February 16, 2011

Home health care can include spiritual care

As published in The Erin Advocate

I was surprised to learn recently that spiritual care is among the many publicly funded health care services that can be provided to people in their homes.

It does seem like a logical extension of the effort to allow people to return home as soon as possible after being in a hospital, where they would have access to a chaplain.

Spiritual Care Providers are included on local teams being set up by the Waterloo Wellington Hospice Palliative Care Network, to benefit terminally ill patients. They can pray with clients, read to them or just chat.

The service is entirely optional, not linked to any particular religion, and available in addition to any visits from ministers or other church volunteers. It is a recognition that people, whether they care to express them or not, do have spiritual needs that can affect their physical and mental health.

It is one of many home services, including Personal Support Workers, coordinated by Waterloo Wellington Community Care Access Centre (CCAC), which also controls access to Long Term Care (nursing) Homes. Funding from the Ontario government for hospitals and home care is allocated through the Waterloo Wellington Local Health Integration Network (LHIN), which currently has an Aging at Home initiative.

Hospice Palliative Care Teams are similar in concept to a Family Health Team, with a core group of doctors working with other professionals. Normally there would be a nurse practitioner, clinical nurses and a spiritual care provider.

The teams enable many patients with palliative diagnoses to return home from hospital (if they wish) instead of long-term care placement. There is no team for the Erin area as yet, but it is something we could have – perhaps something for which a seniors' group could lobby.

The Palliative Care Network offers education for health care professionals to improve their knowledge and skills in this field of medicine. They have also taken the initiative to place symptom response kits in the homes of patients and in long term care homes. These provide specialized medications and equipment so nurses can provide treatment quickly if a patient's condition changes, often without transferring them to hospital.

Palliative care, which focuses on comfort and other needs of dying patients and their families, is available from various sources: hospitals, long term care homes, family doctors and their teams, community agencies and residential hospices.

Since 1980 Hospice Wellington has been providing care for palliative patients and families, including bereavement support. It is a volunteer-centered organization, delivering more than 16,000 hours of volunteer support for almost 700 individuals each year.

Last year they opened a 10-bed residential hospice in Guelph, providing medical care and support in an attractive home-like setting, as an alternative to hospital, when patients are close to death and can no longer stay at home.

Some people resist the idea of going to a hospice, because they are not familiar with the concept. It is worthwhile to get information, or go on a tour, so that if you need their services, you will know what to expect. Information is available at www.hospicewellington.org. For Caledon, there is Bethell House Hospice in Inglewood, with information at www.hospicecaledon.ca.

February 09, 2011

Cared for by angels - what more could we want?

As published in The Erin Advocate

Sitting here in the sunroom at Lisaard House, the Cambridge cancer hospice, I've had a chance to reflect on my mom Gerry's long journey through our healthcare system. Through multiple surgeries, radiation and drug therapies, she has kept a positive outlook. It is her third round with cancer and now, for her body, time is very short.

The hospice is a calm oasis where time seems to slow down and death is treated as a natural process. It is opposite of the hospital, where the battle rages on. Mom's hospital stay last fall was a difficult ordeal, because of her frailty and the risks inherent in a huge system trying to serve so many people.

Mom broke her collarbone, just reaching across the bed. She got an infection that required a quarantine. She developed a pressure sore. A round trip to Kitchener for radiation took eight hours. Often in serious pain, she was distressed by noise from roommates and the busy ward.

The nurses, doctors and other staff at Cambridge Memorial continued to provide good care, even when they were clearly not having a good day, and for that I am grateful.

The long illness has given us opportunities to express our appreciation, say our goodbyes and build up bonds of family support. It has revealed a broader network, with many cards, emails and visits, especially from their extended family at St. Gregory's. My father Earl has been a source of inspiration, accepting the challenges of each day. My parents continue to teach by example, and for that I am grateful.

When Mom returned home, another division of the healthcare army jumped into action. It was encouraging to see how far we've come in developing a system to help people grow old at home.

The palliative team coordinated by Community Care included nurses, a nurse practitioner and an occupational therapist. Thanks go out to Jennifer, Abby, Laura, Maureen and Susan, and to the staff at Lisaard and Meals on Wheels.

There is one group of healthcare professionals that deserve special thanks. The team of Personal Support Workers (PSWs) from Bayshore Home Health – Jackie, Jamie, Robin, Lisa and Angela – provided outstanding service.

"It was their remarkable gentleness, true kindness and genuine caring for perfect strangers which impressed me most," said my sister.

