"What is life?"

Tonight I read a note from a dear young friend Lindsay Kigueta Borrows. Lindsay is one of those individuals whose intelligence, generousity of spirit, strength and agility, gift for languages (English, Ojibway, Spanish....), beauty and kindness are blanketed and glued together by her compassion, empathy, and willingness to reach out.

In her letter Lindsay quoted Chief Crowfoot,

"What is life?

It is the flash of a firefly in the night.

The breath of a buffalo in the winter.

The little shadow that runs across the grass then loses itself in the sunset".

Thanks Lindsay for reminding me.

Kath

Lost emails!... and my committment to responding to emails

I try to respond to emails within a day or two of receiving them.... This got difficult a few months ago when my computer upgrade resulted in a dozen lost emails, specifically a few emails from people I did not know.

Then yesterday, as I was learning a new "smart phone", I managed to delete another dozen emails! UGH!

So, if you have emailed me in the past, or if you email me in the future, and I do not respond in a timely manner, please resend your email....

Perhaps I should take up painting, it looks more fun!
Kath

Hospice for Animals.... What education is available?

I received an email the other day asking if I knew of education for people providing hospice care for animals. What an incredible question!

I know resources exist for pet loss, pet bereavement, pet therapy... but I have not heard of courses/programs addressing hospice for animals.

Does anyone have any resources? Any ideas?

And would the person sending that request, please email me again! Thanks!
kath at lifeanddeathmatters.ca

Kath

Living with Death - lessons on grief

While looking for Pam Fitzgerald on the web, I came across a brilliant short video about grief, living with death, and our ongoing connections with our loved ones. Clips of two movies, Last Orders (2001) and The Three Burials of Melquiades Estrada (2005) highlight the wishes of the departed and the desire of the living to meet those requests.

Pam Fitzgerald and Lysa Toye, both grief counsellors discuss the grief of the men involved in the two films, comment on their styles of grieving, the work of caring for the body. Film critic Peter Howell provides insights into the movies, and into coming to terms with life. It is simple, and beautifully woven together!

I recommend this as a nice introduction to grief.... have a look....

http://www.tvo.org/TVO/WebObjects/TVO.woa?videoid?75546064001

Kath

Winter, time for dormancy and reflection?

Last week I received an e-newsletter from someone I knew 30+ years ago. It was interesting to read a message that I have shared in different words,(not nearly as poetic! :))about the need for dormancy in our lives.
Excerpts from David’s email:
“Pushed by ceaseless demands from all directions, it's easy to deny the significance of the winters in our life, especially in a world that measures progress and worth by external success, growth, and productivity. Yet after every autumn, there's a winter. After every harvest, there is a need for rest. After opportunity comes dormancy. After expansion comes retraction.
For those of us who live in northern climates, winter can cast a multitude of responses. There are winters of sadness and loss, winters of contemplation, winters of personal and economic recession, winters of rest, winters of disappointment, winters of darkness, winters of boredom, and, of course, if you are a skier, there are winters of celebration.
Whether short or long, I'm learning to flow with winter instead of fight it. Before I understood the vital importance of winter in the cycles of life, when winter was here I would wish that it was summer. When things were difficult, I wished they were easy. Since then, I have learned that wishing for it to be different was actually creating the problem. Now, instead of wishing it were easier, if I just stay present to what is here, then I somehow find value in what the difficulties and dormancy are bringing me. In this way, the dormancy is transformed into a gift.” (© 2010 by David Irvine david@davidirvine.com)

His writing reminded me of one of my favorite books given to me by a nursing colleague, “Sabbath, Restoring the Sacred Rhythm of Rest”, written by Wayne Muller. Muller explores the tradition of ‘sabbath’ across world religions, and suggests that not only can we look at Sabbath as a day, but as a moment, as a breath in time, set apart to rest.
In Victoria we have had an unusual cold spell, and the snow has lasted at least four days! Yesterday the wind was howling, and the snow was flying. It was beautiful. It was especially beautiful as we have a lovely wood fireplace, and it does a great job of heating our home. It was so beautiful that we were unable to leave it at bedtime and decided to camp in front of the fire to sleep last night. The glow from the fire was beautiful. It was a great end to a day of retreat, dormancy, and reflection.
Happy Winter,
Kath

“Give so Victoria Hospice can keep giving” Hospice is in need of funds....

In my late twenties we moved to Victoria and I was hired to work with Victoria Hospice. It was at Victoria Hospice that I learned about disease management, symptom management, and the dying process. I learned about being with the dying, about listening and silence, about loss and grief. I learned that some of the suffering that I had witnessed in both friends and patients throughout their dying could have been prevented with adequate education, skills and resources.

