Message from BCHPCA Board President
Donna Flood

Grateful; I am feeling grateful for all the work and support the board of BCHPCA has given our organization over the last several months. This group of very passionate volunteer directors has given their time, talents and tithe, to ensure BCHPCA provides our members with the best possible support. I am grateful to our assistant Bonnie who has weathered uncertainty and upheaval as we position ourselves better to serve you, our members. I am grateful to all of our members who on a daily basis provide our communities with the support they need during very difficult times. I am grateful for our partnership with the BC-Centre of Palliative care, together we will be providing our members and the communities at large with workshops to share resources and tools to strengthen your work at home.

SOSJ GRANT

BCHPCA is thrilled to share the application for the
Sovereign Order of St. John (SOSJ) Grants

The SOSJ is awarding $5,000 + $7,000 in Grants to
support BCHPCA members throughout British Columbia.

Please go to our website for more information

https://bchpca.org/awards/

DEADLINE MARCH 31, 2019

AWARDS OF EXCELLENCE
AND VOLUNTEER AWARD

Do you know someone you would like to recognize for outstanding achievement, contributions to, and impact in the field of hospice palliative care in British Columbia?

Please go to our website for more information and applications
https://bchpca.org/awards/
Submission deadline - April 12, 2019

BCHPCA members are engaged in many aspects of hospice palliative care. This month, the BCHPCA newsletter presents information to pique your interest in topics related to the changing landscape of palliative care in Canada; volunteerism; and Medical Assistance in Dying. Excerpts from reports and links to the full reports follow.

BCHPCA Conference 2018: Leadership and Learning

Awards and Recipients

BCHPCA is proud to partner with the Sovereign Order of St. John of Jerusalem and Life and Death Matters in celebrating the creative, inspiring work in the province that is related to hospice palliative care.
The following recipients were presented with well-deserved recognition for their work at the 2018 Conference.

BCHPCA Award of Excellence 2018

This award is presented to an individual in recognition of outstanding achievement, contributions to, and impact in the field of hospice palliative care in British Columbia.

Lois Brummet - Desert Valley Hospice Society

The communities of the South Okanagan, which are served by the Desert Valley Hospice Society, are richer because of the incredible gifts provided by Lois Brummet. Lois has incorporated hospice palliative care nursing into her entire career. She has extensive education in palliative care including Master’s in Nursing, US certification in palliative care nursing and CNA certification in hospice palliative care nursing. Lois participated in planning and operationalizing the St. Paul’s Hospital’s palliative care program and unit which became the first palliative care unit in Canada to integrate persons with AIDS and general population living with dying.

Lois brings her extensive education and experience to her volunteer work at Desert Valley Hospice by initiating and developing programs for their volunteers. Desert Valley Hospice operates hospice volunteer training programs to support palliative individuals at home and to support acute care nurses working in palliative care. The Grief and Bereavement Support and the Palliative Day Support are also facilitated by volunteers who received training initiated by Lois.

Lois continues to be active in her local society in specific programs such as Advance Care Planning, NavCare, palliative massage, vigils, visitation and training new volunteers.

BCHPCA Volunteer Award 2018

This award is presented to a volunteer in recognition of outstanding personal achievement as a volunteer working in Hospice Palliative Care in BC. Volunteers provide contributions to their organizations in many different ways, and therefore volunteers are eligible for this award if they exemplify excellence in the field of Hospice Palliative Care through commitment and leadership in providing direct care to patients OR if they exemplify excellence in organizational support, through fund development, board activities, or administrative duties.

In 2018, two deserving volunteers were presented with awards:

Margo Fletcher: Nanaimo Community Hospice Society

Margo Fletcher has volunteered at the Nanaimo Hospice Society since 2004. She continues to serve as a client volunteer, assist with fundraising, conduct self-care clinics using Reiki and essential oils, and facilitate volunteer training sessions. Margo offers her time to mentor and train volunteers, and offers a calm, grounding experience with essential oils and hand massage that the client can connect with when experiencing distress.

