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Palliative care – a helping hand for patients and families

As a resident with Memorial University’s School of Medicine in St. John’s, Dr. David Henderson spent one month training in a palliative care unit. That experience motivated him to spend the next two decades studying and practicing in this important area.

DavidHenderson“I really didn’t know what to expect entering the rotation but quickly saw how a team of professionals worked hard to help both the patient and their family understand and adapt to the changes in their lives as the patient was dying,” said Dr. Henderson, Medical Director, Palliative Care Program with Colchester East Hants Health Authority in Truro.

“With prompt, efficient, and effective pain and symptom management, the patient and family were able to focus on quality of life and life closure,” he noted. “This touched something in me, and I have focused on this practice of medicine throughout my career.”

Dr. Henderson was recently honoured for his work – and his many accomplishments – with the Cancer Care Nova Scotia 2011 Leadership Excellence Award. Those accomplishments, noted Dr. Gerry Farrell, who nominated him, stretch across Nova Scotia, across the country – and beyond. “David has been a strong leader on the provincial scene [and] he is leading the way forward to help improve the availability of palliative care for all Canadians. At present, only 15% of people in Canada have access to organized palliative care.”

This is an area where advances need to be made, said Dr. Henderson. “Services need to be more uniformly available. No one yet has a provincial program in place that provides access to all.” In many parts of Nova Scotia palliative care is only available between 9 – 5 and this needs to change.

Enhancing access to palliative care services has been Dr. Henderson’s goal since he worked with a hospice organization in Iowa for six years. There, he was instrumental in developing the first inpatient palliative care unit in the state. Later he worked on the development of a regional model for palliative care in New Brunswick (although it was not implemented at the time).

Since arriving in Nova Scotia in 2004, Dr. Henderson has sat on the board of the Colchester East Hants Community Hospice Society. “The Hospice Society provides practical and psychosocial support to people dying and those grieving in our district. We also provide education and support to volunteers and professionals caring for the dying and the bereaved,” he said.

“One of the Hospice’s programs I am most proud of is the Food From the Heart program that sees 100% of monies raised through donations from customers at local Sobeys and Foodland stores go to families in need. Families with financial struggles are identified (with their permission) through our palliative care program. Imagine having a terminal illness and not being able to afford groceries or other household items due to lost income and employment as a result of your illness or your partner’s illness.”

Palliative care is a relatively new area of health care, having begun in Canada in the 1970s, noted Dr. Henderson, Past President of the Nova Scotia Hospice Palliative Care Association. Then, he said, the practice was very much hospital based. Today, it is focused on the home and the community. “At the end of the day, people want to be at home. Their families want this too. With the right supports this can happen.”

Understanding of palliative care has advanced from those early days. “We try to look at the whole person,” said Dr. Henderson, who represents Nova Scotia on the Canadian Hospice Palliative Care Association. “At one time, the focus was on pain and symptom management. Today, so much more is done. We understand the dying process so much better.”

That understanding does not come easily, he added. “The health care system is primarily geared to preventing people from dying. People are often so far removed from death and dying that it has become an abnormal thing. Most people recognize when their health is failing and, as hard as it is, want to talk about what to expect, what resources are available to them and how to manage the changes ahead. Because dying is as normal a part of life as being born it should not need to be so frightening.”

Palliative care will take on greater importance in our aging society, noted Dr. Henderson. Nova Scotia has one of the most rapidly aging populations in Canada with our seniors population projected to double from 15.1 % to just under 29% between 2006 and 2031. (A Statistical Profile of Seniors in Nova Scotia. 2007).

“There will be tremendous demands for palliative care services. We will need to ensure we can help our patients – and families care for their loved ones.”