George Northcott appreciates the type of care given to his wife Julie.

WCR PHOTO | CHRIS MILLER

George Northcott appreciates the type of care given to his wife Julie.

May 20, 2013
CHRIS MILLER
WESTERN CATHOLIC REPORTER

For everyone born into this world, death is inevitable. But one's outlook on death changes drastically when the date of death is penciled in on a calendar.

That sums up reality for palliative care patients and their loved ones. Yet, placed in a supportive situation, some patients live longer than anyone expected.

When Julie Northcott was diagnosed with terminal stomach cancer, her doctor's prognosis was that she would be dead in roughly six months. Her condition was inoperable, incurable.

That was almost two years ago, and she is still alive. Her husband, George, is grateful that the doctor's projections were wrong.

"We know there will be an end, as we all will have. It's just that when you're sick and your end has been told to you, it's that much more difficult for the patient," said George. "Therefore, as caregivers, our role is positive thinking through spiritualism and voice contact."

Julie started chemotherapy in Kamloops before being transferred to the Cross Cancer Institute in Edmonton. She eventually returned home to Whitecourt, but as time went by, her muscle tone worsened.

SYMPTOMS EXACERBATE

Then, on New Year's Day, she fell in her home. She wasn't injured, but her muscle tone had deteriorated to the point where she could no longer walk. Next, she was admitted to the Whitecourt Hospital. After vomiting blood, she was transferred to the Royal Alexandra Hospital in Edmonton. Her care involved five radiation treatments daily for the tumour in her stomach.

From there, she was transferred to the palliative care hospice unit at St. Joseph's Auxiliary Hospital, which was undergoing renovations at the time. She has been there ever since.

"The tough part is the knowing that I'll be losing my wife, and our two (adult) kids will be losing their mom," said George.

The Sisters of Providence opened St. Joseph's Auxiliary Hospital in 1927, along Whyte Avenue. In 1993, it moved to its present location, 10707-29 Ave. A palliative care hospice unit was opened two years later.

The palliative wing had three semi-private rooms, and eight private rooms with a shared bathroom, which was not ideal for palliative care.

In March, a newly renovated space was opened, providing every patient with a private room. The 14 private rooms have wheelchair accessible shower ensuites and full oxygen.

The redevelopment of the unit has enhanced the delivery of care by providing more privacy, as well as a more home-like atmosphere for patients and their loved ones.

EMOTIONAL ROLLERCOASTER

"When you're told you're dying or your time is due soon, it's an emotional rollercoaster ride. You might feel great for a day or two, then maybe not so great for a day or two," said George.

"When you feel good, you want to feel good all the time. When you have bad days, fear can set in. It's then we need to draw on our inner strengths."

Overall comfort for the dying is excellent. George described the nursing staff as wonderful, the cleanliness immaculate and the food great. His wife's TV set has 128 channels to view in comfort. He can take his wife outside with oxygen and in a wheelchair.

Dr. Deirde Ashton, left, and Marilyn Snow appreciate the need for quality time and space.

WCR PHOTO | CHRIS MILLER

Dr. Deirde Ashton, left, and Marilyn Snow appreciate the need for quality time and space.

"For any patient, their comfort is the key, whether it's my wife's or any patient in this hospital. I found that is the goal of the management and staff here at St. Joseph's," said George.

Donna Hildebrandt, care manager at the palliative care unit, said the aim of palliative care is to help patients find peace and well-being during their final days.

"We want to give the patients some comfort in their last days of life, support for their families, and allow them to die with dignity and compassion. It's much needed," said Hildebrandt.

At the end of life, the patients might be dealing with pain, anxiety, decreased appetite, delirium and other symptoms. With proper palliative care and treatment of such symptoms, the patients can die with less discomfort.

MULTITUDE OF ILLNESSES

"For the regional guidelines for palliative care, they try to determine the last two to three months of life. Years ago, we were predominantly cancer diagnoses," said Hildebrandt, noting that now they also have patients with chronic obstructive pulmonary disease, heart failure and end-stage liver disease.

They have a monthly calendar of light activities at the auxiliary hospital. The activities include crib, baking cakes, bingo, exercise and uplifting music.

The renovation project was funded by Alberta Health Services ($1.6 million) and the St. Joseph's Auxiliary Hospital Foundation ($1 million). The foundation is about halfway towards its fundraising goal for the project.

Dr. Deirdre Ashton, head of the St. Joseph's Auxiliary Hospital Foundation and a member of the community board, said the foundation supported the project because they realized how care would be enhanced if they improved the space.

"At end-of-life, when we are at our most vulnerable, the value of those simple things is immeasurable," said Ashton.

Life expectancy for patients admitted to palliative care is three months. Depending on the circumstances of their illness, some die within a few days.

Marilyn Snow, executive director of St. Joseph's Auxiliary Hospital, said palliative care allows for families to have quality time together, reminisce, laugh and cry when death is imminent for one member.

While some people might choose to die at home, not everyone has that support system. With an elderly couple, for example, pain management of a dying spouse might not be physically possible.

Palliative care aims at providing comfort and allowing life to reach its natural completion, Snow said. It offers emotional and spiritual support to the dying that respects their culture and belief systems.

Marcella Zaluski's husband Raymond is a patient in palliative care. Diagnosed with T-cell lymphoma, and now bedridden, he has been there since early February.

SURPRISING IMPROVEMENT

"When he left the Grey Nuns Hospital, they didn't think he'd last much longer. When he first came here to St. Joseph's, his health was really down. Of all the places he has been, he has improved the most here," said Zaluski, who visits Raymond every day.

"He just seems healthier now. I know my husband is going to pass with this because there's no cure for it, but at least he's comfortable here," she said.

She described the environment as bright, warm and relaxed enough that she would gladly live there herself. The staff is patient and empathetic in making life better for patients in the hospice, she said.

"It's not like a typical hospital with people coming and going and bells ringing, everyone running. When I'm sitting here with my husband reading the newspaper, I don't even hear the nurses walk in," said Zaluski.