"If I had one wish of what the healthcare system knew about end of life doulas, it would be that if you embed end of life doulas into your healthcare settings, not as healthcare professionals, but as social emotional supports that their job would be a lot easier. People would be aware of advanced care plans, and people would be aware of actually just thinking through what they want. Families would be more educated, so families would be calmer and more understanding, and they would know what the death process looked like... together we could really help each other."

Jennifer Mallmes has worked as a caregiver and advocate for quality end of life care in Canada for over 25 years. She has worked extensively in community home care, finding deep purpose in supporting individuals to remain at home as they near the end of life. Jennifer is the co-founder of the End of Life Doula Association of Canada, and the creator and lead instructor of both the End of life Doula program and the Indigenous End of Life Guide program at Douglas College. Jennifer's passion is rooted in the belief that all individuals should have the right to self-determination in their end of life care. Through her work, she strives to ensure that people are empowered to consciously live and die with dignity, choice, and compassion.

Douglas College End of Life Doula program

End of Life Doula Association of Canada

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

"There are people who are saying we can't continue to do what we've always done. Don't tinker around the edges and make things a little bit better in the same old template that you've always had. Get rid of that. Change it radically, be bold, move forward."

Elroy Jespersen envisioned a different type of community where people living with dementia could live their own best life. His vision has resulted in The Village Langley, a groundbreaking community designed for people living with dementia and memory related conditions that offers cottage style living surrounded by five acres of walking past gardens and farm animals.

Learn more about The Village Langley: https://verveseniorliving.com/the-village/

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

How does architectural design impact the quality of life for residents in long-term care? And how does design influence a palliative approach to care? We spoke with two architects at Montgomery Sisam Architects who have a particular passion for thoughtful design in long-term care.

Neda Basharat has been focused on creating home-like environments for seniors within the long-term care sector for over a decade. Her recent work explores innovative models in long-term care, which supports and promotes autonomy for residents, as well as prioritizing both improved resident quality of life and staff wellness.

For almost two decades, Tony Ross has been focused on projects that create a home and provide care for the elderly. A large portion of this work has been supporting innovation in long-term care, working and learning with others to create buildings that pursue normal and the highest quality of life for residents.

Learn more about their work: https://www.montgomerysisam.com/

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

"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/