Excerpt from the 2023 Revised Edition of There’s No Place Like Home
There is a remarkable difference in the quality of care in a nursing home and a palliative care centre. Naturally, fewer residents and specialized end-of-life care by professionals are key factors.
My mother passed away at the May Court Hospice in Ottawa, where staff and volunteers took exceptional care of her for the last three days of her life; and, although she was not conscious during that time, it was obvious that the people who worked there were just as compassionate and caring to those left behind.
Three years later, my experience with palliative care for my dad was just as compassionate. The day he was transferred by ambulance from the Ottawa General Hospital to the Bruyère Palliative Care Centre, all coordinated by the hospital’s social worker, I followed him there in my car so I could sleep on a chair in his room for his first night so he wouldn’t feel alone or forgotten.
As soon as I arrived at the centre, I asked a nurse where to find the bedding and the towels my dad would need, and she looked at me as though I had three heads! She told me I wouldn’t need to help the staff with anything at their facility, and that my job, for the duration of my father’s stay at the centre, was to be his daughter. What a concept, I thought, and I loved and appreciated the opportunity to do just that over the last twenty-two days of my dad’s life.
My father was given a private suite with lovely and clean bedding and drapery to match. The floors everywhere were gleaming and no foul odours could be detected on the floor. I couldn’t believe how lovely the facility was, and how welcoming the staff were, and every day, I would find my dad either chatting or singing with the nurses or the aides assigned to him. No crying in that place, and he seemed so happy and content. I hadn’t seen him like that in years.
That first night at the palliative care centre, my dad’s nurse showed me how the lazy chair in his room worked, and just as I was about to fall asleep, she came back to the room to wrap me in a warm blanket. I have never forgotten that kindness.
Hours before my dad passed away, he had been singing with his favourite nurse when she told him they needed to say goodbye. She said he might not be there when she returned to work the next day, and although it surprised me to hear her say that to him, my father remained completely calm and cheerful, and he thanked her for being his friend and singing with him.
He was asleep soon afterwards, and when I started to massage his hand, he kept brushing mine off. That caught the evening nurse’s attention who told me my dad probably wanted to be alone. I went to the dining room, where she came to get me a few minutes later to say he was gone, and that I could come back to be with him for as long as I wanted. How these palliative care specialists know exactly when a person will leave this world boggles the mind.
I couldn’t help but notice the difference in the level of care and professionalism between my father’s previous facility and the palliative care centre, even though I understood that the more realistic staff-to-patient ratio had a lot to do with it.
There was also a great system in place at the Bruyère Palliative Care Centre. At the beginning of each shift, the charge nurse leaving for home would accompany the nurse who would be taking over from her to discuss the status of each resident who would be under her care throughout the evening or night shifts. The departing charge nurse would go over each resident’s medications, all of the pertinent details about the care already administered, or any that would be required, and if there was a new arrival on the floor, the charge nurse provided an even greater detailed briefing about the new resident’s specific needs.
If common sense, compassion, human contact and laughter could become part of the overall long-term care experience, as they did at the Bruyère Palliative Care Centre, I believe nursing homes might be happier and more relaxing places to live in or visit.
Lise Cloutier-Steele is a writer from Ottawa, Ontario, and the author of There’s No Place Like Home: A guide to help caregivers manage the long-term care experience, currently available from www.ottawacaregiver.com.