Health Calls Season 6, Episode 4 explores the transformative power of Whole Person Care in the context of palliative care, with guest Lori Dangberg, Executive Vice President of the Alliance of Catholic Health Care in California.
Health Calls Season 6, Episode 4 explores the transformative power of Whole Person Care in the context of palliative care, with guest Lori Dangberg, Executive Vice President of the Alliance of Catholic Health Care in California.
Lori shares the origins and impact of a statewide initiative that brings together dioceses, parishes, and health systems to support patients and families through serious illness and end-of-life care. The episode highlights how collaborative education—through a five-module curriculum—empowers parish leaders and clinicians to engage in meaningful conversations around palliative care, Catholic moral teaching, and advanced care planning. With resources available in multiple languages and formats, the initiative fosters dignity, compassion, and informed decision-making. Hosts Brian Reardon and Josh Matejka reflect on the importance of this work as the population ages and the need for holistic care grows.
Brian Reardon (00:05):
Welcome to Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon, and with me is Josh Matejka. Hey Josh.
Josh Matejka (00:13):
Hey Brian.
Brian Reardon (00:15):
Again this season is about United for Change. We're talking about collaborative efforts across Catholic health care, and for this episode we're going to talk about collaborating and caring for the whole person. And I think before we bring in our guest, Lori Dangberg, who serves as executive director, excuse me, executive vice president of the Alliance of Catholic Health Care in California. Before we bring Lori in, probably want to do a little context setting about what we mean regarding Whole Person Care in the context of this episode.
Josh Matejka (00:44):
Yeah, of course. Well, I think a lot of people who listen to health calls will be familiar with the concept of Whole Person Care. I mean, we did a lot of talk about Whole Person Care in our humanity and technology season last year, but I mean, the idea is fairly straightforward. Linguistically caring for the whole person means not just caring for the physical melody, but caring for the person emotionally, spiritually, and obviously in Catholic health care, we really, really value that whole Person Care setup. We've seen that that resonates with a lot of patients and people across the country. But I think in the context of this episode too, we talk about caring for the whole person in end of life. And at a palliative care, one of the things that I love so much about Catholic health care is that all the stages of life are valued from beginning to end.
(01:30):
And life at the end of life isn't just viewed as like, okay, how do we make people comfortable and run out the end of the clock? It's like, no, this is a valuable part of life in which people can flourish in which people have dignity. And so how do we elevate that? How do we teach people that are not in Catholic health care about how that type of care is applied and how do we hold ourselves to a greater standard? And so I'm really excited to dig into that because I find palliative care and whole person care within palliative care to be one of the most really beautiful and enriching parts of Catholic health care and one of the coolest things that it has to offer that maybe some other lanes of health care don't.
Brian Reardon (02:09):
Yeah, and at CHA, we do a lot on this topic. It's in the area of resources, advocacy work, the work with our spiritual care folks. So it's good to kind of add to the amount of, I guess information and knowledge that we're able to share with our listeners and members by having this conversation with Lori. So I'm going to go ahead and bring in Lori now to the conversation. Hi, Lori.
Lori Dangberg (02:31):
Hello gentlemen. How are you?
Brian Reardon (02:32):
Doing great. And again, we're speaking with Lori Dangberg. She serves as Executive Vice President of the Alliance of Catholic health care in California. And so to start off with, I think, Lori, if you could just give us a little bit of background and again, tell our listeners a little bit about the caring for the Whole Person Initiative.
Lori Dangberg (02:52):
Sure. I can't believe it's been 10 years since we started the dialogue around this, and it was in 2015 and in California we would gather the bishops and our sponsors or health care leaders every three years or so and have a whole in-depth dialogue. And providentially. We had scheduled Dr. Ira Byock, who's a well-renowned palliative care physician. He was scheduled to talk, and this gathering took place about a week after our governor in California signed into law the assisted suicide bill. And so that was right on the heels. This gathering was right on the heels, and Dr. Byock talked about a lot of things, but he said something very simple to this gathering and he said, people know what we are against, but they can be forgiven for not knowing what we're for. And that simple statement really, really had this group who was together for two days really began this wonderful dialogue and talk about how do we accompany persons through the end of life?
