You’ve lost someone you love

— 4 signs you may need to seek grief counselling

Talking helps you access your internal resources.

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Grief is a natural response to losing something you felt a bond with. This loss ranges from death to the end of a relationship. It could also be the loss of an election or of a body part through amputation. Grief is natural and normal. It serves as a psychological way of buffering you against the shock brought on by loss.

Experiencing the grief brought on by the death of someone you loved is an emotionally challenging journey. The intensity of your reaction will vary depending on factors like the nature of your loved one’s death, your relationship with them and their age. For instance, violent deaths or the loss of a child tend to evoke more profound pain than a death from natural causes or the passing on of an older person.

As a counselling psychologist who studies trauma and how communities process grief, I believe that understanding the symptoms of grief and recognising the signs that you aren’t coping with loss on your own are crucial for promoting healing and overall well-being.

Symptoms of grief

The common symptoms of grief can be categorised into four dimensions.

Physical symptoms: these affect the biological functions of the human body. They may include a change in eating habits, like overeating or a loss of appetite. You may also experience a general loss of energy and gastrointestinal issues, like constipation and stomach aches. Your immune system could also weaken, meaning you fall ill easier.

Intellectual symptoms: these affect the cognitive dimension. They include concentration deficits, such as repeatedly performing small tasks to accomplish simple assignments. Confusion may arise, leading to disorganisation and difficulty recalling certain things, like the names of children or specific rooms in the house. Making decisions and learning new things could also become challenging. This reaction is a result of the overwhelming pressure and disruption that grief exerts on the brain.

Social symptoms: these include how you relate to others after a loss. Some people may withdraw and retreat from the activities they enjoy. Others may display irritability or mood swings. They may also become more dependent, requiring the presence and support of others even for simple decisions.

Spiritual symptoms: these relate to religious or spiritual beliefs and values. Grief can lead to you questioning where your God was when your loved one died. You may doubt the power of your God or question the effectiveness of your prayers. These spiritual reactions are an attempt to understand grief by finding new meaning through looking to a higher power for answers.

All these symptoms are normal reactions to losing a loved one. They aren’t necessarily problematic. However, grief symptoms can be viewed as harmful if they present for longer than normal (usually more than 12 months) or if they affect your functionality to a point where you’re not able to perform your normal day-to-day activities smoothly.

Signs you aren’t coping

People who aren’t coping well with grief after losing a loved one exhibit several symptoms. These include:

Prolonged and intense grief: while grief is a natural process that takes time, an extended period of intense grief may suggest the need for additional support. If your grief persists beyond six months without significant improvement or relief, seeking professional assistance may be beneficial.

Impaired daily functioning: grief can disrupt daily life, but if it significantly affects your ability to function, it may be a sign that professional help is necessary. Finding it challenging to concentrate on tasks, make decisions or perform routine activities due to overwhelming sadness indicates you could benefit from grief counselling. You may also need the support of your peers or significant others.

Persistent emotional distress: feelings of emptiness, loneliness and a deep yearning for the deceased are normal aspects of the grieving process. However, if these emotions become overwhelming and persistently disrupt your daily life, it may be time to consider seeking professional help. Grief counsellors can help you navigate complex emotions and find healthy coping mechanisms. These mechanisms include sports, prayer, keeping a reflective journal or celebrating anniversaries linked to the deceased.

Self-destructive thoughts or behaviours: in some cases, grief can lead to thoughts of self-harm or a desire to join the deceased. These intense feelings of hopelessness and despair require immediate attention. If you experience persistent thoughts of suicide or engage in self-destructive behaviours, like using drugs in an effort to numb the pain, reach out to a grief counsellor or a mental health professional. This is crucial for your safety and well-being.

Way forward

Seeking professional help doesn’t indicate weakness or an inability to handle grief on your own. Instead, grief counselling provides a safe space to express your emotions, gain valuable insights and learn coping strategies that are tailored to your specific needs.

When in this safe space, talk about how you’re feeling. This helps you express emotions that you may have earlier blocked. It also helps you access your internal resources, such as resilience, spirituality and positive self-talk. Talking it out also helps get you to a place where you can accept a loss and move forward with your life.

