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4 The Canadian Statesman, Bowmanville, Wednesday, April 20,1994 Hospital's Palliative Care Team Offers Support for Terminally III People with a terminal illness who choose to die at home rather than in hospital can rely on Dr. Howard Burke and his colleagues at Memorial Memorial Hospital, Bowmanville, to be there whenever they are needed. They can help to relieve pain, they listen and give advice, and they help both patient and family handle one of the most stressful of all situations. The biggest help they give is often non-medical. "We tell them it's okay to cry," says Dr. Burke. He explains: "I had a patient who said she didn't want her children to see her cry, but I told her, 'Your children children arc crying but they're hiding it from you. If they see you cry, they can ciy with you. Crying is okay."' Not only is crying okay, it's beneficial. beneficial. "Crying helps people to deal with what's happening to them," says Dr. Burke. "Denial can actually cause the pain to be worse." Dr. Burke is one of six doctors and 11 nurses at Memorial Hospital on a palliative care team called PACT, for Palliative At Home and Hospital Care Team. Pharmacists, social workers, cler- "We grieve in our own way," says Dr. Burke. "When we have our meetings, meetings, we talk about the patients, that Patient "X" passed away and what the family said, how they felt, and how they're doing. It's our way of saying goodbye. By talking about the patient you deal with the grief, which is much healthier healthier than denying it. "The hospital has been very supportive. supportive. They have helped set up the PACT Room, which is our headquarters, headquarters, with information on support services. services. This quiet room is available for family and friends of patients who are experiencing a crisis, regardless of whether PACT is involved. "I find I can have the most positive, positive, professional impact when doing palliative care," he says. "Going into a home and helping people through something as difficult as this, where you can really have such a positive influence on their lives, gives me incredible incredible satisfaction. "I know everyone on the PACT team feels the same way. There's never a happy outcome, but you can do an awful lot and that makes it all worthwhile." One of the 20 patients cared for by PACT members was Dawn Higgon Higgon of Bowmanville, a nursing teaching teaching master at Durham College in Oshawa, who died in Memorial Hospital Hospital after a six-year struggle with ovarian cancer. Team member Dr. Debra Jefferson Jefferson was assigned to Mrs. Higgon, whose husband, David, and sons DJ and Darin were at her beside when she died. "She took really good care of Dawn, both physically and emotionally, emotionally, and spent a lot of time with the rest of the family," said Mr. Higgon. "We discussed the situation with her in a very clear, matter of fact way, which was probably the most solid way of supporting us. "And the nursing staff was just , wonderful. Towards the end I was advised advised to get our sons to the hospital so that we could all be there when she died. "That was one of the most beautiful beautiful things they did and I'll never forget forget it. You can't put a price tag on it. You can't even thank someone for doing something like that." Certificates Presented Following Palliative Care Instruction Twenty-one women from Oshawa and Clarington graduated from the Hospice Durham training program program at Memorial Hospital, Bowmanville. the eight-week training course included Emotional and Community Community Support, Communication, Transfer Techniques and Bereavment. The volunteers are now prepared prepared to provide in-home support to individuals and their families facing a life-threatening illness. The volunteers are (not in order of appearance in photo): Louise Anderson, Roxy Barnes, Sally Barrie, Myr- na Bumfield, Melanie Daniels, Penny Anne Davidson, Ann Evans, Sophia Fitzpatrick, Liz Henderson, Vera Jaworiwsky, Lynn Liddell, Antoinette Marstrom, Helen Martin, Helen Moon, Pam Pick, Jan Rice, Belt Sawyer, Bette Sharpe, Shirley Stainton, Cheryl Van Luven, and Rhoda Wraith. Joining the group is Kathryn Roberts, the Volunteer Coordinator for Clarington Region. gy and volunteers with special training training are also on the team, which works closely with agencies such as Home Care, Hospice Durham and Durham Bereavement Services. The team was formed nearly a year ago and has since helped more than 20 patients, from a five-year-old dying of cancer to elderly patients with cpngestive heart failure. "Our aim is to help people die with dignity, to make sure that what time is left is quality time," says Dr. Burke. The team is called in to help family family doctors look after terminally ill patients patients or to take over the care of patients patients with doctors in Metro Toronto. ' They also look after terminally ill pa- . tients in the hospital's continuing cere unit. . ' f- Only one doctor and two or three nurses are assigned to a patient, so . diet care is individual and ongoing, at tiie patient's home and at Memorial Hospital if a hospital stay is necessary. necessary. When the team is called in, the first step is to assess the patient's condition and make an inventory of the medication being used, says Dr. Burke. "Some patients get increased pain as their condition deteriorates. Even though medication is being taken substantially as directed, complications complications may have developed and there still may be other symptoms," he says. "If the medication isn't working effectively, patients often try other sedatives or painkillers that members of the family have suggested, and we sometimes find them taking four or five different kinds of sedatives and maybe half a dozen kinds of painkillers. painkillers. "So we get everything out on the table, to figure out where the patient is at and make some guidelines as to what they should be taking." Once the patient has been made comfortable, team members work to make the patient and family understand understand the nature of the disease and how it will likely develop. The patient and family arc then asked to help decide what should be done. "For example, if a person is getting getting more and more short of breath, we explain that we can give oxygen and, when this isn't enough, we may have to proceed to therapy that may not be pleasant or comfortable." A patient may decide that while this may prolong life, it's not really prolonging living, and decide against it, says Dr. Burke. Whatever the decision, the patient can count on the team's full support. The way a person handles a terminal terminal illness often depends on how well the family handles it, says Dr. Burke. This is where the team approach and all the skills of the various members members are particularly important. "It's a real multi-disciplinary approach," approach," says Dr. Burke. "Each of us looks at the situation from a different perspective. "We assess how the person is coping, coping, make sure all the support services services arc there, that the patient has his or her affairs in order, and that family members themselves arc given help to handle the stress," PACT team member Jennifer Chance, co-ordinator of discharge services at Memorial Hospital, explains, explains, "Letting go of a loved one can be a slow and painful process. It's important for the family to know there is help available and that they arc not alone. There arc ways of learning how to begin again, because life goes on." Team members discuss what the patient and family can do to prepare for the inevitable. "We're very straightforward in our approach," says Dr. Burke. "We call it what it is and we talk about the need to have a will and to make funeral funeral arrangements ahead of lime." Looking after u terminally ill patient patient can 1» time-consuming and exhausting, exhausting, says Dr. Burke. "You've got to be available at all times. The patient may develop a cold, have a belly ache, cramps or whatever, which may be something simple. But it could also be a complication, complication, so they must be assessed by one of the team." When a initient dies, it can be a highly emotional experience for all menmors of the team. WE WILL NOT BE UNDERSOLD. GUARANTEED. • No charge brake inspection • No-charge Offer ends April 30th, 1994. 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