WINNIPEG — Physician-assisted death being a reality in Canada brings renewed urgency to the need for expanded palliative care, which is available to only one in three Canadians.
But palliative care is surrounded by misconceptions, according to a Winnipeg palliative care doctor. Some people believe it actually hastens death, others think it is only for the very old or only for cancer sufferers. Others believe palliative care means that nothing more can be done.
“There is always something we can do,” said Dr. Chantale Demers, about pain and symptoms and bringing comfort to the dying.
Demers was part of a panel dubbed Life is for Living, Stories of Compassion, May 11 at Our Lady of Perpetual Help Church in Winnipeg, with loved ones and caregivers of those who have died in palliative care sharing what it has meant for them to be part of an end-of-life experience.
The evening was among other events marking the National Week for Life and The Family in Manitoba. The week is an initiative of the Canadian Conference of Catholic Bishops and sponsored in Manitoba by the Tri-Diocesan Committee for Life and the Family made up of the archdioceses of Winnipeg and St. Boniface and the Ukrainian Archeparchy of Winnipeg, and led by the dioceses’ three bishops.
“Palliative care is an approach to care which focuses on comfort, quality of life and support for those afflicted by a life-limiting illness,” Demers said. The aim of palliative care, she said, is to “add life to days, not just days to life.”
Palliative care addresses all sources of suffering, be it physical, emotional, psychosocial or spiritual, and requires more than just a physician. “It is a huge team” of health workers, social workers and therapists, said Demers, and palliative care is never a “one-size fits all.”
“The philosophy of palliative care affirms life and regards dying as a normal process,” Demers said. “But our death-denying culture thinks of death as losing the battle.” Demers said patients who receive palliative care report improvements in pain and symptom management, and emotional and psychological well-being.
The first palliative care unit in Canada was opened in 1974 at Winnipeg’s St. Boniface Hospital. Today palliative care is provided by a variety of organizations, often with the indispensable help of volunteers, in hospitals, hospices, personal care homes and private homes.
Andre Brunet is a palliative care nurse who visits people’s homes to help and accompany them on their final journey. The people Brunet serves have been diagnosed with having six months to live and have chosen to discontinue aggressive treatment for their illness. Aside from providing care including pain management and any special equipment to make a person’s final days as comfortable as possible, he is there to listen. “They will go through a lot of emotions and it’s important to talk about it. We talk about depression and you’d be surprised how often they are not depressed.”
Brunet said there is often humour and laughter shared with his clients and their family members, who are usually the prime caregivers. “Being part of it is a real privilege. We all know what’s going to happen.”
Deacon Stepan Bilynskyy, director of Spiritual Care at Misericordia Health Centre in Winnipeg, said the idea of dying with dignity is popular with those who believe in the right to choose to die. “But to die with dignity is not very clear,” Bilynskyy said. “We all must accept our own limitations. To be dependent on those we love most is a gift. Humans are not self-sufficient. A common symptom of our ‘throw-way culture,’ as Pope Francis put it, is to pretend that death doesn’t exist.”
Sister Jo-Ann Duggan, SGM, manager of Spiritual Care and Volunteer Services at Jocelyn House Hospice in Winnipeg, said the mission of the hospice is to accompany persons, to help residents focus on care while respecting their social and cultural needs. “I am blessed in my role as co-ordinator of 43 committed and compassionate volunteers,” said Duggan. At Jocelyn House they celebrate birthdays and all special days. The kitchen is a centre of joy and sharing.
“This spiritual journey is sacred,” she said. “It is one of peace, harmony and reconciliation, to give meaning and purpose to the end of life.”
Duggan said she has seen people “transformed“ from being filled with fear to no longer fearing death. “We all are in need of more palliative care services in Manitoba,” she said.
Cathy Lentz spoke of her mother’s palliative care at Holy Family Home, a personal care home in Winnipeg. She said being able to access all aspects of hospice care without going to hospital was a gift for her mother.
“That spiritual journey is what brought greatest comfort in the last months, weeks and days. How I experienced my mother’s palliative care had a profound effect on me. Experiencing the reality of death helped me renew my own spiritual journey,” Lentz said. “It’s a very sacred place. One can sense God touching each person every day. Excellent palliative care made all the difference in the end of her life on earth.”