Coming out of hiding!

The last two and a half months I have been retreating… time with siblings from Denmark, Australia and Vancouver, time on the water, time in the water, and a lot of time writing!

The new text, “Integrating a Palliative Approach: Essentials for Personal Support Workers” is just about to go to the press. We are thrilled. By the middle of October it should be up on Amazon and available to order.  Thanks to all who have participated, shared stories, contributed to the research, provided your expert opinions!

It is incredible to see the beautiful illustrations by Joanne Thomson. In this illustration, the comfort basket shows a few of the comfort measures that a personal care provider can use to help people feel more comfortable.

Basket of Comfort Measures.jpg

My basket of comfort measures

What are your favorite things to put into your comfort basket? What are you hoping will be in a comfort basket when you are dying?

Next week I head to Montreal for the International Congress on Care of the Terminally Ill. I am so looking forward to rubbing shoulders with health care professionals from around the world, and being taught by some of the greatest practitioners and researchers. If you are attending, email me and let’s try and connect.

Warm regards,


Seeking your advice…

I am writing “Essentials in Hospice Palliative Care: A Guide for Personal Support Workers”  (PSWs are also known as Health Care Assistants, Community Health Workers etc.)

As many of you who read this blog know… The PSW is often the eyes and ears of the health care team. It is often the PSW who observes a problem, reports to the nurse or supervisor in order to get the needed supports to help address the problem.

In the section on Physical Comfort, I discuss common symptoms experienced by the dying, what the PSW might see and hear, what they might report, and comfort measures that they can provide.

When a PSW is in the home setting or in a busy long term care facility, the PSW needs to provide the nurse with enough relevant information so that the nurse will understand the needs and be able to respond in a timely way. In these cases it is helpful to report more than the basics “I think Mr, H is in pain, can you see him”.  A more thorough report is needed.

I like the OPQRSTUV acronym used by many health care professionals to prompt them to complete a more thorough assessment.  “O=Onset P=Palliating or Provoking… etc… but these more complex questions are not really in the scope of the PSW practice…. So, I have taken the basic concepts and developed this list of questions that the PSW could apply to any symptom…

I would appreciate your critique, comments, feedback… what do you think of the questions?
Are they too much for a PSW to consider?
Does the flow of the questions make sense to you?
Are they helpful?

When you respond, please indicate your background, are you a PSW, an instructor, a supervisor, a family caregiver etc…

Here you go:

“Consider these questions when you observe the person. You may be able to ask the person or the family these questions, or you may be alone with a non responsive person, and you may need to use the information you have gathered by observation to answer these questions.

What is happening?
When did it start?
Where do you feel it?
What does it feel like?
What makes it better?
What makes it worse
Can you rate the symptom on a scale of 0-10 (no symptom, or the worse you can imagine) or small medium or large?
What can I do to help?

Use the information you have gathered to report to the nurse/supervisor.”

I would appreciate your input. If you are not comfortable replying in the public blog, you are welcome to email me directly.

Warm regards,

Canadian Association of Continuing Care Educators Conference

Annual Conference in Edmonton!

I was thrilled to meet up with educators I met two years ago at the conference in Saskatoon, as well as to meet new educators and nurses providing education in the clinical setting in Alberta.

The theme of this conference was “Promoting a Culture of Safety”.   Meg Soper RN & comedienne  gave the keynote address.  She suggested that to excel at education and leadership we need to: Be good at what we do, be good at communicating, live in balance, and remember humour/perspective.  Her stunning but simple sleeveless black dress, cut high over the shoulders, revealed beautiful big developed biceps… Though I enjoyed her humour… I drooled over the biceps and determined that I should think about thinking about the idea of joining a gym….. then I reached for a chocolate. (

Laura Milligan from NorQuest College provided a half hour presentation about Care of the Ortho Client.  I love to see people like Laura present.  Her knowledge and passion of bones and fractures radiated.  I learned and was inspired.

Stephen Symon from WorkSafe BC motivated me to go to their website and learn more about the latest of resources to promote safety in the workplace.

Marleen McClellan, Chair of the CACCE spoke at the AGM.  Marleen is a beautiful, gentle woman.  Well loved across the country for her leadership and her leadership style.  Marleen presented about the CACCE, focus project, and new website.  Summary:

  • CACCE is an affinity group of Canadian Association of Community Colleges (CACC).  One of their purposes is to promote common core skills and competence nationally of the “unregulated workers”.  Titles for “health care workers” across Canada vary and include: Personal Support Workers, Health Care Aide, Health Care Assistant.
  • CACC received funding from Health Canada, and in collaboration with CACCE,  has completed the development of “The National Educational Standards for personal care providers” This is a major accomplishment! The standards will be launched in Nova Scotia at the end of May.
  • Today at the AGM the new website was launched. See .  This site links with the ACCC website, will link to upcoming conferences, contact information, and documents pertaining to the educational standards.

Exciting research presented by Donalda Farwell Area Director from Bayshore Home Health, Jake Evans and Erin Bampton from NorQuest College spoke about “Enhancing recruitment and retention of diverse HCA’s in a continuing care organization using an intercultural lens”.   Jake talked about sensitivity and intercultural communication as including the mind, heart, and skill. He suggested that intercultural competence, in the context of health care be defined as the ability to deliver effective, understandable and respectful care that is provided in a manner compatible with the patients’ cultural health beliefs and practices and preferred language. (R Anan, I. Lhahiri, Intercultural Comptence in Health Care, 2009)

Jake presented a development model of intercultural sensitivity… suggesting that the level of understanding moves through the following levels of awareness:  Denial, Polarization, Minimization, Acceptance, Adaptation.

I recognized myself in his description of the person who “minimizes” the differences, focusing on the similarities rather than the differences.  He suggests that this works fine until one comes upon the differences and does not know how to navigate through the differences.  Hm..

I could have listened to Jake present theory on cultural awareness and practical strategies for the workplace and health care for hours!  In fact, I wonder if we can get him to come to Victoria for a conference! (Way to go Bayshore and NorQuest!!!)

Ron Schlegehmilch spoke about keeping heart as managers working in health care and education.

And thanks to Judy Van Seggelen from High River Hospital in Okotoks, I was able to stay and hear the final speaker, Shona Hommy-Bugarin from Northern Lakes College.

Shona spoke with heart about the human side of safety. She pulled together the theme of the conference addressing how this applies to the students who are being educated. SHona finished with “Feels like home to me” music and photos!

The highlight was meeting educators from Nova Scotia to British Columbia and north to Whitehorse and Yellowknife!  Thanks so much for the warm welcome!  Until next year!