Healing from grief takes time. Seeking help is a courageous step towards finding solace and restoring your well-being.

Complete Article HERE!

Why young people with life-limiting illnesses need special end-of-life care

Sydney’s Adolescent and Young Adult Hospice is the first of its kind in Australia, and opened its doors in February this year.

By Shalailah Medhora

Young people with serious illnesses will soon be able to have consistent end-of-life care under the new Paediatric Palliative Care Action Plan, launched by the federal government today.

It is the first road map for end-of-life care specifically targeted at infants, children, adolescents and young adults.

Currently, palliative care services are aimed at people in their 70s, 80s and older, which means that young people aren’t getting the services they need.

Assistant Health Minister Ged Kearney told Hack that the plan aims to bridge that gap.

“There always seems to have been a gap with the need for a specialist palliative care program for young people, because I think their needs are quite different.”

The plan was commissioned under the previous federal government and has been four years in the making.

“We brought together governments, key stakeholder organisations, health services, health workers, families … to build this action plan,” Ms Kearney said.

“It’s going to be out there as of today to make sure … we have national consistency, and that young people, children and infants get the best possible care they can.”

The need for youth-specific care

Earlier this year, the Adolescent and Young Adult Hospice (AYAH) opened its doors in the northern beaches of Sydney. It was the first of its kind in Australia, a facility aimed solely at providing care for young people aged 15 to 24.

“It’s a time when they’re going through emotional changes, social changes, physical changes, etc,” services manager Tayia Yeats said.

“They need to have that different area, which is purpose built for them, where they can interact with others that are going through similar challenges.”

The facility is funded through New South Wales Health, charity the North Foundation, and through donations from the community.

It has purpose-built spaces for activities young people enjoy, like a music room, games room and space to watch movies.

“It feels more like a hangout,” university student Patrick Nolan said.

Patrick is 21 and lives with muscular dystrophy. He has visited AYAH for respite care and says the most important aspect of the facility is the ability to interact with other young people.

“We’d stay up late, just messing around like any young person can do. And for me that that’s a bit of a challenge outside of this place,” Patrick explained.

Three young people who use wheelchairs pose for the camera, alongside three carers
Patrick Nolan (holding guitar) says respite care is like a “holiday from life”, and gives him the opportunity to behave like a carefree young person.

“What they want to be doing at 21 years of age is very different than what you want to be doing at 81 years of age,” nurse practitioner Sara Fleming said.

She’s been working in paediatric palliative care for over 20 years, and said the needs of a young person approaching the end of their lives can be very different to what health care professionals — and even the young person’s family — recommend.

Sara said she had a young patient once who had a life expectancy of just a few months.

“There was great distress in the family and distress experienced by the parents, because this young person, they wanted to go to a party.”

“So my job as a nurse looking after this was to go, ‘Alright, let’s get you to the party. But let’s put some things in place that are invisible to people at the party that just help everyone,'” Sara said.

Assistant Health Minister Ged Kearney said a key aspect of the paediatric palliative care plan is ensuring that the views of young people are respected.

“It’s so important to involve young people in the decision making around the end of their life. It’s their life.”

Complete Article HERE!

A longer life often means a worse death

— Most people are not experiencing a “good” death.

Pieter Claesz, Still Life with a Skull and a Writing Quill, 1628.

By Ross Pomeroy

  • A new study out of Sweden finds that people who live longer often spend more time undergoing end-of-life care, suggesting that their deaths are more drawn out than people who die younger.
  • Medical care at an advanced age often extends life without significantly improving one’s quality of life.
  • The study draws further attention to the gap between lifespan and healthspan. In many developed societies, people are living longer but also spending a higher proportion of their lives living in poor health.

Humans are living longer than ever before. Since 1950, global average life expectancy has risen from 47 to 73. This remarkable gain has been won through reducing poverty and eradicating disease, among other humanitarian advances. But in countries whose citizens are now living to advanced ages in the 80s and beyond, a complicated question must now be asked: Are we actually extending life or merely prolonging death?