I enjoy caring for the dying, I am passionate about this work. However, I much prefer to provide this care with the knowledge, skills and resources that I have learned from Victoria Hospice. Victoria Hospice has led this work nationally and internationally. Much of the work occuring across Canada can be traced back to work initiated by Victoria Hospice. As owner and director of Life and Death Matters and LDMonline, I am concerned as I hear of the financial struggles facing Victoria Hospice. To see announcement, check this site:
http://www.atv.ca/victoria/4994_74424.aspx

Victoria Hospice in their infancy and first decade/s developed a strong foundation of excellence in patient/family care. Over the past twenty years, their knowledge and expertise has been translated into the classic texts "Medical Care of the Dying" and "Transitions in Dying and Bereavement". The education department provides the "Medical Intensive" and the "Psychosocial Care" courses on a semiannual basis. The research department collaborates with researchers from across the country to ensure and/or discover "best practice". This is an incredible team of people and they do incredible work!

Sponsoring Victoria Hospice will help people in Victoria and will help those further afield to provide excellent care. If you have contemplated donating money, donating to the thrift store, purchasing a text, or attending one of their courses... now is a good time to take action.
victoriahospice.org

Kath

A few highlights from the CHPCA conference

A few highlights of the CHPCA conference in Ottawa.....

1. Rubbing shoulders with colleagues from across the country..

2. Co-presenting "Food the Four letter "F" Word in End of Life Care" with Dr. Josh Shadd! It was so much more fun to do this presentation after another editing and deleting of slides, and having Josh address all the pathophysiology slides! (See last months blog!)

3. Attending the challenge panel ""Wounded healers" - Exploring Self Care in HPC". Eunice Gorman, Fred Nelson, David Kuhl each addressed the three questions, Am I taking care of myself well enough to do this kind of work? Do I offer myself the same kind of compassion that I offer those in need? When do I slow down to just sit with the reality of my own vulnerability?

Eunice introduced me to a new term, "vicarious resilience". This term is used to describe the positive effect of witnessing how people cope constructively with adversity. This term describes for me the inspiration I feel when I witness people adapt to loss, overcome significant challenges, and move forward with their lives in a way that they initially thought impossible. Because of these people, I have more faith in myself, knowing that others have walked this road, and that perhaps I too can walk this road successfully. Each time Eunice has presented, or each time I have heard her present, she has identified the joys of the work we do, while still acknowledging the challenges. I appreciate this positive acknowledgement of all that we "get" from working in HPC.

Fred Nelson, who had just won the CHPCA Award of Excellence, spoke from a very personal perspective in addressing each question. Sitting in this big room of people, in what was not an intimate setting at all, we were richly blessed by his generousity of spirit in allowing us into his heart, his world. And, as he told of the challenges of work, the need for exercise, the need for quiet time, time to stop/pull over, and the need for awareness.... he also provided great humour and opportunity for us to laugh!

David Kuhl works with the Center for Professional Renewal, with Providence Health in Vancouver BC. a few of his choice quotes...

• "We work in public but we hurt in private."
• "The air must be clean between and among us".
• "Expert, the person who has experienced every problem possible and made every mistake possible". (I love that definition!)
  

4. "Developing quality palliative care in long term care homes" with Dr Mary Lou Kelley, Alesha Gaudet... In their studies they have identified that 80% of the care is provided by Health Care Workers. They tributed Health Care Workers, and the work that they do!!!! Music to my ears! I look forward to watching this participatory action research over the coming years.

5. "T3:Not for Me" - Bruce Kennedy, pharmacist gave a riveting presentation providing insights into why codeine and codeine with acetaminophen products are poor choices for pain control, despite being the most popular Canadian prescription analgesic. He also presented another session on tips for palliative medications. Once again, great to have a palliative pharmacist ready to share their knowledge in a way that is easily understood!

6. "Improving EoL Care in First Nations communities", with Holly Prince. Holly has repeatedly been involved in interesting work in the First Nation communities. "Living on the edge: working with dying cancer patients in northern remote communities". And finally, "The significant work life experiences of community based palliative care registered nurses". One comment that impressed me was that many nurses working outside of the hospital setting, no matter how remote the community, may feel isolated by virtue of working alone, with few resources available to them.

7. I brought home Room 217's new cd titled Country Roads... which I listened to as I drove up island the other day... GREAT CD if you want some nice gentle bedside music and like some of the old country songs. Bev and her team are gifted at putting together fabulous music. (See http://www.room217.ca )

Unfortunately I missed a few of the keynote speeches, and was not able to attend all sessions.
Next year the conference is Sept 8-11, 2011 in St John's, Newfoundland, and promises to be an incredible experience! Book your tickets, use your air miles, arrange your holiday and education leave.... See you there!

