Yvonne Coburn

Palliative Care Australia’s National Champions are a group of eminent Australians who represent a range of backgrounds, skills, and experiences in their professional and private lives.

National Champions work with our Board of Directors and Chief Executive Officer to build strategic alliances that serve the business objectives, values, and mission of PCA.

Let’s meet one of our Champions, Yvonne Coburn – a former lawyer, newspaper columnist and human resources professional, these days, Yvonne is an executive leadership coach working with a wide range of senior executives and guiding business and commerce students at the University of Sydney Business School.

Yvonne, what is your personal connection to palliative care, what experience has your family had?

What inspired me most to really get involved and become a National Champion for Palliative Care Australia was my own personal experience when my mother passed away four years ago.

So, she had ovarian cancer, and it was a pretty quick journey from time of diagnosis to the time that she passed away. It was actually six weeks, but during that period, she did receive some palliative care within in a hospital scenario, and then within an aged care facility.

And what I realised during that period was that my own understanding of death and dying was really limited – even though I’d lost my father 15 years earlier, that was a very quick death, so I didn’t actually go through him being ill and needing palliative care.

So, I guess in a sense, I was death illiterate, and what I found was there wasn’t a huge amount of information available for me or my mother at that time.

And there seemed to be a lack of, I guess, skill, quite honestly, in terms of palliative care and the skills the nurses had. They were rushed off their feet, and there weren’t enough of them. Their communication skills were lacking, and that also included some of the palliative care doctors who perhaps had seen death too many times.

And I guess I made a promise, that having been through that and witnessing my mother’s experience, that if there was any way I could assist by raising awareness, raising funds, doing anything to really help, both in relation to death literacy, but also in relation to money to encourage nurses and other care professionals to upskill, and also to create more compassionate communities where people would be able to access support outside of the health system, within their community network – that was my driving force.

Tell us about your mum and the life she led.

So, my mum was a bit of a superstar.

She was Hungarian, and she was a survivor of the Holocaust, and she came to Australia, really, with very little English, and she taught herself, and worked really hard. She was the sort of person who was very engaged with the community and who had a strong interest in all that was happening around her. As her own parents aged, she cared deeply about their wellbeing and became truly aware of the needs of the elderly.

She therefore always really encouraged me to go after the things that I cared about.

I stood for a position as a local councillor. My mum got involved by handing out how to vote material. I was elected as a councillor on Waverley Council, and I realised that my mum and my daughter were my biggest cheer leaders.

My mum was always supportive– she took pride in the things that I wanted and chose to do.

When you were talking about your mum’s end of life experience, you mentioned that she received some palliative care. What did that look like? Do you remember?

She certainly received pain relief, which helped her enormously, particularly towards the end. She also had some counselling in terms of her diagnosis, and which was trying to really help her come to terms with what that meant. She was given food and accommodation at the hospice, and just general encouragement in terms of managing her illness.

There wasn’t a lot in terms of real education around death or dying though, for her or for me, quite honestly, we didn’t really talk about death, that subject was never really broached.

Was that a regret you and your mum had? That you didn’t have those discussions earlier, when she was healthier, and have plans in place.

Absolutely, it would have been much better had we been able to do that.

I think for a lot of people, palliative care means, literally – end of life. We don’t necessarily understand that palliative care is a process that actually helps you have a better quality of life.

So, I think, certainly for my mum, she had some fear around what palliative care actually meant. Because, as I say, for many people, and older people particularly, I think there’s a lack of awareness of what palliative care actually means.

You have pointed to some inadequacies with the care that your mum and your family received. How could the system, how could your experience have been better?

More information about what palliative care actually is and what it would mean for her, and for me – understanding the process and what would or would not be available to her, so that I could have brought in other people to assist.

Understanding the limitations of care and just how much care she would receive.

Counselling for myself and other family members, given how quick her passing was, to have people available to support in that process for the family would have been really helpful.

And I think, just an opportunity to discuss what the pain relief measures would be, what things would be available to her – just more information generally.