Extending life or prolonging death?

A team of researchers from the Karolinska Institute in Sweden confronted this query head-on with a study recently published in the American Journal of Public Health. Demographer Marcus Ebeling and his colleagues utilized large public databases to track the course of all deaths of individuals aged 70 and over in Sweden between 2018 and 2020, focusing on patients’ final 12 months. Chiefly, they wanted to know how most elderly individuals die.

Are their deaths short and sudden or long and drawn out? Do they die at home, physically able and mentally sharp until the end? Or do they die in a facility, impaired and care-dependent in their final years, essentially wasting away? Tragically, it increasingly seems to be the latter.

“Two-thirds of all deaths followed a trajectory with extensive elder care utilization throughout the last year of life, and at least half additionally showed extensive medical care utilization,” they found. “Most deaths today do not comply with what is often referred to as a ‘good’ death.”

What constitutes a good death? “Retaining control, being pain-free, having the choice of the place of death, and not having life prolonged pointlessly are principles that have been mentioned, among others,” the researchers wrote.

Ebeling and his colleagues also found that prolonged end-of-life care was increasingly common over the age of 83, Sweden’s life expectancy, suggesting that individuals graced with a longer life are more likely to have a drawn out death, potentially filled with medical procedures and physiological burdens.

Lifespan vs. healthspan

The finding calls further attention to the frequently discussed gap between “lifespan” and “healthspan.” Lifespan is how long someone lives; healthspan is how long someone lives in good health, free from chronic disease and disability. Ideally, they should be nearly equal. In actuality, as human lifespan has rapidly grown over the past half-century, healthspan has not kept up. Analyses suggest a present gap of 10 to 15 years between them in the U.S. That’s more than a decade on average of people living in poor health, often at the twilight of their lives. In keeping with Ebeling’s study, this suggests that most people are in declining health prior to death.

And unfortunately, what a lot of end-of-life care tends to do is boost lifespan, with little benefit to healthspan. Drugs and procedures that treat underlying medical conditions in the elderly are often hamstrung in how much “health” they can truly restore. Ultimately, the best way to boost healthspan and hopefully remain independent until the very end is to prevent debilitating conditions from ever cropping up in the first place. That means eating right, refraining from smoking, drinking alcohol in moderation, maintaining social connections, challenging your mind, and above all, remaining physically active. And it means maintaining these habits even into old age.

The major takeaway is that to give yourself the best chance at a good death, do the things that will help you live a fit life.

Complete Article HERE!

How to know when you’re ready to date again after the death of a partner

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  • If you’re mourning the recent death of a spouse, the idea of dating again may seem impossible.
  • But moving forward is an important part of grieving, and dating doesn’t mean you’ve forgotten your late spouse, experts say.
  • Crying a lot and wanting to share stories of your spouse are signs you’re ready to date again.

When Mr. Big died in the first episode of “Sex and the City” spinoff “And Just Like That…” Carrie Bradshaw was unsure she’d ever date again.

But as her newly single era unfolds, Carrie finds herself dating, kissing, and sleeping with a string of eligible bachelors who are in their fifties. Throughout it all, Carrie is shown mourning Mr. Big, crying over a photograph of him, making the painful decision to sell the apartment they shared, and wearing Big’s suit jackets as part of her outfits.

Carrie first feels overwhelmed while mourning Big, but as time passes, she regains sight of the life she has ahead of her.

When someone transitions from feelings of intense pain to smaller moments of grief that are mixed in with new experiences, it suggests they’re healing from their loss, Marilyn A. Mendoza, a psychologist who specializes in bereavement wrote for Psychology Today.

“If and when you decide to start dating again, you need to understand that it is possible to be happy in a new relationship even though you are still having thoughts and feelings for your deceased spouse,” Mendoza wrote.

There’s no right or wrong time to start dating again after the death of a spouse, since everyone mourns such a massive loss on their own time, Mendoza said. But there are milestones you can look out for that signal you’re ready for a new romance.