(03:59):
How do they feel supported? So that following January, we developed this leadership council, this working group of bishops and diocesan leaders and our ethicists and our mission leaders and our health care leaders. And we began a really in-depth dialogue about the many aspects of what this looks like to accompany persons through the end of life. And we looked at this through this whole Person Care lens, and we kind of knew this was going to be a multi-year effort, but we were resolved to focus on our collective energies on developing this robust Whole Person Care initiative. And what did that mean to us when we talked about it was to really ensure that parishioners and patients feel loved and supported, that they feel equipped to openly talk with their spiritual leaders, with their physicians and families about what they would want at end of life to have early access to quality palliative care.
(04:54):
And then we talk about, well, if we educate the community about palliative care, then we have to ensure that our health care systems and hospitals have quality health care programs. Our audience really were those in the pews, those in community. We know from our health care experience that things like palliative care and hospice care aren't generally understood. And actually people are kind of fearful when you start talking about those issues because there's some unknown and confusion about that also about advanced care planning, pain management. So ultimately what happened is we developed a standardized curriculum for parishes, like a Train the Trainer program where health care can be content experts and we can begin educating parishioners around issues around hospice care and palliative care, Catholic church teaching on end of life, advanced care planning, et cetera. And it really was not meant to be this toolkit in a binder that we hand over to a parish and they feel, oh gosh, we have now another program. The bishops were very clear when we were in dialogue that they wanted this effort to be transformative for parish life, to integrate it into what the ministries are currently doing. So they feel they have resources and support to have these conversations in community.
Brian Reardon (06:20):
So going back to the focus groups and the research that you did, what were some of the barriers that you uncovered in the understanding of palliative care? Because I know from my own personal experience, I have found even physicians, hospitalists, who you think would be very much up to speed. And I've talked to other colleagues too that have been to Catholic Health in Catholic health care, gone to Catholic hospitals with loved ones, brought it up, and there seems to be just a lot of, I guess a lack of knowledge. Is that what you found through some of the research is just sort of a baseline of not really fully understanding palliative care, particularly as it relates to hospice care?
Lori Dangberg (07:01):
Right. I think that's true both within the health care setting and certain disciplines that somehow by bringing in palliative care that the other disciplines are specialties are like giving up, if you will. Then palliative care by its nature is meant to be a support supporting those specialties. And the palliative care teams are physicians and nurses and social workers and chaplains, pharmacists. Sometimes that's kind of the gold standard really, because they're there to have good communication with patients and start those goals of care conversation. So that's what happens inside a hospital in community, I think, and sometimes in maybe some misunderstandings in some of the Catholic circles was that palliative care hospice is almost like you're giving up and it's not care. And we continue to say hospice is care, palliative care is care. It's not like you just, and when we talk about supportive care for patients, that people think nothing is going to happen for them when in fact we bring a lot to the table with palliative care and hospice care and supportive care.
Brian Reardon (08:13):
And you'd mentioned that when you approach the bishops in California about the program, that they wanted it to be transformative. What do you mean by that? What are some of the transformative pieces that you have come up with as you've developed a curriculum?
Lori Dangberg (08:28):
Well, some of the things that have happened is there are current wonderful ministries in parishes, bereavement ministries, visiting the sick, et cetera. But what we did with our teaching modules, and we can talk in more detail about what those included, it really gave them the support, the framework for this work. So in some parishes when we brought the education, it really enliven their bereavement ministries or their grief ministries that they may have been doing something, but it was just so much more rich when we bring in the notion of palliative care and hospice and whole person care and get people comfortable talking about end of life issues. And that is one of the biggest nuts to crack, if you will, is just getting both clergy and deacons and parishioners to feel comfortable about opening the dialogue, about talking about what you would want when you get seriously ill or dying. That's a big part of it.
Brian Reardon (09:31):
And I would imagine there's theological ethical concerns that particularly clergy would have that maybe don't necessarily don't rise to the same level with a clinician that may be thinking more about making sure their patients are comfortable, receive the highest quality care, but from a priest or a bishop's perspective, they may be looking more at the ethical considerations of interventions at the end of life and how that pertains to Catholic teaching.
Lori Dangberg (09:59):
So we partner as also providential that CHAUS had. They were developing workshops for clergy on sort of a refresher on what is Catholic teaching on end of life, as well as how to preach on end of life. So in some dioceses, the bishops really did want that clergy workshop first to sort of bring in the clergy into this conversation and then roll out our education and training to parishioners
Brian Reardon (10:32):
Talk, if you would, a little bit about what does the curriculum look like? Are these sessions like classes that folks attend? Is it a lot of online learning? How is the actual material and education provided?