PSWs don't use high-tech equipment or fancy drugs, and don't make a lot of money. They have the confidence to walk into a home, provide intimate personal care and feeding, then switch to sweeping, cooking or laundry. One day, an unexpected pot of soup arrived.

They taught us what she needed, told jokes to make her smile, whispered little bits of conversation and became her friend and advocate, knowing she might not be there the next day.

Mom was surrounded by angels before her death, and for that I am very grateful.

Here is a song refrain, written by Garnet Rogers. It has been on my mind lately and needs to be released:

We are brief as summer lightning
We are swift as swallow’s flight
We are sparks that spiral upward
in the darkness in the night
We are frost upon a window
We won’t pass this way again
In the end, only love remains

February 02, 2011

Staying in touch with the soil from which we came

As published in The Erin Advocate

I did not realize just how passionate some farmers are about the value of soil until I attended the Fast Forward Film Festival, featuring Dirt! The Movie.

The film is well-crafted, as an education about nutrients and the multitude of organisms in soil. About how farmland has been damaged by development, over-use of chemicals and the planting of single crops over large areas. It is a call for political action in defence of the land.

More fascinating was that 125 people came out to watch a movie about dirt on a frigid January evening, listen to local farmers and share ideas in an open forum.

The festival is a joint project of the Climate Change Action Group of Erin (CCAGE) and Credit Valley Conservation, with the opening night sponsored by Treehaven Natural Foods.

"We're all dirt," said Cathy Hansen of Bernway Farm in Ospringe, who helped organize the event. She is an organic farmer and local food educator. "Every last one of us relies on dirt for the sustenance of all of our cells, and for the future of our families and our children to come. Dirt is an essential living part of our planet – the only planet in the solar system with a living, breathing skin.

"You might think, how do soil and climate change go together? Soil can sequester carbon, take carbon out of our atmosphere if it's managed in the right way, but it can also give up a lot of carbon if we're not careful in how we manage our soils and our forests."

There was a panel of organic farmers, including teacher Amy Ouchterlony of Whole Village, a Community Supported Agriculture (CSA) Program in Caledon, dedicated to sustainable living (www.wholevillage.org). She said it is important not only to talk about sustainable agriculture, but to actually do it.

"We've had students come out and get community service hours on the farm, weeding, harvesting potatoes – you really need to feel that, " she said. "We need students to realize that farming is a career. It's a career path that we don't tell kids about...We're so lucky in this area, within half an hour of this spot there are more of the kind of farms this movie was talking about than any other places I can think of."

There were calls for reform of the provincial curriculum to include more about agriculture. Several elementary school students came to the microphone to participate the discussion. Holly Lauryssen and Paige Bromby of St. John Brebeuf told proudly about their school garden and the composting of lunch scraps.

"The basic knowledge is not taught in schools," said Erin farmer John Slack, President of Agricultural Mineral Prospectors Inc. "It is really up to us as a community to put these things in action. I don't have much faith in our political system, regardless of how hard we yell."

Slack had a lot to say about the unique features of the Erin landscape and the importance of preserving them. There's not room in this column, but I will share more of his comments in the near future.

Abhi Wahi is the manager of Whole Circle Farm on County Road 50 in Erin, near Rockwood (www.wholecirclefarm.ca). He spoke about building the next generation of farmers:

"Whole Circle has been taking on interns and apprentices for quite a while now. Age is not a limit, anyone can join. We train people to become farmers, to work with the soil, to build the soil using biodynamic practices, to encourage life in the soil, to grow food that is nutrient rich, food that's full of life. Not everyone who goes through our program ends up becoming a farmer, but in some way or another it does really affect their lives. They do go forward, encourage others or work within the field. We love visitors and volunteers to come by."

Cathy Hansen had an interesting idea for expanding the concept of community gardens.

"In a town like Erin where everybody is on a septic tank, not everybody can grow a garden in their backyard because of the issues around growing food in proximity to your septic field. We do have acreages in the community that would be walkable for people that would allow people to grow garden plots, like they do in the city.

"I am going to advocate that the Town of Erin start to look into the opportunity that we might have to develop, rather than a new industrial park, an agricultural park. A place that runs on a similar concept to an industrial park, except it's set up to grow food – small plot farming with infrastructures to support those farms.

"Farming is changing. Farms are no longer passing through families. We have new people coming into farming – the young, ambitious landless farmer. I would love to see Erin be put on the map for creating such a thing as an agricultural park, with infrastructure, with a small abattoir, with a functioning feed mill, with small plots available, with communal equipment."