Palliative care doesn’t only go to the dying

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      (Dr. Pippa Hawley will be a panelist at the Georgia Straight's upcoming event, Grassroots: An Expo for the Cannabis Curious on April 7 and 8, 2018. Get your tickets now.)

      Dr. Pippa Hawley is keen to shatter myths about palliative care. In a phone interview with the Georgia Straight from her office, the UBC medical school’s division head of palliative care emphasizes that it’s not only for those with terminal illnesses.

      “The old models of palliative care have not really included survivorship,” Hawley explains. “People wait until they’re 100-percent certain that they’re going to be dead before they even think of palliative care. But by then they’ve missed out on so much potential benefit. They then get too little, too late. We want to get people thinking about it earlier and planning ahead.”

      In a three-page letter published last year in the Journal of Pain and Symptom Management, Hawley pointed out that the World Health Organization’s definition of palliative care has expanded beyond treating people with incurable diseases. Nowadays, it’s applied to life-threatening conditions such as heart disease and renal failure, sometimes early on, to achieve its greatest potential.

      “Palliative care isn’t necessarily a thing or a place,” Hawley says. “It’s an approach to care, which can be delivered in all sorts of different environments. The hospice is…for people who don’t have sufficient support at home to be able to die at home. But many people do have wives and children and other supports. And they would much rather be around home than in an institution—and that doesn’t necessarily mean that they’re not getting good care. They can actually get excellent care in their own home if they know what they need.”

      In effect, she adds, it’s important for people facing life-threatening conditions and their caregivers to find out what they don’t know about palliative care. Because once they find answers, they’re in a better position to obtain the help they need from the health-care system.

      “You’re more likely to indicate to your family doctor that your pain management isn’t really very good,” Hawley says. This, in turn, might lead to the person asking the general practitioner for a referral to a palliative-care specialist.

      Hawley says she became interested in palliative care when she was training in internal medicine with oncology patients. In the early 1990s, she did a research fellowship with Dr. Julio Montaner, who’s been a pioneer in developing effective therapies for controlling HIV. She recalls it as a time when people were “dying in droves” from infections triggered by compromised immune systems. It sparked her interest in learning more about how to control people’s symptoms and bring about improvements at the end of their lives.

      “Being able to treat disease is only one part of what people need from the health-care system,” she states. “They also need to be helped to live with diseases when they’re not curable. This is a part for me that I found to be really satisfying and very much needed.”

      At the same time, Hawley doesn’t want people to think that practising palliative care is depressing and grim. She maintains that it’s exactly the opposite because people with limited life expectancies make the most of their time. She even runs a “Bucket List Festival” in different communities around the province where people show up at events and make lists of what they would like to do before they die.

      “They tend to stop sweating the small stuff,” Hawley insists. “People only want to spend time on things that really matter to them. So it’s a tremendously valuable time. People have a ton of fun.”

      The UBC faculty of medicine’s division of palliative care will host a free public discussion at 6:30 p.m. on December 8 at the Sheraton Wall Centre. Tickets are available at the Eventbrite website.