Supporting both patients and caregivers is key in
palliative care By Emily Dawson aggie Bruneau knows that delivering the best palliative care means offering flexibility and options, for both patients and caregivers. In the lead-up to redesigning Providence Healthcare’s palliative care program in 2016, interviews with dozens of patients and families were conducted to get a sense of how the community wanted to be supported at end of life. One of the key outcomes was a new process to help fulfill people’s wishes to spend their last days at home – while also giving them the assurance that there would be a seamless process for them to return to Providence if needed.
ALMOST 75 PER CENT OF CANADIANS WANTED TO DIE AT HOME. Last fall, the Canadian Institute for Health Information released a report with an assessment of palliative care in Canada and found almost 75 per cent of Canadians wanted to die at home. “Some people think when they enter palliative care, they need to sell everything and this will be their last home,” says Bruneau, vice-president of Programs at Providence Healthcare. “But we have supports that allow patients to return home and come back to Providence should they need to. Even if we send someone home, and they get anxious or feel like something is changing at 2 a.m. we have
the process in place to re-admit them immediately.” Another key strategy was to build robust supports for caregivers who have family or friends in palliative care at Providence. “Our program includes a 33-bed unit – making it one of the province’s largest hospital programs – and we have a legacy of providing comfort, managing pain, and fostering dignity for the dying,” says Bruneau. “We also took great care in designing an environment and services to support their loved ones and caregivers.” We renovated and relocated the inpatient unit to give it a contemporary look and, at the same time, introduced a dedicated Family and Caregiver level, which includes two overnight suites for family members needing to stay close by, a children’s room, private dining area, business offices, and a multi-faith prayer room. These spaces help caregivers manage other responsibilities while balancing the need to stay close to their loved ones in palliative. Looking at evidence-based best practices and to the future, Providence’s leadership recognized that inpatient palliative care is not the preferred path for everyone. “We’ve been able to successfully implement a respite program, which gives in-home caregivers time for rest and renewal while their loved one receives care from us,” says Bruneau. Caregivers can use the time for selfcare, a vacation, or to manage professional obligations, knowing their loved one is safe with appropriate care and pain management. Caregivers may
We both felt at peace that Providence was her last stop,” says Michael Pasquale(pictured), who was his mother’s caregiver before she was admitted as an inpatient in Providence Healthcare’s palliative care program. also be experiencing their own health issues and respite gives them the confidence that they can concentrate on their own healing. For families caring for a loved one at home, respite services are a lifeline to maintaining their own well-being. Every situation is different and the team at Providence works individually with patients and families to help them achieve their plans and goals. Rosie Pasquale and her family chose Providence’s inpatient Palliative Care program. She always had warm memories of Providence, knowing that close family members had received exceptional care there. Her primary caregiver, her son Michael, eventually found she was requiring more intensive care that he could not provide and reached out to Providence.
“We spent lots of time together and I cherished that; I wanted to be able to care for her as she aged. But it was a difficult role for a son because it was very personal, like bathing and dressing her,” he says. “She had so many falls at home and I was nervous all the time. Ultimately, she had a terrible fall that changed everything. Her mind was sharp but her body was deteriorating quickly.” In a hospital after the last fall, Rosie’s doctor recognized that palliative care was the best option. “We both felt at peace that Providence was her last stop,” her son recalled. “Her doctor, nurses, and everyone on the unit were so good, and I always felt in the loop – they took good care of me too. She was safe and comfortable. That’s all we could have H wanted.” ■
Emily Dawson works in communication at Unity Health (Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital). 8 HOSPITAL NEWS MAY 2019
Focus: Surgical Procedures, Pain Management and Palliative Care. Special Supplement: Annual Nursing Heroes