Scientific Committee: Erika Zelko, Georg Bollig, Siobhan Neylon, Yvonne Odoni, Leah MacAden, Raymond Voltz
Organizing Committee: Marina Schmidt, Nicole Labs, Georg Bollig, Golrokh Esmaili
Conference venue: University hospital Cologne, Zentrum für Palliativmedizin and Dr. Mildred Scheel Academy, Kerpener Str. 62 - 50937 Cologne (Köln)
A-01 Becoming Grief Kind - a nationwide approach to enhancing death and grief literacy across the United Kingdom
Bianca Neumann
1
1Sue Ryder England
Correspondence should be addressed to: Bianca.Neumann@sueryder.org
Background: As a national charity, we aim to transform the experience of everyone facing dying and grief in the UK. We know that more people are going to need more resources and interventions. We want to build a society that enables people from all communities to access the care and support they need and improve death and grief literacy within the population to support the global drive to rebalance death, dying and bereavement. Building on our Grief Kind movement, which launched in 2021, we plan to provide a greater evidence base and stay agile in a challenging health economy.
Method: A public health approach is embraced by the organisation, focussing on equipping communities whilst also providing free to access services for varying levels of need.
Results: Grief Kind has supported over 200,000 people directly. Over 95,000 Grief Kind cards have been ordered, online classes have been viewed over 12,000 times and the Grief Kind podcast series has had over 22,000 listens. Over 77,000 unique landing page views, have resulted in people reading blogs and seeking further support from Sue Ryder’s bereavement support services. Through the recent introduction of a Wellbeing and Community Support Service Sue Ryder has also changed the delivery and provision of psychosocial care and support to patients and their families. By adopting this new approach there are also plans to incorporate teaching of Last Aid within UK communities.
Conclusion: These changes will give Sue Ryder the scope to improve access to the most appropriate support for hospice patients and those in the wider communities, whilst also helping to meet and prepare for the anticipated increase in demand for bereavement and end of life care.
Keywords: Grief, grief literacy
A-02 Caring Community Köln – lessons learned so far
Karin Ohler1, Sophie Meesters2, Birgit Weihrauch3, Sabine Eichberg4, Anne Kreische4, Julia Strupp2, Raymond Voltz2
1Caring Community Cologne, Palliative and Hospice Network Cologne, Cologne, Germany
2Department of Palliative Medicine, University of Cologne, Faculty of Medicine and Cologne University Hospital, Cologne, Germany
3 Endlich. Palliativ & Hospiz" Association, Cologne, Germany
4 Public Health Department Cologne, Cologne, Germany
Correspondence should be addressed to: info@caringcommunity.koeln
Background: The Caring Community Cologne (CCC) aims to enhance skills related to end-of-life care, thereby empowering civil society to better deal with serious illness, dying, death and bereavement. In 2017, the concept was developed for a research proposal. Alt-hough funding was rejected, it was implemented by the Palliative and Hospice Network Cologne and the City of Cologne.
Methods: The official launch took place in 2020, led by the Mayor of Cologne. This was followed by an extensive exchange with the city’s society and local politics. Currently, more than 35 institutions and numerous individuals are involved, including palliative and hospice care providers, non-profit organizations, business associations, and companies such as banks. In order to evaluate the implementation a scientific evaluation using focus groups accompanied the process.
Results: Nine members of three working groups took part in the focus groups. Participants considered the structures of the CCC as to be adequate. However, they criticized the co-operation and transparency between the different groups. One core aspect was the need for a coordinating body. They stressed the support of federal institutions as a key factor but also described insufficient citizen involvement. Participants mentioned the need to strengthen citizen support and to better link support initiatives.
Conclusions: As a central partner, the City of Cologne plays a crucial role in the initiative, fulfilling its responsibility to provide public services and promote public health. The CCC can pro-vide initial insights to the national and international discourse: Is a top-down, bottom-up, or hybrid approach necessary to establish caring communities? Which structures ensure sustainable integration into urban society? How can transparent and goal-oriented cooperation among all stakeholders be achieved, particularly with those outside the palliative and hospice sector? How can innovative approaches be developed to enhance death literacy, e.g. through schools, workplaces, or even (carnival) clubs?
Keywords: Caring community, Compassionate community; Compassionate City public health palliative care
A-03 MAiD in Canada and its Relationship to Last Aid
Julie McIntyre, B.A.,M.D., C.C.F.P., F.C.F.P.
Correspondence should be addressed to: jjmac46@me.com
Introduction: Medically Assistance in Dying (MAiD) in Canada was legalized nationwide in June 2016. The practice has grown steadily, by about 30% (2022) annually, so that Canada’s rate of medically assisted death is one of the highest in the world, at 4.1%.
