Once upon a time, competencies were developed for health care providers in palliative and end of life care. There were competencies written for nurses, health care workers (nursing assistants, personal support workers, hospice aides), physicians and social workers, and others. There were competencies developed in many lands, in Ireland and the United States, in Nova Scotia and Alberta, in Ottawa and Vancouver, to name just a few. After creation, competencies struggled to be heard and adopted and too often were not used to inform curriculum or education development.
Palliative Care and ICU
Siobhan Bell, RN, BScN, MN
When people think about an intensive care unit (ICU), they usually picture the beeping and humming sounds of machines. They picture nurses, doctors and other health care providers doing a dance that is going to fix or save their loved one. While in many cases this is true, there is the other side to the ICU. The side where the dance is the dance of comfort. The dance that always ends in death. The goal of this dance is to bring the end for the patient and their loved ones, in a way that we are providing comfort and the opportunities for goodbye’s.
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I am deeeelighted to announce, the new: Frances Montgomery Compassionate Communities Caregiver Award
(Photo of Frankie and myself in Times Square in New York City a few years ago)
Created and Sponsored by Life and Death Matters
This award celebrates the immense contributions of the social community in caring for people at end-of-life and acknowledges that care of the sick and the dying is “everyone’s responsibility”. This award acknowledges the invaluable contribution of community members who provide care and support for people throughout the living-dying and bereavement process. It is presented to an individual who is a dedicated “compassionate community caregiver”. It is hoped that the award will be used to help the individual access education or educational resources to increase their care competencies. (This award is for someone who lives in British Columbia.)
It takes a village to raise a child, (and my mother added, “It takes a community to care for the dying”).
I often think of this quote and celebrate the people who helped me to raise my kids, and those who contribute to the development of hospice and palliative care education resources.
This past week I received some beautiful, inspiring, testimonials about our new nurse’s text, Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse. I want to share those testimonials, but do NOT want to share the testimonials until I acknowledge the people who contributed to the development and inspired or influenced or assisted with the writing of the text.
A bunch of years ago I met with a group of HPC leaders several times over a number of months. Each month George Eisler from the BC Academic Health Counsel, would ask the question, “How do we prepare the workforce for the coming tsunami of dying?” At the end of the series of meetings a project was developed for educating physicians and medical office assistants. As important as that was, I was concerned about the needs of the front line workers, in particular the health care workers and the nurses, who would be providing care for the dying.
We just attended the Hospice Palliative Care Ontario 2016 Conference in Toronto. Wonderful event with nearly 800 attendees.
Much talk about PAD (Physician Assisted Dying) or MAID (Medical Assistance In Dying). The following day there was an interesting opinion piece in the Globe and Mail by Dr Tom Koch, a gerontologist and ethicist, who provides chronic and palliative consultations. The title of the article, “The next court challenge, the right to better care“.
Koch asks the question, “If the Supreme Court decision enshrines choice as a principle of Canadian justice, then what choice are we to be offered? If it is between constant pain and an early death, most of us would prefer the latter. Expert palliative care can mitigate physical suffering in, according to experts, perhaps 95% of all cases. But at present, that level of pain control is unavailable to many Canadians. Without its surety, the choice is limited, if not empty, and justice therefore denied because a real full choices is withheld. Similarly, all agree that end stage home care and hospice care can make the last stage of an illness more than bearable. But many Canadians who would choose this, can not, it is not available. And without its insurance, the choices they are offered to care to the end are limited.”
Today Bill C-14 was presented to parliament.
Today the Canadian Government introduced legislation to make medical assistance in dying legal. The facts about the proposed legislation can be found here.
People have asked what I think about Medical Assistance in Dying. I have not presented my thoughts openly on this topic, for a number of reasons. Tonight, I will respond to those who have asked, and I will share a few very personal thoughts.
April 14th. My reflection on Medical Assistance in Dying
Advance Care Planning Day in Canada, and National Healthcare Decisions Day in the USA, is quickly approaching. On April 16, 2016, it’s time to speak up – and have discussions with friends and family members about your wishes for end-of-life.
Life and Death Matters created Care Planning Cookies, edible cookies with a message inside, each one intended to stimulate conversations about living well and dying well. One hospital in Ontario is ensuring that each patient receives a cookie on their meal tray, and that family and staff are given cookies with their food and beverages in the cafeteria, leading up to April 16th.
Guest post by authors Pat Porterfield, Kelli Stajduhar, Rick Sawatzky, and Cara Pearson of iPANEL. A recently published article by the iPANEL team is the focus of this blog post. The goal of this research was to clarify the meaning of a “palliative approach” to healthcare for people who have chronic advancing life-limiting conditions. Read the full article for more information about a palliative approach and prominent care delivery models.
Palliative care … palliative approach … hospice palliative care … end of life care – Phrases and terms often used interchangeably, often misunderstood, and often the cause of extended discussions among those of us interested in the care of people who are living with and dying from serious illnesses.