By Lorna Coombs, BScN, RN & Erin Donald, PhD, RN
Most people would rather not chat about end-of-life issues over the dinner table, but the speakers at Season 4, Episode 9 of the Gateway Centre of Excellence in Rural Health (CERH)’s virtual lecture suggest they should give it a try. On April 23rd, 2024, Dr. Erin Donald, nurse and clinical director at Huron Hospice, and co-presenter, Dr. Meagan Nolan, medical director at Huron Hospice, shared that when people with serious illness have conversations with those most important to them about their goals and wishes as they get sicker, they have more peaceful and personalized illness journey and end-of-life experiences, both for themselves and for their loved ones.
The two presenters were joined by panelists Lorna Coombs, palliative care nurse educator at St. Joseph’s Health Care, Tracy Snell, nurse and executive director at Jessica’s House Hospice, and Laura Hawkins, nurse manager of the Palliative Care Outreach Team for Home and Community Support Services. Together, the panel shared their expertise in supporting people with serious illness, including what it means to live well with a serious illness and the importance of understanding options for end-of-life care. Some serious illnesses include cancer, congestive heart failure, kidney failure, liver failure, lung disease, and dementia or Alzheimer’s.
(Panelists Left to Right: Tracy Snell (RN), Laura Hawkins (RN) and Lorna Coombs(RN))
Despite great advances in health care, too often a person’s decline and death still comes as a surprise to them and their loved ones. But every serious illness follows a general course or trajectory that a person can ask their doctor, nurse practitioner, or nurse to explain. These signposts let patients, families, and providers know that it’s time to have the important conversation about health care options, goals of care and future plans. Dr. Nolan encouraged attendees to start these conversations with their health care providers to avoid misunderstanding and make sure they have the information they need to make the decisions for themselves.
The next step is to have a conversation with family members and loved ones about what is important, including goals and wishes as a person’s health declines and they may not be able to communicate. These conversations, despite being difficult at the moment, allow patients to support their family and prepare them for what’s ahead.
Dr. Donald concluded the presentation with a description of what it is like to stay at a hospice. Hospice is an option for end-of-life care in Huron County and, contrary to popular belief, is not limited to the final two weeks of life or when someone is actively dying. Presenters also dispelled the myth that hospices are dark, depressing, and sad, or that entering one means giving up. In fact, a hospice is a place to live well until death occurs.
Often, there’s much more conversation and healing – sometimes even lifelong healing – that happens in hospice. There’s music, home-cooked meals for those who would like to eat, there are pets, there are new and old connections made. There are tears, but there’s also laughter and joy.
The full lecture can be viewed here or on the Gateway CERH YouTube Channel. A brief acknowledgement to Lindsay Nuhn, RN, Huron Hospice who assisted in phrashing.
Resources in Huron County
In Huron County, hospice is an underutilized resource. Hospices have the capacity to help more people in our community by providing expert care for those who are seriously ill as well as by supporting their families and friends. You do not have to be ready to come to hospice to be referred – both Huron Hospice and Jessica’s House accept pre-referrals and admit based on need, not waiting lists.
It isn’t always easy to navigate a serious illness or to navigate the health care system, but we are here to help. Patients, loved ones, and community members can call any of the hospices to ask about a referral or how to proceed.
Resources to help start a conversation when someone’s health changes:
Home and Community Support Services:
Hospices in Huron and Perth
Resources on living your best life with a serious illness
Hope for the Best and Plan for the Rest by Drs. Sammy Winemaker and Hsein Seow
Waiting Room Revolution | A Podcast for those facing serious illness. (especially the first season)
About Gateway Centre of Excellence in Rural Health
Founded in 2008 in the community of Seaforth, ON, Gateway CERH is a not-for-profit rural health research organization run by a community-based volunteer board of directors. Gateway CERH's main mission is to better the health and quality of life of rural residents through research, education and communication. Learn more on the Gateway CERH website at: https://www.gatewayruralhealth.ca/ and follow us on Instagram, Facebook, Twitter, LinkedIn and YouTube
The views expressed in this lecture may not necessarily reflect Gateway CERH’s views or opinions, but we believe in providing a platform for a range of perspectives and thoughtful discussion.
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