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Markham Stouffville Hospital’s approach to palliative care supports people to live well, for whatever time remains

By Sheena Campbell
Photography by
Jim Craigmyle

Life is everywhere on the palliative care unit. In the quiet conversation between a mother and daughter. In the laughter echoing from the family lounge and the tears shed in grief for what is being lost. In the warmth of a beloved pet’s fur. And in all the little moments of dignity and compassion that help dying people fill their final days with love, care and comfort.

This is the palliative care unit at Markham Stouffville Hospital, a special 13-bed area in the hospital’s newly renovated facility. Some patients come here when the end of their life is near, to receive care aimed at making them comfortable and easing their passing. Others receive active treatment that helps manage their pain and symptoms and, in some cases, improves their health enough for them to return home. In every situation the goal is better quality of life for whatever time the person has remaining.

Social worker Tanya Dube says the team works collaboratively to tailor care to the needs of each patient and every family, to better support them through this extremely difficult time.

“Our approach goes beyond medication and clinical  goals encompassing the psychosocial aspects around what gives a life meaning and purpose,” Ms Dube says. “Every patient’s situation is unique. Some are able to talk openly about their prognosis and about what they want—perhaps, to be surrounded by family, to go home one more time or to attend a special event. We try to help people appreciate, in a gentle way, the window of time they have to have those interactions and we work closely with them to try to achieve them.

Along with the skilled and caring nursing staff, the interdisciplinary palliative care team at MSH includes palliative care and family physician Dr. Gina Yip and Dr. Andrew Patterson, chief of rehabilitation and palliative  care. A pain and symptom management specialist whom colleagues describe as a “gentle soul,” Dr. Patterson has been a driving force for continuously improving care at MSH for more than 15 years. Both doctors see patients in their family practices, a huge advantage for patients in terms of continuity of care.

The team conducts rounds on the unit regularly, consulting other hospital clinicians as needed to manage patients’ changing needs. Allied health professionals who work throughout the hospital, such as occupational therapists, physiotherapists, speech language pathologists, social workers, recreational therapists and dietitians, play a key role in providing the range of care required.

“It’s impossible to do this work without the support of the team as there are lots of aspects of patient health that need to be considered,” Dr. Yip says. “Many patients are ambulatory and benefit from occupational therapy and physiotherapy at some point in their illness. Social work is tremendous because there are a lot of complicated issues with palliative care. They facilitate family meetings and alternative supports and are very important in transitions to other care settings or to home.”

There is no doubt the palliative care team’s work is valued, particularly its role in creating special memories and legacies.

One nurse sings to her patients. Another team member helps patients write legacy letters or make video messages for their children. There was a young father who passed away several years ago during the holiday season and the staff took up a collection of gifts and toys for his young child. Staff have arranged birthday parties, anniversary celebrations and even a wedding in the hospital chapel. These are the moments of care that can’t be recorded in a health records chart.

“This is an exceptional team. Far and away they offer excellent care that stresses the importance of quality of life, which, when it matters most, is what you need,” says Dr. Mateya Trinkaus, one of MSH’s oncologists. “They are outstanding at supporting patients and families. A hand on the shoulder, a hug for a grieving spouse, reassuring a patient by holding their hand. Everything they do is a gentle reflection of `I get it. I care. You are not alone.’”

An aging population and the high population growth rates in the region are contributing to the growing need for end-of-life care. Over the last 15 years, the hospital has evolved its approach to palliative care to better serve the needs of the community through integrated care provided both in and outside of the traditional acute setting.  

“There is a big movement for people to be able to die at home and many more people looking for the support they need to do that,” Ms Dube says. “If that is the person’s wish, we will move heaven and earth to make it happen.”

Led by Dr. Patterson, the hospital has built a palliative care team that includes specialized nurses and five family physicians. Working with community partners such as the Central Community Care Access Centre, the team is currently supporting 90 patients considered palliative, to receive end-of-life care at home.
According to Dr. Yip, while palliative care is sometimes overshadowed by the more heroic stories of lives saved by the advances of medicine, the field has a vital place in people’s lives.

“End-of-life care is as important in its own way because it’s about extending both the quality and quantity and that brings great comfort to patients and families,” says Dr. Yip. “It’s a very rewarding field of medicine.”

Dr. Patterson agrees. “We are accomplishing very worthwhile, meaningful work here for patients, their families, the hospital and our community. Providing excellent end-of-life care the community needs. We see the benefits of it for our patients every day.”

Bonnie Jean-Baptiste  is the manager of the palliative unit. A social worker by training and former patient relations representative at the hospital, she has spoken to countless grateful families who have been helped by the palliative care team.

“So many people come up to our staff years later and express their heartfelt thanks, saying, `I remember you. Thank you for the care you gave my mother or father. It meant so much,’” Ms Jean-Baptiste says. “Many staff are brought to tears knowing that just by doing their job, they’ve had such a lasting and positive impact on people’s lives.”

Pictured: Members of Markham Stouffville Hospital’s palliative care team (from left) palliative care manager Bonnie Jean-Baptiste, Dr. Gina Yip, social worker Tanya Dube, patient support assistance Wendy Rowland, social worker Jennifer Porteous-Muller, registered nurse Amanda Gooden, registered nurse Chris Orsi and unit secretary Richelle Williams.

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