Innovative palliative approach in residential care making an impact at Coastal and contracted sites
“It’s the ultimate respect.”
That’s how Ed McDaniel describes the Dignity Quilt, “Heartfelt”, which hangs on the wall of the Upper Terrace community at West Vancouver’s Inglewood Care Centre where his mother Belva is a resident.
As part of a culture shift in end of life care in VCH residential care facilities, the Dignity Quilt was recently introduced at Inglewood after Jane Webley, VCH Regional Program Leader for End of Life care, provided education regarding Embedding a Palliative Approach in Residential Settings (EPAIRS).
EPAIRS, which began with the acclaimed Daisy Project at Kiwanis Care Centre on the North Shore, has now been introduced to all owned and operated and contracted sites within the Coastal Community of Care, including Inglewood.
“Death is the one certainty in all of our lives. It is also final, and the experience cannot be shared with others, causing anxiety, fear and uncertainty as end of life approaches. Society has responded to this uncertainty with a reluctance to discuss or plan for end of life, and in some cases even seek out medical interventions to delay death,” says Jane. “The change to the way our older, fragile population living in residential care face death can only happen with buy-in from staff, who will act as champions to change the culture-oriented medical, often non-beneficial approach to resident-centred end of life care.”
Symbolic tribute of dignity
After hearing Jane’s talk on EPAIRS, Inglewood’s recreation therapist Bojana Popovic had the idea to resurrect an idea contemplated by art therapist Paddy Bruce in the past. Bojana raised the idea of the quilt with fellow staff and site leadership.
Jane Webley, VCH’s Regional Leader, End of Life, gives the award-winning book Being Mortal to Inglewood recreation therapist Bojana Popovich for her work and commitment to EPAIRS.
“Following Jane’s workshop, the team felt energized to change the culture and promote openness and discussions about end of life,” says Bojana. “The goal was to involve all members of the Upper Terrace community (residents, family members, staff, companions) in a meaningful activity to create a symbolic piece of art that will increase awareness, and remind us, of the inevitability of death and preciousness of each moment spent with each other.”
The meaning and philosophy behind the Dignity Quilt is as a symbolic tribute to dignify the deceased resident’s final passage from their room through the halls, to the main entrance. Each square holds a memory or a symbol of something important to the person creating the piece. The joining together of all the memories acknowledges the uniqueness and equality of all lives, regardless of disability, explains Bojana.
The “Heartfelt” quilts are placed over the resident, giving staff, families and surviving residents the opportunity to say their goodbyes. Previously, residents would be sheltered from witnessing this last journey and the deceased resident would be taken through a back door.
Belva McDaniel, a resident at Inglewood Care Centre, with the square she made for the Dignity Quilt “Heartfelt.”
“What it does is honour the resident even after death,” says Ed. “I think it also allows the caregivers at Inglewood to realize that what they are doing has meaning. These quilts allow staff to give dignity to the person they’ve been caring for as they make their final journey.”
The goals of EPAIRS
EPAIRS is committed to ensuring persons in residential care across VCH die in their place of choice and opening up the conversation about the goals of care, which Inglewood staff have embraced.
For Inglewood manager Helle Johansen, the message staff want to give residents and their families is: “There is still value to your life when you come here. Everyone is accepted without judgment and this is what we hope families can feel when they come to visit.”
Jane gives the staff kudos for their desire for change.
“Success at Inglewood has been driven by the passion and commitment from the leadership team, who have empowered their teams to focus on what matters most to residents and their families,” she says.
Ed agrees.
“The staff at Inglewood are jewels,” he says. “They do a tremendous job. And having the quilt hanging on the wall will make it resonate with more people who walk the halls of Inglewood and help them understand its meaning. The quilt opens up a wider avenue of gratitude.”
Palliative work wins national award
Jane’s work on EPAIRS and the success of the Daisy Project at KCC, which has seen 99% of residents dying at home in the last two years, was honoured last week by the Canadian Foundation for Healthcare Improvement at its annual conference in Toronto.
Jane received an award for Demonstrated Innovation in palliative and end of life care.
“A palliative approach can help reduce the suffering of many people and encompasses a positive and open attitude towards living in the shadow of death and dying, and prevent unnecessary hospital admissions, medical treatments or visits to the emergency department,” says Jane.
