Diabetes In Motion

Programs

A New Model of Health Care

visitng diabetes/cardiometabolic clinic
self-management program
weekend retreat
facilitators’ training program

Patient-centric health care must avoid aligning the patient in the centre like a target, to whom things are done, for whom things are done. The health care professional easily and unintentionally wields power by virtue of his/her professional expertise. The innovative programming of Diabetes in Motion explores an alternative model in which the patient moves from the centre into the circumference of the circle as a participant with the care-providers. The centre is now an empty space that might be thought of as the possibilities of the future, or perhaps the as-yet-unknown outcomes, or even the difficulties yet to arise, which the group as a whole now faces together. The group now becomes a small community that shapes its future in a manner that is interactive so that all decisions impact upon and form each person in the circle. Although each person contributes according to his/her skills, expertise does not translate into a hierarchy of power. No one person becomes singled out as the object, no one person is left alone with his/her troubles, no one person profits from competency, no one person is traumatized by greed. Yet greed, anger, and fear do happen in human relationships, as do joy, healing, and gratitude. The group as a community shares all the experiences of being human, being present without judgement to one another, at times managing suffering, and at times basking in gratitude. This is the community of compassion that empowers patient and professional alike in the programs presented by Diabetes in Motion.

VISITING DIABETES/CARDIOMETABOLIC RISK CLINIC brings the endocrinologist to the family practice office, facilitating communication between consultant and family doc, and providing a teaching/learning relationship with the allied helath professionals right on-site in the family practice venue. The patients benefit from the “one-stop shopping” model of health care delivery.

v The endocrinologist comes to the family practice offices and occupies one examining room for one day per month. Patients with diabetes and other cardiometabolic risk factors ( hyperlipidemia, hypertension, sleep apnea, etc) will be seen in consultation by referral from the clinic family doctors.
v The nurse educator sees each patient weekly after the initial endo-consultant visit to support the efforts at home blood glucose monitoring, carb counting, log book management, and insulin/medication adjustment. Issues of resistance are identified gently, without naming things as good or bad, to intentionally avoid imprinting a sense of failure.
v The endocrinologist provides ongoing supervision to the nurse educator and monthly on-site patient follow up until professional practice guideline targets are in place. The endocrinologist is available for phone consultation to the allied health professionals (and family doctors) of the host practice should questions arise between clinic visits.
v Available allied health professionals are welcome to learn our unique approach by working alongside our nurse. Our presence in the host practice cultivates relationships of collegiality between specialist and family doctor, as well as a hands-on learning experience of medically aggressive diabetes intervention.
v Regular conferences are held with the referring doctors and their staff to assess how we can improve the model that we are evolving. Diabetes in Motion, with our unique holistic facilitation skills, has the capacity to help define the differing capabilities of the various health-care professionals as they evolve their roles within the health care teams.
v Records are maintained using the Practice Solutions software that is common to all the family practice offices. Paper copies are printed and retained by the endocrinologist for reference if questions arise between clinic visits.
v This process initiates the patient-provider relationship of trust that is the basis of the Self-Management Program. (See Self-Management Program for details.)

To discuss how DinM Traveling Diabetes/Cardiometabolic Risk Clinic might benefit you and your family practice, please call Dr Ann Sirek 519-745-6741.

Self-Management Program teaches standard diabetes information along with strategies for managing one’s barriers to making changes. Our approach is story-telling, mindfulness practice, and mind-body integraton.

2 hr sessions.

Small groups

Interactive, entertaining power point presentation about diet, exercise, log book, and medication skills to help accomplish the recommended health-promoting targets for blood sugar, cholesterol, and blood pressure.

Unique mind-body emphasis teaching breath-based techniques for stress-management and (food-) craving control.

A safe space to share your own story of living with diabetes. Share the challenges and also the wisdom gained when diabetes is a part of your life.

Location: the gathering room at Forest Heights Long Term Care facility, Westheights and Highland Rd, Kitchener

Facilitators: Ann Sirek, MD, Kathy Greener, RN, Diane Frederick, R.N., M.A., I.C.A.D.C., I.C.C.S.

Upon completion of the self-management program you will

v Set up a useful log book to mirror your progress with the home blood testing

v Count carbohydrates and feel at ease with your meal plan

v Understand your medications and lab results.

v Work on an exercise plan.

v Recognize at least one personal barrier to following the recommendations for healthy living with diabetes

v Begin to deconstruct old guilt trips, and frustrations.

v Have an experience of diaphragmatic breathing as a tool to stress and depression management

v Have a sense of supportive community and feel good about yourself

v Have an opportunity to arrange ongoing follow up group meetings

call 519-745-6741. or info@diabetesinmotion.ca

Weekend Retreat Program provides an intensive experience of encounter with that vulnerable inner self that struggles to care for the person that has diabetes. Our approach is story-telling, mindfulness practice (silence), music, and mind-body integration. (Basic information about diabetes medical skills are not part of this program.)

Diabetes in Motion RETREAT for HEALTH CARE PROFESSIONALS

What we hold to be virtuous and worth-while is usually inherited from our parents and passed on to our children. Are these core identities possibly at odds with the culture at work? Unless invited to do so, most of us never really consider the values that hold deep meaning for us. We may find ourselves tired because of the environment at work, but not because of the patients. The fatigue may be generated by an inner and unconscious tension between a core value for the professional and an imposed core value of the System. We may have resigned and given up voicing our considered objections because no one seems to be listening. The difference may at first seem unimportant, just the way life is. We may find ourselves resigned and apathetic. “Suck it up,” and “ Soldier on.” We may feel unable to make a change in the System. Yet we live in times of extra-ordinary cultural shifts. Change is intrinsic to our world. Change and evolution for the Healthcare System is in our own hands.