Kath

Teaching: the art of connecting. Lesson from the front line

Teaching is an art. Teaching is a pleasure.... when it goes well.

Last month I had the opportunity to do one of those "didn't go so well presentations". The topic was a favorite. The group was fabulous. What went wrong?

Parker Palmer writes in his book "The Courage to Teach" that good teachers having the capacity to help students weave connections (with content, with personal experiences, with other students, and with the teacher.)

I was reminded that before we can help people connect with the content, we need to connect with the content ourselves!

I had recently updated my presentation with an esteemed colleague in preparation for a team teaching opportunity. With his permission I included "his slides". I thought I knew his slides - we had talked through them and worked with them several times over the phone. But when it came to presenting the material and to answering questions, the words to explain the slides were not there and a few slides did not seem to make sense!

In this incident, I thought I was prepared.... after all, we had worked with the presentation several times. But in the end, I realized that I had not really connected with his slides, with the words to talk about the slides, and with the science behind the slides.

For dinner that night I ate a lovely piece of humble pie, and was grateful for kind participants and honest feedback - both of which helped me remember CONNECT CONNECT CONNECT.

When Pharmacists show up to play! Announcing the new Canadian Palliative Care Formulary

Hospice Palliative Care is all about team - and team is all about who shows up to play. Over the years I have noticed the difference when a strong, committed and talented pharmacist shows up to play.

Bruce Kennedy is a pharmacist in Fraser Health. His kids, he says, figure he is “just a pharmacist”. And yet in BC his dedication to HPC, desire to translate his knowledge of medication into language that can be understood by the rest of the team, and his desire to play on the “team” has contributed to the development of the Fraser Health Symptom Management Guidelines http://www.fraserhealth.ca/professionals/hospice_palliative_care. These guidelines provide a strong foundation for the delivery of symptom management. I tribute Bruce and the FH team for these guidelines.

More recently Bruce’s commitment to education and resource development has resulted in the writing of a Canadian version of the Palliative Care Formulary, adapted from the parent edition produced in the UK by Twycross and Wilcock. This book links with the international www.palliativedrugs.com (a website dedicated to disseminate information and stimulate international dialogue about the use of medications in HPC). This book looks to be a fabulous resource and can be ordered in Canada from the CHPCA website http://www.chpca.net/home.html .

A great pharmacist may be a nurses best friend and a most effective advocate for patient comfort. In Dawson Creek in north eastern BC, Nicole Dahlen is one of those pharmacists! Nikki's support is felt locally and her leadership influences care regionally across the north as she helps to integrate and teach the FH clinical guidelines in practice.

Way to go Bruce! Good work Nikki! And way to go pharmacists who show up to play!

Dr. Dana Cable - an inspiring mentor and professor, and a great leader in thanatology....

I love to tell stories of people.... how they have inspired me, guided me, shared great moments together.... And if I was to share these memories of Dana three months ago, it would have been as easy as that... but today, after his all too sudden death, it feels difficult to sum up my thoughts in a public forum, and to share something that would have meaning to anyone other than myself and my "Hood College colleagues".

Parker Palmer in his fabulous book "The Courage to Teach" states "Good teachers possess a capacity for connectedness. They are able to weave a complex web of connections among themselves, their subjects, and their students so that students can learn to weave a world for themselves. The methods used by these weavers vary widely: lectures, Socratic dialogues, .... The connections made by good teachers are held not in their methods but in their hearts..."

In 2004 I traveled to Hood College to check out their Masters in Thanatology program while attending a course at Johns Hopkins University just an hour south. It was obvious from my first meeting with Dana, that Dana was student centered. He was willing to support my unique needs as a student traveling from the other side of the continent.

After addressing the practical concerns of how I could combine on-site, distance, transfer, and independent study... one question remained....












"Why Hood College?"

Why was this program not offered at Johns Hopkins or some prestigious college or university?

I learned the answer in the months that followed -

Why Hood College?

The answer - Dana Cable.

In the summer of 2004 and some of 2005, I lived in Frederick, Maryland.















It was a rather fairy tale existence. I studied, ate soft pretzels, walked the streets and park of this historic town, and then more of the same. I always expected girls to come skipping down the steps of the beautiful old brick buildings wearing poodle skirts!

Classes were held in basement rooms that lacked style or charm. And sitting in the uncomfortable old desk/chairs, using outdated equipment, Dana would teach.... and teach he did.

