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Ottawa South MPP John Fraser has been quietly working away on one of the provincial government’s worst problems: How we die.
When Premier Kathleen Wynne made him parliamentary assistant to Health Minister Eric Hoskins and they asked him what he wanted to do, palliative care is what he told them.
“This job, this office, this responsibility — I think I landed here because this is where I’m supposed to land,” he says.
Fraser’s father died of cancer about two years ago. He spent most of his illness being cared for by his children, then moved to the May Court hospice in Old Ottawa South for the last three weeks of his life.
“If I die like that, I’ll think I won the lottery,” Fraser says. “It wasn’t without pain, it wasn’t without discomfort. The services that were available to us — we had to do a lot to support it, we needed volunteers to support it. But many people don’t get that.”
Getting services wasn’t always easy. Fraser was an MPP and he’d spent years as Dalton McGuinty’s local lieutenant. Yet even he and his sisters had problems dealing with the health system on their father’s behalf. A couple of weeks before Christmas, for instance, they got a call from their father’s case manager at Ottawa’s home-care agency, to let them know she was retiring. They’d get a new person in January. What should they do in the meantime?
“In the health system, people are all working hard and they’re trying their best,” Fraser says. “But sometimes things fall through the cracks. In end-of-life care, it’s a real problem when people fall through the cracks.”
He’s concluded 16 consultations across the province about what Ontario should do about improving care for the terminally ill and is roughing in a report on what he’s heard. It’s due in about six weeks. In broad strokes, he says, it’ll talk about improving palliative care in hospitals, helping doctors talk about end-of-life care with patients, expanding hospice care, and what Ontarians as individuals should do to prepare for their own mortality.
Most of us don’t want to die in a hospital but most of us do, which can be a problem because hospitals are machines for keeping people alive. When a patient arrives at a hospital in a crisis, everyone will work flat-out to save his or her life unless they’re specifically instructed not to, and most people don’t really understand what that means: Ventilators, ribs broken by chest compressions, tubes everywhere. Pain and drugs. Families waiting in limbo by intensive-care units.
Plenty of people have reasons to withstand all that, but if you don’t want it you need to say so. Otherwise, an acute-care hospital will do what it’s designed for.
Only about five per cent of Ontario’s deaths are in hospices, places designed and staffed for palliative care (which, by the way, can mean long-term support, not just helping with an imminent death). The province intends to double the number of hospice beds in Ontario, though that’s not as easy as it sounds. The organization that runs the May Court has to raise $2 million a year for its 19 beds. In nursing homes, the government covers medical care but residents still pay rent and fees for things like activities. In hospices, it’s the same idea: medical treatment is covered but not other things, and there are a lot of other things.
That’s OK, in Fraser’s view. Hospice care should be a community responsibility, he says, supported by government but not run by it. Babies are often born in hospitals, but the general idea is that health workers should play as small a role in births as possible, because they can’t take the place of new parents’ families and friends. The same philosophy should apply to dying. The government can do more but it can’t do everything, he says.
“We invest a lot — as parents, as a society, as a government — when people come into this world. I think going out deserves the same sort of attention and support,” Fraser says, and he means from everyone.
People’s worlds narrow when they’re dying, he says, but the things they still want, they want very badly. “It’s generally acknowledgments of what’s important to you — often, that’s just that you’re here and it matters,” Fraser says.
dreevely@postmedia.com
twitter.com/davidreevely
查看原文...
When Premier Kathleen Wynne made him parliamentary assistant to Health Minister Eric Hoskins and they asked him what he wanted to do, palliative care is what he told them.
“This job, this office, this responsibility — I think I landed here because this is where I’m supposed to land,” he says.
Fraser’s father died of cancer about two years ago. He spent most of his illness being cared for by his children, then moved to the May Court hospice in Old Ottawa South for the last three weeks of his life.
“If I die like that, I’ll think I won the lottery,” Fraser says. “It wasn’t without pain, it wasn’t without discomfort. The services that were available to us — we had to do a lot to support it, we needed volunteers to support it. But many people don’t get that.”
Getting services wasn’t always easy. Fraser was an MPP and he’d spent years as Dalton McGuinty’s local lieutenant. Yet even he and his sisters had problems dealing with the health system on their father’s behalf. A couple of weeks before Christmas, for instance, they got a call from their father’s case manager at Ottawa’s home-care agency, to let them know she was retiring. They’d get a new person in January. What should they do in the meantime?
“In the health system, people are all working hard and they’re trying their best,” Fraser says. “But sometimes things fall through the cracks. In end-of-life care, it’s a real problem when people fall through the cracks.”
He’s concluded 16 consultations across the province about what Ontario should do about improving care for the terminally ill and is roughing in a report on what he’s heard. It’s due in about six weeks. In broad strokes, he says, it’ll talk about improving palliative care in hospitals, helping doctors talk about end-of-life care with patients, expanding hospice care, and what Ontarians as individuals should do to prepare for their own mortality.
Most of us don’t want to die in a hospital but most of us do, which can be a problem because hospitals are machines for keeping people alive. When a patient arrives at a hospital in a crisis, everyone will work flat-out to save his or her life unless they’re specifically instructed not to, and most people don’t really understand what that means: Ventilators, ribs broken by chest compressions, tubes everywhere. Pain and drugs. Families waiting in limbo by intensive-care units.
Plenty of people have reasons to withstand all that, but if you don’t want it you need to say so. Otherwise, an acute-care hospital will do what it’s designed for.
Only about five per cent of Ontario’s deaths are in hospices, places designed and staffed for palliative care (which, by the way, can mean long-term support, not just helping with an imminent death). The province intends to double the number of hospice beds in Ontario, though that’s not as easy as it sounds. The organization that runs the May Court has to raise $2 million a year for its 19 beds. In nursing homes, the government covers medical care but residents still pay rent and fees for things like activities. In hospices, it’s the same idea: medical treatment is covered but not other things, and there are a lot of other things.
That’s OK, in Fraser’s view. Hospice care should be a community responsibility, he says, supported by government but not run by it. Babies are often born in hospitals, but the general idea is that health workers should play as small a role in births as possible, because they can’t take the place of new parents’ families and friends. The same philosophy should apply to dying. The government can do more but it can’t do everything, he says.
“We invest a lot — as parents, as a society, as a government — when people come into this world. I think going out deserves the same sort of attention and support,” Fraser says, and he means from everyone.
People’s worlds narrow when they’re dying, he says, but the things they still want, they want very badly. “It’s generally acknowledgments of what’s important to you — often, that’s just that you’re here and it matters,” Fraser says.
dreevely@postmedia.com
twitter.com/davidreevely
查看原文...
