It’s Hospice Palliative Care Week in Canada.
The campaign (May 5th – 11th) this year focuses on #BustingTheMyths about Hospice Palliative Care
This year, the Canadian Hospice Palliative Care Association (CHPCA) designed a “Busting the Myths” campaign as a response to the need to educate Canadians including caregivers, physicians and all healthcare providers, citizens and political leaders around common myths about hospice palliative care.
The #BustingTheMyths campaign aims to empower Canadians through education by identifying and clarifying misperceptions about Hospice Palliative Care in Canada.
Working together to educate one another is a vital step in the pursuit of excellent Hospice PalliativeCare.
Source: CHPCA Canadian Hospice Palliative Care Association
About National Carers Day
In April 2010, the Parliament of Canada unanimously adopted a motion declaring the first Tuesday in April “The Invisible Work Day.” This day was designated to recognize the importance of the “invisible” unpaid work carried out by parents and caregivers on behalf of their children and aging family members, as well as the volunteer work done in the community. Recognizing that caregivers come from all walks of life and take on many roles, the first Tuesday in April is a special day where we can recognize all caring Canadians.
Honoured to offer "Exploring the Language of Loss: Caring, Supporting and Empowering" as the Opening Keynote for the PalCare Network 2018 Fall Symposium.
This workshop will explore the language of loss while also examining tools and resources to support individuals, families, and ourselves.
1. Examine the impact of loss in person and family-centred care
2. Encourage the caregiver to engage in the dialogue of loss
3. Explore self-care as an essential element of professional practice
For more information about the PalCare 2018 Fall Symposium, or to register, please visit: http://www.palcarenetwork.org/
Excited to present "From Diagnosis to Bereavement: Engaging the Public Across the Continuum" at the 2018 Partners in Care: Central West Palliative Care Network Annual Conference.
1. Consider systems challenges impacting care of people facing dying and loss;
2. Examine psychosocial implications for individuals, families and healthcare providers facing illness, grief and bereavement;
3. Explore compassionate community events as essential opportunities to engage the public following a life-limiting diagnosis through to bereavement.
For more information, or to register, please visit: http://cwpcn.ca/en/annual-conference/
Excited to co-host and participate on the panel for the launch of the 2018-9 season of "The 100% Certainty Project. Death: Something to Talk About". Join us for a screening of the Netflix documentary, "END GAME" followed by a conversation with Palliative Care clinicians.
Our free public event at McMaster University features the brilliant documentary "End Game" from Shoshana Ungerleider, MD highlighting the essential tenets of Hospice Palliative Care. The film showcases the collaboration, compassion and communication as the heart of person and family-centred care at UCSF Medical Center with Steven Pantilat and the extraordinary interprofessional team. The film also highlights the brilliant work of Zen Hospice Project, showcasing Dr. BJ Miller and the extraordinary interprofessional team in Hospice.
Please join us for this engaging event! While the event is free, registration is required via Eventbrite via https://www.eventbrite.ca/e/end-game-documentary-and-discussion-tickets-50535681584
“The key to providing decent palliative care is a little bit of basic planning. Four conditions – cancer, cardiovascular disease, COPD (lung disease) and diabetes – account for 70 per cent of deaths.
Those chronic conditions all have fairly predictable courses of illness in the terminal phase. You don’t get diagnosed with lung cancer or heart failure one day and die the next. It’s a months-long process and providing pain relief (palliation) should be standard, and a priority.
Two in three people receive home care in their last year of life. But only one in seven receive palliative care in the home.
That’s the failure point – and that’s what we need to fix.
There needs to be a commitment – philosophical and financial – to bringing palliative care to patients when they need it and where they want it.
Not everyone can (or should) be cared for at home in their final days. It’s back-breaking, emotionally-draining work for loved ones. Yet many would do so willingly and lovingly.
But they run up against a gross number of barriers, ranging from difficultly getting home visits from physicians (who are poorly remunerated for that work in many provinces), lack of nursing support (because of caps on home care hours), and absurd rules that mean drugs taken at home are not covered by medicare.
