Nova Scotia Hospice/Palliative Care
Table of Contents
Mission Statement and Definition
Board of Directors
Communication Committee Report
Education Committee Report
Nominations Committee Report
District 1 – South Shore Health
District 2 – Southwest Health
District 3 – Annapolis Valley Health
District 4 – Colchester East Hants Health
District 5 – Cumberland Health
District 6 – Pictou County Health
District 7 – Guysborough Antigonish Strait Health
District 8 – Cape Breton Health
District 9 – Capital Health
District 9 – IWK Health Centre
Advocacy has been the key focus for the Nova Scotia Hospice Palliative Care Association this past year.
We are pleased to say that several of our goals were met as outlined below:
1. A commitment from the government to hire a Provincial “Co‐ordinator for Palliative Care” was
obtained and this coordinator has been hired. We welcomed Ms Heather MacDonald to this very
important position and look forward to working with her in the development of the Provincial
2. We have increased public awareness of the issues and needs for Palliative Care in Nova Scotia.
3. Our board has added representation from the ALS society, the Lung Association and Care Givers
Nova Scotia and we have met with some of the hospice societies across the province and other
stakeholders to form alliances with groups concerned with the care of the dying.
4. Education continues to be provided through the newsletters and the provincial conference.
We look forward to the next year and have identified important goals for 2009 ‐2010 including:
• Continue public awareness.
• Advocate for medication/equipment coverage specifically for Palliative Care patients.
• Ensure that work continues to progress on the development of the Provincial Palliative
• Work with the Department of Health to develop standards for Hospice Palliative Care in
• Develop a stronger link with community Hospices across the Province.
Dr. David Henderson,
Our Mission is to strive towards achieving comfort and peace for persons living and dying with a life
threatening illness throughout Nova Scotia.
The Association exists to promote the philosophy and principles of palliative care through networking,
public and professional education, advocacy and research.
The Association is committed to education and public awareness of the needs of those with a life
threatening illness; thus enabling and empowering communities to recognize the values, needs and
wishes of all persons across all stages of life.
PALLIATIVE CARE (CHPCA)
Hospice palliative care is aimed at relief of suffering and improving the quality of life for persons who are
living with or dying from advanced illness or are bereaved.
Les soins palliatifs visent à soulager les souffrances et à ameloirer la qualité de vie des personnes qui
sont a un stade avancé de leur maladie, de celles qui sont en fin de vie, et des celles qui vivent un deuil.
Nova Scotia Hospice / Palliative Care Association
207 Willow Street
Truro, Nova Scotia
Phone: (902) 893‐7171
Fax: (902) 893‐7172
BOARD OF DIRECTORS 2008‐09
Dr. Ina Cummings Montreal
Elizabeth Dingwall Black Point
Elinor Mullen Digby
Dennis MacDonald Pictou
President Dr. David Henderson Truro
Palliative Care Physician
Colchester Regional Hospital
Past‐President Krista McMullin Truro
Colchester East Hants Health Authority
Treasurer Louis Brill Halifax
President and CEO
Nova Scotia Lung Association
Secretary Vacant Halifax
Education Co‐Chairs Grace MacConnell Halifax
IWK Health Center
Communication Co‐Chairs Nancy Cameron Pleasant Hill
Palliative Care Coordinator
Kathryne Phillips Wolfville
Retired School Administrator
DHA 1 (South Shore Health District)
Janet Carver Lunenburg
Manager, Palliative Care SSH
DHA 2 (Southwest Health District)
Nancy Castlebury Yarmouth
District Manager, Palliative &
Supportive Care Services
Yarmouth Regional Hospital
DHA 3 (Annapolis Valley Health District)
Kathryne Phillips Wolfville
Retired School Administrator
DHA 4 (Colchester East Hants Health District)
Mark Scales Truro
Manager, Seniors Clinic & Palliative Care
Colchester Regional Hospital
DHA 5 (Cumberland Health District)
Gerry Helm Amherst
DHA 6 (Pictou County Health District)
Tracey Meade New Glasgow
DHA 7 (Guysborough Antigonish Strait Health District)
Nancy Cameron Cleveland
Palliative Care Coordinator
St. Martha’s Hospital
DHA 8 (Cape Breton Health District) Sydney
Dr. Ann Frances D’Intino
Palliative Care Physician
DHA 9 (Capital Health – IWK Health Centre)
Peter MacDougall Halifax
Health Services Manager
Capital Health Integrated Palliative Care Services
Dr. Gerri Frager Halifax
Medical Director Pediatric Palliative Care
IWK Health Centre
Pediatric Palliative Care Service
Grace MacConnell Halifax
IWK Health Centre
Alyson Currie Halifax
Caregiver Support, Coordinator,
Social Worker Candidate
Caregivers Nova Scotia
Judy Simpson / Marianne Arab Halifax
Cancer Care Nova Scotia
Maggie McGee Halifax
Vice‐President, Prevention Programming &
Nova Scotia Gaming Corporation
Louis Brill Halifax
Nova Scotia Lung Association
Mary Hatcher Halifax
ALS Society of Nova Scotia
Martina Munden Truro
Carolyn Irving Truro
Krista Anderson Kentville
Webmaster / Newsletter Publisher
The significant change from last year to this is the addition of Heather MacDonald as the
Coordinator of Palliative and Supportive Care in Nova Scotia. She started her in her position in
early January. Preliminary work has begun but many Nova Scotians are still without
medications required for pain and symptom management, access to appropriately trained
