A History of Hospice Palliative Care in Quesnel
In 1985, a local Home Care nurse, Laurie Lawlor, learned about Hospice Palliative Care. Knowing this would be an invaluable resource to Quesnel residents, she approached the internist at GRB Hospital for assistance to initiate this service for the community.
Teamwork was essential as the core team included the Director of Nursing, an acute care nurse and the hospital pharmacist. Vital to this ‘total care’ model would be trained volunteers. These volunteers would be trained and supervised by a Volunteer Coordinator as they provided a ‘befriending’ service to those living with a life threatening illness.
Initially, there was no budget allotment for Palliative Care. The acute care nurse added these new duties “to the side of her desk”. Later, the acute care nurse was allotted one day a month to conduct the duties as the Hospice Palliative Care Resource Nurse.
It soon became apparent that an organization was needed to take on responsibility for the trained volunteers and provide them with insurance. BC Hospice Palliative Care Association had became an umbrella association in 1984 and had developed educational guidelines for training volunteers.
In the fall of 1985, the Quesnel & District Hospice Palliative Care Association had its inaugural meeting in the fall of 1985. Many of the public were our first members and many of the executive were members of the health care system.
Using Victoria Hospice’s constitution and bylaws as a model, we developed our own, and received our status as an official non-profit association in 1986. We could now officially take donations and begin fundraising.
So Much to Learn
Our first guest speaker, paid for by donations, was Nancy Reeves from Island Loss clinic. She helped educate the public and caregivers about healthy grieving and the effects of complicated grieving.
A psychologist/minster from one of our city churches conducted our first volunteer training program. Another minister became our first Volunteer Coordinator and a psychologist from the Mental Health program held our first grief support series.
The Anglican Church Diocese presented a televised series on Death and Dying that medical staff and caregivers eagerly watched and learned.
Team members took the week long Hospice Palliative Care education sessions on death and dying in Victoria.
We read the US and Canadian Hospice Palliative Care journals. Our local internist further developed his expertise by reading journals from the British Isles.
The acute care nurse took a 4th year university course offered by the University Of Victoria and attended a course in Victoria on pain management.
In short, everyone involved with, or interested in, the provision of palliative care services and support attended as many education sessions as possible.
Hospice as a Place
As crucial as education was, it was evident that a "Palliative Care Room" was needed at GRB Hospital.
The Hospital Auxiliary provided furnishings to make it feel as homey as possible and "out of hours" visiting privileges was negotiated for family members. When not used by a medical patient, this room was reserved for palliative patients.
The first end-of-life patient to use this room received specialized care provided by her doctors and medical staff. These caregivers received two valuable lessons from this patient.
1. A physician reluctantly asked her if she wanted her heart to be restarted if it stopped beating. This was answered by a firm, “Definitely not!”
2. She was receptive to talk about her pending death.
Perhaps the most unexpected lesson was that the only person who offered to pray from her was a member of the housekeeping staff. Further education for this fledgling palliative care team!
The Core Team consisted of the Internist, a home care nurse, the acute care liaison nurse, the Volunteer Coordinator, and the Spiritual Support Volunteer.
They met every Thursday at noon to address issues involving patients and families on the palliative care program, developing plans for the patient, family and the caregiver as appropriate.
From the outset, this team included a spiritual person. We were aware that as the physical body deteriorates, the spiritual needs become greater.
In 1993, the acute care nurse, the In-service Education Coordinator, and the Internist set up a Liaison Committee for Palliative Care. This committee consisted of a representative from Home and Community Care, the acute care liaison nurse, the hospital pharmacist, the hospital physiotherapist, the Association’s Volunteer Coordinator, and the Spiritual Support Volunteer.
They met the third Thursday of every month to address broader issues and concerns brought up by its members. Case reviews occurred every third month. Recommendations were identified and appropriate action(s) occurred.
Quesnel Leading the Field
The Liaison Committee for Palliative Care was instrumental in developing researched based policies, procedures, and protocols. These were revised as new information came forward.
We developed a pain and symptom manual for patients that was used in GRB Hospital, Baker Lodge, Dunrovin Lodge, and people in community. The Palliative Care team in Quesnel was using protocols and had an emergency kit at the ready before many other hospitals, including Vancouver General, had theirs.
It became very evident that when the family, the patient and the caregivers were ‘on the same page’, things went so much smoother.
Any team member could request a patient conferences. These were held at home or in hospital, and included family and patient, the patient’s Doctor and the core team. Issues brought up at these conferences were transferred to the care plans, and plans to address the issues were developed. On rare occasions, a second case conference was needed. .
Hospice, not Hospital
As we grew better at pain and symptom management, we realized that an acute care bed was not the place to have Palliative Care patients. There was the noise of the intercom and the call bell system, along with the busy activity that goes with an acute care ward.
An evaluation of the existing service was performed with patients, family members, staff, and the public included in the process.
The Palliative Care Board called a strategic planning meeting, inviting the public to participate in the discussion; consensus determined that a hospice house would be the answer.
It soon became apparent that this project would involve more than purchasing and renovating an existing house somewhere close to GR Baker Hospital.
Thus began 15 years of fundraising, sustained and supported by the entire community. Major donors included Diana McColl and estate, Quesnel Rotary Club, Tolko, Arion Gabriel, Canada Safeway, and Hydrecs.
The Quesnel Rotary Club initiated a five year campaign which raised $100,000 towards the building of Quesnel’s Hospice House. This campaign encouraged many other clubs, organizations, businesses and individuals to support QDPCA’s fundraising efforts. The community raised almost $1,000,000 towards the building and furnishing of the Hospice Unit.
In June of 2005, Northern Health offered to include three palliative care beds as part of the addition to Dunrovin Park Lodge. QDHPCA negotiated including a separate hospice Unit with an additional three respite beds with Northern Health agreeing to cover all operating costs for the Unit.
The Association pledged to commit $500,000 to the capital cost and to provide all furnishings, fittings, and fixtures, and, in August of 2009, the community joined the Association in celebrating the opening of Quesnel’s Hospice Palliative Care Unit at Dunrovin Park Lodge.
In 2009 an anonymous donor made it possible to add a deck to the back of the Hospice Palliative Care Unit for the use of the patients and families which was incorporated into the completion of the garden and fence.
From the Association’s perspective, there has been a clear delineation between the two components of quality palliative care in recent years
1. The medical piece is financed, managed, and controlled by the Health Authorities and the Province of BC
2. The support piece is championed and sustained by volunteer associations such as the QDHPCA.
It is important to remember that the genesis of Hospice Palliative Care in Quesnel was a meeting of the minds between these 2 groups. Both groups have always had the same goal in mind – the best end-of-life care for the dying, at home if possible; in Hospice if not.
The Canadian Hospice Palliative Care Association provides the standards and guidance for the present and future of the QDHPCA. The BC Hospice Palliative Care Society provides the guidelines for training volunteers.
We remain active with fund-raising activities to meet on-going needs for equipment and furnishings in the Hospice Unit, Quesnel Home and Community Care, and within the community.
- Hike for Hospice
- Hearts for Hospice Gala
- Celebrate a Life and Remembrance Tea
We are committed to providing as education and training for physicians, medical staff, and our Volunteers. Our focus is on public awareness and education, working toward a time when all members of the community know what palliative care is and why Hospice is an option.
The QDHPCA advocates for equitable access to palliative care for all, encouraging those in positions of influence to see the value of, and need for, both medical palliative care and the Associations who support that care.We are confident that Hospice Palliative Care will continue to be a part of our health care system in Quesnel.
If you are interested in joining us, click on the butterflies below