Effective communication is essential for the optimal delivery of healthcare services. In developing countries, family members typically shoulder a great deal of the burden of caring for patients. Families serve as caregivers, provide food and transport, and pay bills. The contributions of family members at end-of-life are thus crucial to the plan of care in low- and middle-income countries. In an effort to create a formal model of end-of-life care that is suitable to the Rwandan context, we must begin by understanding the suffering of families and the community at the end of life.  
The aim of this workshop is to teach a practical guide developed in Rwanda to understand the language of suffering expressed by patients’ families to optimize communication at end-of-life care.
We observed and described the behavior of more than seven hundred meetings of healthcare staff with family members and patient caregivers in hospitals, hospices, and at home.
We developed a framework called “Safari,” which means “Journey” in Swahili, based on a Rwandan social-cultural approach to decode the language of suffering from families and caregivers during family meetings. Twelve animal archetypes were used to describe families’ suffering behaviors, language, and expectations. The framework has helped healthcare providers improve their understanding of and communication with families. 

Background: More than one-third of deaths in Australia each year are residents living in aged care homes (ACHs). Undoubtedly, care of the dying is routine care in ACHs and palliative care (PC) needs to be core business in this sector.The Royal Commission into Aged Care Quality and Safety highlighted the need to develop greater palliative care competency in the aged care sector as a priority. The Palliative Aged Care Outcomes Program (PACOP) is a national program that promotes optimal palliative and end-of-life care for residents and their families through routine point of care assessment to inform care and timely referral to specialist palliative care. Reporting of outcomes and benchmarking is used to systematically improve resident outcomes in participating homes.

How does PACOP work and how does it intersect with other palliative care initiatives reaching into aged care?

Aims/objectives: This workshop will provide a framework for palliative care services to collaborate effectively with ACHs to provide equitable palliative care for residents. The objectives are to:

Key learning outcomes: At the end of this symposium the audience will be able to:

Methodology: The workshop will involve a presentation about the practical implementation and application of PACOP followed by table discussion/interactive discussion and presentation of case studies to explore the opportunity for a collaborative approach to embedding palliative care in ACHs, building capacity in the sector and supporting equitable access to high quality end of life care for people dying in ACHs.