And quite honestly, more care, more nurses skilled in palliative care, and also a brighter physical environment. I mean, the hospice that she was in was very old, very dark, very dingy – quite a depressing place. Just having a nicer environment would have been better.

I did actually take her out of that hospice because I just didn’t think it was good enough. So, I ended up hiring an entire team of carers, and engaging an external palliative care doctor, and I brought that entire team into the aged care facility. That was really towards the end, I was lucky to be able to manage her care better

What you were able to create for your mum is very much what PCA advocates for – that palliative care is embedded within aged care. So, I’m sorry to hear that you had to go and create your own palliative care unit within the aged care facility.

Yeah, that’s exactly right.

Since your mum’s death, have you changed your own approach to dying and death, and perhaps how you want the end of your life to look?

Absolutely, it was a huge wake up call for me. My thinking now is that each of us will die, and we have to really tackle our denial or ignorance of the subject.

So really thinking about advanced care planning – all the things that perhaps we don’t really want to think about but will actually lead to a better experience for each of us and for our family and friends.

Thinking about the choices that we can make to minimise the risk of a bad death.

Really stepping into those conversations and making death and dying and palliative care less of a taboo, so there is a greater acceptance.

I also have a real itch or urge to create more compassionate communities where people really engage and help each other through this phase of life, supported by a strong public health system.

Yvonne, tell us a bit more about you and your professional background. Tell us about you and the people and communities you are connected to.

I started off life as a lawyer and worked as a lawyer for many years, and I have a commerce marketing degree.

But I left law to become a management consultant, specialising in human resources and executive recruitment work. I went to Harvard to do a short course in leadership at the Kennedy School of Government, and that particular leadership program really led me on to the work that I’ve been doing for many years now, which is in the executive leadership space. So, I’m an executive leadership and organisational development coach.

Also, I had a moment in politics, with my local council and I also worked in the office of a federal member of Parliament.

Although others said that I had an aptitude for a more senior elected political role, I decided that politics was not really for me. I’m an influencer and a connector, that is my middle name, and I thought I would be able to do a lot more in terms of effecting change outside of the political system. I probably would have been a great lobbyist. I’m a very good nagger.

I’ve sat on a number of school boards and not for profit boards. I was involved in The Hunger Project for a period. When I attended the 30th anniversary for the Hunger Project held in New York, I met James Wolfensohn, who had been President of the World Bank, He told me that I was a connector and that I should use those skills either in political life or as a change agent. He remained a mentor in my life for many years. Like Mahatma Gandhi, James believed that each of us needs to be the change we seek in the world.

I have spent my life influencing and trying to effect change at a local level.

Thinking about the leadership training and mentoring that you deliver. Leadership is all about stepping into the hard stuff in a way or having to deal with the hard stuff.

Is there anything that your leadership experience can teach us about stepping into those difficult conversations and talking more about dying and death?

Absolutely, it’s something called conversational intelligence.

So we know about emotional intelligence, well conversational intelligence was actually pioneered about 30 years ago by neuroscientist Judith Glaser.  The premise of conversational intelligence is, first of all, not to judge, not to interrupt, holding space for others to actually express themselves fully.

And I think in terms of those difficult conversations, holding space for people to be able to share in that space is really, really important. The second area is thinking more about the words and the language that we use – using more ‘we’ language or co-creating language, as opposed to yelling, telling, or selling.

Studies show that when we use ‘I’ language, the prefrontal cortex of our brain shuts down and we find it harder to make really effective decisions. Our thinking brain is limited, as opposed to when we use inclusive language that is much more about thinking about the other. You’re much more likely to get a better response from a conversational perspective.

And because the subject of death and dying can stoke fear in people, thinking about what the likely triggers might be so that you try and avoid that amygdala response, or that fight-or-flight response.

That’s the kind of response where people just switch off. They don’t want to know, they don’t engage. So, if we’re using language that’s much more calming, soothing, direct but appropriate, we are more likely to get a better, more engaged response.

Relationships are central to the work and success of PCA, reach out if you’d like to speak with Yvonne – pca@palliativecare.org.au

Let’s see how we can work together to increase access to palliative care and support people and families at the end of life.