Heritage Day will be celebrated by Albertans of all backgrounds on August 2nd. To commemorate this holiday, we are exploring palliative and end-of-life care from around the world! Heritage Day in Alberta: August 2, 2021 Access to palliative care should be viewed as a fundamental right. In fact, it is recognized as a universal health right by the World Health Organization. The World Health Organization's Resolution 67 in the year 2014, asks governments to integrate palliative care in the mainstream health care system.
-- Palliative Care Around the World --
Africa
Culturally across the African continent there is diversity among beliefs on death and dying. In Africa, palliative care has been largely overlooked within the health care systems and is not a priority compared to other services. Many countries in Africa do not have palliative care facilities available as part of the health system. The African Palliative Care Research Network was formed in 2011 to focus on building a research base for improving palliative care. South Africa is one of the leading countries that has realized the social-economic benefits of this specialty of medicine. Malawi and Uganda have also integrated palliative care into their mainstream health care systems, and Uganda became the first country in Africa to recognize liquid morphine as an essential drug for treating pain. It also set a precedent in Africa by allowing palliative care nurses to prescribe it.
HIGHLIGHT - Continuum of Care for Persons Living with HIV/AIDS in Tanzania (CHAT)
CHAT started in 2006 with the aim of adding palliative care capacity to home-based care programmes throughout the Lutheran healthcare system in Tanzania. The goal or the program is scaling up palliative care capacity while linking
existing Lutheran hospitals and church congregations throughout Tanzania.
The agency coordinating the program is the Evangelical Lutheran Church of Tanzania (ELCT). ELCT already operated a model palliative care programme at Selian Lutheran Hospital and Hospice, which was extended to 13 other hospital sites and their surrounding communities. Innovations include a day care where palliative care clients received care near their homes, and where their spouses and children received free voluntary counseling and testing services at the same time.
Source: African Palliative Care Association
Palliative Care Around the World continued...
Asia
In Asia, many patients often view palliative care as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception among the diverse populations. Asian and Pacific cultures are characterised by very strong cross-generational, family-centred behaviours in supporting each other in times of crisis, including death. In the Asia-Pacific region, there are few national policy palliative care guidelines. Singapore has had a history of palliative care since 1985, and in Malaysia there are requirements for palliative care units in public hospitals. Throughout the continent, family and religious belief play a significant role in guiding care at the end stage of life.
HIGHLIGHT - In Asia, many patients often view palliative care as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception among the diverse populations. Asian and Pacific cultures are characterised by very strong cross-generational, family-centred behaviours in supporting each other in times of crisis, including death. In the Asia-Pacific region, there are few national policy palliative care guidelines. Singapore has had a history of palliative care since 1985, and in Malaysia there are requirements for palliative care units in public hospitals. Throughout the continent, family and religious belief play a significant role in guiding care at the end stage of life.
Central / South America
Many Latin American and Caribbean national health systems mainly focus on disease prevention, prenatal assistance, undernourishment, and more. Many still do not have the conditions for developing palliative care. Often the quality of life during the palliative process is poor, with fragmented assistance as most health systems do not conceptualize palliative care as an important element of health care. Inequalities in access to advanced care planning, adequate palliative care, and pain medication are common in the region. There are reported national palliative care programs in seven countries. Three countries (Chile, Costa Rica, and Cuba) are active and support palliative care nationwide.
HIGHLIGHT - Programa Argentino de Medicina Paliativa – Fundación FEMEBA
Palliative Care in community: all services provide outpatient care, day care, inpatient care and home care. They each provide free care to 200-300 new patients each year Community Education Research Professional education, including annual training courses for volunteers FEMEBA is a not-for-profit nongovernmental organisation to promote palliative care nationwide. The main activities include:
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Cultural Palliative Care
Europe
Cultural Backgrounds
Practicing in an ethnically and culturally diverse society requires healthcare providers to understand, respect, and take into account the particular cultures from which their patients come. When it comes to how patients make the pain and palliative care decisions, cultural background influences a significant part of their process.
