welcome to medical matters i am here again with doktor bottom and doktor burnham i understand we have a guest with his bed archibald welcome thank you you welcome in what are we gonna talk about that well i brought back along we won t go palliative care today so just remind listeners what palliative care is based is supportive of someone who's in the stages of life along with their families and loved ones through this process and we're fortune off in halbert and have triple hs palliative care team and beth is the patient navigator with this team whose a trained bachelor science of nursing said many roles in our community but probably none more important than the one she's in right now now that palliative care units fairly recent is it not well we ve been doing palliative care for a long time and we ve actually had a palliative care designated bad and with a new unit we are sure to bats now but a palliative care team is actually an outreach team so they reach right across the county to access people so the beds is actually very small component of what they do anyway beth welcome aboard thing here and there but it s also about dissipation navigator leaves do a lot of work with her the fierce speaking from the perspective of the physicians to help coordinate services and that so if we have a patient in need and we know that their sort of it in a terminal illness first person we cause bad about who will get her team involved so that we can talk about or were you take it i've called you with somebody who's gonna terminal illness ok so i will start with individuals who are eligible for the palliative care community team support and it is anybody who's living with a life limiting illness and so that is from diagnosis onward regardless of what treatment plan that they are pursuing and what their goals of care are there are eligible for our support in a life limiting diagnosis might be something like cancer but it also can be chronic obstructive pulmonary disease or el ass or leucoryx these or it could be congestive heart failure there is parkinson's disease is allowed him your name a man he added years allotted diseases that change how you live every day and potentially may change the length of your life well there is a period of time but say you have cancer in its first stage or whatever and you ve got maybe two weeks to go now with some of the other diseases they could be one two three four five months or years you know there are different ones like our home care services we have two way to a patient becomes has a certain level of disability from their cancer to qualify for extra services but a palliative care team all you really need is that terminal diagnosis and their how did it get involved at any point an indifferent for every family ran off absolutely i'm some people don't feel quite ready to speak with men and i'll be honest that the word palliative care in the title in it said government funded programmes so that's what we're called does create a bit of a barrier but it is absolutely from diagnosis onward for that we have a very broad view of what palliative is so when i get involved or our team because we are an inter professional team there is myself a registered nurse who's the patient navigator there is a social worker and there's also a hospice volunteer coordinator from these are the employees of tripoli to us but we really see ourselves as a part of a very broad teem with home and community care with community support services aaa chest and also the family physician said nurse practitioners in the rest of the family halting we work together and with the goal of our other palliative care community team is really providing individuals and their loved ones with the right information at the right time so they can make informed decisions and we are a lot of what we do is called advance care planning and it is coming up with i'm thinking about discussing and coming up with a plan of how you see the coming months weeks days going and how you what you're goals are what's important cue to achieve in some people what's important to them is be being as independent as possible for as long as possible other goals that might term get expressed to me i just wanna be comfortable and some people to talk about where they would like too to be some people would like to die in the hospital and and lots of people do choose to die at home so at what point in time what's a process whose starts this off and how does it how does it sort of progress in other words somebody is admitted into the hospital or palliative care or this is done before their admitted or what is the process is actually a very open process anybody can if if that person calls me themselves or their loved ones as long as i have the clients consent to be involved then they can become a client of this programme i receive referrals almost the majority of them come from the family physicians i get a lot of referrals from the care coordinators with home and community care and quite a few from the hospital so someone's come in there i engaged in a difficult time either there's a symptom that isn't being well managed or their feeling quite unwell so there in the hospital for a period of time and many times the nurses will ask for referral and the physicians as well to to get me involved and i go when i meet them and we talk about what their goals are there other people had come along after you or do you get them involved with you or how does it work like that that's a really great question one of my eye i usually say there's about five things i do and one of them is connecting and that can be connecting to if they haven't been already connected to home and community care work with the family physician to make that happen i also connect with them resources within the community and i could be the food bank that can be mental health services that can be meals on wheels or could be within