Christine Graf: Crossroads Hospice Society

Christine Graf has been volunteering at the Crossroads Hospice since 2004. She initiated the Art Care program which is a joyful opportunity to engage in an art-making experience that allows for moments of respite with other family members and friends while reducing stress and anxiety. Christine brought her art talents to the Society by introducing a legacy program of forming clay models of handprints of clients and their loved ones. Whether it is Hike for Hospice, art projects or bereavement projects, Christine graciously and generously gives her time to make cherished memories.

The Frances Montgomery Compassionate Community Caregiver Award 2018,
Created and Sponsored by Life and Death Matters

This award celebrates the immense contributions of the social community in caring for people at end-of-life and acknowledges that care of the sick and the dying is “everyone’s responsibility”. This award acknowledges the invaluable contribution of community members who provide care and support for people throughout the living-dying and bereavement process. It is presented to an individual who is a dedicated “compassionate community caregiver”. It is hoped that the award will be used to help the individual access education or educational resources to increase their care competencies.

Maureen Mitchell - Kamloops Hospice Association

Maureen Mitchell was nominated for this prestigious award in recognition of her exceptional care for palliative patients and their families.

The Marjorie Willoughby Snowden Hospice Home in Kamloops, BC opened in 2004. Prior to opening, Maureen was a hospice volunteer who helped many people in the community and assisted in establishing a functioning house to provide hospice care. Maureen was one of the original Health Care Assistants employed with Kamloops Hospice and with intense passion she continues to work here today.

Over the last 14 years Maureen has demonstrated empathy, loyalty, a desire to learn and she diligently provides the best standard of care. Maureen’s work experience includes many caregiving roles. She realizes how invaluable compassionate, gentle care is for individuals and their families in end-of-life.

Danielle Filgate has worked with Maureen for 10 years states, "She has her own exceptional standard of care that she upholds, and she always advocates for her patient’s goals despite her own values and beliefs. As my own trainer and mentor, Maureen is a caregiver that I have aspired to become these last 10 years. She is unwavering in her care, finds the little things to bring joy to her patients and is there for them when they are sad, frustrated or scared. She is certainly someone I would want to look after me during my final days".

The Sovereign Order of St John of Jerusalem grants recognize
enhanced end of life care for British Columbians.

This special granting opportunity is funded by the Vancouver Commandery of the Sovereign Order of St. John (SOSJ) of Jerusalem, Knights Hospitaller and is administered by the BC Hospice Palliative Care Association (Secretariat). The SOSJ grants are intended to enhance care to patients and families receiving end-of-life care and bereavement support.

In 2018, SOSJ determined that there were 14 organizations which were deserving of this award, and presented grants in varying amounts to these organizations totaling $66,400.00. Brief summaries of a sampling of grants awarded by SOSJ follow

