Gift-giving that makes a difference…

The Wood Buffalo Primary Care facility in Fort MacMurray, Alberta, has put in place an equipment borrowing program for palliative patients and their loved ones. Upon referral, patients and families can access the resource center, where a variety of equipment is available free of charge, and for an indefinite period.

The reason why I found this interesting is that when people think about palliative care, they tend to think mostly about medications. Obviously treating symptoms pharmaceutically is an important component of what we do, but there are many other dimensions involved that are often overlooked or misunderstood by the public—and the role of specialized equipment is one of them.

When someone is being cared for at home, specialized equipment becomes incredibly important. Things like bath aids, railings, grabbers, and soft blankets are essential to ensuring the comfort of someone who is sick. But of course, these supplies are costly and it’s not a cost that should be borne by patients or families during this difficult time. Many programs across the country provide these tools, but it’s something that is perpetually in demand. So as the season approaches where many of us are donating to the myriad worthwhile charities, please consider your local palliative care center. Your gifts will help bring comfort to those who need it most.

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.

 

 

 

Book now a reference for the Canadian Virtual Hospice

I just thought I would let you know that my book Dying in the Land of Enchantment has now been posted as a Tools for Practice with the Canadian Virtual Hospice.

You can read about it here http://bit.ly/P5QVQa

I have been using the Canadian Virtual Hospice as a reference for my colleagues and patients so it is quite an honour to have my book mentioned on their site.

Thanks to them for acknowledging my book!

Beating the palliative burn-out

One of the most frequent questions I get as a palliative doctor is, “How do you do it—day in and day out?” While burn-out certainly isn’t something that’s isolated to my field of practice, I will say that the toll this line of work can take on you both emotionally and physically is extremely high. Anyone who goes into this speciality and thinks they’re going to be immune to burning out probably doesn’t have a realistic understanding of what this line of work entails.

In fact, seeing families going through difficult times does, in many ways, give me an additional insight into what the effect is of this work on my own well-being. People don’t realize that emotions like grief take an incredible toll on your body. And one of the most important things I tell the families and friends of patients is that it’s incredibly important that you take care of yourself. We’re so focused on taking care of our loved one, that we forget that if we neglect ourselves we won’t be any good to anyone.

Obviously the best tact is to choose something that works for your personality and interests. The most important thing is that you aware that burn-out happens to everyone, and that you need to take steps to avoid it.

Coping mechanisms can include a huge wide variety of things: hobbies or crafts, reading, counselling, or just talking about your emotions, sports, movies, writing, cooking, listening to music.

It’s obviously a very individual thing, but the bottom line is that you make the effort to recognize that exhaustion and burn-out are normal, and that you should never ignore it. But you can do a great deal to help prevent it.

So what do I do? I’ve found that the most important things for me to do are to make sure that I eat well and get a full 8 hours of rest every day (this doesn’t necessarily mean sleep). It’s important that you have decompression time where you can not only unwind, but process everything that’s gone on during the day in a positive way. Then I make sure to get some physical activity during the day. For me, the best way to do this is to take my dog Chase out for walks. Not only do I get the exercise and fresh air that helps physically, but I also get the emotional benefit of a little ‘pet therapy’ from Chase (it’s no myth that people with tend to have lower blood pressure and cholesterol!).

And remember, never be afraid to ask for help. Palliative practioners and caregivers take a lot on their shoulders each day, it’s important to take some of that weight off whenever you can.