Lori Dangberg (10:49):
So we have five modules in our standardized curriculum, and let me just talk through the modules and we can talk through who facilitates and who presents. But module one is an introduction to this concept of Whole Person Care Initiative. And again, these trainings we're going into diocese and parishes, and then our first module after we do an introduction of what this concept of Whole Person Care or caring for the whole person is we go right into an introduction of what palliative care and hospice care is, and that was developed by our palliative care and our hospice leaders to develop that curriculum. Module two for me is really to me is the heart and soul of, it's a module about Catholic moral teaching, both the ethical and the legal and the spiritual aspects around end of life care. And that module probably got the most vetting, if you will.
(11:43):
We have this wonderful resource, a former health system, ethicist and leader of theology, and he was also a nurse and a hospice leader. So he developed the curriculum and then we sent that through our health system ethicists to vet it and give us their comments. And then we went to the two archbishops in California and we said, we want your moral theologians to also look at this curriculum that we've developed. And they gave us their comments and we made changes. And so that module is important to us because it's basically been vetted and endorsed by the bishops of California because as you know, there can be different interpretations of Catholic teaching around the end of life. So that was important that we vetted that module. Module three is about caring for parishioners in the continuum of care and the role of clergy and how you communicate between clergy and parishioners.
(12:43):
And we had a wonderful person help lead this, and we worked with our diocesan leaders to develop that module. The fourth module is about advanced care planning and pulse forms and how to have serious illness conversations. And that was a collaboration of our ethicists and clinicians, and we have some wonderful advanced care planning leaders in our hospitals. And then finally the fifth model was, okay, so how do you create a supportive community in the parish? How do we support families for grief and bereavement? And then what are the next steps? What do we do? So that is how the development of the curriculum started. So literally right when we were going to go on the road and start doing these trainings, COVID hit. And so the blessing with COVID is that we learned to meet and have meaningful conversations online virtually. And so we were able to pivot fairly quickly.
(13:41):
We had sort of a list of presenters and we talked to them and say, can we do this virtually? And they all stepped up to it. So we, within a month or so, we have pivoted from what was going to be an in-person train the trainer to a Zoom, and we got very comfortable doing that chat rooms pre and post test, and it worked out really well because rather than California is a IT state and we have 12 dioceses that we wanted to go to, rather than trying to find faculty in each of those regions, we were able to do those virtually with basically our alist faculty. And as a result, we recorded those as we got our legs under us. We recorded those sessions and now those were all available both in English and in Spanish. We have a lot of resources in Vietnamese because we have a big Vietnamese population down in Southern California. So parishes are able, even without direct virtual training from our presenters, they're able to take these videos and in partnerships oftentimes with Catholic health care is show the video and then have facilitated dialogues in parishes.
Brian Reardon (14:52):
And so as participants go through the curriculum, what are they taking away? What are you seeing as some of the results of them putting the knowledge that they've gained through the initiative into practice?
Lori Dangberg (15:05):
Well, for our parish leaders and our diocesan leader, it really has give them resources. And we've always known Whole Person Care doesn't start with those who are seriously ill and dying. It goes upstream, right? I mean, whole Person Care is way upstream. So even before advanced care planning, so in some of our diocese is they have embraced the branding of caring for the whole person to include a whole variety of ministries, including mental health ministries. So it really has broadened based on what the needs and resources are of the dioceses. So that's been one thing. What we found is, especially when we do issues around advanced care planning and Catholic moral teaching without fail at every session almost is we hear where a participant will come up and say, wow, you've given me so much relief, and I have so much gratitude because when I was taking care of my mom and we had to put her in hospice when I was taking care of my dad and we had to withdraw treatment, we didn't know if we were doing something ethically and morally and it had been weighing on them.
(16:18):
So one of the most satisfying things is knowing that they are now informed. They feel much more prepared to have the conversation and they feel better about having these goals of care conversations in some of the treatment options that need to happen. We know many of the folks that come, seniors that we've learned that they may live in assisted living or independent living situation, they take this information and they share it with their neighbors. So a lot of learnings come out of it, and I think our parish ministry leaders feel very supported with the resources that we give as part of caring for the whole person.
Brian Reardon (17:01):
So for folks listening, and again, a lot of our listeners are working in Catholic health care and may be interested in adopting again this coursework or this curriculum of the initiative, what advice would you give them? What are your plans going forward?