All the problems raised by the CIHI report are easily resolved. For example, having paramedics provide palliative care can eliminate transfers to hospitals. Sending doctors and nurses to homes or nursing homes can free up hospital beds – and save money in the process. Not to mention that, at the very least, people deserve a modicum of dignity in their dying days.
The whole point of palliative care is to improve quality of life. We shouldn’t let bureaucratic and structural inadequacies undermine that necessary and noble work.“ by the brilliant André Picard via The Globe and Mail
Excited to be teaching my 9th consecutive semester in the Palliative Care Certificate Program for regulated and certified healthcare professionals (RNs, RPNs, OTs, PTs, RTs, SLPs, Social Workers, Dieticians, Physicians, etc.) with Continuing Education @mohawkcollege
It is so important to demystify the breadth and scope of this approach to care while highlighting the need for early integration of Palliative Care. Every healthcare provider has an active role to play in supporting anyone (individual or family) facing a complex illness, from time of diagnosis, through to bereavement.
For more information about this holistic and collaborative interprofessional certificate program, please visit: https://www.mohawkcollege.ca/ce/programs/health-and-nursing/palliative-care-multidiscipline-017
Honoured to have been on Faculty for the National Learning Institute hosted by the Canadian Hospice Palliative Care Association (CHPCA) in Ottawa (June 14th-16th).
The CHPCA’s Learning Institute brings together healthcare professionals from across the country for an intense learning weekend. The program is directed towards intermediate and advance learning levels and is facilitated by specialist Hospice Palliative Care Clinicians, Educators and Researchers from across Canada, together with international leaders, making a sophisticated caliber of educators and mentors. This is the only event of its kind in Canada.
For information about the event, please visit: http://conference.chpca.net/about/
Excited to facilitate this interactive workshop at the 11th Annual Day in Faculty Development with the Faculty of Health Sciences at McMaster University.
This interactive workshop will engage learners and faculty by exploring the common language of loss through different scenarios while also examining tools and resources to support families, learners and ourselves.
1. Examine the impact of loss in person and family-centred care
2. Encourage the learner to engage in the dialogue of loss
3. Explore self care as an essential element of professional practice
For information, or to register, please visit: https://fhs.mcmaster.ca/facdev/online_registration.html
Am excited to co-facilitate this event with the Division of Palliative Care at McMaster University as we discuss, "What makes life worth living in the face of death?".
Many healthcare students and providers do not feel prepared to encounter dying and death. As part of our 100% Certainty Project. Death: Something to Talk About, this event will feature: the stunning memoir When Breath Becomes Air; will show the brilliant TED Talk from Dr. Lucy Kalanithi; and will conclude the evening with a Death Cafe where we will discuss how to make the most of our finite lives.
Dinner is provided. Registration is required and space is limited. All healthcare disciplines are welcome!
For information, or to register, visit:
As we all encounter serious illnesses, uncertainty, grief, death and bereavement, there is a remarkable opportunity to create compassionate care for individuals and families of all ages, from time of diagnosis, into remission, at end of life and into bereavement.
It is so essential to demystify the incredible breadth and interprofessional scope of a Palliative approach to care in the education of all health science students and healthcare professionals.
It was a wonderful honour to speak with Death By Design Podcast - Kimberly C. Paul about the future of healthcare. As death is not elective, and illness and dying do not discriminate, we all encounter life-limiting illness, dying and grief. So... let's talk about it.
This episode is available via: http://www.deathbydesign.com/podcast/season-2-episode-10-c-elizabeth-dougherty/
Highlighting the need for integrated Person and Family-Centred Care...
"The results show that there might be a gap between what doctors think is important or disturbing for patients, and what patients really think. Physical, psychological, social and spiritual support is needed at every stage of the disease"
Source: Patients feel psycho-social impact of chemo more acutely than physical side effects. MedicalXpress
"Yet, amidst the storm, some remarkable health professionals create a circle of calm. They go about their work in an unhurried way, finding time to greet their patients, put them at ease, listening deeply and offering kindness and compassion. They don’t neglect their clinical tasks, indeed they seem to get the work done with quiet efficiency. These inspiring workers go home with satisfaction and joy in their hearts. How is that possible?"
