What hospice is — and is not

Dear editor,
This past Friday (Oct. 7), a guest editorial from the Victoria News regarding End of Life Care in British Columbia was reprinted in the Comox Valley Record.
As I began reading the piece, I was pleased that a thoughtful and realistic view of this looming issue was being addressed in a forthright manner.

Dear editor,This past Friday (Oct. 7), a guest editorial from the Victoria News regarding End of Life Care in British Columbia was reprinted in the Comox Valley Record.As I began reading the piece, I was pleased that a thoughtful and realistic view of this looming issue was being addressed in a forthright manner.Unfortunately, as I read on, I was horrified by the description of “hospices” which was, at best, grossly inaccurate and misleading.  In addition, it was disconcerting to see the implication that currently non-existent funding for hospices should be diverted to other programs such as iPANEL.First, “hospice” refers to a philosophy of care — regardless of where that care is delivered. Hospice care is compassionate, holistic end-of-life care which focuses on supporting the person who is dying and their loved ones to live each day to the fullest.At the core of this care is a respect for the person’s dignity and comfort — all based on their choices and beliefs. Hospice care can be provided in hospitals which sometimes have palliative care units, in residential hospices, in nursing homes or in the person’s home. Second, when the term “hospice” is used to describe the location of care, it refers to homelike places where the person is cared for in a private room by specially trained multi-disciplinary staff.Family members and loved ones are encouraged to be present and involved — rather than having to abide by the more rigid guidelines often found in acute care facilities. Hospice care focuses on the medical, emotional, spiritual and practical concerns of the dying person and their loved ones.Grief and bereavement support is offered to those who must go on living with their lives forever changed by the death of a loved one.  Support for caregivers, often overwhelmed by the demands of caregiving, is also available.Further, in most communities in the province, people have almost no choice about where they will receive care in their last days and weeks.For example, on Vancouver Island, the only “hospice” is in Victoria — and, that is only partially funded by the Vancouver Island Health Authority — the majority of the funding comes from the generosity of the community through donations. In the Comox Valley, we have no dedicated acute palliative hospital beds/services and no residential hospice beds/services. People who do not choose to die at home or simply cannot be supported at home by their loved ones all too often end up in a hospital ward, or even worse, on a gurney in the hall — if they are able to be admitted at all.Home caregivers are all too often emotionally, physically and financially devastated as they are frequently given no alternative but to try and take this on.This is in no way meant to say that everyone is not trying to do their best — rather that many of the necessary resources and services are simply not available here.It is absolutely correct that each of us has a right, regardless of where we live, to have access to compassionate, high-quality and appropriate end-of-life care.It is also correct that policymakers have failed to address funding of these programs and services at even the most minimal levels — especially outside of Victoria and the Lower Mainland. Although certainly inequitable, availability of hospice services in our community is almost solely dependent on the generosity of the community forcing our community hospice to go begging for program funding. I would suggest, that while programs such as iPANEL are very worthwhile, they are not meant to replace hospices or other end of life care support which is desperately in need of core funding support from the province. As so accurately put by Apple CEO, Steve Jobs, in his 2005 Stanford University commencement address, “Death is a destination we all share.” If our community is to meet the ever-increasing end-of-life care demands being placed on both formal and informal caregivers, residents of the Comox Valley must work together to ensure each of us who is dying or caring for a loved one who is dying, has access to a full continuum of well co-ordinated and integrated hospice palliative care services as envisioned in the 2006 Ministry of Health Provincial End of Life Framework — a plan which has seen only very minimal implementation more than five years later.  Terri OdenealEditor’s note: Terri Odeneal is the executive director of the Comox Valley Hospice Society.

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