The heat has been weighing heavily on us. That said, we've given ourselves permission not to accomplish much, other than ADLs. Groceries, laundry, dishes, household chores. At our age, we still feel the pressure of having to accomplish something in order to value ourselves.
I have an interview for a new volunteer position. I've been reviewing all the clients I've had over the years, and remembering the good work I have done. It has really helped my mindset.
I remember my first assignment. The client had 5 adult children, all with their own ideas of what should/could be done. I noticed that the client while not entirely awake all the time. The son who lived with her thought that if only I could get some scrambled eggs into her she would be fine. He had the night shift.
A daughter had made up a schedule for caregivers. I was there for a few hours in the afternoon. Said daughter was very busy, with a job that was way more than 9 - 5. A daughter-in-law was there for another shift. It was teamwork.
It was May, 2009. I put pansies in her planters. It's a nice sight on a front step. Mostly she slept.
I took a mandatory 6-week course Fundamentals in Palliative Care in 2008 with PSWs, nurses, and it was the full deal. Six weeks, three hours a week. Many are things volunteers need not know, and should not do. As I watched my client laying in her hospital bed in her living room, I could see she was agitated. I knew the non-verbal signs of pain and the PPS. My late father showed this as he was dying. No one would believe me when I said he was in pain. Vets are better at identifying pain, as their patients are always non-verbal.
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| Palliative Performance Scale |
I also learned about disease trajectory. It is well-documented for many diseases.
They had a wonderful communication book, in which I would write comments. Volunteers can't give meds. We don't do treatments. There is a very different Scope of Practice for volunteers, PSWs or nurses.
I got myself into good trouble! I talked to the DIL, and told her my suspicions, that there was unmitigated pain. Back in those days, doctors were afraid of medicating patients. There were these myths of pain management. How terrible it would be if someone dying became addicted to morphine??!! It took me 3 days to get the proper pain management for my late father. I know how tough is is. The myths abound. (See below.)
The daughter talked to the nurse, who wasn't her regular nurse, just an on-call. The nurse thought I was full of shit. She asked the client, and the client was unable to articulate her pain. Said nurse phoned my supervisor, Sandra Winspear (now retired), and I got into good trouble. I explained what I'd seen and heard: the plucking of the clothes, the irritation, discomfort on her face. She was put on pain meds. She had a good death. In peace.
I found myself an advocate for families navigating the journey.
Hospice Muskoka was working on creating a physical hospice. Finally, in 2020, they found the money to build and sustain such a building. With hospital crowding, they don't like to designate a room for this.
I volunteer virtually with Canadian Virtual Hospice. They write of the 10 Myths about Palliative Care.
10 Myths about Palliative Care_2024.pdf <= if you are interested.