Discussion: Eligibility for MAiD requires that individuals be adults capable of making healthcare decisions, suffering from a grievous and irremediable medical condition, and experiencing enduring and intolerable suffering that cannot be relieved by means that are acceptable to them. Recent amendments to MAiD legislation, enacted in March 2021, have expanded eligibility to individuals whose natural death is not reasonably foreseeable. In Canada, there continue to be ethical, legal, and medical debates around MAiD provision for mental illness alone, for mature minors and for advance requests, and other issues. Currently, our healthcare system and societal supports in Canada are insufficient to provide adequate universal access to mental health treatment, sustainable housing and palliative care. There is widespread concern that MAiD may be becoming an easier alternative than rectifying these deficiencies, although it is currently accessed more frequently by those with a higher socio-economic status. Other than providing resources for further information, we haven’t dealt with MAiD in our Last Aid courses, since it is a such a complicated issue for this “appetizer” course.
Conclusion: Since Last Aid can help individuals and their families feel more comfortable and confident in thinking and talking about and planning for dying, death and grief, navigating the healthcare system, and accessing effective palliative care, it may be something we need to consider adding. There may be cases where, with this knowledge and adequate support from the healthcare system, families and the community, individuals may feel that MAiD is not their only option for a dignified death.
Key words: MAID, Canada, Last Aid
A-04 Last Aid in Brazil
Karin Schmid
1
1Last Aid Brasil
Correspondence should be addressed to: karin.cuidadospaliativos@gmail.com
Background: Currently in Brazil people die poorly, in addition to this, due to demographic change, in the coming years, an increase in demand for palliative care is expected, both of specialized professionals and of family members and professionals in general. Currently, knowledge about palliative care is very limited or completely absent in most communities. With a minimum of literacy in palliative care, the population can become better prepared to face end-of-life situations and participate in palliative care. Based on the international consensus of the Last Aid course curriculum, the course was translated by a few palliative care professionals to fit the Brazilian reality. The course was offered then to the public through personal networking.
Method: Directly after attending the course all participants received a questionnaire to evaluate their views on the course.
Results: Since 2020, 316 people have participated in the course, 224 in person and 92 online. 88% of the participants were women, and the social status ranged from favela residents to high income professionals. At the end of the course, 208 participants responded to the questionnaire and of these, 92% gained confidence in relation to end-of-life care; and 99% would recommend the course to someone else.
Conclusions: The results of the courses are encouraging, as despite noticing an initial resistance to join, the participants appreciated the course and felt more prepared for a potential death of someone they know. The appreciation can also be seen in the growing interest in courses, even without external funding or institutional support.
Keywords: Palliative Care, Last Aid Course, Compassionate Communities, Public Palliative Care Education, Brazil
A-05 Death literacy and caring communities
Raymond Voltz
1
1University Hospital Cologne, Germany
Correspondence should be addressed to: raymond.voltz@uk-koeln.de
Background: Dealing with severe illness, dying and bereavement is a major life issue for all of us, but often competencies can be improved, both in health and social structures as well as in patients, relatives and healthy people.
Objectives: To improve death literacy in a community by setting up a Plan-Do-Study-Act cycle.
Design: Based on longstanding hospice and palliative care experience, as well as studies on how the last year of life was perceived by bereaved relatives and what they felt was needed as additional support we have started (some completed, some ongoing) several interventions at different levels.
Methods: Multi-methods research by surveys, secondary data analysis, focus groups, in-depth-interviews.
Results: Networking projects: Setting up a caring community structure based on a palliative and hospice network together with political and civic support in the city. Health and social care system projects: Implementation of the Surprise Question 12 months in addition to Patient Prompt Sheets, improvement of care of the dying in general wards and intensive care units, offering a communication training on the desire to die for professionals, volunteers and relatives, early integration of palliative care and coordination in multiple sclerosis, glioblastoma and bone marrow transplant patients. Outreach projects: Setting up a “buddy” system for seriously ill people and relatives, last aid and bereavement support in the workplace, school projects on death, dying, bereavement and suicide.
Conclusion: Improving death literacy in a community can be approached at multiple levels combining innovative practice and scientific evaluation. As this is an ongoing process over decades, appropriate structures need to be put into place to make it independent of specific projects and individuals.