Hospice Society of the Columbia Valley, "Hello Game" Program: The Hello Game provides a stepping stone to Advance Care Planning (ACP) information sessions by promoting ease of conversation around the challenging topics of dying and death.
Comox Valley Hospice Society, Supporting Hospice Volunteers through Cumulative Loss: Volunteers are vulnerable to compassion fatigue and burnout. The Comox Valley Hospice Society (CVHS) offers support to those who give so much of themselves and are foundational to the creation of a compassionate community of caring—in essence a partnership between the organization and CVHS volunteers as well as volunteers in residential care facilities.
Cowichan Valley Hospice Society, Palliative “Tool Kits” for Volunteers: Cowichan Hospice offers psychosocial support for community members and their families who are on a palliative journey. Volunteers would each have a "tool kit” with relevant materials that they could take to homes and hospital.
Desert Valley Hospice Society, Face to Face, The Social Way Project: This project provides the gateway for hospice clients, seriously ill and palliative people to connect with their families and friends using social media. It promotes volunteerism among hospice volunteers and hospice helpers, the general public, and high school students and supports social participation and inclusion of all age groups.
Lillooet Hospice Society, "I couldn’t talk about it before, but I can now.": The objective is to build an intergenerational and intercommunity greater awareness of Grief and Loss for young children.
Mission Hospice Society, Children’s Support Groups: Offerings include a series of support groups for children aged 6 – 12 and 12 – 14 who have experienced a loss and for children with Refugee status who have many secondary losses. Another program is aimed at encouraging youth who would like to be in a ‘helping profession’. Other programs involve painting horses and the therapeutic benefits of working with animals and Expressive Arts Therapist sessions.
Nanaimo Community Hospice Society, "Grief Mobile": A "mobile grief" vehicle, refitted with proven methods of therapy (art supplies, therapeutic toys, games, musical instruments, miniature figures, etc.) would enable our child and youth counsellors to provide services directly to the children where they are most comfortable (school, home, day care) in a timely, effective, and unique manner.
New West Hospice Society, Compassion Crew Volunteer Training Program: The Compassion Crew Volunteer Training Program is a comprehensive, experiential training program that will be facilitated by expert staff and will consist of 7 modules that will take approximately 20 hours of interactive classroom time.
North Kootenay Lake (Kaslo) Hospice Society, Grief Support Program: People mourning the death of a loved one, family and friends often find it difficult to know how to help, especially if they are also grieving. A grief support program creates a safe place for grieving and sharing the depth and complexities of grief.
Salt Spring Hospice Society, Youth Grief Initiative: A 5-week grief support program to be offered to community youth, in partnership with the school district. Initially, the program will be focused on the most “at risk” grieving youth in our community, but in order to reach out to all youth, our initiative will also include a 1-hour educational workshop about grief, designed specifically for youth.
Powell River Hospice Society, Caregiver Support Group: facilitate an eight-week Caregiver Support Group in Fall of 2018. The objective is to create a support group for caregivers who provide unpaid care for a friend or relative who is elderly, living with dementia, or who has a chronic or acute illness
Pacific Rim Hospice Society, Ahousaht Grief Support Program: Ahousaht is a First Nation community which is accessible via boat or float plane only. This is a drop-in grief support program, whereby adults can access a compassionate person who listens without judgment and in confidence. Any adult may attend grief support and there is no cost for this service.

BC Centre for Palliative Care: Competency Framework

"The Inter-professional palliative competency framework was developed to identify ideal competencies for Health Care Providers (HCPs) caring for people with life-limiting conditions. HCPs may be in the generalist, enhanced practice or specialist categories. There are competencies shared by all HCPs (Core), as well as discipline-specific for Nurses and Health Care Assistants. We are currently developing Social Worker / Counselor and Physician competencies. Much of the framework was adapted with permission from the Irish Palliative Care Competency Framework and The Nova Scotia Palliative Care Competency Framework."
For more information - Click Here

Competency Framework - ONLINE
HCA Competencies - ONLINE
Nurse Competencies - ONLINE

Health Canada Report: Framework on Palliative Care in Canada

"Executive Summary

In late 2017, the Act Providing for the Development of a Framework on Palliative Care in Canada was passed by Parliament with all-party support. During the spring and summer of 2018, Health Canada consulted with provincial and territorial governments, other federal departments, and national stakeholders, as well as people living with life-limiting illnesses, caregivers and Canadians. The findings from that consultation, as well as the requirements outlined in the Act, provided the foundation for the Framework on Palliative Care in Canada.

In Part I, the Framework provides an overview of palliative care, setting out the World Health Organization’s definition in the Canadian context. The Framework describes how palliative care is provided in Canada, and the roles and responsibilities of the numerous individuals and organizations involved. It lays out the purpose of the Framework as providing a structure and an impetus for collective action to address gaps in access and quality of palliative care across Canada. It also provides a brief description of the consultative process.

