Date of Award

3-11-2025

Document Type

Project Portfolio

Degree Name

Doctor of Leadership in Global Perspectives (DLd)

Department

Seminary

First Advisor

Aaron Friesen, PhD

Second Advisor

Holley Clough, DMin

Third Advisor

Jason Swan Clark, DMin, PhD

Abstract

Signature Healthcare at Home (Hospice, Palliative, and Home Health) workers are often not prepared to facilitate courageous and culturally competent “Goals of Care” conversations with their patients as they approach the End-of-Life. Working in Hospice has given me a direct line of research as I worked on ways to help healthcare workers gain confidence in talking with patients about death and dying in what we call a Goals of Care conversation.

One of the challenges I found in my research was finding healthcare workers who could give the time to participate in stakeholder workshops. Much healthcare operates at high demand, speed, and efficiency, including hospice and palliative care.

I have spent over 10 years working in Hospice and Palliative care, many of those as a Chaplain. One of the most significant tasks of my ministry context is to help patients and their families find meaning, forgiveness, and hope in their end-of-life process. In the most recent available statistics, the average length of stay in Hospice was 92.1 days; the median lifetime length of stay (MLOS) was 17 days. I found insufficient time to give patients or families the space to create or find meaning and reflect on their lives. I decided it was time to go upriver and research why patients chose Hospice so late in their disease process. As I began having Goals of Care conversations with potential palliative or hospice patients, it became evident that even if they had Goals of Care conversations in their health journey, they were not effective.

This research has led to the development of three two-hour workshops for healthcare workers, which aim to educate and empower them to have courageous, culturally and spiritually competent conversations about the Goals of Care.

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