The proposed Retreat is an invitation to enter into a process of radical change by getting in touch with experiences of compassion which will humanize the prevailing healthcare principles of efficiency and profit.

The Retreat would offer the following goals:

§ Be innovative. Create confidential, professionally facilitated, small groups that would serve as a safe container for an exploration of radical change.

§ Be holistic. Foster times of inner stillness (as in yoga-like, mindful body movements and meditation) to get in touch with those deeper spaces of Wisdom.

§ Be accountable. Identify those aspects of the work day that drain, stifle, and de-rail the professional from what feels creative.

§ Be self-aware. Explore how difficult personal experiences from our personal past can cause a kind of “inner gyration” (for better or for worse) in certain clinical settings.

§ Be compassionate. Care for yourself as you would have yourself care for others. Feel renewed and refreshed.

§ Be heard. Bond into a community gentle enough to access deep inner Wisdom and strong enough to impact the System.

The proposed venue is the Spirituality Centre of the Sisters of Providence in Kingston, easily accessible yet secluded, bright and spacious, with meeting rooms, single bed-rooms, shared bathrooms (dormitory style), and communal meals in a dining room. The w/e would run from Friday noon to Sunday noon. Target date Jun 4-6, 2010. The cost would be kept under $400.00 inclusive of room and board, facilitation and printed materials. Principle facilitator: Ann Sirek MD FRCP©(endocrinology) MTS.

TEAM BUILDING for the NEW MILLENIUM info@diabetesinmotion.ca

Friday, June 4

SESSION 1

1:00 pm Introductory comments. Welcome!

2:00 pm Fairy tale: Vasilisa the Beautiful.

Meditation: Come to trust my own personal, beneficent intuition.

2:45 pm Narrative sharing: The approach to our quest for light and vision

4:15 pm rest and reflection, on your own.

5:00 pm supper in Providence dining room, together.

SESSION 2

6:30 pm Fairy tale: Brother Spear Legs.

Meditation: Consider life-giving vs death-defying, a paradox.

7:15 pm Narrative sharing: Name the tensions when power and greed take over.

8:30 pm rest and reflection. Good night!

Saturday, June 5

SESSION 3

9:00 am Fairy Tale: The Bird with the Beautiful Song

Meditation: Consider conflict, self-awareness, and self-preservation.

10:30 am Narrative sharing: The process of seeking and following intuitive spontaneity creates a fully human self.

11:30 am Rest and reflection, on your own

12:00 pm lunch in Providence dining room, together.

SESSION 4

1:30 pm Fairy Tale: The King’s Son and the Devil’s Daughter

Meditation: We seek a beneficence that is deeper than “you get what you deserve.”

2:45 pm Narrative sharing: Consider a Healthcare System of utility and efficiency without compassion. Then consider what would change with an ethics of compassion.

4:00 pm Rest and reflection, on your own.

5:00 pm Supper in the Providence dining room, together.

SESSION 5

6:30 pm dance, Cain and Di, the Two Faces of Diabetes. Professional dancers will lead an interactive session of interpretive dance.

Sunday, June 6

9:00 am Meditation: To rest in gratitude is an experience of freedom in community.

10:00 am Narrative Sharing: How was I as I entered the w/e; how am I as I leave?

12:00 noon lunch and departure.

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Facilitator’s Training Program provides health-care professionals (or other leaders) with experiential training in the listening and facilitation skills neccessary to implement the Self-Management Program in their own professioanl practice environment. The process teaches mindfulness practice. The structural framework for story-telling is modified from Dorothee Soelle’s book, Suffering, (ISBN 0-8006-1813-0).

At present the program is geared towards training the facilitators (physicians) for the weekend retreat program. This program is readily modified to train other health professionals, pharmaceutical reps, or members from the diabetic community with leadership intentions.
Four 3-hour sessions held monthly over the 6 months preceding the weekend retreat in a participant’s private home including a simple shared meal.
Sessions are experiential. The docs participate in a group process that parallels the process to be experienced by the registrants during the w/e retreat. After each hour of group process, the docs are invited to reflect upon what they just experienced, so as to become aware of the movement that they will be looking for when facilitating their own groups.
The process is story-based, narrative-driven, and personal. Listening with the heart as well as with the head is encouraged in order to teach the art of non-judgemental presence.
A strong bond of collegiality is formed so that the retreat staff become very much a team.
Professional facilitators for this program are Ann Sirek, MD, physician/endocrinologist, founder and executive director of Diabetes in Motion, Marian Krauskopf, OSU, spiritual director/supervisor, Diane Frederick, RN, Adult educator and addictions counselor. This is a holistic program that builds upon traditional medicine, psychology, and spirituality.

Upon completion of the program the new facilitator will

Cultivate an alternative way of listening to a person’s story that goes beyond the analytic, diagnostic, traditional way of “taking a history.”
Become more personally aware of the meaning of his/her being a physician.
Be able to create a safe, non-judgemental milieu for the members of the group
Feel understood and supported by peers and colleagues in one’s vulnerability and humanity, rather than in perpetual competition towards an impossible and unrealistic perfection.
Have an experience of the dynamic in a group and how to move this towards healing and transformation of suffering (non-judgemental embrace), rather than trying to fix what cannot really be fixed (chronic illness like diabetes).
Bring new skills to the daily practice of medicine, with the capability of developing supportive group process to patient care and to interprofessional, collegial relationships.
This innovative model has the potential of becoming a new mode of health care provision for persons with chronic disease.

Interested in becoming a facilitator? Contact us at info@diabetesinmotion.ca