the palliative care community team the social worker also someone happens to be in our community is approaching end of life and doesn't have a local family physician and would like to have one i can make that connection as well now doktor bottom at what point in time would you recommend they go and talk to somebody palliative care i mean you know me you may see someone that you think has cancer and then eventually they finally i do here and there through there's gonna be a point in time at which you're gonna make that reassure and is as no set time for any one person sometimes you just get a sense of people are struggling with a diagnosis and what to do and when you get that terminal diagnosis off there's a lot of panic and upset and confusion their death maybe still years away but just having somebody to talk to his alien oh these are the things that you're gonna be looking at in a while they get our ducks in a row here make sure things looked after swinging focus on living with cancer rather than dying with cancer so for those people you know we get beth involve quite early in and sometimes you know i'll have that discussion within the office in bathroom crop of corn and they think now things are selling our okay now and that always says i'll call you back in a month i'll call you back in a month probing ninety nine percent of the time eventually yes we'd like to talk to you and so eventually had happened self and other people you know you sir to see there the diagnosis is horrid things have happened very quickly and you get all hands on deck we get referrals to home care we get referrals to bath we make sure everything some place could sometimes those diagnoses happen in the persons death as was quite eminent so we have to start a jump and very quickly so again bath and her team are very nimble that they consider job in very quickly when a crisis happens with you can't predict what can have no that's true so is there anything else you can tell us about what you do in their palliative care unit why would like tat to share that term we really do i focus on the individual and their families getting the right information and being able to adopt a bottom set get your ducks in a row but also you know even to thinking about what you would like to decide on and you are faced with a crisis at some point and you haven't even thought about it you're able to have those those thoughts and think about what you would like to have happen under certain future circumstances then you talk to your loved ones about that so if there ever called upon to make a decision on your behalf if you are unable to they feel a level of confidence that their making a decision that you would want now do you get a whole family together already like to speak to the patient first or the family first or what what procedure do you like to follow well normally what happens is i meet with the individual and their primary caregiver so the person whose with them the most i'm sometimes i meet with only the individual because they may be not requiring a caregiver yet so that does happen but it does tend to be with the primary caregiver because the primary care carers are that fair reason they care and they they wanna be there they want to be involved and they want to be supportive cell i absolutely i'm glad to have them there is well yeah what amount of information fisher and you know those connections are important and makes it so much easier when everybody's on same pages as a person moves through the dying process you know what we anticipate how do we deal with us communicate with their family and friends we know this is going on her son and you're gonna love one that comes in doesn't know what's been happening there is many a communication and a concrete alot havoc and turmoil when you really don't want that when somebody's in various stages of their life that could be devastated children when they didn't know we have another important thing this is all covered through the ministry of health is no must for the service i think that's important piazzas free i go to your home you can call and ask if i've forgotten something today or as something that has been said i raises more questions in someone's mine i'm absolutely love anybody to call me we can talk about it and we can get the number here and if they call here or call your family family as they are affected out nurse practitioner as a hospital and they'll be able to forgit my extension super likely leave as a whole line through the office and the added through email as she's got a red phone just sitting there waiting in all its great having that help really supports us well so we can focus on dealing with the law the symptom management in that and then having that back up of emotional support i have an unbearably we're all on the same page so it really does make it a lot easier for the patients and their families is difficult time as it is you want to make sure that things are organised and people are working together for the right and people are feeling supported exactly not alone it's important document and thank you very much for bringing methane beth thank you so much for coming in here and letting our listeners know exactly what the processes and as we ve told everybody you can get a hold of you either by getting hold of the family physician or the family doctor and or calling the hospital absolute thank you so much for coming in and thank you doctor bottom for bringing her and you're welcome that set for this addition of medical matters if you have a topic you'd like does to discuss email us at medical matters at canoe fm dot com i will do our best to discuss it on a leader programme medical matters can be heard every monday at eleven forty five a m thirsty at five forty five p m on canoe fm one hundred point nine your community radio station for the halloween night my name is barry wilhelm thanks for listening