Part II, the heart of the Framework, sets out the collective vision for palliative care in Canada: that all Canadians with life-limiting illnesses live well until the end of life. Key to this vision is a set of Guiding Principles, developed in collaboration with participants of the consultative process. These principles help reflect the Canadian context and are considered fundamental to the provision of high-quality palliative care in Canada.

In recognition of the dynamic state of palliative care in Canada, and its multiple players, this section provides a Blueprint to help shape planning, decision making, and organizational change within the current context. It identifies existing efforts and best practices, and sets out goals and a range of priorities for short, medium and long term action to improve each of the four priority areas:

• Palliative care education and training for health care providers and caregivers;

• Measures to support palliative care providers;

• Research and the collection of data on palliative care; and

• Measures to facilitate equitable access to palliative care across Canada, with a closer look at underserviced populations. In this section, the Framework also lays out how we might recognize success as collective progress is made.

In conclusion, Part III outlines implementation and next steps, proposing a single focal-point to advance the state of palliative care. It concludes with the recognition that advancement of the Framework will require the collective action of parties at all levels, as well as the flexibility to evolve and respond to new ideas and emerging needs over time."
For the full report: Click Here

Volunteer Canada: Canadian Code for Volunteer Involvement

Excerpt:

"Purpose and Elements

The Code recognizes and reflects the changing realities of volunteer engagement and management practice, and supports the work of those who manage and support volunteer involvement within an organization. It is flexible and applies to organizations of all sizes, with different levels of resources, rural and urban, crossing a range of mandates, led by paid staff or by volunteers. Elements of the Code are designed to be inclusive and applicable to a diversity of people, cultures, communities, opportunities and appproaches.

For volunteer involvement to be effective, the organization's leaders must actively champion a culture and structure that supports and values the role and impact of volunteer involvement.

The Code consist of three important elements:

The value of volunteer involvement.
Guiding principles that frame the relationship between the volunteer and non-profit organization.
Standards of practice for involving individuals in meaningful ways to ensure successful integration of volunteers while meeting the needs of both the organization and its volunteers.

By adopting the Canadian Code for Volunteer Involvement, non-profit organizations commit not only to strengtheneing their volunteer engagement strategy, but also to strengthening the capacity of the organization to meet its mandate and contribute to strong and connected communities."

For the full report: Click Here

A Hospice Story

Submitted by: Maureen Taylor - July 7, 2017

The night my husband died, I slept beside his corpse in our bed. All night. This wasn't exactly by choice: the funeral home did not retrieve bodies after 8pm, and there was no other bed available for me to sleep in, as all our children were home to help care for their father.

I tell this story whenever I discuss the realities of dying at home. Even as a physician assistant, I did not appreciate the challenges – or the immense rewards – of caring for my husband at home until his death.

According to a 2014 Harris/Decima survey, of those Canadians who express a preference for where they want to die, 75 percent say they want to die at home, surrounded by loved ones. Interestingly, another Canadian study found that those loved ones aren't quite as keen on the experience: half of the patients who said they wanted to die at home had family members who hoped the death would take place in an institution, like a palliative care unit. No matter: The majority (about 65 percent) die in a hospital, which isn't anybody's first choice.

The palliative care and hospice community often use this data to advocate for more government funding of community supports, such as personal support workers, to help people die at home. And they're right that home care and palliative care access is too uneven across Canada and in urgent need of more funding.

But what we don't understand is how many of these hospitalizations at the end of life could be diverted with more nursing, more personal support workers, more respite for family caregivers. I believe that without better education around what's involved in dying at home, extra resources won't be enough.

Dying is messy. It shouldn't have to be painful anymore, though in some cases, only deep sedation can relieve the worst pain. But pain aside, there is no getting around the progressive weakness, the loss of appetite, the fluctuating level of consciousness, the need for diapers or a catheter, and eventually, the shallow, laboured breathing. None of this has to be distressing for the patient, who can, if needed, be heavily drugged or even sedated. But it can be extremely distressing for family members to witness, and it can go on for days and, in some cases, weeks.