Key words: death literacy, grief literacy, last year of life, regional learning cycle, palliative and hospice care
A-06 Travelling Together: A Multilingual Approach for the Last Aid Movement in Switzerland
Eva Niedermann
1
and Esther Schmidlin
2
1Evangelical- Reformed Church of the Canton of Zurich in Switzerland
2Palliative vaud, Lausanne, Switzerland
Correspondence should be addressed to: eva.niedermann@zhref.ch
Background: For 7 years, the Evangelical-Reformed Church of the Canton of Zurich has been licensed to provide Last Aid Courses in Switzerland. Various organisations are involved in this project. Churches, regional chapters of the Swiss Society for Palliative Medicine and Care, hospitals, nursing homes, home care organisations and foundations from 20 cantons of Switzerland now offer courses in German, French and Italian. Many different factors led to the successful implementation of this public health initiative in three different linguistic and cultural regions of Switzerland.
Results: The following factors helped to overcome existing barriers:
Non-profit organisations in the French and Italian speaking regions in Switzerland were convinced of the concept and motivated to invest their resources in the project.
The persons responsible within these organisations were able to translate all the course material and adapt it to specific cultural conditions.
Despite the cultural and linguistic differences, the project leaders have a common understanding of the underlying principles: knowledge about death and dying is not just in the hands of health professionals and specialists. Everybody has innate competencies to care, if informed and encouraged.
Positive feedback from the public, media and course participants encouraged the organisations involved to continue their efforts.
A non-bureaucratic, pragmatic approach and close collaboration between the stakeholders fostered national and regional development (learning by doing).
The national strategy for palliative care in Switzerland (2010 – 2015) emphasised the importance of empowering society in end-of-life issues and thus laid useful groundwork.
Conclusion: As organisational priorities and human resources are changing, innovative solutions are needed to ensure the transition from the preliminary phase to an integrated and sustainable public delivery.
Key words: Last Aid, Switzerland
A-07 Implementation and impact of Last Aid in France
Marie Danel, Christianne Roy, Colombe Storet
Correspondence should be addressed to: Danel.Marie@ghicl.net
Background: The relationship to death in our society is marked by a taboo and a medicalization of the end of life. Knowledge of the gestures of support that everyone can make at the end of a loved one's life has become limited since death has disappeared from the family environment. This evolution is a source of fear, isolation and suffering for people at the end of life or in mourning. Strengthening the resources of care within families could reduce fears and develop community skills to support people at the end of life. In France, the concept of Last Aid has been deployed by the French palliative care society since October 2022.
Our study was conducted with the main objective of evaluating the impact of this project on the participants’ sense of confidence in their ability to talk about death and to accompany a loved one at the end of life. The secondary objective is to measure their degree of satisfaction.
Methods: This quantitative study was carried out among all participants agreeing to answer an anonymous survey, between the 1st of January 2023 and the 16th of May 2024.
Results: 1114 surveys were analyzed. 83% of participants feel more comfortable talking about death and the end of life, 77% taking care of a person at the end of life, 72% accompanying a person with a serious illness. 98% would recommend raising awareness about Last Aid.
Discussion/conclusion: As in Germany, the Last Aid in France highlights public satisfaction and a very significant impact on citizens' support resources.
Key words: Last Aid, France
A-08 How Last Aid Courses strengthen the sense of meaning and dignity
Stefan Dinges1,2, Manuela Straub1,2
1Institute for ethics and law in medicine, University of Vienna
2Last Aid Austria
Correspondence should be addressed to: stefan.dinges@univie.ac.at
Background: The word ‘dignity’ does not appear in the slides for the last aid courses - which are an important contribution to strengthening and ensuring a sense of meaning and dignity in the support and care of all those involved and affected at the end of life.
Methods: A) Definition of terms: In addition to meaning and dignity, other terms from the nursing terminology are considered that do not appear as terms, but describe the didactic orientation and attitude of knowledge transfer in the last aid courses: A vulnerability inherent to us humans, which as a guiding characteristic enables and encourages us to show resilient solidarity, as well as the experience of resonance, which connects individuals, but also institutions, organisations, citizens and society with each other in solidarity. B) Literature review: Results from psychology, sociology and political science on these terms
Results: Harvey Chochinov's ‘dignity question’ does not contain the word ‘dignity’: ‘What do I need to know about you as a person in order to provide you with good care?’ expresses an appreciation of that person whose best possible care will subsequently be at stake. At the same time, this question reinforces a sense of purpose and dignity and turns those affected into participants. Barbara Prainsack and Alena Buyx show that people in community and society seek and need a common characteristic in order to be able to make decisions and act in solidarity. The dimension of resonance taken up by Hartmut Rosa is the experience that unites course leaders and participants in the transfer of knowledge: resonance as entering into a relationship has four characteristics: 1. We experience encounters in which people touch and move each other. 2. This type of encounter enables response, in which the responder communicates and experiences him/herself as self-effective, in the form of being alive. 3. These encounters change, we do not remain the same, we change in the experience of resonance. 4. The moment of resonance is unavailable; it cannot be forced - it is not possible to predict when people will enter into resonance.