“Try to find meaning in your life and [think about] how you can continue to find meaning while carrying on their legacy here,” Jonathan Singer, a grief specialist at Texas Tech University, told Insider.

You’ve cried a lot or spent days in bed

In order to mourn a life-changing loss like the death of a spouse, you have to allow yourself to feel emotions like sadness, despair, anger, and hopelessness, licensed social worker and therapist Shahem McLaurin previously told Insider.

It can feel overwhelming or impossible to recover in the moment, but crying your eyes out or spending a full day in bed enveloped in sadness are common ways to move through intense grief, even if it feels like the last thing you want to do in the moment. In fact, Sarah Chaves, who lost her father in 2007, wrote that screaming out her intense emotional pain helped her move forward.

As time passes, those feelings should be less acute, allowing you to enjoy parts of life outside of your marriage. But if they don’t dissipate within a year’s time, it could mean you have prolonged grief disorder and should speak with a mental health professional.

“You’ve got to go through rage, but don’t get stuck in it,” Edith Eger, a therapist and Holocaust survivor, previously told Insider.

You want to share stories about your spouse

If you’re dating after the death of your spouse, you’re bound to have sweet or silly memories pop into your head from time to time.

If you get the urge to share one of those stories out loud with a friend or even a date, you should, as it’s an empowering way to dually honor their memory and your strength, Megan Devine, a psychotherapist and grief advocate, previously told Insider.

You still feel grief, but it comes in waves

According to Eger, prioritizing your needs is another sign you’re mourning in a healthy way that’s conducive to dating.

Part of that is realizing you deserve to feel love and support from a romantic partner again, if that’s something you desire. And that desire doesn’t detract from the love you had, and still have, for your late spouse.

When you live by that idea, allowing yourself to have new experiences without your spouse, the grief will no longer feel all-consuming, according to Jacobsen.

Complete Article HERE!

4 tips for saying goodbye to someone you love

By ,

Isabel Stenzel Byrnes has spent her entire life practicing goodbyes.

Byrnes, a grief counselor and patient advocate, and her identical twin sister, Anabel Stenzel, were both born with cystic fibrosis, a progressive disease that damages the lungs, pancreas and other organs. It’s a condition that significantly reduced their life expectancy and meant many hospital visits.

But the illness also gave the sisters and best friends a unique perspective. “We both were afraid of death, but we also shared a joint passion for life, knowing that our time could be limited,” says Byrnes. “We knew from an early age that one of us would die first, and we actually practiced that.”

Readying themselves for that final goodbye was a big part of their shared existence – whether that meant making separate friends or entertaining different interests. And yet, when Anabel died in 2013 from cancer, Isabel’s grief loomed large.

Isabel Stenzel Byrnes (left) and her identical twin sister Anabel (Ana) Stenzel at a film screening of their film “The Power of Two” taken in 2011. Ana died of cancer in 2013 when Isa was a hospice grief counselor.

“The complete separation of someone as close as my twin was very difficult,” she says, “but I pursued things that made me feel closer to her, and I also strengthened my relationships with friends and family, and that really helped me dig myself out of the hole of grief.”

Now, through her work, Byrnes helps others with the hardships that can come with saying goodbye to loved ones for good.

She shared some advice with Life Kit on the art of thoughtfully saying goodbye – be it a, “See ya later,” a final farewell or one of the many shades of parting in between.

“Recognize the role” of the person you’re parting from

If you want a goodbye to be impactful, offer more than just a generic “Good luck on your future endeavors” or “Thanks for the memories!” Byrnes says no matter how weak or strong a relationship, any goodbye is more meaningful when you take the time to “articulate the value” of that person.

Were they your most trusted colleague? A reliable neighbor? The friend you could always count on for a laugh? Be open and specific about how someone has impacted you, and thank them for the role they played in your life.

Embrace your emotions, then let them go

When processing the grief of separation, Byrnes says it’s important not to judge your emotions. “Saying goodbye naturally evokes really intense emotions,” she says – and that’s OK. If you’re feeling big feelings, that might speak to “the enormity of the loss and the love that [you’ve] experienced.”