Source: Hearts in Healthcare Practising compassion in an uncompassionate health system
"When you are facing a serious illness, you need relief from symptoms. You need to better understand your condition and choices for care. You need to improve your ability to tolerate medical treatments. And, you and your family need to be able to carry on with everyday life. This is what palliative care can do." #SeriousIllness #PalliativeCare
For more information visit Get Palliative Care
Was honoured to present Across the Continuum: The Need for Innovative Approaches to Person and Family-Centred Care, a H.I.T (Healthcare, Innovation, Technology) Talk at the Hospice Palliative Care Ontario 2017 Annual Conference "Accessing Compassionate Hospice Palliative Care Across the Continuum" (excerpt below).
From time of diagnosis so much is asked of those facing a life-limiting illness… Ultimately, they’re expected to “hold on” while also having to “let go”. How then can we consider innovative approaches to person and family-centred care across the continuum, at a time when healthcare providers are required to do more, with less?
I am honoured to say that I am a Social Worker, and there’s a phrase that rings true for me in the work that I do as I often step outside of my comfort zone. The idea of “leaning into the discomfort”. I’d like to reflect on why it’s important for every healthcare provider to consider the way we approach our work.
Working within a frenetic yet extraordinary healthcare system, we face time-constraints, the demand for evidence-based competencies, the expectation of metrics and outcome measures, people often referred to by a medical record number or identified by a disease… quite often, healthcare feels rushed and impersonal… As a result, healthcare providers may not fully engage because of increasing practice demands and time constraints, they may avoid certain experiences where they don’t feel competent or hesitate to go those places when faced with uncertainty…
In fact, much like life itself… acknowledging and meeting the challenges in the midst of uncertainty and chaos are really an integral part of our work. How then can we engage and enter those spaces when we feel that we don’t have time, when we don’t know the answers, or when we’re unsure of what we may find?
While the idea of creating and implementing innovations in practice may sound weighty, the definition of innovation is actually quite simple. Innovation is the introduction of something new… a new idea, method or device. That’s it. You don’t necessarily need to write a grant, or consider retraining, or apply to the research ethics board (and while that may be part of your innovation), introducing something new doesn’t have to be onerous, it can actually be something quite simple.
Hospice Palliative Care has always been ahead of the curve… in recognizing and valuing person and family-centred care, in acknowledging "total pain", in taking holistic approaches to supporting quality of life, to recognizing and integrating interprofessional collaboration. Innovations in Hospice Palliative Care remain essential today, and perhaps more so now than ever before.
At present, we’re faced with tremendous opportunity. With the quality of living and dying on our social and political landscape, with Bill C-277 (An Act providing for the development of a framework on Palliative Care in Canada) passed by the House of Commons, with the provincial and federal governments acknowledging the need for increased funding in Hospice Palliative Care… we’re on the precipice of change. How then can we be agents of change, and consider innovative approaches to person and family-centred care across the continuum - from time of diagnosis, throughout the trajectory of an illness, at end of life and into bereavement?
We face the reality that many people, including many healthcare providers, assume that Hospice Palliative Care is nothing more than a euphemism for end-of-life care. That presents us with an opportunity… to continue to advocate and educate about the remarkable scope and breadth of Hospice Palliative Care across the continuum. But in doing so, it’s also important to consider, when does dying begin, and how can we support people to live well during that process?
Does dying begin the moment we’re born? Or when a fatal condition begins? Is it when that condition is recognized by a physician, or it when nothing more can be done to reverse the condition or to preserve life? As we know, the answer to that question varies from one person to the next…
While many focus on the quality of dying, or on death as a singular event, isn’t the whole end-of-life experience informed by the people and the events leading up to that death?