Discussion: The human rights category ‘dignity’ is to be concretised by the verb ‘dignify’ - it needs practice. Chochinov's dignity question and research shows this. The shared experience of vulnerability and being dependent on one another creates solidarity. In ‘public palliative care education’, this is translated into caring for one another in solidarity. Resonance also means that it should not be confused with harmony and reassurance: resonance is sometimes exciting, upsetting, irritating and sometimes disturbing - challenges of end-of-life care.
Keywords: strengthening a sense of meaning and dignity, shared experience of vulnerability, creating solidarity, coming into resonance as relationship
A-9 “Don’t Leave Us Behind”: A Qualitative Study Assessing the Feasibility of a Palliative Care Training Program for Non-Health Caregivers in Honduras
Sheryl Ruiz1, Martin Stafström2, Leda Parham3, Luis Roberto Orellana3
1Faculty of Medicine, Lund University
2Department of Social Medicine and Global Health, Lund University
3Department of Nursing, Universidad Nacional Autónoma de Honduras- Centro Universitario Regional del Litoral Atlántico
Correspondence should be addressed to: nicoleruiz96@hotmail.com
Background: Palliative care plays a crucial role in alleviating suffering and improving quality of life, yet significant disparities remain, particularly in Honduras. Through training programs, non-health caregivers can experience reduced burnout and stress, ultimately leading to a better quality of life for both themselves and the patients they support. This study seeks to explore experiences and viewpoints regarding the feasibility of a palliative care training program for non-health caregivers in Honduras.
Methods: Data was gathered through semi-structured interviews with twenty-five participants from four key groups: cancer patients, non-health caregivers, palliative care experts, and health-related decision-makers. The study employed maximum variation sampling and the data was assessed through latent content analysis.
Results: The study identified three overarching themes: a) Patients with cancer and caregivers face a challenging reality as they navigate the unfamiliar territory of palliative care in a lower-middle-income country with constant struggles. b) A palliative care training initiative for non-health caregivers has the capacity to transform a country afflicted by a lack of knowledge. c) A training program built from the ground up will lay the foundation for Honduras' future growth and success.
Conclusions: Although challenges typical of a lower-middle-income country are expected, participants highlighted the essential need for this program and its clear feasibility. Implementing such a program offers substantial benefits both individually and nationally, aligning with shared values and goals across various sectors to guarantee health equity and ensure no one falls behind.
Keywords: palliative care, compassionate communities, Latin America, training program, Honduras
A-10 Last Aid for different groups
Georg Bollig
1University Hospital Cologne, Germany
2Last Aid Germany, Schleswig, Germany
3Last Aid Research Group International (LARGI), Schleswig, Germany
Correspondence should be addressed to: georg.bollig@uk-koeln.de
Background: People are different and diverse and the international Last Aid Movement welcomes and embraces diversity. Today Last Aid Courses are provided as method for public palliative care education (PPCE) in 23 countries in Europe,
Brazil, Canada, Singapore and Australia. As diversity is an important factor and in our modern societies different Last Aid Course formats for different groups are needed.
Methods: Working groups of Last Aid International and Last Aid Germany have established a number of adaptations of the Last Aid course format for different groups. All new course formats are subject for scientific evaluation and are tested and evaluated in pilot studies and after that in larger implementation studies.
Results: Many people engaged in the International Last Aid community have provided a lot of voluntary work in official working groups. This has led so far to the following Last Aid Course formats: the classic Last Aid Course with four teaching modules for everyone, the Last Aid Course online with 4 teaching hours, the Last Aid Course for kids and teens with 4 teaching hours, the Last Aid Course for healthcare professionals with 10 teaching hours, the Last Aid Course for people with handicaps or learning impairments with 4 teaching hours and the Last Aid Course diversity with 6 teaching hours.
Discussion and conclusion: The first scientific pilot-evaluations of special Last Aid Course formats for different groups and audiences are very promising. Adaptation of the Last Aid Course concept for different groups can help to enable more people to participate in Last Aid Courses worldwide. This can raise public awareness for the topics of serious illness, palliative care, death, dying and grief. These measures can contribute to increase health and death literacy of the public.
