Palliative Care
“We do well to remember that death, dying, caregiving and loss are social problems with medical aspects to them and not medical problems with social aspects”
At Mosaic, we are focused on a person centered community integrated care approach, centered on The Meaning of Me®, and knowing the wishes of our clients and their families.
Palliative Care and end-of-life are two areas where closely working with the wider medical team and the family are of immense importance.
Homecare focuses on non-medical (PSW) and nursing supportive care, an area identified as being of immense importance in allowing the wider health care system to provide palliative and end-of-life supports to persons and families in the community. To do this the home care team needs palliative expertise in the provision of personal supports and nursing care. Mosaic has that expertise.
In this webpage we provide a brief explanation of palliative care and end-of-life care, the issues that people face and the need for person centered care, navigation, forward planning and often counselling. Where Mosaic lacks the expertise we provide navigation and direction through our many community partners and relationships.
What is Palliative Care?
Palliative care and end-of-life while often considered one and the same, and they do overlap, have important differences. Drawing from the European Association of Palliative Care’s own description of Palliative care:
- Palliative care is the total care of persons whose disease is not responsive to treatment. The approach to treatment will be to improve the quality of life for patients and their families, and will include pain management.
- Though not always the case, someone may be palliative but still able to do much for themselves. Care provision in this respect is collaborative and supportive where needed and preferably dictated by the person.
- The control of pain is the best-known element of palliative care, but it should also address social, psychological and spiritual needs.
- Person centered care focusing on the person is we believe the only way both palliative and end-of-life care can be delivered.
- Palliative care involves the person, the family, the community and the public health team.
- Knowing how to work with and accommodate the wider aspects of palliative care is important to the successful provision of palliative care.
- Palliative care affirms life and regards dying as a normal process.
Palliative care is much more than pain management
The earlier you can plan for addressing the social, emotional, spiritual and pain management needs of the person the better the end of life. Research shows that palliative care can help improve symptoms, reduce unplanned hospital admissions and enables forward planning about end-of-life care and other treatments, including exercising the choice to die at home. But we also know that for many, palliative care is provided later than needed and often not at all. The health care system is often lacking in resources and/or the necessary coordination and forward planning and preparation is critical to supporting end of life in this respect.
Our home care services can cover system navigation, provide guidance with respect to planning forward about your care and treatment needs, personal supports and nursing care within a framework sensitive to social, emotional and spiritual needs. Addressing palliative and end-of-life needs in advance is especially important for those with complex care needs.
Knowing the Person
Knowing the person (client) their personal preferences, their life history, their likes and dislikes, their cues, their preferred avenues of communication is critical to our ability for Mosaic Home Care Client Services, Client Services Liaison, Nurses, Personal Support Workers & Mosaic Lifestyle Companions® to deliver palliative and end-of-life care.
Knowing the client applies to the whole care team: the client services team that oversees the whole process and that remains accessible at all times to the family; the Personal Support Workers and nurses who deliver care, provide evolution to the care planning and who get to know the person and families at a much deeper level; our client liaison that visits the home and checks up on how services are being delivered and addresses the wider non clinical psychosocial aspects of care. This also involves the physical, psychosocial, spiritual, person, and the community whole.
Knowing the person is not the initial information we may acquire at outset, but is the evolution of the wider body of knowledge and awareness you develop through the delivery of holistic care.
Personal Support Worker & Registered Practical Nurse Support Focus
Caregivers and nurses working with palliative clients employ many strategies, for personal care and care of the person: Note: Care notes, as always, are entered for the family to review on our home care software.
- Support for mobility and personal care (grooming, showering and dressing).
- 'Pampering' care such as polishing nails, styling hair and putting on makeup
- Rubbing lotions to reduce dryness of skin and also comfort of touch
- Gentle massage
- Working cooperatively with care partners such as Home & Community Care Support Services and Temmy Letner Centre for Palliative Care through Sinai Health.
- Work with professional staff in retirement residence or Long-term care facility to provide a coordinated care environment when necessary. And providing additional resources to family caregivers and clients when needed.
- Refer family for Occupational Therapy or Speech Language Pathologists for assessment and recommendations.
- Incorporate our person centered care model The Meaning of Me®; meaningful conversations, facilitating connection to the community, interests and activities, looking at photographs, listening to music, playing games, discussing life history and memories.
- Take clients for walks, encourage exercises as prescribed, set goals, support person’s abilities to perform their daily activities
- Medication reminders (Personal Support Worker)
- Registered Practical nurse will have duties to perform as per care plan with regards to pain management.
- Actively listen and provide emotional support when client and family verbalized feelings about impending death
- Observe and report changes in health or Activities of Daily living (ADLs) for proper medical management and guidance.
Palliative Care Resources
The Canadian Virtual Hospice provides support and personalized information about palliative and end-of-life care to patients, family members, health care providers, researchers and educators.
Evergreen provides community based supportive services to individuals and their families in Markham, Stouffville and Thornhill, who are living with a life-threatening illness or living with the death of a loved one.
Evergreen is a non-profit, charitable organization which depends on donations and limited government funding in order to provide support at no charge to the client.
Evergreen is delighted to be partnering with MOSAIC to provide counselling and support services in the Thornhill community. Moving away from their site near Dufferin to MOSAIC, allows Evergreen bereavement clients, caregivers and people with a life-threatening illness, receive counselling and group support in a more central location.
All MOSAIC clients who are interested in these programs are welcome to register through Evergreen at the number below or by email at info@evgcares.org.
Evergreen looks forward to this expansion of their relationship with MOSAIC!