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P-186 ‘Time to Be’: A therapeutic alternative providing pre and post bereavement support for patients and family caregivers
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  1. Jane Pantony
  1. Hospice in the Weald, Tunbridge Wells, UK

Abstract

Background The word ‘counselling’ like ‘Hospice’ may have negative connotations for people needing therapeutic support at end of life (Hawley, 2016). Time to Be (T2B) was developed to address this need for alternative therapeutic support in end-of-life care. T2B is a talking-therapy that is client-led, gentler and less invasive than more traditional counselling. T2B supports symptom management and client autonomy by combining the following techniques: guided imagery (Roffe, Schmidt & Ernst, 2005. Psychooncology. Aug 14; Nooner, Dwyer, De Shea , et al., 2016. Clin J Oncol Nurs. 20: 547), diaphragmatic breathing (Hamasaki, 2020. Medicines. Oct.), holding safe space and gentle conversation. These techniques help activate the vagus nerve (Breit, Kupferberg, Rogler et al., 2018. Front Psychiatry. March; Kolk, 2014) trigger relaxation responses and calming Alpha waves (Kolk, 2014) within the brain. T2B is facilitated by trained volunteers with peer supervision, this planned community involvement enhances social engagement.

Aims To evaluate the T2B intervention and its impact on physical and psychosocial symptoms such as: 1) relaxation state, 2) lifting mood, 3) anxiety, tension, and stress management, 4) pain and nausea management, 5) sleep disturbance, 6) connectivity/social engagement (Wagner, 2016. Counselling Today. June 27).

Methods Phase 1 (Feb – June 2021): internal consultation, literature review, model development. Phase 2 (Sept – Oct 2021): Volunteer recruitment/training, T2B pilot. Phase 3: (Nov 2021 – ongoing): collation of feedback, outcome measurement, volunteer supervision.

Results 227 T2B sessions since programme inception.

Mode of delivery – Patients: face-to-face = 68, Zoom = 40, Telephone = 14. Family carers (pre-bereavement): Face-to-face = 16, Zoom = 8, Telephone = 6. (Post- bereavement): Face-to-face = 26, Zoom = 28, Telephone = 21.

Gender of client accessing support - Patients: Female = 20, Male = 4. Family carers (pre-bereavement): Female = 4, Male = 4; (post- bereavement): Female = 13, Male = 0.

Outcome measures on impact on physical and psychosocial symptoms are forthcoming. Staff and volunteer experience in the programme has been reportedly positive with no adverse experiences or incidents.

Conclusions T2B therapy developed, during COVID-19 pandemic, has much potential and would benefit from a dedicated coordinator, reflective evaluation, and further research.

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