The day after…

Canadians watched the election results roll in on Tuesday with rapt attention—myself included. While I’m Canadian, having completed much of my training in the US, I was obviously very much interested. In the run-up to this week’s election in the United States a great deal of time was spent talking about ‘Obamacare’ and the virtues and evils of the system. While certainly the changes made by Obama result in something that is a far cry from the type of system we have here (or in any of the other OECD countries), the fact that upon its implementation more, rather than fewer, patients across the country have access to health care cannot be seen as anything other than a positive.

But there remains much work to be done there in terms of access to palliative care. In 54% of public hospitals less than 40% of sole community provider provide access to their patients. There’s also a significant lack of board-certified palliative physicians. In one state, Mississippi, there is just one doctor available per 1,698 medicare (public system) deaths.

But beyond our neighbours to the south, the state of palliative health globally is extremely varied in both quality and access.

In a country with one of the most advanced healthcare systems in the world, the Kingdom of Jordan, it’s estimated that 10,000 people die every year without the access they need to palliative services.

In New South Wales, Australia, just 10% of those dying from predictable (non-cancer) illnesses receive end-of-life care.

Only four of the 53 African countries have palliative care frameworks included in their health systems—a growing concern as HIV/AIDS continues to ravage the continent.

I’m hardly the first person to talk about how lucky we are, as Canadians, to have a publicly-funded health care system. Yes, the system isn’t perfect, but you don’t throw the baby out with the bathwater; by and large the level of access to services we have in this country is envied by many the world over. I didn’t hear the words “palliative health” uttered even once during the months upon months of American campaigning. It still does not appear to be a global health priority, and it needs to be.

Ensuring quality palliative care for all

A new article on end-of-life care was recently published in the CMAJ, talking about the need to create a national system of standardization for palliative healthcare delivery. I found it really fascinating on a number of levels, and it’s certainly a discussion that needs to be had.

Because there is no effective regulatory system governing palliative or home care in Canada, essentially anyone can set up a business providing these services—they don’t need to be a medical practitioner or have any medical training whatsoever because accreditation is voluntary (one of the few exceptions is found in Quebec).

Now obviously, this sets up a very dangerous situation and sadly, has resulted in numerous cases of injury, and abuse. What especially bothers me about the situation is that this means that there are people out there treating end-of-life care as though it were just another service-based business, like window washing. As a result, you get unqualified individuals providing sub-standard care to those who are most in need.

I’m glad to see that we’re having this discussion in the medical field—it’s an important one to have. And I hope as we move forward in ensuring the highest level of palliative are for patients, that we also include a broad variety of those involved in end-of-life issues. Let’s remember that expertise in this field isn’t derived solely from a medical degree.

 

 

 

Meditating my way towards perspective

Ever since my time at Upaya, meditation has been playing an increasingly important role in my life. In fact, it’s an important part of the coping mechanisms to avoid stress and burn-out that I talked about a few weeks ago.

I’d taken a break from it for a little while, but recently a friend got me back into practicing it more regularly. She sent me this little blurb as a reminder why it had been so important to me to do in the first place:

12 symptoms of a spiritual awakening:

1.   An increased tendency to let things happen rather than making them happen.
2.   Frequent attacks of smiling.
3.   Feelings of being connected with others and nature.
4.   Frequently overwhelming episodes of appreciation.
5.   A tendency to think and act spontaneously rather out of fear based on past experience.
6.   An unmistakable ability to enjoy each moment.
7.   A loss of the ability to worry.
8.   A loss of interest in conflict.
9.   A loss of interest in interpreting the actions of others.
10. A loss of interest in judging others.
11. A loss of interest in judging oneself.
12. Gaining the ability to love without expecting anything in return.

People sometimes get thrown off by the words “spiritual awakening,” but they needn’t be The beauty of meditation is that it requires no religious affiliation to be practiced.. In the context of meditation, it’s really just about achieving psychological balance, calm, and emotional and physical relaxation—what person couldn’t use more of those things their life?

And the benefits of meditation are countless both for medical practitioners and patients. Stress can have a serious negative impact on your health and it’s not to be taken lightly. Meditation can help provide you with the perspective needed to better cope with daily stresses.

With the autumn months come myriad changes and its easy to get bogged down with all the details. It’s the perfect time to embrace the opportunity for self-examination to the balance in our lives we all need and deserve.