Last Updated: Friday - 09/24/2010
Week of October 28, 2002
Palliative care softens dying
The patients 'run the show' in this specialized city medical unit
By RENATO GANDIA
"Here, we give more personal care because we connect with the patients deeper than in an active treatment facility."
- Janet Kljajic
Professionals such as physicians, nurses, social workers and dietitians from around the globe come to study this facility - from Argentina, Bulgaria, Chile, England, Georgia, Italy, Japan, Mexico, South Africa, Switzerland.
Karen MacMillan, manager of the unit, said, "Our practice has become evidence-based. We have to research to back up what we are doing.
"We're looking at controlling symptoms so that the person living with a terminal illness can get the best quality of life. We consider what's important for them and what is meaningful for them."
The philosophy behind their care is "let the patient run the show" which means patients direct their care.
"Patients and family probably have taught me more about nursing than any textbook or any class I've been to," said MacMillan.
She began her palliative career as an oncology nurse at the Cross Cancer Institute.
MacMillan learned how important it is to find out who a person was before coming to the unit when she cared for a 20-year-old woman with a brain tumor.
Her physical condition caused by the treatment made it hard to connect with the young patient. She couldn't talk and could only point to things. She pointed to a picture of a young girl with beautiful long hair.
MacMillan couldn't understand at first until she realized the patient was showing her how she looked when she was well.
What's their life story?
What did they do before disease struck?
And what is the meaning of their life now that they are close to the end?
These are the kind of questions they try to find answers for when they receive a patient in the unit.
"History and story are very powerful components of care," MacMillan said. "We have to recognize that not only medication can make a difference.
"Sometimes just being with the person makes a lot of difference.
"I think you connect with their soul and with their spirit."
Although a world leader in palliative care, the unit wants to keep improving its care. MacMillan wants to enhance the way they assess any psychosocial distress of patients and discover how best to care for that.
Physical symptoms are easier to manage. It's the emotional and spiritual components that are more difficult, she said.
"Here, we give more personal care because we connect with the patients deeper than in an active treatment facility where you're always busy and in a rush," explained Janet Kljajic, a nurse at the unit.
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