Hospice Palliative Care is not a topic that we feel comfortable talking about, unless personal circumstances force us to face our need for it.  When we do seek help, what we often find, is a myriad of services that are complex and confusing, at a time when we long for simple and direct answers for treatment, support and care. What is out there?  Who can we contact to help us navigate the system?  This column is the first in a series that explores many different issues including how the health and community service providers in Muskoka and East Parry Sound are working to simplify and unify “the system” and to make it easier for caregivers to access the support they need.

 

“What is Hospice Palliative Care?  It is a philosophy of care, as well as the combination of active and compassionate therapies intended to comfort and support individuals and families who are living with life-threatening illness.  During periods of illness and bereavement, palliative care strives to meet physical, psychological, social and spiritual expectations and needs, while remaining sensitive to personal, cultural and religious values, beliefs and practices.  Palliative care may be combined with therapies aimed at reducing or curing illness, or it may be the total focus of care.” (Appropriate Settings for Primary Care, Peter C. Coyote and Doris Howell, Department of Health Policy, Management and Evaluation – University of Toronto, Aug. 2001. p.5)

 

For generations, death – like birth – routinely took place at home.  Family doctors held a dying patient’s hand, and sometimes administered morphine to ease pain and suffering.  But beginning in the 1950s, with post-war advances in medical technology, dying people were moved out of their homes and into hospitals, where they often felt neglected or subjected to treatments that unnecessarily prolonged their suffering.    Palliative care emerged in reaction to that approach.  In 1967, Dame Cicely Saunders opened St. Christopher’s Hospice in London England; a place dedicated to good death. 

 

In Canada, the movement did not begin until 1973 when Dr. Balfour Mount, a urologic cancer specialist in Montreal helped to organize a panel discussion at his local church, with the intent of helping participants better understand death and dying.  The evening focused on the book “On Death and Dying” written by Elizabeth Kubler-Ross.  This book, which became an international bestseller, called for a more compassionate approach, to allow people to die at home rather than in institutions.  During that discussion, Dr. Mount began to realize that he knew very little about death and dying.  He volunteered to head up a study to get patient and family feedback on their dying experiences at the Royal Victoria Hospital in Montreal.  The results shocked Dr. Mount, who then traveled to St. Christopher’s to work in the hospice and learn first hand about another approach to caring for dying people.  He realized that “Palliative Care” (a phrase that Dr. Mount coined) is one that should be in place from initial diagnosis, all the way through the journey, and when it becomes a case of changing from curing to caring, staying supportive of the individual and their family through the transition and the dying process.  Dr. Mount opened the first pilot palliative care ward in Royal Victoria Hospital which is still in place today.