Healthy Living in the North
Patti Doering

About Patti Doering

Patti was raised in Prince George and graduated from the CNC Nursing Program in 1991. She has been employed with Northern Health for 26 years and has worked in many different areas such as Med/Surg, Emergency, Mental Health and the Operating Room.
Patti joined the Palliative Care Consultation team in October 2017, in a one year term position which is focusing on personal support worker palliative care education, advanced care planning, and other projects which support the work of the consultation team. Patti is presently working on her BScN through the UNBC’s online program. In her spare time, she enjoys the outdoors, sports, and spending time with her daughters and her schnauzer, Dexter.

Advance Care Planning in Long Term Care

Patti sitting on a boulder amongst rocks.

ACP Lead Patti reminds us to have a conversation about end of life care with our loved ones.

I started working with Advance Care Planning (ACP) about a year and a half ago. While my position includes promoting ACP, I’m also a nurse consultant with the palliative care team, which means I meet with clients who reside in Long Term Care (LTC) facilities.

When I did my Registered Nurse (RN) training many years ago, I did a portion of my practicum in a LTC facility; at the time it was seen by my classmates as a position that lacked excitement and offered limited experience. Twenty-seven years later, I see this experience differently! LTC is an area where there is more of a focus on comfort and normalcy within the resident’s care, because this is likely the last home they will reside in. In these kinds of situations, we must consider the individual’s needs and wants within the care that they receive, including cultural-based values and beliefs. As such, it’s even more important that there’s a focus on the individual, and whether they have thought about what’s important to them regarding their wishes for end-of-life care.

The last year in this position has led me to further see and understand the importance of ACP in LTC facilities, including: discussions that need to happen amongst family members; awareness regarding what the future looks like for the resident; and situations and circumstances that need to be explained. Not having these conversations may lead to misunderstandings and the failure to follow the dying person’s wishes.

As health care staff, we have to ensure that there are open lines of communication with the family members and loved ones, as well as the residents. As a family member, we need to be proactive, involved, and not afraid to ask questions, in order to be informed. ACP needs to be an ongoing process to keep everyone from questioning care choices. Sometimes the residents are at a stage where they can no longer have these conversations, or they may not have loved ones who are involved, and these topics don’t always get discussed. This makes it even more important to have these conversations with our patients before it’s too late, at a time when they are still able to express their wishes.

The extended length of stay creates relationships and bonds between staff and the residents, often closer ones than exist in regular hospital wards. So, sometimes it can be difficult for the staff to experience the decline in the residents and the care involved, and even harder if there is no ACP in place.

Advance Care Planning day was April 16, but ACP should be encouraged every day whether it’s with a loved one or a patient. Find out what’s important to them and get them thinking about what their beliefs and values are, and what would matter most to them at end-of-life. Let’s all work at promoting ACP and make an effort to have those conversations. For more information on ACP visit www.speakup.ca and www.advancecareplanning.ca.

Patti Doering

About Patti Doering

Patti was raised in Prince George and graduated from the CNC Nursing Program in 1991. She has been employed with Northern Health for 26 years and has worked in many different areas such as Med/Surg, Emergency, Mental Health and the Operating Room. Patti joined the Palliative Care Consultation team in October 2017, in a one year term position which is focusing on personal support worker palliative care education, advanced care planning, and other projects which support the work of the consultation team. Patti is presently working on her BScN through the UNBC’s online program. In her spare time, she enjoys the outdoors, sports, and spending time with her daughters and her schnauzer, Dexter.

Share

Advance Care Planning: why wait?

Do you know what Advance Care Planning (ACP) is? Honestly, neither did I.

Hi, my name is Patti, and I am a Nurse Consultant with Northern Health Palliative Care. My position with the Palliative Care team is fairly new, and my knowledge base in regard to ACP was quite limited – until it became a part of my job.

As individuals, we all tend to shy away from thinking about the future and what may happen to our health. Why would we bother thinking about something that is so distant?

Well consider this: imagine how tough it would be on your family if you were in a major accident and on life support. You may have treatment limitations that are important to you, but is your family aware of them? Without a directive or a plan, your loved ones may not know what your wishes are and may have their own ideas on what they feel is the best treatment for you. What should they do, or what would you do if you were in their position?

One would think, that with all of the different experiences I’ve encountered as a nurse throughout my career, that I would be more cognisant of my own plans for end-of-life care. The truth is, I really hadn’t put a lot of thought into what my wishes would be if I was ever unable to speak or make choices regarding my own care. In fact, the most that I had done in respect to an advanced care plan was to sign a consent to be an organ donor! I suppose I never realised how this may affect my family and loved ones until I started working with Palliative Care and learning about ACP.Patti Doering on a beautiful bridge at dusk.

Advance Care Planning is a way of allowing your loved ones to be aware of your beliefs, wishes and plans, in the event you are unable to speak for yourself. It allows them to have peace of mind if they needed to make treatment choices on your behalf. Without a plan, this can be quite stressful and may even lead to unnecessary animosity among family members during an already difficult time.

Since starting this position I have discussed my wishes with my loved ones, and I am continually encouraging them to think of what theirs may be. Not only do I want my wishes to be known, I want to be aware of what my loved ones would want for themselves if ever the situation arises.

The resources at SpeakUp and Advanced Care Planning are very informative, and helped me to find the answers to certain aspects of ACP that I was unsure of. They explain the importance of making a plan, where to begin, and the steps to complete the process. They also give feedback from other individuals through sharing their experiences.

Have you thought about the level of care or treatment that you would wish to have under certain circumstances? Advance Care Planning is about conversations and decisions. It’s about how we care for each other. Now is the time to have these conversations with those closest to you and your physician to let your wishes be known. Discuss options with your doctor and familiarize yourself with the different levels of care. It’s never too early, so make your plan today.

Patti Doering

About Patti Doering

Patti was raised in Prince George and graduated from the CNC Nursing Program in 1991. She has been employed with Northern Health for 26 years and has worked in many different areas such as Med/Surg, Emergency, Mental Health and the Operating Room. Patti joined the Palliative Care Consultation team in October 2017, in a one year term position which is focusing on personal support worker palliative care education, advanced care planning, and other projects which support the work of the consultation team. Patti is presently working on her BScN through the UNBC’s online program. In her spare time, she enjoys the outdoors, sports, and spending time with her daughters and her schnauzer, Dexter.

Share