Erin Collins

Discipline: Nurse

Funding awarded to: The Peaceful Presence Project

Improving Rural Access to Palliative Care with Community Health Workers (CHWs)

In the twenty-six rural or frontier counties in Oregon, many patients travel hundreds of miles for a visit with an oncologist or specialist and may or may not see a palliative care team. Community-based palliative support delivered by CHWs is a solution to ensure equitable care for rural residents living with serious or terminal illness. With this nurse-led project I will develop and deliver continuing education for CHWs that prepares them to provide early palliative support in the rural communities where they live: connecting clients with resources, engaging in advance care planning and end-of-life planning conversations, and ensuring adequate caregiver support from diagnosis through the end of life. Curriculum will include principles of palliative care and aspects of the end-of-life doula model of care. CHWs will be part of a referral hub directly connecting them to clients in their communities.

“I believe that equitable and compassionate end-of-life care is a human right. And yet, our death-denying culture deprives people of the opportunity to experience quality of life as they face serious illness. Rather than engage in conversations about what defines “quality of life,” mortality, and future care preferences, our system focuses on curing and saving lives at all costs without regard to how treatment is affecting the whole person. I believe that beyond symptom management, palliative care is the chance to focus on treating people, rather than diseases, and addressing what matters most--emotionally, physically, spiritually and in relationship with others. Especially in rural communities, access to palliative care is limited or non-existent, leading to broad disparities in care for rural residents who are living with serious and terminal illness.”