A reflection by Maureen Russell

Today I met with a wonderful group of Health Care Assistant students from Capilano University. In preparation for the time together they sent me a list of questions, and I in turn considered the questions and what I might share. I shared with them a reflection written by Maureen Russell, a psychosocial care provider who lives and works in southern Ontario.
This reflection was inspired by a man whose experience with a Personal Support Worker helped him to trust, to open up, and prepared him to eventually be able to meet with Maureen in the last weeks of his life. Maureen was adamant, that without the work of the PSW the man never would have been able to open up with her and address some of the deeper issues that he carried.

Reflection—Undressed 

You entered, and my heart sank. Today would be the first day I would allow a stranger to bathe my broken body. 

How could I have come to this…this moment of unwanted dependency? 

I cringe with despair. A tear dares to sneak its way from beneath the mask of courage I so sheepishly hide behind. 

Who are you, Stranger? Who are you they send to enter my intimate space? 

Do you know ME? Do you know who I am? 

How do I let go into your hands, that which has only been felt by the gentleness of my mother’s touch oh so long ago? 

I shudder as you draw near. My decrepit body tenses and my stomach churns. I close my eyes and turn away, anticipating your cold and callous touch. 

I wait…I wait… 

Till broken is the air by your slow and soft voice…“This must be difficult for you. How can we best do this together?” 

How     can       we       best     do        this            together?  you asked…. 

Breath releases, body relaxes and my facade of courage slips.  Tears flow. I let go. And the waltz begins… 

In the weeks and months to come, we danced every day as you cleaned and cared for my declining body with the utmost respect and compassion. 

Within this place of “the intimate” that I so desperately feared had morphed a space of trust. I felt safe to wonder aloud with you…“How will I die?” “Have I mattered?” “How will I be remembered?” “What is the purpose of it all?”  

You quietly listened without judgement or a need to fix…For that, I thank you.  

And then, you offered me another partner, a counsellor, who could take these new steps and dance the dance of purpose and meaning with me. And because of you, I could accept her help.

I could let go of my masks and facades and bare my true self on my last waltz. 

Little did I know when you entered that being undressed would allow me to be naked.  

Deep gratitude to YOU who cared for my body and gave space for my spirit.   

Contributed by Maureen Russell 

Thank you Maureen for sharing this wonderful reflection with us!

A personal reflection on grief during the pandemic

Submitted by Kassey M. June 2021, reflecting on her grief while working in Long Term Care during COVID

Grief is an understandable reaction to loss. It’s the emotional pain you experience when something or someone you care about is taken away from you. It can be excruciatingly painful at times. From shock or fury to disbelief, remorse, and deep grief, I experience a wide range of uncomfortable and unexpected feelings. Grief is a total whole person experience, and may have a negative impact on physical health, making it difficult to sleep, eat, or even think clearly. These are common reactions to loss, and the greater the loss, the greater the grief. 

Personally, my most profound experience with grief was during my time working at a retirement home in the heart of the pandemic.

Personally, my most profound experience with grief was during my time working at a retirement home in the heart of the pandemic. I was approached right before our home was hit with its first case to come work at the front desk. I was warned that things would be more intense than the work I was doing previously, but I was up for the challenge. Immediately I was hit with a whole different perspective that I did not get to see working in dietary. Besides working with management and staff, I experienced constant losses as I cared for residents. 

I grew closest to the residents that had severe dementia on the second floor of the building. They loved my company and conversation. Making them smile and laugh brought them joy and allowed them to feel like they had loved ones around them. It made me feel attached and I would imagine caring for my own grandmother. Knowing that many of them did not have family visit, I felt proud that they remembered who I was and became excited when I arrived. Knowing this…was what really broke me when working through the pandemic.  

Our first deaths were those with severe dementia, then other residents who I had newly become acquainted with. Having to hear the news at almost every shift that someone else had passed and watching the residents deal with the loss of their friends and loved ones was difficult.  

There was no room to show any signs of emotion because they were so broken. Having to bottle these things in (still to this day) was debilitating. Having to speak to family members grieving over the deaths became numbing because again, you had to be strong. Knowing that there was nothing I could do to take away the pain from the residents and families made me feel almost like I was at fault. I could only offer my words and time to help them forget the world around them, even if for only a few moments.  

These feelings eventually caught up to me and I realized I was burned out. I was extremely emotional on some days, then snapped into feeling numb and emotionless. The grief felt like waves crashing down and flowing rapidly at all times. My emotions were about to burst and overflow at the drop of a hat. There were many moments at work that they did.  

I wish there was more help for staff who have to suffer through this grief. When I reached out for help there was nobody there to listen or allow me to process what was happening. Why? Maybe because we were all dealing with this and because we all felt like we were drowning. 

Grief doesn’t always get better with time; I am learning to function with it and it surprises me less often. I am forced to cope and adapt. It affects me in all aspects of my life. I have learned to seek help, and have learned how important mental health and selfcare is to cope with the grief. Recognizing and processing how I am feeling is the first step to getting better. 

Submitted by Kassey M

WEBINAR FOR PSWs  Addressing our Grief associated with COVID  

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Palliative Care – a Human Right – so apparent during COVID

Deaths from COVID-19 are approaching 3 million world-wide. Much of the discussion about ethical issues has centered around the availability of ventilators, but little has been said about the need and the responsibility to provide palliative care, ways to integrate a palliative approach for those who are seriously ill, and how to best support those who may or many not get (or want) a ventilator.

In Ontario palliative care specialists helped and provided care in the long term care facilities hardest hit by COVID. But specialist cannot do this in isolation.

In the Journal American Medical Association, article titled, “Integration of Palliative Care into All Serious Illness Care as a Human Right” Rosa, Ferrell and Mason wrote:

“COVID-19 has highlighted that every clinician needs knowledge and skills in the fundamentals of palliative care.“

Palliative care is not dependent on life-saving interventions. It may very well include a ventilator, but it is ultimately structured around the individualized wants and needs of the patient. It includes alleviating suffering and managing complex communications, psychosocial dynamics, fluctuating symptom management needs, and spiritual care throughout the dying process.

Every patient treated with a ventilator also needs palliative care. It is not an either-or clinical proposition, but rather a both-and moral imperative.

COVID-19 has accentuated the need for clinicians to have frequent conversations with patients and families about dying. The pandemic has forced many healthy people to confront rapid-onset, life-threatening trajectories of acute illness. Patients are dying without their loved ones, and families are grieving alone. For every person who dies, an average of 9 others are profoundly affected and grieve.2 COVID-19 has interrupted the cultural and community practices for coping with death, raising concerns about the pervasiveness of grief and loss associated with the pandemic…. 

Access to palliative care is a human right. Our inability to deliver it in the setting of COVID-19 and other serious illnesses is a human rights violation. Education… is needed now.

Personal Support Workers and nurses (both in field and in training), like all health care providers, need the tools and foundation to know how to support individuals living and dying with COVID-19 or living and dying with any life-limiting illness. Now.