"It's about looking at the finer things... preferences in their meals, and giving families special spaces to be together with their loved ones in those final moments ... ensuring we meet the needs of each individual resident."

Grand View Manor is a long-term care and assisted living facility located in Berwick, in Nova Scotia's Annapolis Valley.

Laurel Pizarro is a registered nurse and the Director of Care at Grand View Manor with over 10 years experience in geriatric care and a passion for making a meaningful impact in long-term care.

Helen Stoakes is a registered nurse originally from the UK with a background in dementia and palliative care. She is the Nurse Manager at Grand View Manor and leads the Palliative Care Champion Committee.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"It's kind of an altered state of consciousness where they are just not themselves. Dealing with my dad, sometimes it comes across as delusions and paranoia, it's this otherness, it is not him. It's a body response or a mind's response to these things that they can't handle." - Marlene Moorman

Delirium is frightening for both the affected person and their loved ones. It can be caused by many factors and is often characterized by confusion and behavioural changes.

We spoke about delirium and dementia with Pam Holliday, Margaret Keatings and Marlene Moorman, members of SPA-LTC's Partner Working Group.

A Partner Working Group is composed of family or care partners with diverse experiences. They add value to research and the development of clinical tools to support professionals and family care partners. The Strengthening a Palliative Approach in Long-Term Care program has put together a Partner Working Group with the support of a grant from Health Canada to help align the materials created for professionals working in long-term care homes and for family members caring for persons living in long-term care homes.

Learn more about SPA-LTC resources for care partners

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"There's kind of a magical quality with music, a healing or a support really that comes from the music. As long as people have been around, we have been making music and it really does connect with us on an emotional level." - Sheila Killoran

Sheila Killoran is the Education Lead for the Covenant Health Palliative Institute. She is a certified music therapist and holds a Master's in Creative Arts Therapies with an interest in guided imagery and grief. Sheila teaches at the University of Alberta and the University of Saskatchewan, and has provided music therapy for the past 20 years in Palliative Care, Hospice, and Continuing Care settings in Edmonton Alberta.

Learn more about music therapy programs:

Canadian Association of Music Therapists: www.musictherapy.ca
Canadian Music Therapy Training Programs:
Related Links - CAMT : CAMT
https://www.musictherapy.ca/about-camt-music-therapy/related-links/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"Sometimes people can really shut down and the horses can get in there and reach in and welcome them back to being present. The horses are gifted. It's all them."

Jennifer Semach is the founding Executive Director and program facilitator of Walkabout Farm Therapeutic Riding Association, a charitable organization in Minden, Ontario that offers free mental and physical health services on 100 acres of land with the help of therapeutic support animals: horses, cats, and rabbits. She also brings miniature horses to visit residents and their families in long-term care.

Equine therapy promotes the physical, neurological, and emotional well -being of all through human and animal interactions.

Learn more about Walkabout Farm: https://walkaboutfarmtra.com/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"You don't know what's going wrong. And you have all these theories, but it's a long time before dementia is one of the hypotheses..."

Fay Martin is a retired social worker who lives in Haliburton County, a small rural community in Ontario. She cared for her husband, who had dementia, until his death in 202. He died with - but not of - dementia, sparing them the ravages of the later stages of that disease. Nevertheless, it knocked their lives sideways.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

What is person-centered care and how does it contribute to a 'good' death? We spoke with Kristen Lew-Byrne, a registered social worker who talked to us about patient-centered care, and how social workers work with team members, residents and families to help achieve a good death means for each individual.

Kristen Lew-Byrne is a registered social worker who has worked alongside and supported residents and their families within long-term care for 11 years. She works from a holistic person-centered approach, which consists of intersecting psychosocial pieces and needs. Kristen is passionate about taking an ongoing palliative approach and redefining end of life care and what a good death can look like for residents in long-term care.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"Nurse Practitioners are well positioned to help residents and families navigate their life limiting illness. We have the knowledge and skillset to provide their primary medical care, their maintenance therapies, and the treatment of chronic illness flareups. I think the value add is that we can also integrate this approach and philosophy throughout the continuum of care."

Nurse Practitioners play a significant role in long-term care, but many homes do not have one on the team. We spoke with Nurse Practitioner Jennifer Burgess about the role and how NPs can support other team members by modelling conversations, and how they are part of a holistic effort to integrate a palliative approach in long-term care.

Jennifer Burgess is a primary healthcare nurse practitioner who has been caring for older adults and within the long-term care sector for 20 years. She has been a direct care provider as a charge nurse and educator, a collaborator with community partners, and is now a nurse practitioner. For the past 10 years, she has been fortunate to have many wonderful mentors in palliative care that initially sparked her interest in helping those who are approaching end of life and who are at the end of life.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"I think a lot of people, when you say the word palliative, they think the end of life is imminent. And that's not the case at all. These are conversations that should be starting to happen on move in or even before move-in."

Sarah Murphy is a licensed practical nurse and the assistant director of care at The Hamlet's long-term care community in Vernon, British Columbia. She has been working long-term care for eight years and has served as a Care Service Lead, Care Coordinator, and now the Assistant Director of Care.

In this episode, we spoke with Sarah about the benefits and drawbacks of pre-printed orders, and the need to distinguish between palliative and end-of-life care.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/