Dana presented theory and told stories. The hours cruised by. He was inspiring, and we were inspired.

He taught about Near Death Experiences . One day in class Dana asked, "If you could take one thing with you when you die, what would it be?"

After some discussion a student asked Dana what he would take. He replied, "A fork."

In answer to the question he told us a story from his childhood.... after dinner, his mom would clear the table and say, "Save your fork, the best is yet to come."

With love and gratitude for a beloved man,

Kath


Dana's formal obituary can be found at:
http://www.staufferfuneralhome.com/obits/obituary.php?id=36543

Online support group for Canadians affected by cancer

I am on a roll today highlighting Canadian resources.

As part of a nation-wide effort to provide high-quality psychosocial care to all Canadians affected by cancer, several of Canada's leading authorities for psychosocial oncology have partnered to provide counsellor-led online support groups.

These online support groups are available to Canadians who have been diagnosed with cancer and their families/loved ones and are free of charge no matter where they live.

Weekly sessions are 1.5 hours long and take place in "real time". The groups operate continuously throughout the year for 8 - 10 weeks at a time.

Please contact Cancer Chat Canada toll-free at 1-800-663-3333 extension 4955 or 4966, or email cansco@bccancer.bc.ca.

Before teaching in the Dr John Morgan online program in death, dying, palliative care education (which became www.LDMonline.ca) I questioned if death dying and palliative care education could be taught online in a satisfactory way. If you had asked me at that time if an online support group could be effective I would have questioned that as well!

After five years of teaching online, developing strategies designed to meet the needs of individual learners, utilizing various new technologies, and enjoying phenomenal discussions during teleconferences and within forum postings, I am convinced that online communities can support, educate and energize one another. And so I am very interested in hearing of these support groups and expect that they will be very successful!

In the online education program (Death Dying and Palliative Care Education Online www.LDMonline.ca) we see individuals who may not be comfortable sharing in a face to face group, share more easily in an online discussion. Those who like time to consider before responding, often share later via postings. Participants with visual, auditory and mobility challenges appreciate the opportunities in online participation and posting.

This project is limited to individuals who are affected by cancer.

Recently Deb Ribeyre, on Vancouver Island led both a phone and an online support group for caregivers of people with dementia. (Deb is going to teach the online course "Loss Grief and Dying with Dementia" with LDMonline.ca in the fall)

We repeatedly hear how our lives are changing because of the new technologies. Here is another great example of this!

If you have feedback on these groups, please share via comments.

Kath

From Loss to Life - New Canadian bereavement resource

Cynthia Mitchell has launched her new website "From Loss to Life". (http://fromlosstolife.com/index.html)

It appears that she will provide: counselling for individuals and groups who have experienced a variety of losses, workshops on death education, and funeral/memorial services.

The site offers: a blog, practical suggestions for people who are grieving, and a place for upcoming events.

It is great to see the development of Canadian resources.

All the best to Cynthia!

Kath

Award goes to Canadian Virtual Hospice

I am a fan of Canadian Virtual Hospice! They provide excellent online resources and respond individually to questions from patients, caregivers, and professionals.
Last month the website was "recognized as “exceptional” by an international panel of judges at an awards ceremony in Boston, Massachusetts. The site, received a silver award in the website category from the Health & Science Communications Association (HeSCA)...
“This is the Olympics of health care communication so obviously we are very pleased,” said Shelly Cory, Executive Director of Canadian Virtual Hospice, which is based in Winnipeg, Manitoba.
Dr. Harvey Max Chochinov, Chair of Virtual Hospice said, “most gratifying is the feedback we receive every day from Canadians saying that we’ve made a real difference in their lives - that we’ve made a difficult time a little easier.” (Canadian Virtual Hospice, News Release June 14,2010, Retrieved July 27, 2010 from http://www.virtualhospice.ca/Assets/HESCA%20award_20100614133538.pdf )

Congrats to the CVH team - they are a great group of individuals, with insight, heart, and compassion. Great to have a Canadian resource do so well on the international stage!

Kath

Loss Grief and Growth is on Curriculum Services Canada's website

It is very exciting to announce that the Loss Grief and Growth Resource is available free of charge for download from http://www.curriculum.org/ . Simply go to the site, choose English or French, then choose Classroom Resources, then Supplementary Resources, and then scroll down until you come to Loss Grief and Growth. Click on the link, and you will come to a description of the resource, and click to download.

Mary Kay MacKenzie and I presented the LGG Resource at the Canadian Association of School Administrators last week in Quebec City. It was gratifying to see the response, to hear the interest in the resource, and to know that it fits in the school budgets (it is free!). Way to go to the Teachers of Ontario who wrote the original curriculum, and to the Funeral Associations of Ontario and Canada, and the Ontario Board of Funeral Services who provided leadership/support to bring this to fruition!

