David Moller of the Truman Medical Center spoke with Dr. Gloria Horsley during the 2015 Annual Association for Death Education and Counseling conference. Currently, Moller is working with a group to create training on cultural competence for the medical staff at Truman. “We’re extending their learning out and into the neighborhood,” he explains. Hospice home visits are common for medical residents, as are inner city visits. Most patients come to the hospital, but Moller is committed to reversing it. Bringing doctors into the home allows for learning about poverty challenges, racial barrier issues and to experience another side of their patient that isn’t available in clinical settings or textbooks.
“We’re trying to deepen their capacity for empathy,” says Moller. Reversing the “who visits whom” equation is nothing new—in fact, it’s the way all doctor-patient relationships used to work. “House visits” were once the norm, and something has been lost since that shift. Moller’s book Dancing with Broken Bones is an original, ethnographic research project detailing Moller’s experiences as he went into inner city neighborhoods to record stories regarding end of life and poverty being at an intersection.
A New Type of Care
“The poor are systematically beaten down and broken by poverty,” he says. However, he also found extreme courage and faith. The My Story: Because I Matter Project at The Truman Center is helping to encourage cultural competency, too. There’s a whiteboard in every patient’s room, which helps staff appreciate the patient as a person. Nurses have meaningful conversations with each patient when they arrive focused on favorite music, food, pets or TV shows. This gives medical staff a snapshot of who the patient really is.
On the flipside of the board, there are notes of what goals, fears and aspirations patients have during their care. Doctors and nurses easily have these “voices” communicated to them. Giving a voice to the voiceless is paramount, and Moller’s innovative approach is changing the way medical care for the terminally ill is being handled.