Chaplain's Corner

Palliative Care

  • Larry Hirst, Author
  • Retired Chaplain, Bethesda Place

Your wife hasn’t been well, a cancer diagnosis a year ago has led to a total reorganization of your life. There were radiation treatments and chemotherapy and more days of not feeling good than anyone wants to remember. Last week, something changed and you brought her to the hospital, she was admitted and the doctor that cared for her in the Chemo Clinic has been caring for her. A week after her admission the doctor catches you in the hall and says, “I think it is time to consider palliative care.” This wasn’t all he said, but it is all that stuck. “Palliative Care,” what is it, what does it mean, it doesn’t sound good and just the words send a chill up your spine.

What is palliative care? Actually, it is a specialty in medicine: a specialty that focuses on the care of people who have a terminal illness. This type of medicine is usually initiated when it is determined that there is no more that can be done to affect a cure for the disease and the focus turns to managing pain and other distressing symptoms, providing psychological and spiritual support to the person who is dying and offering a support system to help relatives and friends cope during the patient’s illness and death.

It is one of the most compassionate fields in medicine and those who are drawn to this specialty generally have a far greater understanding of the integration of the body, mind and spirit than do those in other medial specialties  Part of the work I do is with the palliative care service offered here in South Eastman Health. My role begins most often after a person has been admitted to the hospital. I provide, as a person and the supporting family wish, spiritual support for the duration of the hospitalization. Some families have well established spiritual support and need little form me during the time of palliation, others come into the hospital with little or no spiritual support and I have the opportunity and privilege to become involved at whatever level they desire in the closing chapter of a person’s life.

Our team here in South Eastman health is exceptional! Anne Plett who heads the team has developed a wide and deep understanding of every aspect of the palliative process. She possess an exception understanding of the medical issues related to palliative care and has developed an intuitive ability to know how to address difficult symptom management problems. She is an able problem solver. She is also a deeply spiritual woman who understands the spiritual impact of dying both on the person and the supporting family. Wrap this and more in a passion for caring and, well, she is just an amazing asset to our region. Anne is supported by two palliative care nurses, a psycho-social specialist, and a volunteer coordinator who are equally committed to pulling out all the stops to provide the support needed during this challenging period of life.

Our Palliative care nurses, Debbie Krahn and Pauline Gosselin serve throughout the region, from Sprague to Lorette and from Dominion City to East Brain Tree. These nurses are real specialists and they often are angel-like in their support for people who are dying and their families. They do most of their work in the homes of those who chose to die at home or supporting the acute care or long term care staff in our region’s hospitals and personal care homes when symptom control requires a special touch.

The team’s psycho-social specialist, Ruby Garand, is an experienced social worker who has a wide base of experience that provides the people on the program and their families with the kinds of support that they require beyond the medical issues. Sometimes when the terminal disease has created a financial strain on the family, Ruby will go to work to see what assistance can be garnered from the various social programs that are provided by our government,. Other times she works with families who are experiencing relational difficulties that are impeding the process. Ruby is involved in supporting love ones in their grief which almost always begins long before the death and continues after the death.

Our Palliative Care program has an active volunteer support team. Violet Vogt is the Volunteer Coordinator who facilitates the training of new volunteers, the continuing support and education of the volunteers and the placement of volunteers. Violet and her crew of volunteers are called on to support the person who is dying, the supporting family and even the staff in the hospital. That support takes many shapes but Violet and the volunteers in our Palliative Care program are usually able to address the needs that arise and provide much needed support for all involved.

Our Palliative Program has a doctor as well. Dr. Darren Reimer, one of the family physicians at the Steinbach Family Medical Center works part time as the regions Palliative Care Physician. He has taken additional training in Palliative Care Medicine enabling him to support the team philosophically as well as medically. He attends the Palliative Rounds every two weeks, as do the other members of the team. In those rounds  each person on the program is reviewed and everyone is updated on what is happening. He also makes house calls, going out to the farthest corners of the Region when necessary to support the person, the family and the team in dealing with challenging medical complications that arise as the process of living with an terminal illness arise.

Our Palliative Care services are a part of the Region’s larger Home Care program and are supported by the other services that Home Care provides. The Region’s Home Care program helps people live at home, many times to the very end and other times, long into the last stages of the illness before they have to come into the hospital.

Not that long ago, if a person was diagnosed with a terminal illness there was little support except the family doctor. Most didn’t even think they had the option to die outside the hospital and those who came to the hospital often received less than optimal care because they were treated as acute patients or because nothing more could be done to affect a cure, little more was done. Our Region was not unique; this is the way things were just about everywhere. That has all changed. In the relatively short history of Palliative Care in our Region, wonderful advancements have taken place to make it possible for our staff to support a person’s choices as to how and where they would like to live out the final months of their life.

Dying is the last task we complete in our earthly existence. Some die quickly and suddenly, while many die slowly, knowing that death is coming and waiting for it to arrive. This slow process of dying has been made better by the availability of Palliative Care services in our region. So if your doctor ever approaches you and says, “I think it is time to consider palliative care,” be open to the suggestion, for our Palliative Care service and the people that provide the service can do a lot to make the last chapter of life a good chapter. I have seen them at work and it makes a huge difference at one of the most difficult times in a person’s life.

Chaplain's Corner was written by Bethesda Place now retired chaplain Larry Hirst. The views and opinions expressed in this blog are solely that of the writer and do not represent the views or opinions of people, institutions or organizations that the writer may have been associated with professionally.