Let us know what your thoughts are as you look at it, plan to use it, and then as you integrate it either proactively or as you respond to the needs of kids when a loss occurs.

Happy Summer,

Kath

Loss Grief and Growth Education project is launched!

Can you imagine -

Attending the Funeral Services Association of Canada annual conference in Mt Tremblant in Quebec was a fabulous and fun event. I somehow did not imagine that a room full of funeral professionals would be so full of laughter, kindness and caring.

Perhaps I thought that hospice palliative care events held the ownership on such fun.

I was in attendance to launch the Loss Grief and Growth (LGG) resource. This project was spearhead by a visionary man, Yves Berthieume (handsome man in the photo) knew firsthand the value of teacher student relationships. Yves was a child when his father died, and was blessed by teachers who cared, advocated, and encouraged him. Years later as a Funeral Director, he provided tours of the funeral home for the schools. The tours became a favorite among both students and teachers. When teachers repeatedly asked him, "How do I support grieving students?" he wanted to address their needs and Loss Grief and Growth education project was born.

Initially developed as curriculum, Curriculum Services Canada advised that it be written as a supplementary resource for teachers to integrate as appropriate. The resource provides ideas for proactive lessons to help students understand loss and grief, death, as well as ideas to respond when a death has occurred in the school community.

The funeral associations, both national and Ontario based, who have supported this project over the past decade, have a deep commitment to children.

I applaud them for their commitment, and hope that as the project lead we can get this document in the hands of teachers across the country.

I heard it said that "death neither obeys the school timetable nor appears on it... it enters the classroom without knocking."

Loss Grief and Growth can help teachers prepare and support students.

Kath

PS The document will be posted, with the Curriculum Services Canada Seal of Quality on their website in the coming week. It can be downloaded free of charge.

Dignity Therapy - Ontario HPC Conference

One of the highlights of attending the Ontario HPC conference in Toronto was hearing Dr. Harvey Chochinov speak.

According to his bio listed on the Canadian Virtual Hospice website Dr. Chochinov "is known around the world for his research into the emotional and psychological needs of dying patients. His work exploring dignity in palliative care has been published in journals such as The Lancet, the Journal of the American Medical Association and the British Medical Journal....."

"Dr. Chochinov established the Manitoba Palliative Care Research Unit at CancerCare Manitoba and holds the only Canada Research Chair in Palliative Care. He is a recipient of the Queen’s Golden Jubilee Medal and the Order of Manitoba for his work in palliative care. He is also a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences."

He is also the Chair of Canadian Virtual Hospice (see previous blog). But for me, it was his gentle presence and his statement "I am not an expert but a messenger" that drew me to him. (Did you know that Dame C. Saunders defined an expert as "One who knows the answers before the question is asked"?)

Dr. Chochinov spoke on Dignity Therapy, and in addressing our role as caregivers he said that our role is to "make sure that the individual does not lose their sense of self". He talked of how this is sometimes done intuitively, but also referred to a model.... "His A, B, C and D guide to patient care – A for attitude, B for behaviour, C for compassion and D for dialogue – reminds doctors and other health professionals to make time for kindness and humanity in health care. Dr. Chochinov’s research shows that something as simple as a kind word or sympathetic touch influences how patients experience illness."

June 14-16 a course on Dignity Therapy is being offered in Winnipeg. As of this date, there are still a few places open to the public. This course will draw on people from across the globe, and provide an incredible opportunity to be a part of a rich learning experience. For more information about the workshop, please contact: CancerCare Manitoba Research Unit at
mpcru@cancercare.mb.ca

For those of us who can not make it to the course, they are developing a website which should be up and running soon. Because Dr. Chochinov is chair of Canadian Virtual Hospice, and because Canadian Virtual Hospice is one of the finest online learning resources I know,... I am sure that this site will be full of resources and practical ideas.