Allow those feelings to come — and also, to go. “Because none of us can cry 24/7,” she says.

“We cry, we let it out, and then somehow we end up maybe even talking and laughing. That’s all part of the process.” And then, over time, she says, work to let go of emotions that cost you energy or no longer serve you – things like guilt, anger or envy. Work to remember that person with more love than pain.

Practice goodbye rituals

Not everyone gets the luxury of saying goodbye face-to-face, or in real-time or at all. But Byrnes says saying goodbye is also an internal and symbolic process. Even if you can’t speak directly to the person you’re saying goodbye to, it’s still important to recognize and honor how that person made an impression on you.

Light a candle, write a letter, add an artifact to your ancestral altar or spend a solitary afternoon on the beach. Choose for yourself what ritual best serves you, and then make the time to commemorate that relationship.

Saying goodbye well takes practice

A well-crafted goodbye takes time and care – that’s not always easy. Byrnes says to keep trying anyway. “Authentic, intimate conversation can sometimes be very awkward if you haven’t done that before,” she says. “But really living in the awkwardness, feeling uncomfortable, but doing it anyway is what helps us grow as human beings.”

Though often uncomfortable or difficult, getting familiar with farewells can serve a powerful purpose.

“The other side of the coin of saying goodbye is learning how to love stronger and harder, knowing that a goodbye can come at some point in time.”

Complete Article HERE!

Meditating on my death made me feel thrilled to be alive

I hoped a death meditation workshop would ease my fear of dying. And then something else happened.

By Deborah Netburn

On a recent Saturday night, the scene was serene inside Tac-tile Mountain, a small, carefully curated shop in Pasadena. The meditation cushions were laid out on the concrete floor. A sea of white candles was flickering in the window. And then the restaurant next door started blasting “Umbrella” by Rihanna.

The six of us who had gathered inside laughed nervously. We were already excited and a little hesitant. After all, we were there to contemplate our own deaths.

Tac-tile Mountain was hosting “Death Reflections,” a two-hour, $55 workshop led by Marifel Catalig, a trained death doula and breathwork instructor. It had been advertised on Instagram as “a breath guided meditation intended to contemplate death in many forms.” The description ended there, so no one knew exactly what to expect.

Going into the workshop, I hoped that spending an hour meditating on my inevitable demise would ease my fear of dying. What I didn’t anticipate is that I would walk out feeling profoundly grateful for all the ordinary, messy, glittering life I’ve been blessed to live so far.

“What I have been seeing for 15 years now is that knowing one has to die allows one to value life, and feel more grateful for what life allows us to do and enjoy,” she said.

Catalig, 40, greeted us at the door wearing a white blouse and wide-legged jeans, and then asked us to find our seats. After lighting the candles that were placed at the head of each of our cushions, we began with a gentle movement to release the tension of the day, and then focused on our senses — paying close attention to what we could see, hear, taste, feel and smell.

Death meditations are wildly variable. In the Buddhist tradition the practice of maraṇasati, or mindfulness of death, is designed to remind practitioners that death might come as soon as the next morning, the next meal or even the next breath, and encourage them to act accordingly. Another Buddhist practice focuses on a detailed visualization of the body’s eventual decay to help relinquish attachment to the material world.

Catalig once attended a death meditation where participants were wrapped in a white sheet to mimic the shroud they might wear after they die. Another time she led a living funeral workshop where people were asked to write a eulogy for themselves that she read out loud to the group.

The meditation I attended was simpler. The focus was primarily on the type of life review many people undertake before they die.

Accompanied by a playlist of instrumental music that was more evocative than annoying, Catalig asked us to imagine our earliest memories and consider where we were, who was there, what we felt like, what it smelled like and what sounds we heard. We did the same for our early childhood, pre-adolescence, adolescence, early adulthood and on.

As she spoke, memories of the many lives I’ve lived flashed through my mind. Most of them were mundane, but they filled me with a sense of tenderness. There I was playing with a Fisher-Price barn on a green carpet, walking to school in new saddle shoes, riding bikes on the sidewalk with my sister. I saw sleepovers and middle school dances, late summer nights wandering around my hometown, blissfully bored and aimless.

