As a palliative care physician working in the Cowichan Valley, I am involved with the care of many with terminal illness.
With the miracle of modern medicine, patients with terminal disease live longer lives but with increased suffering. Today, more people die from cancer, respiratory, liver and cardiac failure. They suffer from severe complex pain, disfigurement, severe air hunger, confusion, delirium and other difficult to treat symptoms. In response to this new face of living with terminal illness is the emergence of a new specialty — palliative care.
Palliative care physicians and nurses are specialists trained to treat these complex symptoms. Symptom control should start at the time the patient is diagnosed with a terminal illness. Palliative patients may start chemotherapy, radiation therapy, treatment of their heart, lung, liver or kidney failure; however, maximizing quality of life during that patient’s limited life is of utmost importance. Studies show that patients who have active palliative care with their active cancer care live longer and better than those who had cancer treatment alone. The same can be said for those awaiting transplants, on dialysis and other life-prolonging interventions.
Palliative care also recognizes the importance of psychological and spiritual aspects in a patient’s care. Imagine the young mother with three children dying of cancer, the man with painful, disfiguring cancer of the face, a woman with severe lung failure living at home alone, a father trying to support his family, awaiting a liver transplant.
It is inappropriate to care for these people in a bed in a nursing home or even a busy hospital ward, where staff are not trained to address their complex symptoms or their emotional/social/spiritual needs.
Hospices are specialized treatment centres for those with terminal illness and complicated symptoms and needs. Hospice house outreach programs can support patients at home and hospital. The goal is to keep patients as active, alert and independent as possible so that they can have a meaningful living and dying experience with friends and family (including pets). Isn’t this what we want for our loved ones? Isn’t this what we hope for ourselves?
The Cowichan Valley has only one purpose-made hospice room in Chemainus. Fortunately the community has developed a new partnership with Island Health to move forward to build and operate a hospice house — a palliative centre of excellence. A place we can all experience a good living and dying for our loved ones and ourselves.
Dr. Valorie Masuda