Strengthening a Palliative Approach in Long-Term Care

"When we did work talking to patients and care partners and providers, a lot of patients and care partners weren't aware of frailty as an idea or concept. But once it was explained to them, they felt much better and understood what was happening.  We all seek understanding and explanation in some way, and I think that can really help people really understand what's happening to thei...

"When we are talking about culturally safe care, it's really having that background, that trauma-informed care approach. And that's for any person, it's not Indigenous-specific. To make it Indigenous-specific is to understand that Indigenous people in Canada have had a very different history. Every single Indigenous person that you have met or spoken to in Canada has been affec...

"There's a lot of love and respect for our elders, but for ourselves too, as  individuals. Generosity and humbleness and the teaching from our elders. I really like to look at them as our teachers in the way we care for people and how we treat people. It's a part of my drive to make sure that our elders are cared for in the best way." Renate Goodstriker is a proud Blackfoot Fir...

"One Green Care home that I just loved was kind of messy and untidy. You had the feeling that life was happening all around you, and it was busy enough that not everybody could tidy up entirely ... a little bit of what we did yesterday, reminding us today of what we did yesterday, which actually with dementia is a very good idea.  And the woman who had initiated it identified that the culture...

"Stories in Motion are a way to give the unspoken a voice. Because so often with the people I'm working with, they've not had that voice...but if we can put it into a story, if we can put it into a world where anything can happen and people can say anything, then those unspoken thoughts, feelings get transposed and transformed into something for the person who creates, and for the p...

"If I had one wish of what the healthcare system knew about end of life doulas, it would be that if you embed end of life doulas into your healthcare settings, not as healthcare professionals, but as social emotional supports that their job would be a lot easier. People would be aware of advanced care plans, and people would be aware of actually just thinking through what they want. Families...

"There are people who are saying we can't continue to do what we've always done.  Don't tinker around the edges and make things a little bit better in the same old template that you've always had. Get rid of that. Change it radically, be bold, move forward." Elroy Jespersen envisioned a different type of community where people living with dementia could live their own...

How does architectural design impact the quality of life for residents in long-term care? And how does design influence a palliative approach to care? We spoke with two architects at Montgomery Sisam Architects who have a particular passion for thoughtful design in long-term care. Neda Basharat has been focused on creating home-like environments for seniors within the long-term care sector for ove...

"It's about looking at the finer things...  preferences in their meals, and giving families special spaces to be together with their loved ones in those final moments ...  ensuring we meet the needs of each individual resident." Grand View Manor is a long-term care and assisted living facility located in Berwick, in Nova Scotia's Annapolis Valley.  Laurel Pizarro is a registere...

"It's kind of an altered state of consciousness where they are just not themselves. Dealing with my dad, sometimes it comes across as delusions and paranoia, it's this otherness, it is not him. It's a body response or a mind's response to these things that they can't handle." - Marlene Moorman Delirium is frightening for both the affected person and their loved o...

"There's kind of a magical quality with music, a healing or a support really that comes from the music. As long as people have been around, we have been making music and it really does connect with us on an emotional level. " - Sheila Killoran Sheila Killoran is the Education Lead for the Covenant Health Palliative Institute . She is a certified music therapist and holds a Master&ap...

"Sometimes people can really shut down and the horses can get in there and reach in and welcome them back to being present. The horses are gifted. It's all them. " Jennifer Semach is the founding Executive Director and program facilitator of Walkabout Farm Therapeutic Riding Association, a charitable organization in Minden, Ontario that offers free mental and physical health service...

"You don't know what's going wrong. And you have all these theories, but it's a long time before dementia is one of the hypotheses..." Fay Martin is a retired social worker who lives in Haliburton County, a small rural community in Ontario. She cared for her husband, who had dementia, until his death in 2022. He died with - but not of - dementia, sparing them the ravages o...

What is person-centered care and how does it contribute to a 'good' death? We spoke with Kristen Lew-Byrne, a registered social worker who talked to us about patient-centered care, and how social workers work with team members, residents and families to help achieve a good death means for each individual. Kristen Lew-Byrne  is a registered social worker who has worked alongside and suppo...

"Nurse Practitioners are well positioned to help residents and families navigate their life limiting illness. We have the knowledge and skillset to provide their primary medical care, their maintenance therapies, and the treatment of chronic illness flareups. I think the value add is that we can also integrate this approach and philosophy throughout the continuum of care. " Nurse Practit...

"I think a lot of people, when you say the word palliative, they think the end of life is imminent. And that's not the case at all. These are conversations that should be starting to happen on move in or even before move-in." Sarah Murphy is a licensed practical nurse and the assistant director of care at The Hamlet's long-term care community in Vernon, British Columbia. She ha...

How do we support the elderly and their loved ones as they transition through the phases of end of life? Registered Nurse Ryan Collins talks with us about how the Palliative Performance Scale tool and courses through the SPA-LTC program have helped him adapt care strategies for long-term care residents to ensure that they get the care that's right for them. Ryan Collins is a registered nurse...

Dr. Melanie Leger is a palliative care physician in Moncton, New Brunswick. She recently developed standardized templates for order sets in palliative, to help guide community and long-term care health professionals as they review and update palliative protocols. The templates also increase efficiency by adding medication quantities and refill orders that can double as a prescription. "Some o...

How do we address the issues of health equity when jurisdictional issues create a gap between two systems of care? We spoke with Holly Prince about the barriers to care for Indigenous peoples, and the importance of equitable access to palliative care within Indigenous communities. Holly Prince is an Anishinaabekwe  and a member of Opwaaganisiniing  in Northwestern Ontario. She has a Master’s Degre...

A Green Care farm is a combination of agricultural activities and a population that could benefit from time in the outdoors. Green Care Farms CEO and Founder Rebekah Churchyard provides outdoor day programs for people with dementia, connecting them with nature on a farm in Milton, Ontario. The program includes planning and planting sensory gardens, and growing food for the local food. She says tha...

Living with a disability can add extra complexity in health care settings, especially if communication is a challenge. Carrie Batt draws from her personal and extensive professional experience within the developmental disability sector to offer end of life care, support and planning for people across the disability spectrum.  She helps people navigate systems for equitable and quality healthcare,...

How do we better support family, friends, and long-term care staff as they grieve the death of a long-term care resident? Joe Peters is a funeral director with more than 35 years of experience at funeral homes in Toronto. He has supported many family members and friends through grief, and he has also experienced a wide range of approaches to honoring the deaths of residents in long-term care.  Lea...

How do we ensure that Indigenous people receive palliative care that aligns with their culture and spirituality? In this episode, guest host and researcher Mary Lou Kelley has a conversation with Jeroline Smith, a retired nurse, Elder and Knowledge Keeper who has made significant contributions to palliative care for Indigenous people. Jeroline talks about the importance of community, the need for...

How do we make mission statements real ? Pat Morden says that leadership is critical to ensuring that people have autonomy and a sense of purpose to understand the mission. Pat Morden, the 'upcycled' CEO of Shalom Village, is committed to enriching the experiences of those who need to live closer to care and want to live life on their own terms. Pat has worked to achieve this alongside o...

What role do End of Life Doulas play in long-term care, and how can they help residents, family members and long-term care staff during the dying experience? We spoke with End of Life Nurse Educator Olga Nikolajev about the role of an End of Life Doula in long-term care, and how they contribute to quality end-of-life care. Olga Nikolajev is an end of life nurse educator with over 25 years of profe...