Cultural Beliefs
African, Asian, Chinese, East Indian, Hispanic, Indonesian, Japanese, Native American, and Vietnamese families may request providers not to disclose a terminal diagnosis as they want to avoid emotional suffering and preserve hope. For Christian Scientists, Hinduism, Jehovah’s Witnesses, Mormons, Muslim, and Seventh-Day Adventists, it is considered contrary to the church’s teachings regarding euthanasia and possible use of drugs that may hasten death. Cultural beliefs regarding pain and death may influence the patient and family’s preferences for palliative care. Many cultures also have distinct cultural beliefs regarding the meaning, origin, and role of pain, which can affect how a patient interprets and perceives pain.
Buddhists may not want any drugs that cloud the mind near death.
examples from around the world
Japanese Culture
South African Culture
Kenyan Culture
Death: Avoid the discussion as they believe talking about it will make it happen.
Death: May avoid discussion
Death: Generally, desire life to be preserved at all costs.
Pain: Maybe very stoic
Pain: Usually, they avoid pain medicine.
Pain: accept pain medicine.
Palliative: May take assistance, often at home
Palliative Care: Usually, die at home with limited involvement of health professionals.
Palliative care: Commonly wish to die at home.
East Asian Culture
Ghanaian Culture
Jamaican Culture
Death: Telling a patient they are going to die isunacceptable.More acceptable to say, “It is time to put your home in order.”
Death: Reluctant to talk about death.
Death: Maybe very emotional with crying and mourning typically
Pain: Maybe stoic, look for non- verbal signs.
Pain: Highly variable
Pain: Often described as emotional
Palliative: Will seek health care but may believe in a possible cure despite terminal illness. Generally, accept end-of-life care
Palliative care: May believe dying at home may bring bad luck. Will accept palliative care.
Palliative care: Usually prefer to die at home with little or no medical assistance.
Here in the beautiful Bow Valley, we are lucky to have access to some of the most striking scenery and nature in the world.
One habit that has helped many people process and deals with their grief is spending time in nature … Have you heard of “nature bathing”?
What is a nature bath? The idea of nature baths comes from a Japanese concept called shinrin-yoku, which means “forest bathing” or “relaxing in a forest atmosphere.” You don’t need to put on your swimsuit or get wet — during a nature bath, you’re “bathing” in the energy and clean air of the woods. A nature bath isn’t a brisk hike to raise your heart rate, either. It’s more of a calming stroll that helps you take it easy and appreciate the beauty of your surroundings. Think of it as meditation. You’re relaxing and reflecting while improving your focus and immune system in a soothing setting. (source: Mercy Health)
There are many reasons to incorporate time spent enjoying our beautiful landscape into your life.
Nature reminds us that death is part of the circle of life.
“In the spring, life begins anew, continues into summer, begins to fall in autumn, and dies in winter. But there is hope – life begins again. In many ways, our individual lives experience these seasons.”
Nature nurtures our mental and emotional health.
“Research shows that there is a link between connecting people with nature and faster recovery rates, reduced stress, and eased symptoms of mental and physical disorders. ”
Nature brings wonder back into our lives.
“When we’ve lost someone we love, life seems a bit dimmer. Its joys aren’t as joyful; its mysteries aren’t as fascinating. But nature can help bring wonder back into our lives. The majesty of the Rocky Mountains; the beauty of a sun-kissed beach, flanked by turquoise waters; the rolling green hills of spring. Nature is limitless in its artistry and can remind us that there is still beauty in the world.”
Nature also affords us quietness and solitude, allowing us to disconnect from the world around us.
Throughout these beautiful summer months, we encourage you to go get outside, and find the beauty in nature that will connect to you own journey.
Sources: Nature & Your Grief Journey, Nature Baths: What Are They, and What Are Their Benefits?
Palliative Care Around the World continued...
Europe
European palliative care is significant and substantial, with the European Union funded project INSUP-C (Patient-centered palliative care pathways in advanced cancer and chronic disease), meant to optimise palliative care delivery in Europe and predict future healthcare needs. At the national level, hospice and palliative care activities have been developing in Europe since the late 1960s. International organisations to support palliative care have been in existence since the late 1980s There are only a handful of countries in the European region with no known hospice or palliative care initiatives.
