living your best to the end

Screen Shot 2015-03-19 at 11.15.48 AMComfort Care and Quality of Life

What does Quality of Life mean for you? For a 98 year old, nearly blind, and unable to pee without a ‘stent’ in place, it’s being comfortably positioned in the warmth of her garden, with tissues and a cup of tea within reach.  A proud woman, she doesn’t like calling her health aids ‘caregivers’ because it makes her sound needy. Instead, they’re companions and a chauffeur.

What does ‘Comfort’ mean to you? Sometimes comfort comes of small pleasures: a loving touch, soothing music. For the 80-year old wheelchair bound man, it’s stroking his cat and getting his feet massaged.

Comfort can take on a different meaning as life winds down: shortness of breath, skincare, dry mouth, constipation along with pain and anxiety. Ensuring these needs are known, and are met, can make the difference to both patient and caregiver.

Ricky’s mother had a ‘good death’

Of the three siblings, Ricky – the sole daughter – was closest to her mother, Anna. “When my marriage ended, my kids and I lived with my mother. We all adored her.” In the last three years of her life Anna- who died at age 91 – was beset by Dementia. “It was more than memory loss – it was her wonderful personality that vanished.” In spite of the pain of her beloved mother disappearing, Ricky took care of her until the end.

A beautiful death

“My mother was ‘dying’ for about 10 years – with her sickness, she seemed often on the brink of death, and then she’d rally. We’d all said our goodbyes a number of times. But on the day she actually died, my father was in her bed, his arm around her, holding on to her. He’d been in this position for a long time when my former brother-in-law came to visit. “My mother and her former son-in-law had kept up a really special relationship even after my sister had divorced him. They were very close and spent a fair bit of time together. My father would call him ‘her spiritual companion’. When he came into my mother’s room, she was looking grey and frail. My father’s arm was falling asleep holding her. ‘Can you take over here?’ he asked when former brother-in-law appeared. Take over he did, cradling my mother against him. My mother looked at him and her face lit up. Her cheeks became rosy and her eyes twinkled. She looked like a teenager again. She smiled, and took her last breath. It was a beautiful death. I was glad to have been there. Interestingly, when I was about 5 years old, I had a dream that my mother died in the arms of a younger man. It was the only such dream I’d ever had.”  ...

Personal Support Worker (PSW): caring at life’s end

Dealing with grief and End of Life as a Personal Support Worker Guest Post by Natrice Rese It’s something that you are prepared for as a student.  It is understood that as a caregiver, a PSW, you will maintain a distance, a separation, a formal kind of relationship with your clients and residents. But when you actually begin the job you quickly find out that it is not quite as easy to deal with when you can put faces, names and personalities to the residents you care for.  Close connections bring an affection for your clients and vice versa.  Personally I found it hard to be at a distance: When you give total and personal support to residents you can’t help but have feelings of friendship, protection, and empathy that is by nature what a caregiver has in his or her “toolbag”. I recall one particular lovely lady who was often in my care in the facility where I worked.   I will call her “Mary”. Mary had brilliant silver hair and very blue eyes, lots of smiles, laughs and mischievous looks. She was obviously loved by her family and had visits often. Mary was dealing with many issues: she endured a stroke that limited her movement and mobility.  She also had dementia so she needed a lot of support, smiles, hugs, and conversation. Although Mary was confined to a wheelchair she was able to roll her chair around the halls and with one hand surprisingly strong. She was as continually busy as a small child is, always on the move, always into something – often trying to exit through doors, enter...

End of Life in Long Term Care: Personal Support Workers

Personal Support Workers (PSWs) Rock and Rule Anyone who’s needed practical help with daily living when in a health situation knows that it’s not the doctor or nurse you turn to or rely on. Whether at home, or in a health facility, the day to day care delivery falls to the Personal Support Worker. In a workshop organized by the Ontario Long Term Care Association focusing on Palliaitve Care in Long Term Care – with the theme: Care for Life, I sat amongst a packed room-full of (mostly) women PSWs.  Their satisfaction comes not from having the latest medical intervention, or cutting edge equipment but rather from spending more time with their ‘residents’ than any other healthcare professional – which means knowing the small pains and pleasures better than anyone – often more than family members. I tweeted to the world:  Day-to-day efforts may seem thankless work but for the PSW this goes with job satisfaction:   In Palliative care – with its emphasis on whole person comfort and whole person symptom management – these PSWs have learned to read their residents non-verbal language: often a factor in those with Dementia. PSWs form such lasting relationships with residents and their families that they often attend the funeral and keep in touch after a residents’ death.I wonder, with so many who are in their care at life’s end, how do they cope with deaths – do they call upon social workers, chaplains or bereavement counselors? The resounding answer is: “We get comfort from our colleagues – fellow PSWs: only another PSW can understand the relationship and loss.“ I was shocked...

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It’s not death, it’s dying that alarms me.

Michel de Montaigne

Philosopher