Nobody has lived your life but you. All of your experiences, everything that got you here, that belongs to you.
— Marifel Catalig, breathwork instructor

I saw scenes from my adult life before kids, my life as a new parent, my life with small children and, finally, my life now — my husband, my teenage sons, my colleagues, my friends. All the different and distinct lives I’ve lived.

“Nobody has lived your life but you,” Catalig said. “All of your experiences, everything that got you here, that belongs to you.”

Then the music shifted and she asked us to imagine that we were nearing death. Our eyesight was fading, our hearing becoming more muffled. Food didn’t taste as good as it once did and we were eating less. In my mind I felt myself receding from the immediacy of life — a fog of gray between me and the world. As my experience of the world became more muted, I felt less afraid of leaving it.

Then Catalig had us imagine our last days. Who would visit us? What would they say? And then we pictured our last breath. “What do you want to breathe in?” she asked. “And what do you want to breathe out?”

We imagined hovering above our lifeless bodies, what they would look like, and who would tend to them. For a brief moment, we imagined what might be next.

In a society that rarely encourages reflections on death and dying, many of us respond to our innate fear of death with denial, Testoni said. Carving out time to visualize and imagine our own passing can help us face that fear in a productive way.

“Reflection makes us realize that we are afraid of something we do not know,” she said. “Knowing that we don’t know but we can know a lot is definitely reassuring.”

When the meditation was over, Catalig invited us to share about the experience.

One participant said the meditation helped her reframe the times in her life when she thought she was a bad person. Instead, she saw herself with more compassion. Another participant said she felt that her higher self had been with her all along, and was still with her. This brought her great comfort.

As for me, I walked out of the store in a state of elation. I was less afraid of dying, but mostly I felt so thrilled to be alive.

If you’re curious to try one of Catalig’s death meditations, you can find future offerings on her Instagram page, or contact her through her website breathtodeath.com.

Complete Article HERE!

Older people who are homeless need better access to hospice and palliative care

A core focus of palliative care is on easing symptoms and increasing quality of life for people who have a serious or chronic illness, and not solely for those who are dying.

By , , &

Most people may not wish to devote much time to thinking about their death. However, it’s an unfortunate fact that the entry point into experiences or conversations around death and end-of-life care can happen abruptly.

An unexpected death or a terminal diagnosis can leave people ill-equipped to navigate what often feels like uncharted territory of navigating end-of-life care, bereavement and grief.

The challenging realities surrounding end-of-life care are especially difficult for older people experiencing homelessness. For these older adults, intersectional and compounding experiences of oppression, such as poverty, racial disparities and ageism, create barriers to accessing hospice care.

Misconceptions about hospice care

The need for end-of-life and palliative services for unhoused people will likely continue to grow as the population experiencing homelessness grows and ages.

Currently only 16 to 30 per cent of Canadians have access to hospice and palliative care services, and 34 per cent of Canadians are not clear on who is eligible or who should utilize hospice services. In response, May 7-13 marks National Hospice Palliative Care week, which is aimed at increasing awareness about hospice care in Canada.

senior man sitting in chair and talking with a health-care provider wearing scrubs and a stethoscope
Hospice care is provided in a number of settings, including in patients’ homes.

The misconceptions about hospice care have had a direct impact on the engagement of services for the public, but also for Indigenous communities and for older adults experiencing homelessness.

Efforts to increase awareness about hospice often neglect the most vulnerable populations. Future efforts must merge education and awareness with intersectionality, which takes into consideration the intersections of inequities that impact unhoused older adults.

Hospice care focuses on addressing the full spectrum of a patient’s physical, emotional, social and spiritual experiences and needs. A common misconception is that hospice is exclusively a location or place where people go to die. Contrary to this notion, hospice is a service that is provided in various settings including within one’s home, long-term care facilities, hospice centres or within a hospital.