Keywords: awareness, education, Last Aid, Course, palliative care, health literacy, death literacy
A-11 First experiences with Last Aid Professional in Germany
Marina Schmidt1, Doris Kellermann1
1Last Aid Germany, Schleswig, Germany
Correspondence should be addressed to: marina.schmidt@letztehilfe.info
Background: The concept “Last Aid Professional” was developed at the beginning of January 2020 by a group of experts from different areas of palliative care. Last aid courses for adults are well implemented in Germany. Research on last aid courses1 has shown, that approximate 10% of the participants were nurses and doctors. Another research study at the University of Freiburg reveals, that healthcare professionals gain benefit from last aid courses aimed at citizens. However there is further need of information which can be applied in everyday practice.
Methods: The multidisciplinary group of participants learns about symptom control as well as about ethical issues by the use of case studies, videos, group discussions and by presentations by the lecturers. The participants take on a change of perspective and learn from each other in small groups. Ultimately, they not only reflect on the last phase of a dying patient but also on their own mindset to the finite nature of life.
Results: “Last Aid Professional” - courses take place in academies and several healthcare institutions. The courses have been in great demand from the beginning which has enabled us to gain experience fast in different settings and in groups of various combinations.
Conclusion: The feedback on the last aid professional courses has been very good. It will be an extensive task to find out how more people from the healthcare sector can be reached by this and other training courses in the field of palliative care. The situation of dying people in Germany shows a need for more qualifications and basic knowledge on the topics of dying, death and bereavement in the general healthcare system.
Key words: Last Aid Professional, Germany, healthcare, nurses, doctors
A-12 Children and teenagers want to talk about death and dying – Lessons Learned from a Multi-Center Mixed-Methods Study on Last Aid Courses for Kids and Teens (LAC-KT)
Raymund Pothmann1,
Kirsti Gräf
1, Harry Gruna1, Daniel Drexler1, Georg Bollig1,2,3
1Last Aid Germany, Schleswig, Germany
2University Hospital Cologne, Germany
3Last Aid Research Group International (LARGI), Schleswig, Germany
Correspondence should be addressed to: georg.bollig@uk-koeln.de
Background: Participation of the public is needed to enable more people to die at home. Last Aid Courses (LAC) can contribute to empower citizens to participate in end-of-life care. Last Aid Courses for adults have been established in 21 countries in Europe, Australia and America to improve the public discussion about death and dying and to help people to participate in end-of-life care provision. In 2018, the first Last Aid Courses for kids and teens (LAC-KT) were introduced. The aim of the study was to explore the views and experiences of the course participants and Last Aid Course instructors on the LAC-KT.
Materials and Methods: A mixed-methods approach was used. The views of the LAC-KT participants, aged 7 to 17 years, on the LAC-KT were collected using a questionnaire. In addition, the experiences of the Last Aid Course instructors were explored in focus group interviews.
Results: A total number of 2996 children and teenagers participated in the LAC-KT, and 2534 of them participated in the study by returning a questionnaire after participation in the LAC-KT between mid-2022 and October 2023. The results show that 84% of the participants had experiences with death and dying. The majority of the participants appreciate the opportunity to talk and learn about death, dying, grief and palliative care. 91% found the LAC-KT helpful for everyone and 79% would recommend the course to others.
Conclusions and future prospects: The findings are also supported by the interviews of LAC-KT instructors who frequently report that the course participants are very thankful for the opportunity to talk about death, dying and grief. LAC-KT could contribute to improving both awareness and public knowledge about the topics. The results of the current study underline the importance of a training course in Last Aid for Kids and Teens in general.
Key words: Palliative Care, education, curriculum, population, kids, teenager
A-13 Perceptions of death education in young citizens and factors influencing implementation: an exploratory multi-perspective qualitative study
Clare Carolan1, Caitlin Davies1, Leah Macaden2, Kirsty Bateson3, Lee Heaney4, Susan Speke3
1University of the Highlands & Islands
2University of Edinburgh
3Highland Hospice
4NHS Highland
Correspondence should be addressed to: clare.carolan@nhs.scot
Background: The COVID-19 pandemic has increased the visibility of death, engendering debates about how to discuss death and dying across the life-course. Whilst enhancing death literacy in young citizens would align with a public health approach to palliative care, teaching about death and dying to young citizens in Scotland remains uncommon. Recognising that health-promoting approaches should adopt participatory methodologies, a multi-perspective qualitative study exploring relevant stakeholders’ perceptions about death education in young citizens and perceived factors influencing implementation was conducted.
Methods: Participants included young citizens (16-25yrs), Last Aid facilitators, Last Aid recipients, educators and people supporting young citizens. One-to-one interviews and focus groups were conducted between 2022-2023. Data were analysed using a Framework approach informed by Normalisation Process Theory.
