distressing and painful. Many homeless people are also reluctant to be admitted to hospital and as staff, friends and family may not be aware that the person is in the final stages of life, their death often comes as a shock. Therefore, those who are homeless often have a poor end of life experience, with poor symptom control and often die in hospital, following an emergency admission.

End of life care has become increasingly important for the Prison Service too, as more prisoners die of old age and incurable, terminal diseases. This brings new challenges for both prison regimes and prison facilities to accommodate the end of life care needs for those prisoners who require them. In addition involving families in the end of life care process is a key part of end of life care. Support from families and friends who wish to be involved can make an enormous difference to a prisoner’s quality of life in its final stages.

What can we do?

  • Have a compassionate response to those who are homeless and those who are imprisoned at end of life.

  • Ensure that our hospice and other services work closely with the prison and the services that support the homeless, to ensure end of life care needs are understood and the staff who care for these individuals feel supported.

  • Support Dartmoor Prison to become a Compassionate Prison and share best practice with other prisons.

  • Ensure those services who work with the homeless community feel supported and have access appropriate end of life training.

Our city will have compassionate networks that work together, in communities, to support those who are dying or experiencing loss in emotional and practical ways.

This charter objective seeks to support those individuals who are dying or experiencing loss, death and bereavement to live in communities that that recognise that care for one another at times of crisis and loss is not simply a task solely for health and social services but is everyone’s responsibility.

We know 80% of people want to die at home but only about 23% manage to do this. This objective aims to support the creation of volunteer compassionate neighbourhood networks, that will offer practical help to those at end of life, by doing the little things that can make such a difference e.g. make a meal, walking the dog and shopping.

Often people tell us that they do want to help, but they worry about becoming too involved or that the time commitment maybe too much. However, if there is a network of people helping, with a co-ordinator ensuring the support is shared; it becomes possible to help someone in need, at the end of their life or experiencing loss, death and bereavement.

It is through the support of these compassionate networks that people can die at home, in a place where they feel secure and cared for and surrounded by those they love.

What can you do?

Our city will establish and review these targets and goals in the first two years and thereafter will add one more sector annually.

Deliver a Compassionate Network

The aim of this objective is to ensure that the collective will across the city delivers the aims of the Compassionate City Charter for End of Life. This requires a co-ordinated effort from all sectors to improve the lives of those who are dying or experiencing loss, death and bereavement.

The charters objectives will be delivered through a city wide End of Life Compassionate Network which will have leads who are linked to charter action groups that will implement the Compassionate City Action plan, using the Compassionate City Charter as a framework. This network will be hosted by Plymouth City Council and administered by St Luke’s, lead by the different section leads/organisations in the city and surrounding areas.

There will be a Compassionate City Charter End of Life Steering group who will review the activities and progress of the network to promote engagement and support from across all sectors of the city.

The network will;
Raise public awareness of the issues around death and dying including those from diverse communities so every can make better-informed decisions on what can be done to help each other and themselves nearing the end of their lives.

Build emotional resilience in our communities by developing and encouraging our communities’ ability to talk about death, dying and bereavement giving everyone the best chance to die well and have a normal grieving process reducing the risk of negative long term impacts on mental and physical health due to isolation, anxiety for those who are experiencing loss and bereavement.

Increase compassion at end life through developing self-sustaining voluntary compassionate networks so people, colleagues, families and communities are better supported in practical, emotional and empathetic ways. To support those who are dying in our communities so they can die in a place of their choosing.

What can you do?

  • Join and support the network as an individual or organisation and sign up to the charter.

  • Sponsor, provide funds or assets to help the network meet the charters objectives.

A Compassionate City Charter:
A Community wide approach to end of life, loss and bereavement.

“Every day people die and hearts are broken. Death and dying are more  than medical issues and caring for those affected is not just the role of the doctor and the chaplain. End of life care is everyone’s responsibility and we all have a practical role to play”

Kellehear (2018)

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