It’s these processes that take place in the days, weeks, months and even years before the death that are of paramount importance and contribute to overall quality of life - and that’s where we, as a community of care providers, can have the greatest impact.
Healthcare providers are often inhibited by their anxieties about saying or doing the wrong thing. This is true for any clinician, beyond our formal training and education, we continually face new scenarios, challenging experiences and uncertainty… We need to step outside of our comfort zone, and with humility… explore person and family-centred innovative approaches to care in an effort to promote healing.
It’s a profoundly intimate experience when we are allowed to share that space with someone facing dying, death, grief and loss… that compassionate connection can transcend so many barriers, and sometimes, however momentarily, sometimes… it can even transcend suffering. That connection can be extraordinary.
I believe as Health Care providers in Hospice Palliative Care, we can continue to lean into our discomfort and remain open to uncertainty and to wonder. I believe, through our humility and vulnerability, we can create compassionate and innovative approaches to person and family-centred care, and in doing so, provide invaluable opportunities for people to connect, and collectively process experiences across the continuum - from time of diagnosis, through to end-of-life and into bereavement.
As Dr. Rachel Remen explains, "the most important questions don't seem to have ready answers. But the questions themselves have a healing power when they are shared. An answer is an invitation to stop thinking about something, to stop wondering. Life has no such stopping places; life is a process whose every event is connected to the moment that just went by. An unanswered question is a fine traveling companion. It sharpens your eye for the road".
We’ll always face challenges and uncertainty in our work, but we need to be invested in innovative approaches to person and family-centred care, because as Dr. B.J. Miller says "Quality of Life isn't a Consolation Prize".
"We’ve seen too many patients regret decisions that they made without fully understanding their options, or the possible outcome. We encourage our patients, and our colleagues, to be partners in what are often life-changing decisions about health care."
Read the full article The New York Times
Starting a Conversation with Your Healthcare Team
Whether you or a loved one have been newly diagnosed with a serious illness, or have been told your disease has progressed, you will have to make decisions about treatment. You may have many thoughts and emotions at this time. This can be a time of uncertainty and it is common to feel worried. It can be helpful to ask your healthcare team questions about what to expect, how to plan and what support and resources are available to you and your family.
It can be helpful to ask your healthcare team questions about your illness so that you can best understand your treatment options. The following is a list of questions that may help you to make informed decisions about your plan of care. Please ask these questions if they are helpful in guiding you and your family, or ask whatever questions are important to you. It can be helpful to bring your list of questions to your medical appointment and record/write down the answers. If you have the support available, you can have someone accompany you to your appointments to listen and help record the details.
Some questions you may ask your Healthcare Team:
• Is the condition short or long-term? Reversible or irreversible?
• Is the Illness curable or incurable?
• What types of treatment are available to treat the illness/condition?
• Where is this treatment offered? Hospital? Clinic? Home?
• What is the goal of treatment (cure, manage pain/symptoms, improve function, extend life)?
• If the goal of treatment is to extend-life, how long does the average person live while receiving this treatment? What about those who do not receive this treatment?
• How often is this treatment successful?
• Does having this illness/condition impact the effectiveness of treatments/
interventions one might receive in an Intensive Care Unit?
• What are the common risks and side effects of this treatment? Are there any possible dangers connected to this treatment?
• Where and how often will I receive this treatment? How long do you expect this treatment to continue?
• Is there a financial cost associated with this treatment?
• When and how will you know if these treatments are working?
• When or why might these treatments stop? If this treatment stops, what are other treatment options?
• How will this treatment impact my life? What are the expected physical, emotional, psychological and practical issues?
• What type of additional support is available to me? What about my family?
• What are the physical, emotional, psychological and practical resources that
can help? How do I/my family access them?
It is important to take time to have conversations about your treatment with your healthcare team. Please ask questions that are important to you. Honest and open communication about your healthcare is so essential.
"What’s often overlooked is that the simple conversation between doctor and patient can be as potent an analgesic as many treatments we prescribe."