Findings: Seven focus groups and six one-to-one interviews were conducted (n= 30). Data generated 10 themes within the interconnected four constructs of Normalisation Process Theory. Findings suggest that universal delivery of death education within schools using a spiral curriculum is desired. While most of the Last Aid curriculum content was deemed as relevant and acceptable to early/mid-teens, the imperative to include content on all deaths, including sudden death and suicide was notable. Significant tailoring to the mode of delivery is necessary, including i) chunking of content ii) serial delivery over time and iii) the use of interactive methodologies. Promotion of safety was vital to enable successful delivery. Implementation barriers identified included societal death taboo, time, financial resources, school/ community buy-in, and facilitator capacity.
Conclusion: Death education in young people is desired, however course design and delivery must be informed by constructivist pedagogical approaches. Participatory community engagement and statutory recognition of death education could mitigate implementation barriers. Co-production to iteratively develop the content and mode of delivery of a Last Aid-type death education initiative for teenage citizens is merited.
Key words: Last Aid; death; schools; qualitative
A-14 Development of Last Aid Through Research
Erika Zelko
1,2
1Institute of General Medicine, Johannes Kepler University Linz, Austria
2Katedra za Družinsko Medicino, Uiniversity Maribor, Slovenia
Correspondence should be addressed to: erika.zelko@jku.at
Background: The “Last Aid” concept has emerged as a vital element of end-of-life care, highlighting the importance of education and support during life’s final stages. Coordinated by the international Last Aid Research Group Europe (LARGI), the scientific evaluation of Last Aid Courses (LAC) has expanded from 18 to 25 countries in recent years. These courses have proven to be feasible and well-received across various cultural contexts.
Discussion: The ongoing development of Last Aid is heavily research-driven, aiming to enhance the quality of care for individuals nearing the end of life.
Research plays a crucial role in shaping Last Aid by providing evidence-based insights into the needs of patients, families, and healthcare providers. Future research should focus on vulnerable groups, addressing their specific needs for empowerment in palliative care. A primary objective of Last Aid research is to develop comprehensive training programs for both healthcare professionals and the general public. These programs equip individuals with the knowledge and skills needed to provide compassionate care, whether in a professional setting or within the community. By creating standardized curricula informed by research, Last Aid initiatives can ensure consistent, high-quality care across different regions and cultures. This approach has led to the inclusion of Last Aid as an elective course in medical schools in Austria and Germany, where feedback has been instrumental in refining the program.
Additionally, Last Aid research underscores the importance of ethical and cultural considerations in end-of-life care, ensuring practices are inclusive and respectful of diverse beliefs. The courses also provide a platform for participants to share experiences, which not only empowers individuals but strengthens community bonds. In an era increasingly dominated by consumer-oriented medicine,
Conclusion: Last Aid plays a crucial role in normalizing discussions around death and dying. Ultimately, advancing Last Aid through research is essential for improving end-of-life care, enhancing the quality of life for individuals in their final days, and offering better support to families and caregivers.
Keywords: Research, Last Aid, Last Aid Course
A-15 Online Delivery of Last Aid Training During the COVID 19 Pandemic: Perceptions and Experiences from Rural Scotland
Leah Macaden1, Kirsten Broadfoot2, Clare Carolan3, Kevin Muirhead4, Siobhan Neylon5, Jeremy Keen6
1Nursing Studies, School of Health in Social Science, University of Edinburgh
2Sterena Consultancy, Cromarty, UK
3Centre for Rural Health Sciences, University of the Highlands & Islands
4 Hillcrest House, NHS Highland
5NHS Highland
6Highland Hospice
Correspondence should be addressed to: leah.macaden@ed.ac.uk
Background: Normalising conversations around death and dying is becoming increasingly important to build personal and community capacity as part of promoting death literacy. Last Aid Training (LAT) is an innovative education approach to enhance peoples’ everyday capacity to support death and dying conversations in their communities. The Highland Hospice [HH] in Scotland is the only adopter of LAT [in person delivery] in Scotland since March 2019 and online since March 2020 to accommodate pandemic restrictions.
Aim: To explore participant and facilitator experiences and perspectives of LAT in an online environment.
Methods: This study used a mixed-methods approach, combining an online survey with LAT participants followed by individual semi-structured qualitative interviews with both LAT participants and facilitators. Data were collected between October 2020 and April 2021.
Results: A total of 105 people opted in to participate in the study at the time of registration. However, recruitment to the study was challenging during the pandemic. 68 people attended LAT sessions online with only 26 participants completing the survey, giving a response rate of 38%. Eleven participants (six LAT participants and five facilitators contributed to one-to-one semi-structured virtual video interviews.