Kath

Publish Post

Information retrieved on April 29, 2010 from the Canadian Virtual Hospice website:
http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home+Navigation/About+Us/Meet+the+Team/CVH+Team+Members+/Executive+Team/Dr_+Harvey+Max+Chochinov_+OM_+MD_+PhD_+FRCPC_+FRSC.aspx?group=Meet+the+Team

New book: Transforming Palliative Care in Nursing Homes The Social Work Role

Edited by Mercedes Bern-Klug

Many of you have heard me talk about one of my favorite articles, which I consider a seminal paper, “The Ambiguous Dying Syndrome” written by Mercedes Bern-Klug. In this paper she explores the challenges experienced by those who are certainly dying, but their time of death is unknown, and as such, they miss out on the ‘death benefits’, those things that we “get” when we are dying, i.e. the opportunities for closure, financial benefits, home support help etc etc etc! She links in with Joanne Lynn’s materials on dying with chronic illness, and how many people will not know a week before they die that they are in fact going to be dead in a matter of days. (Health and Social Work: Feb 2004; 29, 1, page 55)

In a new book Mercedes brought together experts on nursing, law, medicine, sociology, and social

work to provide a thorough understanding of palliative care in the long term care setting. Their broad definition of palliative care suggests that comfort care is appropriate across the illness experience, not just in the last days. A majority of residents in long term care are older adults facing multiple, advanced chronic conditions. This book is grounded in the provision of palliative care in nursing homes, but can be applied to

other long-term care settings, such as assisted living. The contributors combine scholarship with practical wisdom in each chapter, mixing reviews of scholarly literature with insights gleaned from clinical practice.

I highly recommend you ordering this book if you work in the long term care setting, and if you believe that palliative care should not be limited to those dying of cancer in a shorter more predictable time line.

Kath

Mercedes Bern-Klug is an assistant professor in the School of Social Work at the University of Iowa

Title: Transforming Palliative Care in Nursing Homes The Social Work Role

ISBN • 978-0-231-13225-1

Opportunities for community work in Nicaragua

In March we went to Nicaragua for two weeks. The first week we stayed at "Monty's surf camp" on the west coast in Jiquilillo a small fishing town. We soaked in the sun, met the local people and marveled at the community work that Monty is involved in.

The camp is owned by Monty (Donald Montgomery)a Canadian teacher, is managed by a warm and delightful Gerry, and the cooking/cleaning is done by a warm and welcoming team of people.

I was totally thrilled to see the projects that they are doing in the community. They built and opened a health clinic, provide regular lunches for one of the local schools, installed water filters for families in the area. Currently they are building a community center which will house the Women's Collective and provide space for the women to sew and bake.

If you are interested in community service Monty is very approachable and can link your skills with the local needs. They have had students, interns, physicians, nurses, builders, architects, etc... come to work there.
(Disclaimer and pride filled announcement - Monty is my dear cousin!)

(http://www.montysbeachlodge.com/default.htm)

The Final Disposition De-Mystifying Death, Funerals, Cemeteries & Ceremonies

I received notice of this interesting one day forum titled:

The Final Disposition De-Mystifying Death, Funerals, Cemeteries & Ceremonies.
Mountain View Cemetery is a wonderful location with a beautiful celebration hall where this forum will be held. I have attended a seminar there before, sponsored by Lees and Associates on Cemeteries, and was so impressed with the content and the location.

This particular session will provide a screening of the film "A Family Undertaking: Home Funerals in America." When I was a student I studied with a woman who was involved in the making of this film. It is a very interesting film.

The speakers who I know are all quality presenters.... (Romayne Gallagher, from "our" HPC community is an engaging and fabulous speaker. Stephen Olson is one of the real gems in the Cemetery field!)

But mostly, I am impressed at the topics that are being addressed. The topics reflect current issues, and will stimulate fascinating discussion. These topics have been brought forward by professionals working with funerals and cemeteries themselves! Way to go!

If you attend, please be sure to let me know how you find it. I will be returning from a conference in Ontario and on route to the birth of a grandbaby... so doubt I will make it in person ! :)

Saturday, April 24, 2010
10:30 am - 4:30 pm
Mountain View Cemetery in Vancouver.

11:00 am – Noon Film Screening
“A Family Undertaking: Home Funerals in America”
A one hour, provocative documentary exploring the psychological,
cultural, legal and financial issues surrounding the home funeral movement

12:30 – 1:15 pm Romayne Gallagher
Romayne Gallagher is Providence Health Care’s Division Head of Palliative
Care, and the Physician Program Director for the Palliative Care Program at
Providence.
What is hospice palliative care, what services are available to those living with
a life-limiting illness in Vancouver, dying at home and useful information resources
for patients and families.

1:15 – 2:00 pm Barry Jeske
Barry Jeske is an independent funeral director and co-owner of Wiebe & Jeske
Burial & Cremation Care Providers in Abbotsford.
The Funeral Home, the Funeral Director. What do they do? Does a bereaved
family really need one? Can someone “do it themselves” in British Columbia?

