'The dying have value'

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Barb Sweet
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Formalized plan needed for palliative care, doctors say

Gander doctor Eileen St. Croix, who specializes in chemotherapy and palliative care, says she's on call 24 hours a day.

"I try to look after as many patients as I can in their homes," St. Croix told reporters gathered Wednesday at a Newfoundland and Labrador Medical Association (NLMA) session on palliative care.

The Newfoundland and Labrador Medical Association held its sixth public information session Wednesday morning to discuss the challenges of providing and accessing palliative care in the province. Speaking at the session were Gander family physician Dr. Ei

Gander doctor Eileen St. Croix, who specializes in chemotherapy and palliative care, says she's on call 24 hours a day.

"I try to look after as many patients as I can in their homes," St. Croix told reporters gathered Wednesday at a Newfoundland and Labrador Medical Association (NLMA) session on palliative care.

"But oftentimes that means travelling as much as 100 kilometres to see one patient. I feel it is a valuable use of my time, but it infringes on the other things I have to do. ... It means I am on call every day, 24 hours a day. I am in hospital every Saturday, every Sunday. ... I do it because I like what I do."

But dying at home with one's loved ones and family pets is not often the reality for many people.

"Unfortunately many Newfoundlanders end up coming to a health care facility which might be an hour or more from their home. They are admitted to a doctor they've never seen before," said St. Croix, who has practised for nearly four decades in rural Newfoundland.

"And they are at the end of their life and their family is trying to cope with it ... These people are not admitted to fancy palliative care units. They don't exist in our rural hospitals."

It was the NLMA's sixth session publicizing health care gaps as part of contentious negotiations with the provincial government.

Dr. Susan MacDonald, divisional chief of palliative care for Eastern Health, said the province lacks a plan to deal with the demands for palliative care services that will only increase as the population shifts further into a blip dominated by seniors.

"I would like the government to be looking at the population base and developing a plan how are we going to manage this increased number of people," MacDonald said.

"We are struggling as it is now. What are we going to do 20 years from now?"

MacDonald noted palliative care is not just about cancer, but is about improving the quality of life for people who are living with or dying from advanced life-threatening diseases.

"The dying have value and it's a gift to manage their symptoms and ease their suffering," she said.

The lack of doctors specialized in palliative care and support services is a national complaint, but it's acute in this province, MacDonald said.

"The bottom line is we are not putting out enough palliative care consultants to provide the expertise and support to family physicians," she said of the country as a whole.

"Let's face it, it's not a glamourous speciality."

The base for providing palliative care services remains with family physicians.

But many people here don't have a family doctor or the doctor is already too strapped for time to provide the service, MacDonald said. So the dying patients end up in an emergency room and get stuck in a bed in a hospital because they don't have care in their communities.

Even in St. John's, providing the service is tough, said Dr. Patrick O'Shea.

"You can easily become overwhelmed, especially when you have to make emergency house calls during clinic hours, leaving a waiting room full of patients who are then forced to wait even longer," he said.

"I am restricted to the number of palliative care patients I can look after. I can only take on two or three patients requiring palliative care at one time because I am still running a full-time family practice and I'm also looking after nursing home patients."

MacDonald said she is more positive about the situation than in the 13 years she's been practising in the province - Eastern Health has approved the community teams around the region. But she said there is much to be done across the province.

"There needs to be a formalized plan. We are in the process of piecemealing it," she said.

St. Croix said not only are more doctors required, but there needs to be a mechanism to free family physicians, nurses and home care workers around the province when palliative care demands are high.

And in St. John's, an on call system needs to be developed for palliative care calls, O'Shea said.

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Organizations: Newfoundland and Labrador Medical Association

Geographic location: Eastern Health, Newfoundland, St. John's

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Recent comments

  • David
    July 02, 2010 - 13:34

    The dying have value because until they're dead, they're the living. br br We're all dying.....it's just a matter of when.

  • David
    July 01, 2010 - 20:24

    The dying have value because until they're dead, they're the living. br br We're all dying.....it's just a matter of when.