Palliative care

 A friend of mine has been fighting a number of issues for the past year and finally, his family decided to follow the doctor's advice and put him into palliative care. The decision was made after my friend had a bad fall, which aggravated his health. A few weeks after the fall, I was told that he had pneumonia and was rushed to the hospital. He is having trouble eating, drinking and swallowing. It is unlikely that he will get to go home. His wish was to have palliative care at home. Due to his current condition that is unlikely to happen.

My friend like most patients requiring palliative care support is known to have complex health services needs and to be a high health system user in the last months of life. Research has shown that referral to specialized palliative services, and the application of a palliative approach by primary care services even when still receiving curative treatments, can lead to a reduction in aggressive intervention at the end of life, reduced emergency room visits and hospitalizations, thereby increasing the quality of life.

Patients often express their wish to have end-of-life care at home. They want to die peacefully in their own home surrounded by their loved ones. However, if they experience acute symptoms such as shortness of breath, inability to eat or drink, or delirium, their caregivers may call 911. In my friend's situation, it led to patients being transferred to the emergency room. In some jurisdictions in Canada, paramedics and palliative care programs allow paramedics to treat those acute symptom needs, avoid transfer to the hospital and ensure continuity of care with the community team. This allows the patient to get the right care, in the right place at the right time. Ultimately, it honours the patient’s wishes for a peaceful death at home.

Palliative care for many is not understood and so people are reluctant to use this service. The earlier a person can take advantage of palliative care the better. The goals of palliative care are to provide comfort and symptom relief when faced with a life-threatening or life-limiting illness. Primary care clinicians are well placed to identify and work with those who may need palliative care, and many regions have palliative home care community programs to support palliative patients and their caregivers. However, both primary and palliative care community programs are often unable to provide urgent care 24/7 and do not have immediate access to resources such as medications. Expansion of the primary health care team to include service providers outside clinical settings and structured hours of care, with the goal of improving access to palliative care services, is needed.

 

Vancouver Town

 I read a blog on Rolf Harris and his song "Vancouver Town" and I thought I wonder how many songs are there about Vancouver. Here are a few:( enjoy) 

"Bridge Came Tumbling Down" by Stompin' Tom Connors

"English Bay" by Blue Rodeo

My Community by Ghost of Blood Alley

"Expo '86" by Death Cab For Cutie

"Fallen Leaves" by Billy Talent

"Dumptruck" by Blind Melon

"Summer Wages" by Ian Tyson

"Vancouver Shakedown" by Nazareth

"Vancouver" by Jeff Buckley

"Main & Broadway' by Cub

"The City You Live in is Ugly" by Young and Sexy

"The Crawl" by Spirit of the West

"Vancouver" by Genesis

"Vancouver Blues" by Tim Hus

"Vancouver B.C." by The Smugglers

"Vancouver Divorce" by Gordon Downie

"Vancouver Town '71" by Rolf Harris

"The Vancouver National Anthem" by Matthew Good

"Pine For The Cedars" by Dan Mangan

"Wrong Side of the Country" by Old Man Luedecke

"False Creek Change" and "2010" by Said the Whale

"Black Day in December" by Said the Whale

"Vancouver, une nuit comme une autre" by Aut'Chose

"Vancouver" a song and album of the same name by Véronique Sanson

"Vancouver" (Instrumental) by Violent Femmes

"Girl from Vancouver" by Svavar Knutur

"Tropical Rainstorm" by Doug and the Slugs

"Doldrums" by Elbow

"Wreck Beach/Totem Park" by The Zolas

"Effort" by Blue J

"Timezone" by Blue J

"Up Granville" by Peach Pit

"Back To Vancouver" by Funboy Five

We're Here For A Good Time (Not A Long Time) by Trooper

Chinatown Calculation by Doug and the Slugs

High School Reunion

 I graduated 57 years ago and I went to the 25th, 40th, and 50th reunions. Each of them had a different feel and I was glad I did. On the 25th I was struck by the posturing and one-upmanship that seemed to me too prevalent. I had the impression that people were trying to impress each other with how successful they had become. The other thing I noticed was that high school behaviours and cliques were reformed very quickly. I was not impressed, most of the people at the reunion were people who had stayed close to our hometown. I had moved away and had not been back or been in touch with anyone from high school since I left. I was glad I came but was a bit saddened by the event.

I was not going to go the 40th but a friend suggested I give it another chance. So I went. The reunion was a complete turnaround. People seemed more settled in and ok with what they had accomplished in life. There was more talk of family, and friends who were no longer with us. I think most people had become successful and held no need to boast or try to put others down. I saw some friends from school that I had forgotten but I was glad to see them and to catch up. Again, most lived near the town, but many had returned because they had parents and family to take care of in town. It was a lot more fun and I met some people, with whom I continue to correspond from time to time. The group actually started a Facebook page and I read it at least two or three times a week to keep up to date. I was very glad I went.

We had our 50th, 7 years ago and we are looking forward to the 60th. The 50th was more fun and surprisingly there were more people that had not been to the other reunions. I had forgotten many of these people, but when I saw them, it was a pleasure and fun to get caught up. I had a great time and I hope that when we have the 60th there may be other surprises that await me.

Reunions have their own unique culture and each of the ones I have gone to has given me ideas to think about, surprises and brought back many positive memories. I hope that you have someone who is committed to organizing and running your high school reunion. I would like to thank the men and women of my graduating class who  over the years have done a great job of keeping memories alive.

Spontaneous

 I have a friend who has vascular dementia but he is handling it well and by doing mental and physical exercises he has slowed down its advance. He is open and friendly and sometimes can get caught up in the moment and lose himself.

We were at a football game the other day and our team won so everyone was in a great mood. Three of my friends including my friend who has vascular dementia had arrived together. We had all parked in the same parking garage. 

As we wandered back to the car, my friend and I were chatting and we were falling behind the other two who were in a hurry to leave before the crowd. All of a sudden  I am talking to myself, and my friend is off talking to someone in the next block The conversation lasted about 5 minutes. I stopped and waited for him. As he came back, I asked him, if the person he was talking to was someone he knew. He said no, he just wanted to tell the man that he liked the football sweater he was wearing. My friend then wandered back in history to when he had actually met the player named on the sweater worn by the stranger. 

My friend looked around and looked a bit confused, so I said the car is this way and our friends are waiting up the street. My friend smiled and we moved to catch up to the other two, who had realized we were not right behind them so they had stopped and waited. As we moved into the parking lot, my friend saw something someone was doing in their car and he stopped and went over and chatted with them for a few minutes. All of us waited and then when he was ready we took him to the car.

My friend is spontaneous and always has been so, but these days we need to keep an eye on him because once he has finished talking to a stranger, he can forget where he is and where he needs to go next. He gets to meet a lot of great people and always has a good time. Sometimes i wish I had the courage to be just as spontaneous as he is, It is a good trait.