A mother of three adult sons and grandmother to three young girls, RoseMary Morrison was an active and independent 72-year-old whose busy life included raising a 14-year-old granddaughter and hosting international students in her home. So when her family noticed her becoming absent minded and disoriented in late October 2005, they began to worry about her health. “The day she told me that she didn’t want to drive her car anymore was the day I knew something was really wrong,” recalls her son Jamie Morrison.
Tests revealed RoseMary had a malignant brain tumour and little time to live. The family barely had time to absorb the devastating diagnosis before she suffered a severe headache and fell into a coma. When RoseMary was taken to the neurotrauma ICU at St. Michael’s Hospital, and then transferred to the Palliative Care Unit her family found themselves embarking on an unfamiliar and frightening journey.
But in the calm of the 10-bed palliative unit, they discovered something unexpected. “It was a little piece of heaven,” says Jamie, describing the serenity his family felt once in the capable hands of the Unit’s staff and volunteers.
After a couple of days in the Unit, the Morrisons experienced an unexpected miracle. RoseMary started to make some recovery, awoke from her coma and eventually was able to sit up and converse with the staff and her family. Her family had the opportunity to spend some good times with her, and obtain closure, before her condition started to finally deteriorate.
“In palliative care we don’t just care for our patients, but also support their families and friends. Ongoing dialogue and communication with patients and their families throughout the course of the illness is a core tenant of the Unit’s philosophy,” explains registered nurse Rose Tuck, the co-ordinator of the Palliative Care Unit. “We also assume patients can hear until the very end so we continue to talk to them even when they are unresponsive. It’s an important part of maintaining respect and dignity.”
And it was one of the aspects of their mother’s care that the Morrisons appreciated the most. “The nurses continued to speak to my mother, even when she was in her coma and toward the end of her life when she drifted in and out of consciousness. The nurses were exceptionally compassionate.”
For patients nearing the end of their life, effective pain management is of primary importance. “For most people, the prospect of being in pain is the most frightening aspect of death. Active management of pain and other symptoms is of paramount importance. In the Palliative Care Unit we specialize in pain management. Our goal is to ensure that patients are as comfortable as possible so they can die with peace and dignity,” says Rose.
“Despite the fact that the tumour was growing and she had suffered very severe headaches before her diagnosis, my mom didn’t have a single severe headache during the time she was in Palliative Care,” says Jamie. “The nurses were really on top of her pain and their ability to control it was beyond belief.”
In addition to pain and symptom management, providing compassionate care is the Unit’s main mandate. “Palliative care is focused on comfort, not cure, so the care we provide has to be exemplary,” explains Rose. “When hiring, we look for people who are empathetic and compassionate team players, with excellent clinical skills and life experience that equips them to meet the unique needs of dying patients and their families. This is more than just a job for many of our staff. Several of our volunteers are individuals who have lost loved ones on the Unit, and then come back as volunteers.”
Death is a constant in this Unit that admitted 179 patients last year and loses an average of three patients a week. But despite what most would consider bleak circumstances, the staff maintain an atmosphere of hope. “They have a way of bringing happiness into a unit that is full of dying people. It was quite uplifting,” says Jamie. Rose explains that making the most of every day is an important aspect of working in palliative care: “Working in this field teaches you that life is precious. We want to optimize quality of life for our patients and their families for the time they have left together. We celebrate many occasions – birthdays, Christmas, Valentine’s Day. We’ve even had christenings and weddings on the unit. We want to create final memories that families can cherish forever.”