Paula K. Baldwin

Communication Dynamics in Hospice Teams: Understanding the Role of the Chaplain in Interdisciplinary Team Collaboration

BACKGROUND Hospice chaplains provide a specific expertise to patient and family care, however, individual roles and responsibilities that facilitate the interdisciplinary team environment are less well known. OBJECTIVE The primary aim of this study was to investigate how hospice chaplains perceive their role in interdisciplinary team meetings and to what extent hospice chaplains share common experiences within the interdisciplinary team approach in hospice. METHOD Hospice chaplains within a 10-state region participated in a 39-item phone survey about professional roles, group roles, and structural characteristics that influence their ability to participate in interdisciplinary collaboration. RESULTS Findings revealed that professional role conflict is experienced, primarily with social workers. Informal group task and maintenance roles included team spiritual care advisor and conflict manager, and structural characteristics consisted of extracurricular communication outside of the organization. CONCLUSIONS Although chaplains foster interdisciplinary collaboration within the hospice team, future research needs to address improvements to the chaplains role within the interdisciplinary team process.

Exploring Children/Adolescents’ Final Conversations with Dying Family Members

In the current study, the authors expanded on a program of qualitative inquiry exploring final conversations (FCs) to the understudied population of children/adolescents. Participants were 61 children/adolescents aged 5–18, who participated in semi-structured interviews regarding their FCs with a dying family member. Inductive coding analysis led the authors to discover four overarching themes of children/adolescents’ FCs messages, in order of descending prominence, are: everyday communication, messages of love, messages of individual identity, and messages related to religion/spirituality. The authors applied Functional Theory to further delineate how participants used, and continue to use, the messages from each theme within their FCs. Discussion of results, including limitations and directions for further research, is outlined.

Final Conversations, Phase 2: Children and Everyday Communication

This qualitative study examined messages of everyday communication (small talk and routine interactions). The importance of these messages was highlighted in light of their role in creating structure, safety, and meaning making in the family at the end of life. In addition, family rituals that developed from childrens everyday communication were explored and discussed. Retrospective interviews were completed with children. Descriptions of small talk topics revolved around school, daily activities, sporting events, and shared experiences about mutual hobbies. Routine interactions included reading bedtime stories, doing chores together, and doing other everyday activities with one another. Interviews demonstrated that everyday communication helped children make sense of the death of their loved one. These innocuous, common, and routine behaviors also gave children avenues for humor and positive talk and provided comfort, a sense of security, and normalcy during the familys negotiation of the death of a loved one.

Organizational factors associated with the use of telehospice

We investigated organizational factors associated with the use of telehospice (defined as the use of video technology by hospices). The investigation was based on the 2007 National Home and Hospice Care Survey. There were 695 hospice agencies, of which 6% used telehospice. Logistic regression was used to examine the relation between use of hospice and a number of organizational factors. The dependent variable was the use/non-use of video technology in patient monitoring or consultations with professionals. Most of the variables that were significantly associated with the use of telehospice were related to characteristics of the agency director. If the director had at least a Masters degree or had a longer tenure as director of the agency, there was a higher likelihood that the agency used telehospice. If the director was a nurse, the likelihood that telehospice was used was considerably lower. Organizations with inter-agency contracts were less likely to use telehospice. Providing financial, training and organizational support to agencies that recognize the potential benefits of telehospice would probably assist in its future introduction.

Death Cafés: Death Doulas and Family Communication

The Death Café is part of the Death Positive movement, and as such, is uniquely positioned to bring the dialogue about death and dying to the public. Participants in a Death Café typically have two different perspectives. Some participants have not experienced death in their family and friends’ circle and wish to converse with others about their beliefs on death and dying. Others are those who have experienced death somewhere in their circle of friends and families. One of goals of the Death Café facilitators is to help attendees reconcile their family narratives regarding death using the broader lens of the Death Café. Using the insights provided by interviews from 15 Death Café facilitators, this manuscript discusses the role of the Death Café facilitators as the death doulas of family communication.