Ting Chan

Ting Chan

Choosing Where to Die

If you’re lucky (or unlucky) enough to be aware of your imminent death from a terminal illness, you’ll be asked a simple question – Where would you like to die?

Several options, that I’m aware of, are available:

  • At home
  • At hospice
  • At palliative care unit

I don’t think you’d disagree with me if I made a sweeping statement like most people want to die at home. Dying at home has its obvious merits; it’s familiar, it’s private, and most of all it’s comfortable! Nothing is better than home, am I right?

We were completely convinced that dying at home was the best option for mom and her wishes were also inline with our thinking. It wasn’t until mom was hospitalized and admitted into VGH’s palliative care unit where we had a change of heart – but before we get into that let’s talk about the palliative care unit.

The palliative care unit at VGH is a specialized group of nurses and doctors whose primary objective is to provide care to patients on the last stretch of their life. Not only do they provide medical support to the patient, they also provide emotional support to any accompanying loved ones. Since there are limited beds in the palliative care unit, there are some criteria that the patient needs to satisfy to be admitted – criteria that I’m afraid I’m not privy to. The palliative care unit at VGH is situated on the topmost floor and is a secluded area only accessible via the service elevators. The rest of the hospital pales in comparison to this floor. The patient rooms are triple the normal size. The hospital bed is double the size. You have your own private room with your own washroom. Most impressive was the observatory room which was an extension of the unit that was constructed with a large glass window perimeter providing an almost 360 panoramic view of Vancouver’s city scape.

Material perks of the facility aside, there were less obvious confounding factors that we felt made the palliative care unit a fitting place for death.

Having mom with the palliative care unit:

  • provided access to intravenous pain management
  • provided peace of mind
  • transitioned our role as caretakers back to sons
Intravenous Pain Management

Two benefits of having access to intravenous pain management is the reduced time for pain relief and ease of administration. If you’ve ever taken a regular pain killer orally, you’ll know that it takes a while for you to feel the effects. When the pain is substantial, there’s an obvious appreciation for intravenous pain relief that’s manifolds quicker. Furthermore, a person’s mental ability can deteriorate significantly to a point where even swallowing water becomes a difficult task. It’s not as if the pain vanishes along with their cognitive abilities. Intravenous administration of pain medication becomes a principal avenue for continuous pain relief.

Peace of Mind

I found myself completely clueless and helpless at home. Unless you are a trained nurse or doctor, I think it’s natural to have no clue how to take care of someone that’s approaching death. I admit that there are palliative care nurses and resources available to answer some questions but I found that it didn’t ease my worries. The default answer to my enquiries was – if you’re really concerned just take her into the Emergency Room. Having mom in the palliative care unit brought upon a sense of peace knowing that nurses and doctors in this ward were specialized in taking care of patients approaching death. They know what signs to look for like the furrowing of the brows that indicates pain. They provide daily cleaning and grooming. Most importantly, they provided care that I, as a son, was not comfortable or capable of providing.

Transition from Caretakers to Sons

Upon mom’s admission in the hospital and our realization that she wasn’t returning home, we had a discussion with one of the palliative care doctors about what being in the palliative care unit would mean for us. The principal takeaway from that conversation was the opportunity for a transition of roles – from being a caretaker to being a son. This notion that I was less of her son and more her caretaker was unsettling. At the end of of mom’s life, I just wanted to care for her as a son. I didn’t want to worry about when or if she was receiving her pain killers. I didn’t want to worry about whether she was having bowel movements. I didn’t want to worry about her personal hygiene regime. I wanted to spend what little time I had left talking to her, eating with her, laughing with her,¬†loving her.

Until next time my friends.

Love deeply. Live deliberately.

Ting

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