Overall, participants reported enhanced personal knowledge, skills and confidence with increase in intentions and decisions to support end of life care needs following LAT. Qualitative finds were grouped under three key themes: (i) demystifying palliative care and enhancing understanding, (ii) creating normalised conversations around death and dying, and (iii) thinking ahead and advocating for self and others.
Conclusions: Findings from this study concluded that there is potential to include LAT as the foundational core training to promote death literacy in communities with further exploration to integrate/align LAT with other national/global end-of-life care frameworks.
Key words: Last Aid, Online, Rural, Scotland, Participants, Facilitators, Pandemic.
A-16 Last Aid – lessons learned from Australia
Jason Mills
1
1Flinders University Research Centre for Palliative Care, Death and Dying
Correspondence should be addressed to: jason.mills@flinders.edu.au
Last Aid training was first made available in Australia in 2021. Since then, it has slowly grown and evolved over time, adapting to its unique multicultural cultural context, and drawing strongly from the principles of public health palliative care. Specifically, highlighting health promoting practices aligned with the Ottawa Charter for Health Promotion that support the development of personal skills and strengthen community action in fostering compassionate communities. This presentation provides an overview of the background context to Last Aid training in Australia, and explores its implementation within the States of Queensland and South Australia, including tailored activities and lessons learned along the way.
Key words: Last Aid, Last Aid Course, health promotion, death literacy, Australia
A-17 Acceptance of Last Aid Courses for medical students at the University of Cologne
Georg Bollig1,2,3, Axel Doll1, Raymond Voltz1
1University Hospital Cologne, Germany
2Last Aid Germany, Schleswig, Germany
3Last Aid Research Group International (LARGI), Schleswig, Germany
Correspondence should be addressed to: georg.bollig@uk-koeln.de
Background: All medical students in Germany receive obligatory first aid training as part of their basic studies. Since 2015 Last Aid Courses for the public have been introduced in Germany and a number of other countries in Europe, Australia, Canada and Singapore. The University Hospital Cologne was one of the first universities to introduce voluntary Last Aid Courses for medical students.
Methods: Since 2023 voluntary Last Aid Courses were offered by the Center of Palliative Medicine, University Hospital Cologne, Germany. The courses were held with mixed groups consisting of students from the first year to the last year of medical school. A questionnaire that has been used in previous studies was used to evaluate the experiences and views of the students with the Last Aid Course.
Results: Between June 2023 and June 2024 four Last Aid Courses for medical students were held as pilot courses. A total number of 45 medical students participated in the courses. 44 of them provided written feedback using the Last Aid Course questionnaire (response rate 98%). The reported gender of the participants were: female 38, male 6, divers 0. The age ranged from 19 to 36 years with a mean age of 25 and a median age of 24 years. All participants found that the Last Aid Course is helpful for everybody and 43 stated that they would recommend the course to others.
Discussion/Conclusion: The results show that the Last Aid Course for medical students was feasible and very well accepted. 98% of the participants would recommend the course to others. The Last Aid course will be offered to more medical students in the future.
Keywords: Last Aid, Last Aid Course, medical students, death literacy
A-18 LAUT - Last Aid in the workplace
Julia Strupp
1,
Georg Bollig
1,2,3, Karin Ohler1, Alina Kasdorf1, Golrokh Esmaili1, Helena Kukla1, Raymond Voltz1
1University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Germany
2Department of Anesthesiology, Intensive Care, Palliative Medicine and Pain Therapy, Helios Klinikum Schleswig, Germany
3Last Aid Research Group International (LARGI), Schleswig, Germany
Correspondence should be addressed to: georg.bollig@uk-koeln.de
Background: The number of deaths in Germany in 2023 was 1.02 million, of which around 15% were of working age. It is highly likely that everyone will be directly or indirectly confronted with colleagues who are affected by dying, death, serious illness or bereavement during their working lives. Dealing with these issues has a serious impact on the ability to work and the psychosocial well-being of all those involved in the workplace. A culture of communication, adaptation of working conditions and emotional support are needed to help those affected.
Methods: In a representative online panel survey managers and employees will be asked about their experiences of dying, death and grief in the workplace. Needs for change in dealing with dying, death and grief will be identified. Last Aid Courses will be offered and evaluated for use in the workplace. Focus group interviews with trained caregivers will be used to gather ideas for the redesigning the content and possible implementation of Last Aiders.
Results: The project is running from 01/10/2023 to 31/12/2025. First results will be presented.
