Evaluation pf palliative care etc on YouTube - 1

Palliative care and Palliative Care social work on YouTube

Malcolm Payne
6th March 2010

This paper is slightly adapted from a post of my blog:

http://blogs.stchristophers.org.uk/one/

It is an evaluation of YouTube videos on palliative care and palliative care social work. It
briefly tells you how to find YouTube, assuming that there will be some of my readers
who have never done that. There is then some comment on the top videos the week I did
these searches, and this is followed by some overall comment, which you could sum up
as ‘could do better’.

Finally there a sort of appendix which tells you how to use the YouTube video viewer,
again assuming I might have some readers who have never used one of these things.

People who don’t use YouTube probably just know it as that controversial site that
teenagers are supposed to look at to find unsuitable videos of unknown rock bands, which
then shoot to popularity, or films uploaded by oppressed groups in countries who don’t
have much access to the internet.

In fact there is a very wide range of material uploaded, including stuff on medicine and
social work, and a lot of members of the public might well look there for information
about palliative care, and might be more used to visual presentations than reading
documents or leaflets. Some alive organisations have obviously realised that, because
there are a lot of ‘what is palliative care?’ type presentations. Obviously there aren’t any
alive organisations in palliative care social work, because I didn’t find much about that.

Using YouTube
If you’ve never used YouTube, it’s a simple process. Search on your browser for the site.
As with a lot of internet sites, it’s about being up to the minute, so it shows you a list of
recently uploaded stuff. If you use the YouTube search engine to search the site, you
simply put in “palliative care” or any topic you fancy, and it comes up with the most
recently uploaded stuff with that computer tag. When I did this for “palliative care” this
week I’ve noted the first ten things I got; there were only three for “palliative care” and
“social work”. It would change over time, although my experience is that it hasn’t
changed all that much over several weeks; palliative care obviously isn’t the hot topic
among the tuberati.

Palliative care search comes first, then “palliative care” “social work”.
 Evaluation pf palliative care etc on YouTube - 2

The Palliative Care search

First up came a German film that looked very hospital, but I couldn’t understand it, so
I’ve left that one out.

Student Volunteers in Palliative Care in Kerala

http://www.youtube.com/watch?v=gfdUKcH-ZPg

This is an Indian man talking briefly about how wonderful it is to volunteer in palliative
care in Kerala, India. It’s not clear what they do, how they got involved or anything
practically useful, so it’s a bit of a pointless puff for volunteering in principle.

Cancer and Palliative Care Video.mp4

http://www.youtube.com/watch?v=KSVljzqeKBA

A UK video showing GPs how to find things about palliative care on the internet; it
shows you how to click on various sites. Boring presentation but useful, I learned some
things from it.

Palliative Care: What is it and who is it for?

http://www.youtube.com/watch?v=ttW8pxF__g4

This is an American film, presenting palliative care as something that hospitals do, a
medical treatment for pain and other symptom relief done in hospitals alongside curative
treatment; it does mention social workers, but all the speakers are doctors, even the
patient experience. There’s a mixture of people talking to camera and pretty pictures.

Pain and Palliative Care: What the Future Holds

http://www.youtube.com/watch?v=Ai-MbsANxHY

A film of an American lecture from a university somewhere (they tell you the initials of
the University at the beginning, obviously the rest of the world will know what it is) by
Katherine Foley, an eminent American palliative care physician. It was obviously such an
important lecture that she had a hair styling for the occasion: it doesn’t move. Neither
does she, much, she was obviously told to stay in view of the camera. She reviews the
progress of palliative care and has an international focus. You see the PowerPoints filmed
as she talks, which are not easy to see in this format and some of them you can’t read.
The presentation is very comprehensive, but very professional i.e. boring. It goes on for
nearly an hour, so I haven’t watched the whole thing, and therefore I don’t know if it
mentions social work. She does talk about palliative care as a human right.
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Canadian Virtual Hospice Palliative Care Video

http://www.youtube.com/watch?v=ZWLoQkJD0WA

A 7 minute film about a Canadian information website, introduced by Chochinov, a well-

known beardy in supportive care; it describes the site – you can submit questions for an
expert to answer, and it has discussion bulletin boards and the usual information. There is
an affecting account by the adult daughter of a cancer patient. Nice film, lots of variety.

Right to Relief: Palliative Care in India

http://www.youtube.com/watch?v=0_FK-5aMkEo

A 4-minute Human Rights Watch video complaining about how the Indian government
and most of Indian medicine does not make pain relief through cheap morphine available.
Good photos and video and presents a range of settings, including home care, so it gives a
picture of what is probably quite a good Indian palliative care service. Presents the
international human rights issue of availability of morphine succinctly and caringly.

What Is Palliative Care? – Dr. John Mulder

http://www.youtube.com/watch?v=QIF99iKnVcU

This American (?) doctor for a private sector health service describes palliative care as a
consultative service for the longterm quality of life consequences of being treated for a
life-limiting illness. He’s interviewed by an extremely thin, blonde, glossy woman in red,
and in the 2-and-a-half minutes it does mention bringing in social workers. Talking heads
stuff, presumably to advertise their services.

