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The palliative care team at Elizabeth Seton Children’s Center works daily with residents who are approaching the end of life. Similar to direct care workers in aging services, that care can be physically and emotionally overwhelming for caregivers, leading to burnout and high turnover. 

The evolution of an interactive educational strategy the center incorporated that led to increased staff resiliency and employee engagement was the topic of discussion during a LeadingAge policy update call on Monday, Alvin Moyer, MD, chief medical officer at the New York-based long-term care center for children, and Kat Penyak, music therapist.

The center launched its first palliative care and caregiver conference in 2006 as an educational strategy to celebrate and empower direct caregivers, and demonstrate their integral role on the palliative care team. 

The conference included an introduction to palliative care, a discussion on grief with a psychologist, and an experiential piece involving a music therapist. During the conference, Moyer said he heard stories from staff who opened up about their caregiving duties outside of their jobs for loved ones with dementia or significant health issues.

With the conference paused during the pandemic, Moyer said he kept returning to those conversations and stories and suggested a change in programming to focus more on resilience and empathy building.

Penyak said the pandemic presented a perfect time to shift focus. The conference maintained the educational component of palliative care but added the empathy component to teach staff how to become resilient and find longevity in their work. The wellness experiential, she said, provided a way for direct caregivers to “get back in their bodies.” 

“You’ve been sitting all day, listening and talking,” Penyak said. “Now it’s a way to recognize the physical toll our work can take and learn a way to release that stress and how to revitalize ourselves physically, emotionally, cognitively, spiritually.”

While the Elizabeth Seton Children’s Center used a music therapist to to lead the wellness experiential, Penyak encouraged organizations to look within and use their own resources, which could be an art or dance movement therapist, or a “stellar social work team.”

“The nature of the program and talking about grief and what grief does to us is an invitation to people to share,” Moyer said, adding that the grief portion of the program is led by a psychologist. “Narrative medicine is a way of asking people to interpret a passage or a story or a piece of art and relate it to their own experiences.”

The program, which is a full-day and voluntary, also added a “hint of improv.” 

“This is very much an audience participation program,” Moyer said, adding that its focus on direct caregivers provided access to educational programming not typically available to those employees. “We really wanted to celebrate them and acknowledge the important role they played, but give them an experience to participate in a more robust educational, as well as audience participation.”

The center is now measuring the impact of the program through resiliency questionnaires and engagement surveys given to participants prior to participation, one month after the program and one year later. While it’s early in the data collection, Moyer said resilience scores increased an average of four points, and employee engagement scores increased an average of half a point. The center also noticed higher retention rates in participants vs. nonparticipants.

Penyak said anyone looking to replicate the model can look within their own organizations and tap into existing expertise. She also recommended following up with participants by providing information on employee mental health resources.