Discussion: Last Aiders may support people in the workplace in dealing with dying, death and grief. They can provide emotional and practical support, access to open dialogue about burden and grief and create spaces for mourning. The results of the ongoing project can be used to develop important recommendations for action for companies and organisations. The implementation of Last Aiders in the workplace can be a promising approach to supporting people in distress at work.
Practical implementation: It is important to investigate the long-term benefits of Last Aiders in the workplace. The implementation of Last Aiders may serve as a resource for increased well-being, an open communication culture and as motivation for developing guidelines for dealing with dying, death and grief in the workplace.
Keywords: Last Aid, end-of-life care, grief, bereavement, death literacy, workplace
A-19 INSEL - Informal Care in Outpatient End-of-Life Care
Nino Chikhradze*¹, Chantal Giehl2, Horst Christian Vollmar¹, Georg Bollig3,4, Ina Otte1,4
¹Institute of General Practice and Family Medicine (AM RUB), Faculty of Medicine, Ruhr University Bochum, Germany
2Department of Geriatric Medicine, Marien Hospital Herne, University Hospital of the Ruhr University Bochum, Germany
3Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Germany
4Last Aid Research Group International (LARGI), Schleswig, Germany
Correspondence should be addressed to: nino.chikhradze@rub.de
Background: Informal caregivers of people in the last stages of life face challenges and require training and appropriate support services. In order, to support them in their daily tasks, Last Aid Courses are offered in Germany. The aim of this project is to evaluate these courses from the perspective of informal caregivers.
Method: The project uses a mixed methods approach consisting of literature review, participant observation in courses (n=5), individual interviews with course participants before and after the course (n=30), focus group interviews with course participants (n=6 groups, n=24 participants) and course instructors (n=24), quantitative data collection from course participants via questionnaires (n=200). Following the final qualitative data collection, immediate recommendations for the optimisation of the Last Aid Courses will be derived to support their further development. Subsequently, the project will proceed with: Workshops (n=3) for course instructors to familiarise them with the optimization recommendations and implement new course content based on didactic guidelines. Two months after delivering the optimized courses, participants will complete a follow-up quantitative survey using the same questionnaires (n=200) to conclude the Last Aid Courses evaluation.
Results: The outcomes of this evaluation include:
An overview of the Last Aid Course content and delivery
Suggestions for improving the Last Aid Courses, specially in Germany
Description of the content learned and implemented by informal caregivers
Account of the factors facilitating and hindering the practice of learned content
Identification of the needs of informal caregivers
Conclusion: The evaluation of the Last Aid Course improves the safety of patients and relatives by updating the course content with the latest scientific knowledge and by addressing the needs of informal carers. This strengthens their self-help skills in their daily care.
Key words: Last Aid Course, palliative care, informal care, mixed methods, evaluation
A-20 Last Aid and caring community in Liechtenstein
Yvonne Odoni
1
1Last Aid Liechtenstein
Correspondence should be addressed to: yvonne.odoni@gmail.com
Background: The Hospice Movement in Liechtenstein has played a pivotal role in promoting palliative care and end-of-life support, underscoring the importance of community solidarity and compassion. In autumn 2021, the Hospice Movement Liechtenstein (HBL) obtained the license to implement the Last Aid program.
Methods: Five individuals from Liechtenstein completed the Last Aid Trainers course in Zurich, enabling the initiation of Last Aid courses in the country.
Results and discussion: Since the first course in September 2022, Last Aid courses have seen significant participation, with 96 individuals trained in 2023 alone. These courses are offered in cooperation with the Liechtenstein Old Age and Health Care (LAK) and have been made accessible to the public and internal volunteers from Familienhilfe Liechtenstein without any participant fees. The collaboration between HBL and LAK reflects a long-standing tradition of mutual support in end-of-life care, emphasizing a holistic approach that combines medical, psychological, and social support. Liechtenstein’s compact size and close-knit community provide an ideal environment for fostering compassionate care initiatives. The Hospice Movement and Last Aid courses aim to empower individuals to offer dignified care, addressing critical topics such as making provisions, alleviating suffering, and saying goodbye. The initiative aligns with the broader societal goal of creating a caring community, where mutual support and responsibility are paramount.
Conclusion: Looking ahead, the Hospice Movement Liechtenstein plans to host the Last Aid International Conference in 2026, marking its 25th anniversary. This event will celebrate the achievements in palliative care and set ambitious goals for further advancements. The initiative highlights Liechtenstein's commitment to enhancing the quality of life and dignity for its residents, particularly in their final stages of life, demonstrating how small communities can make a significant impact in compassionate care.
Key words: Last Aid, Hospice movement, Liechtenstein