HIGHLIGHT - St. Giles Hospice
St. Giles is an independent voluntary sector organisation, operating as a charity. It offers specialist palliative care services with a mixed model of professionals and volunteers. Current innovations are developing from the recognition that engaging with local communities, promoting well-being, and a supportive care approach will be needed in the future. They use their day therapy centres to encourage personal contact, both social and therapeutic, to enhance personal well-being and resilience. Palliative and end of life services are now part of a national strategy in the UK and are increasingly being provided outside of stand alone community hospices and in National Health Service Hospitals.
sources and further reading
The Conversation Publication
The Importance Of Cultural Competence in Pain and Palliative Care
Palliative Care Development in South America: A Focus on Argentina
A Special Article: Palliative Care Development in South America: A Focus on Argentina
End-of-Life Care in Latin America
WHO - Global Atlas of Palliative Care at the End of Life
Palliative care development in the Asia-Pacific region: an international survey from the Asia Pacific Hospice Palliative Care Network (APHN)
What is the meaning of palliative care in the Asia-Pacific region?
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Help today for support tomorrow !
WE NEED YOUR HELP – GIVE TODAY! It will take financial support from people like you to reach our goals.
You can donate online or you can mail a cheque to us directly to Palliative Care Society of the Bow Valley, PO Box 40113, Canmore Crossing, Canmore, AB T1W 3H9. Specify if you want to contribute to our projects: General or Building. Donations of $25 or more will receive a charitable receipt. Your donation will contribute to the amazing work done by our volunteer teams, including the efforts towards building our future rural residential hospice right here in the Bow Valley.
Contact Kristin Fry at (403) 707-7633 if you would like to help.
We appreciate your support !
FB: @palliativecarebowvalley | Twitter: @PCSBowValley | Insta: Palliative Care Bow Valley
LOCAL PARTNER EVENTS! AUGUST 2021
free “ Try Mountain Biking ” session
adulting 101 session
Practical skills and tools to face adult situations Topic-specific resources and local contacts Self-esteem and the confidence in their ability to live on their own An opportunity to meet other people the same age and create a support network A chance to win an Adulting goody bag with local treats and workshop-specific items Canmore FCSS is hosting ADULTING 101 Sessions. Ranging from outdoor survival skills to mental health and smart travel, each Adulting 101 workshop focuses on a different skill. Every workshop will provide participants with:
Community Connections Bow Valley is hosting a free “Try Mountain Biking” session for local permanent residents! From July 21st – September 12th, instructions, transportation, and mountain bikes will be provided at the Canmore Nordic Centre for those interested in learning more about this activity. Community Connections in the Bow Valley is funded by Immigration Refugees and Citizenship Canada to provide services to permanent residents. To register : 1) Email community.connections@banff.ca 2) Call / text; 403-497-4471
To register : ADULTING 101
Bow Valley Interagency Meetings
The Bow Valley Interagency meetings are co- hosted by Banff and Canmore FCSS. All community organizations and agencies throughout the Bow Valley are invited to attend to share information and to listen to guest speakers throughout the year discuss issues that are prevalent in our area. For more information on Bow Valley Interagency, please contact Lu Douce, Canmore FCSS 403.678.7136, or Shawn Carr, Banff FCSS 403.762.1255. Bow Valley Interagency 2021 Meeting Schedule: Thursday, Sept 16 Tuesday, Nov 16
canmore banff stroke support group
The Canmore Banff Stroke Support Group meets every 3rd Thursday of the month via Zoom. The goals of these meetings are to allow participants to join forces with other stroke survivors to offer encouragement, shared experience, and support along the journey.
To learn more, contact the organization at beginning2c@gmail.com
Bow Valley non profits speakers series
Bow Valley Primary Care Network
The Bow Valley Non Profits Speaker Series is continuing throughout the summer. Upcoming sessions include “The Value of Collaboration” on August 24th and “Strategic Planning” on September 28th. Free for all Bow Valley non- profits, the online event is available live on the 4th Tuesday of each month at 12 pm. To learn more visit Bow Valley Non-Profits
The Bow Valley Primary Care Network has a number of events happening in August and September! From “Designing your Health” to “Food From Home: Eating the Harvest,” and “Flexibility, Mobility, and Functional Fitness,” there are a wide variety of topics to choose from. Learn more and register at Primary Care Network Bow Valley
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