When I worked as a physician assistant in the emergency department, I saw many patients brought in by ambulance in those last stages of their disease. When I spoke to the family members, it was often clear they were overwhelmed by very predictable symptoms. But no one had laid it all out for them before. They weren't looking for miracles – they accepted that death was inevitable – but they felt unprepared and untrained for the burden of watching their loved one struggle to breathe, to communicate, to just let go. Sometimes a spouse confessed that as the husband or wife's death neared, they worried they'd always associate the home with the death. And so, they dialed 911.

How can we better support those family caregivers so that they don't end up in the emergency department? Prepare them. Acknowledge the messiness of death. And obviously, provide palliative care resources.

In our house, I had a frank discussion with all the kids and even our cleaning lady: no matter how bad Don looked, no one was ever to call 911. I knew that if he was taken to hospital, he'd never come home again, and he'd die there. Our palliative care team had a binder that stayed on the kitchen counter, with Don's Do Not Resuscitate order right at the front. We had a nurse we could call if his symptoms weren't being managed well. Don had opted for terminal sedation at the end: an induced coma, without food or fluids. The palliative care physician visited every few days to make sure the drugs were working, and to give us his best guess as to how much longer Don could go on like that.

I often see frail, elderly spouses who try to provide this care for their dying loved ones at home, and it wasn't difficult to understand why they struggled. There's no question that we were luckier than most families: I was relatively young, and we had the resources for me to stay at home and care for Don from the night they diagnosed his brain tumour until his death seven months later. Our children were incredibly strong and present, and we took turns doing even the most personal and intimate tasks for him. Don had desperately wanted an assisted death, an option unavailable to him at the time. But if he had to die "naturally," he told us, he'd prefer not to have strangers assisting him. In the end – only after Don was sedated, and with no small amount of guilt, we accepted help from those "strangers" to bathe him and turn him so he wouldn't get bed sores.

There was so little comfort we could take in the fact of Don's too-early terminal illness. But knowing that we helped him fulfill at least one of his wishes for his death – that he die at home – was comforting to us. And I thoroughly recommend it to other families if they can manage.

After Don died in my arms, all the kids came up to our bedroom and we surrounded him, breaking out his favourite scotch and sharing stories and memories. The palliative care doctor on call came to pronounce him dead and then I called the funeral home. And learned he'd be spending one more night beside me.

I'll admit, it was weird. But as I pulled up the covers, I found they were mostly over on his side of the bed, and I smiled and looked over at his sweet face one last time. "Really Don? Hogging the covers, even in death?" And I slept soundly all night.

Maureen Taylor was married to Toronto microbiologist Dr. Donald Low, who died of a brain tumour on September 18, 2013.

BCHPCA MEMBERSHIP RENEWAL

Maintaining your Membership in BCHPCA is extremely important as we work together to advance quality hospice palliative care for all British Columbians. All BCHPCA Memberships expire on December 31st.

Let us remind you about the benefits of membership in BCHPCA:

The opportunity to be a part of the collective voice shaping the future and advancement of hospice palliative care in BC and Canada;

One vote at the BCHPCA Annual General Meeting;
Affiliate Status (non-voting) in the Canadian Hospice Palliative Care Association (CHPCA);
Discounts on registration for CHPCA and BCHPCA conferences and/or institutes and on merchandise offered on CHPCA online Marketplace.
Regular communication from BCHPCA on issues of interest;
Eligibility to apply for annual Sovereign Order of St John grants (limited to organizations with charitable status);
Eligibility for the BCHPCA-Westland Group Insurance Program for affordable and customized insurance, see Link for details;
Eligibility for the BCHPCA-OASSIS Group for affordable, comprehensive employee benefits, see Link for details;
Eligibility to enroll in OASSIS' new EAP program for trained hospice volunteers;
Access to CHPCA-sponsored interest groups, and CHPCA's AVISO e-newsletter and regular national updates

We are committed to Hospice Palliative Care in BC

A Hospice Story

Submitted by: Maureen Taylor - July 7, 2017