End-of-life care

While many Canadians prefer to die at home, older people experiencing homelessness do not have the same opportunities for end-of-life care options, and as a result many unhoused older people die in the hospital or institutional settings.

Family and friends often play an essential role in caring and advocating for a loved one during their end-of-life process. We can only hope to have loved ones by our side during these final stages; however, that is not the reality for many unhoused community members who do not have the option to die at home with loved ones.

Older people experiencing homelessness are especially vulnerable due to limited family or social support networks. Lack of social support can result in unhoused older people feeling isolated and fearful about dying alone or anonymously.

A core focus of palliative care is on easing symptoms and increasing quality of life for people who have a serious or chronic illness, and not solely for those who are dying. Palliative care can be a valuable form of health care for older people experiencing homelessness, as it can offer a tailored approach to managing multiple chronic or terminal illnesses, which are prevalent among unhoused older people.

Palliative care that takes place in a hospital setting can decrease end-of-life care costs by nearly 50 per cent by reducing intensive care unit admissions and unnecessary intervention procedures.

We believe it is valuable to consider that if end-of-life care costs were reduced by using palliative care practices, the cost savings could be used to fund services that directly support unhoused older adults, such as increased affordable housing options.

Aging in the right place

As members of the Aging in the Right Place project research team at Simon Fraser University, we are working to better understand what aging and dying in the right place means to unhoused older adults in two sites providing end-of-life care in Vancouver.

May’s Place Hospice, which is in the Downtown Eastside of Vancouver, provides end-of-life care for community members in that part of the city. May’s Place has created a communal, home-like environment with private rooms, meals provided three times a day, 24-hour nursing care, a smoking lounge and family gathering space.

A person in a hospital bed looking out a large window with a mug in their hands.
Palliative care that takes place in a hospital setting can decrease end-of-life care costs by nearly 50 per cent.

Another inpatient hospice setting in Vancouver is Cottage Hospice, located in a 1924 heritage building. Patients have a view of the North Shore mountains and are close to the water. Cottage Hospice and May’s place provide the same types of hospice palliative care support, and both care for older patients experiencing homelessness, but serve different populations based on their location and setting, demonstrating that hospice and palliative care is not a one-size-fits all approach.

The Aging in the Right Place project captures the perspectives and lived experiences of older people experiencing homelessness through integrating photovoice interview research methods as well as data collection methods that focused on the hospice setting, the neighbourhood, and experiences of staff who work to support unhoused older people. Photovoice is a method used in community-based research in which participants use photo taking and storytelling to document their own perspectives and experiences.

In the Vancouver area where we work — also known as the land that belongs to the Skwxwú7mesh (Squamish), xʷməθkwəy̓əm (Musqueam) and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) people — and throughout the province, colonization and colonial medical models have had lasting and detrimental impacts on Indigenous knowledge and traditional practices around death and dying for First Nation communities.

One example of these impacts is that current hospice models may not reflect culturally relevant care models. Hospice organizations throughout B.C. should prioritize increasing policy and practice for Indigenous groups to ensure safety and culturally relevant care are implemented. Ensuring accessibility to hospice and palliative care is one step towards dismantling these barriers for Indigenous populations.

B.C. can turn to the Palliative Education and Care for the Homeless (PEACH) service fostered by Inner City Health Associates (ICHA) in Toronto as an example. PEACH is taking a diverse and innovative approach to providing palliative care among the homeless and vulnerable populations, including Indigenous communities and older adults. Innovative and culturally sensitive services such as these, are a step in the right direction to providing better end-of-life care to older adults experiencing homelessness.

It is crucial that we make hospice and palliative care services available to all community members, especially with the aging population and an increase in chronic illnesses throughout Canada.

In addition to supporting community members, hospice and palliative care should focus efforts on tailoring approaches to provide culturally relevant care, increasing staff education about the lived experiences of older people experiencing homelessness, and creating safe and accessible services in B.C. for marginalized communities.

We must actively dismantle misconceptions about the role of hospice and palliative care through education and awareness to facilitate appropriate service delivery and use for diverse populations.

Complete Article HERE!