Lori Dangberg (17:17):
Yeah, I have some that we think I think about often. What have we found and what are the key takeaways? So we in California have been very fortunate. We have had very good working relationships between Catholic health care through the Alliance and then the diocese is through the Conference of Bishops. So we've always been collaborative, but I know that's not necessarily always the case across the us. So what this initiative does, it is really, it builds great relationships between health systems and the bishops. It gives us this common focus that working on something together, quality palliative care should be a hallmark of Catholic health care and Catholic ministries. It also has allowed terminally ill and dying patients to feel supported and accompanied within their communities of care in their parishes. The key takeaway is that you need the support of the bishops. That is critical, and you need to also take about a year or so if you have a strong diocese and a strong hospital or health system come together and just start a dialogue.
(18:27):
But it takes about a year to talk through these issues and see what resources you have and how you want to work together. So give yourself time to do that. You do need somebody who takes the lead, whether for the whole project of both the diocesan side and the health care side, or you just need somebody within the dioceses to have this as part of their book of business within California. As we went through the trainee, each of our diocese named a person as the lead, as well as within our health system. We had folks, and now that Diocesan leadership group, they come together as a learning community. So they meet regularly still after these many years and talk about best practices, or they may consolidate a regional training among two or three dioceses. So that is part of you really do need somebody who says, caring for the whole person is part of my portfolio and is something I'm responsible for. Then you start working on what you can work on together and what the resources you have.
Brian Reardon (19:37):
Well, this sounds just like an amazing example of collaboration between health care, between the church, between, again, local parishes, which again, if you think about it, health care really is local. It begins with the person and the family. They're the most important stakeholders in any person's health. And to know that we're getting the parish community more involved, especially around end of life care, I think is just tremendous. Josh, I'm going to bring you back into the conversation you've been listening to. Lori and I talk here for the last several minutes. Anything you take away or any question you have before we wrap things up?
Josh Matejka (20:11):
Yeah, thanks Brian. Lori, you mentioned something in some of your comments that I thought was really fascinating and something that I almost see as almost like a knock on effect of this type of education and it being so appealing to people that we can treat people with dignity and we can have this more holistic view of palliative care and end of life care, but then theres a continuing education aspect to it. You mentioned having some senior citizens as part of this curriculum that went and shared it with their community. How do you support that type of learning environment for those people? How does the curriculum enable people to then go and communicate these learnings to the people around them so that this type of care can spread or the awareness of this type of care can spread?
Lori Dangberg (21:06):
Sure. I mean, by virtue of the Train the Trainer program, that was its intent. But also we have a tremendous amount of resources on website, whole Person Care. So you can go on, you can look at a Catholic advanced care planning document. You can look at information around palliative care and hospice care. So the website supports them. We have decision aids, what it's like to have CPR or a nutrition hydration. So all of those resources are on the website, but they're also given real time at these trainings. We have a lot of the dioceses have adopted what's called Care and Prepare. It's sort of an abbreviated training that, I dunno if I mentioned that talks about more the Catholic teaching and advanced care planning. That is what really draws people into it. So they can take a lot from those sort of abbreviated sessions. Its sessions.
Brian Reardon (22:02):
That's great. So anybody who's interested, who's been listening to this, again, they go to WholePersonCare.care, and there's a ton of information on that website that they can look at. They can obviously follow up with you or somebody with the caring for the Whole Person Initiative to learn more and maybe again, get the program in their diocese or their parish. Great. Well, Lori, again, thanks for taking time out to talk to Josh and I about this. We love this initiative. Again, anything related to palliative care I think needs more attention because there just is not that level of awareness and it, it's just so important, particularly as we're having parents who are getting older. Our population as a whole is getting older. We know the baby boomer generation. So I think this work is going to take on even more importance as we go forward. So it's just great to hear about the collaboration that's occurring in California. Love to see this spread to other states. I know it's getting picked up in different places, but really important work. So again, thank you for sharing some insights and how this initiative came about and how it's working.
Lori Dangberg (23:08):
Thanks for the opportunity.
Brian Reardon (23:10):
Again, great to see you, Lori. And this has been another episode of Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon. Our executive producer is Josh Matejka. Our scheduling producer is Sarah Marchant. Health Calls is produced at one studios in St. Louis, Missouri. You can of course, listen to health calls on all of your favorite podcast streaming services, and you can go to the website, chha usa.org to download and learn more about our episodes as well as support material, including that website that Lori mentioned earlier. And again, as you listen few health calls, be sure to give us a five star rating and share your comments about it.