2:00 – 2:45 pm Glen Hodges
Glen Hodges is the Manager of Mountain View Cemetery.
The cemetery is much more than just a place to bury our dead. Learn about the
many roles of the cemetery and how they can help future generations. Even if
your loved ones are not buried here, find out how the cemetery can become an
important place for you, your family and friends.
2:45 – 3:00 pm Break

3:00 – 3:45 pm Stephen Olson
Stephen Olson is the Executive Director of Royal Oak Burial Park in Victoria
Green burial, is it a fad or a trend? From concept to reality, the story behind
Canada’s first urban natural burial site in Victoria’s Royal Oak Burial Park. For
the ecologically minded green burial is regarded as the final act of selflessness
for the benefit of environment.

3:45 – 4:30 pm Paula Jardine and Marina Szijarto
Paula Jardine is the Artist in Residence at Mountain View Cemetery
Marina Szijarto is a contemporary rites of passage celebrant, artist & designer
As long time celebration artists and the creators of MVC’s Night For All
Souls, Paula and Marina have a deep understanding and appreciation for the
power of community experience and expression. They were led to their work
in honouring the dead through personal experience, and a need to understand
- and reclaim - the role of the artist in the sacred life of the community.
They will give an overview of what they have learned about various cultural
practices, and each will talk about ceremonies they have led.

Refreshments: Tea and cookies will be available but please bring your
own snacks/lunch as there are no restaurants on site.
Mountain View Cemetery
Celebration Hall & Courtyard
5445 Fraser St

Registration: The event is free, but registration is mandatory as seating
is limited. Please phone or email the office to confirm your space.
604.325.2646 mountainview.cemetery@vancouver.ca

BCHPCA conference, May 2010, Vancouver/Surrey BC

Hi all, I am excited to announce the upcoming BCHPCA conference in Vancouver BC.

Several years ago I attended the International Congress on the Care of the Terminally Ill in Montreal. I was greatly influenced as I heard internationally renown speakers address the issues that face people dying with non-cancer diagnosis, the challenges that these people experience when they need HPC services but do not qualify, and the challenges we will face in the coming years as the majority of us die following progressive chronic illnesses. (This conference influenced me my development of my presentation titled "Unprecedented! We have never died like this" addressing dying with chronic illness, the changing demographics, and the coming of the Baby Boomers!)

Della Roberts, nurse consultant extraordinaire, and chair of the BCHPCA conference planning committee was also in attendance. When we met in the planning sessions for this conference, we discussed the Montreal conference, the great speakers that we heard there, and some of the speakers who presented at the National Hospice Palliative Care Organization conference in Denver Colorado in Sept 2010. I am thrilled to announce that some of these great presenters will be providing keynote addresses at the BC conference!

This will be an excellent conference for those individuals who may not necessarily be working IN hospice palliative care, but who ARE caring for the dying across the continuum of care, in diverse settings.

I hope to see some of the LDMonline students and some of the college students who are using "Essentials in Hospice Palliative Care" resources at the conference!

BCHPCA Annual Conference

Raising the Torch – Expanding the Vision
May 14-15, 2010
Sheraton Guildford, Surrey, B.C.

Professional and Volunteer Care Providers Working in Hospitals, Hospices
Residential Care, Community Care, Chronic Disease Services, Critical Care,
This Conferences is for you!

We invite all physicians, nurses, and allied health professionals to join with Hospice Palliative Care providers,
administrators, lay leaders, and Hospice volunteers for two days of educational sessions and networking opportunities.

Did you know?

· 2/3 will die with 2 or more chronic diseases after months or years in a state of vulnerable frailty - only 1/5 of us will die with a recognizable terminal phase

· Those sick enough to die, but not sure to die within months, will not be referred to palliative care programs but would benefit from a palliative approach to care

· 260,000 die each year in Canada – projected to increase to 430,000 in just 20 years

· For each death that occurs 5 others are affected – 1.5 Million this year in Canada

Key Speakers:

Dr. Graeme Rocker, Respirologist, “Palliative Care: Expanding the Vision”

Bev Foster, performer & music educator “ENDNOTES: How music can be used as a means of care for both care receivers and caregivers”

Dr. Sara N. Davison, Nephrologist, “A Palliative Approach in End Stage Renal Disease: Shifting the Focus from Aggressive Life Prolongation”

Barbara Morningstar, Hospice Program Director, “What I know now that I didn’t know then”

Camara van Breemen, Clinical Nurse Specialist, Play Therapist & Nurse Practitioner “Care of children & families”

Antony Holland, One of Canada's most acclaimed actors, performing “Tuesday's with Morrie”

For More Information: Call 604-267-7024

To Become a Sponsor: To become a sponsor contact, Dan Levitt, Director, Fundraising and Development, Tel: 604-341-0445

