We’ve asked community members to share how they are planning their work (to spread the importance of end-of-life care conversations) so it continues in the long run. The five most common ways groups or individuals are ensuring this work lives on are listed below.

 

 

1. Ensuring a regular rhythm of sharing through recurring programming or media messaging: So this isn’t just a “flavor of the month” topic, groups are hosting more than one event, creating recurring or follow-up events (reaching more people and/or creating multiple sessions for the same group to provide deeper support). This can help keep the topic part of the fabric of the community and, importantly, helps you identify others that you can team up with (and share your materials with) to spread further. If you only have the bandwidth for a one-time event – that’s OK! Try to identify at least one person, one “champion,” at that event to help ‘pay it forward’ and commit to reaching 5 more people by hosting their own event or spreading the message or tools to followers on social media. For an example of regular rhythm, Bethel AME church leaders created a dedicated ministry and program called “Planning ahead” that brings groups of congregants together three times over three months. Read more on this work here.
2. Establishing a position (within an organization) or team dedicated to this work: Some groups are getting really serious and securing funding or organizational commitment to have a dedicated advance care planning (ACP) person or team within their organization. Groups such as Making Choices Michigan,  The Conversation Project Boulder, Kitchen Table Conversations, and many more (see our Conversation Champion Map for more details) are forming formal, community-based ACP non-profits. Fundraising and networking are crucial components to sustaining this. For those of you who are solo, grassroots volunteers spreading this work on your own, you can still ensure longevity by joining up with another friend or two! A great example is Death Talk L-A, created by two friends in their twenties who teamed up to get people talking in their Lewiston-Auburn, Maine community. This dynamic duo is making a huge splash (read more here).
3. Creating alliances, networking, and organizing with others: No matter how small or big your group is, the old African proverb is truly applicable here: “If you want to go fast, go alone. If you want to go far, go together.” Many individuals and groups are tapping the assets within their own community to identify others to align with and organize together for change. For example, in Arizona, the Community Coalition for Advance Care Planning collaborates with SEAGO Area Agency on Aging and the Thoughtful Life Conversations Program sponsored by the Arizona Hospital and Healthcare Association to align and work together. Two organizations and one grassroots volunteer shared their lessons on organizing on our May 2019 community call, Working Together–Organizing and Building Coalitions, check out the slides and recording here.
4. Building activities or providing tools as standard practice: Some groups are finding ways to build programming into the fabric of an organization or creating standard work to automatically spread tools and resources to jump start conversations. For example, some hospitals talk to all new hospital admissions about ACP and provide each person with a TCP Conversation Starter Kit, as standard practice. Some are using “Conversation Ready” principles and practices to ensure their systems are designed to support and respect people’s wishes for care. Other organizations include the Conversation Starter Kit within all new hire orientation packets. Healthy Aging Martha’s Vineyard is planning a two year project, working with and training the local hospital to build these activities into their usual inpatient and outpatient protocols. And, several financial firms are integrating end-of-life conversation starter tools into their financial services practices (read more here).
5. Educating and training others to take this forward: Many individuals/groups are building the skills of other community members to take this forward. For example, one champion of this work in faith settings in Boston, MA co-led a workshop with her rabbi/chaplain colleagues at her place of work to transfer skills so colleagues can now lead these workshops on their own. Dartmouth Hitchcock’s Honoring Care Decisions program has trained a group of dedicated facilitators who are either embedded at care sites or are travelling facilitators that can be hired for events. One hospital’s ethics committee is now fully on board to foster these events and provide education on an on-going basis.

True sustainability takes a combination of the above, coupled with passion and strategy setting to determine the right methods and people to keep this work going in any community. We hope this helps jump start your thinking! For additional learning, listen to our free Community Call on Designing for Sustainability . This call highlighted various models for starting and sustaining programs to spread the importance of conversations across a community.  We heard from seasoned community members and together explored various components to keep the momentum going, including funding.

If you are just starting to think about this work, check out our Getting Started Guide for Communities for help with introducing The Conversation Project in your communities. You can also stay up to date about our latest resources, news and events by signing up for our monthly newsletter here!

Lastly, we’ve heard from many of you who want to connect with others locally and nationally. As a reminder, add your pin to our map (scroll down to bottom of this page) to help create connections to each other.

What other things are you doing to sustain this work into the future?  Please share what you are doing below!