What is Palliative Care?

http://www.youtube.com/watch?v=Uy5PDoPfmWQ

Brief film, Diane E. Meier, Director of the American Center to Advance Palliative Care,
talking about the kind of patients who might be helped by palliative care. Talking head
stuff again. Going down the list further, there are several short films from the Center of
the same sort and format, all about the American system as though the rest of the world
does not exist, so it makes it peculiarly irrelevant.
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The social work and palliative care search

Then I searched for “palliative care” and “social work”. This is what I got:

Social Work and Health Palliative Care – Care Accolades 2009 finalist

This is a one and a half minute film about Angus social work department (they’re not
called social services or social care in Scotland, but that doesn’t mean that everyone
involved are social workers). They obviously nearly won the prize for this competition
for good services. The scheme is about generalist palliative care: it refers to a two-day
training the trainers project to give training to it-wasn’t-clear-who, and they gave training
to 122 (count them) front-line carers, who then said they were much more confident with
advance care planning and talking about death and dying, presumably either with people
in care homes or receiving community care services, it’s not clear. Professional film, but
not really much information, and as it’s a prize competition, it’s not really a critical
discussion of the issues.

Hospice San Miguel

http://www.youtube.com/watch?v=JFWNL9z8_wk

A five and a half minute ‘promo trailer’ for this hospice – it turns out it’s in Mexico, but
you wait a long time to find that out, and it rather feels as though it’s an American city
with a lot of Latino/a people. They would clearly like to influence American palliative
care with their experience. Don’t be put off by the start, which is in Spanish, because
most of it’s in English and there are subtitles when people speak Spanish.

It seems to be an American neo-colonialist project run by Americans for Mexican people

(although the volunteer coordinator of the bereavement service may be British) and the
comparisons made are with the American medicare system for funding hospice care; they
claim they are going to show America how to be more flexible. It seems this is just about
not having government interference. It’s not clear whether there is an in-patient unit or
whether it’s a community service only, since they don’t actually say what they do, just
tell you how wonderful it is. There is some patient and carer ‘testimonial’. There is a
strong focus on bereavement groups and family work, which is achieved by getting social
workers and volunteers in early (more or less the same thing as far as the speaker is
concerned – it’s not clear who most of the speakers are, but they present as very do-
gooding). The message of the film is mainly: ‘don’t be frightened of hospices, come early
for care’. We can all appreciate the need for this, and it is well-filmed and produced.

End of Life Care Panel (10/30/09)

http://www.youtube.com/watch?v=t7g1WO68KYE
 Evaluation pf palliative care etc on YouTube - 5

This is a panel of four people, one of whom is a social worker, answering questions; she
talks well from experience about working with people with a different ethnic background.
It looks as though it’s a public event by the Commonwealth Club of California explaining
palliative care to the masses (well, poorly informed professionals really, I would guess; I
suppose they are the masses). It’s led off by an extremely boring (male) medical
professor with a grating voice and a very long job title saying how other medical
specialties need palliative care. But it (and he) get better; there’s a very warm and
practical nurse, a glossy, severe lawyer and a frizzy social worker. Most of the discussion
is about assisted dying and advance care planning. It’s very long, more than an hour, and
a very boring straight filming, with the occasional mid-shot of a panel sitting crammed
unmoving behind a small table. I haven’t watched it all.

The Evaluation
There is some material on palliative care on YouTube, but not a lot and it’s mainly
talking heads or educational. It’s mainly American, so there’s an opportunity for British
organisations or individuals or people in other countries to make a good impact. In fact
British viewers are likely to be seriously misinformed by the American stuff. And the
American stuff is very American; there’s no attempt at international coverage in the
American material, except in the lecture by Katherine Foley. India is also represented.

However, her lecture and the panel discussion from California illustrate the other problem
with academic material on YouTube, they’re very long, very static and very boring. I
cannot imagine anyone being prepared to sit through the whole thing. However, there is
useful material in this stuff, but it should be carefully edited. At least cut out the doctor
moderator with the two-minute job title (I’m exaggerating but not by much). Academic
presentation like this also needs to be interspersed with appropriate illustration. The
lecture had very interesting material, but it needed to be animated and shown properly.
This requires work, guys. Not just slapping it on the internet.

You can put up with talking heads for a minute or two but not much more than that.
Come on, we’ve seen the BBC or CNN, we know what it should be like.

Another weakness of some of the material is that it is promotional and it really does not
make clear what it is promoting, so you don’t get to know what the volunteers do, just
that (for a couple of minutes – it was so repetitive I almost switched off but I couldn’t
believe he could say so little again and again) it’s wonderful that it’s there. It’s even
easier to switch onto the next thing on the internet than it is with a television set or radio,
so your material really has to be focused.

On the other hand, some of the short films which wanted to make just one point with
interesting film or photos and lots of variety are really informative. Going for that makes
a good impact. Less is more.