Update from the Quality End of Life Care Coalition of Canada

This morning I received a Press Release from the QELCCC (Quality End of Life Care Coalition of Canada). I am just going to include the statistics on deaths in Canada and projections of death in the coming decades, their priorities, and the link for you to check for further information:

"More than 259,000 Canadians die each year.[1] Of those, only a small proportion receive hospice palliative care. By 2026, with the aging population, the number of Canadians dying each year will increase by 40% to 330,000. By 2036, Canada will see more than 425,000 deaths a year.[2]"

The QELCCC has identified their priorities:

"To continue to improve care at the end of life for all Canadians, the progress report outlines four priorities of the QELCCC over the next 10 years.

• Ensure all Canadians have access to high quality hospice palliative end-of-life care.
• Provide more support for family caregivers.
• Improve the quality and consistency of hospice palliative end-of-life care in Canada. Canadians should expect to receive high quality care in all parts of the country.
• Encourage Canadians to discuss and plan for end of life. Hospice palliative end-of-life care will not be a priority in our health care system until it is a priority for Canadians.
  

For more information on the QELCCC, or to download a copy of the 10 Years Later: A Progress Report on the Blueprint for Action, please visit: www.qelccc.ca.

[1] Population Projections for Canada, Provinces and Territories - 2000 - 2026, Statistics Canada, Catalogue #91-520, p. 110.

[2] Population Projections for Canada, Provinces and Territories - 2000 - 2026, Statistics Canada, Catalogue #91-520, p. 124.

Haiti - There are no words ....

Together with the rest of humanity, we share the sorrow of the people of Haiti and their loved ones wherever they are.

Over the past weeks I have reflected on this tragedy from the perspective of a thanatologist, a hospice nurse, a mom, and a neighbour. Each of these perspectives brings me new thoughts, new questions, and new wonder about how the community is coping, and what they have yet to face.
I am sure that through the rubble, stories of sorrow and stories of triumph will emerge. My concern is for those stories that are not told, not held, and not shared.

Stephen Lewis spoke at the ADEC (Association for Death Education and Counseling) conference a few years ago. He spoke beautifully, in his passionate way - what an orator! He thanked the "grief counselors" for the work that they do - not only locally but internationally. He concluded with a call to respond to individuals who face tragedy and such significant losses in the international community.

I was intrigued by his call to action. I often wonder what we can do to support those whose grief is far beyond any loss or grief that we can begin to comprehend. I was heartened to hear from his perspective, as one so immersed in the losses experienced in Africa, in particular, that despite cultural and language barriers, there is a need for our skills.

As nations reach out to help Haitians rebuild, individuals experienced with grief and death can help survivors face life.

Kath

Meeting with the Gerontology Nurses and Allied Caregivers....Victoria BC

Tonight I had a sweet experience. I met with a group of people specializing in gerontology. Most were nurses, some were Resident Care Assistants, and we were fortunate to have a Social Worker in our midst. In the group were a few leaders who have led the way and set a great example to follow. Their commitment to excellent care for our seniors is and always has been evident in their work. In the group there were many nurses and caregivers that I had not met before. The group oozed with enthusiasm for their work.

I reflected on the fact that almost 100% of people who go to live in a long term care facility will die in that facility unless they transfer to another facility. Very few return to independent living. In BC the length of stay has decreased due to shortage of beds and an attempt to keep people in the homes as long as possible. Residents are admitted with more complex issues. This work is "big", this work is "complex". This work is challenging.

I reflect on the concept of a "hospice palliative approach", and the need to address end of life issues from time of admission onward. Palliative Care Australia suggests that 65% of the dying do not need the services of a specialty hospice palliative care service, but can be cared for well with the skills of primary care team. I agree, that many of our dying can be cared for beautifully in the long term care facilities. But adequate funds are necessary to provide this care!

My heart goes out to this team of people who work hard and do so much with so few resources. I wish them the best, and salute them for the great work of care giving that they do!

Way to go!

Warm regards,

Kath

Announcing two NEW WORKBOOKS

In response to feedback from college instructors and hospice colleagues we fine tuned the "Essential in Hospice Palliative Care Workbook". We created one workbook specifically for students in the Practical Nurse program, and a second workbook specifically for Health Care Workers. Both workbooks are companions to the "Essentials" manual, link with the DVDs, PPTs and Podcasts and can serve as a self study guide or for integration into core curriculum. The answer keys for the workbooks will be available in February.

Thanks to all who provided feedback and who reviewed the materials. Thanks to Terry Downing and Kelly Townsend for their contributions!