professionals and volunteers to support them and their families while facing end of life. A
strong foundation is required, including sound standards, to build a Provincial Palliative Care
program and our role, along with helping with the development, will be to remind people of
the urgency to accomplish these goals for the sake of the 8000 plus people who will die in
Nova Scotia in the next year and in years to come. 70,000 people have died in the last 10
years while this issue has been studied and discussed without significant standardized
We had the pleasure of meeting with the Minister of Health, the Hon. Karen Casey, and
reviewed the above issues. Our Province needs to continue to move this agenda forward
despite the difficult economic times. Dying people in Nova Scotia can’t wait. There will need
to be money dedicated to the improvement of Palliative Care services in Nova Scotia in the
next budget. With an expected spring election we are requesting meetings with the NDP and
Liberal parties to discuss these same issues. Nova Scotians can’t afford to lose more time with
a potential change of Government. We need assurances that the work being done won’t be
We will need to advocate for the development of standards for not only Palliative Care
services provided by the district Palliative Care programs but also for Hospice Societies as I
believe they will become even more involved with the care and support of those living in their
communities. There are currently no residential Hospice Houses in Atlantic Canada (Hospice
Greater Saint John has recently been promised operational funding for their 10 bed facility
scheduled to open in 2010). We will need standards for these and for Nursing Homes
reporting to offer “Palliative Care beds/services”.
Our board continues to develop and has some tremendous members as evident by the
exceptional newsletters that are produced and the quality of the Provincial conferences and
the advocacy work being done in the province. We are up for the challenges ahead.
Dr. J. David Henderson
As my role as past president, I have been a board of director with the Canadian Hospice
Palliative Care Association (CHPCA), as the Nova Scotia representative; have been chair of the
NSHPCA nominating committee and have taken an active role in the NSHPCA advocacy
campaign. I am a member of the Policy Sub‐Committee of CHPCA.
Below I will highlight some of the initiatives that CHPCA has been working on this year that
support the mission of the organization.
1. The planning for the 2009 Conference in Winnipeg in 2009
2. Affirmed commitment of our Memorandum of Understanding between the provincial
associations and CHPCA.
3. The GlaxoSmithKline Foundation has committed to another year of funding for the
Living Lessons Campaign.
4. CHPCA is planning to review and update new information for the Issue Document on
Euthanasia and Assisted Dying.
5. Hospice Palliative Care Week 2009 theme is Palliative Care as a Human Right.
6. CHPCA is continuing to strengthen their partnership with Canadian Partnership Against
7. On the policy sub‐committee we are looking at developing board evaluation process and
tool, and a confidentiality pledge.
8. Some of the issues that the provinces have identified for further discussion are:
• Workforce issues
• How to strengthen provincial voices through advocacy and sustainability
• Common voices, common visions
• Advance Care Planning
• Primary Health Care and Long Term Care
• Relationship Building with our partners within our provinces
• Hospice Palliative Care Norms
9. CHPCA Award of Excellence was awarded to Dale Orychock at our National Palliative
Conference in PEI in October. Dale has been a leader in Palliative Care not only in Cape
Breton but through NSHPCA for many years. Congratulations, Dale.
Next year looks to be very busy both nationally and provincially as we move toward
making palliative care a human right.
Krista McMullin, Past President
Our general funds increased significantly this year due in large part to the financial success of
the 2008 NSHPCA Conference. This event incurred $28,595 excess revenue. The year began
with $29,522 in the bank. Throughout the year additional $18,674 excess revenue was raised.
To enhance the benefit of our cash surplus the Board approved the purchase of $40,000 in
short term GIC’s with Credit Union Atlantic. This money is currently invested at 2.5 %.
We are also pleased to have implemented the software Simply Accounting to manage the
NSHPCA books. As well NSHPCA has purchased Point of Sale (POS) technology that will allow
processing of both debit and credit card payments. This POS terminal cost approximately
$1900. This technology will add to the efficiency of the Annual Conference and will also provide
potential contributors a donor friendly method to support our association.
The Association would also like to thank Smith and Touesnard, Chartered Accountants for their
continued assistance on the review of our accounting books, filing for HST rebate and compiling
year‐end reports to Revenue Canada to maintain our charitable status.
Nova Scotia Hospice Palliative Care Association
Financial Statement of Operations and Surplus
Year Ended – March 31, 2009
Credit Union Interest 0.00 933.53
Spring Conference 28595.00 24,214.48
Membership Fees 3,265.45 5,296.00
Corporate Support 1,000.00 1,214.00
HST Rebate, Revenue Canada 3,435.54 1,506.94
Donations 359.80 1,517.00
Volunteer Manuals 0.00 300.00
Fundraising 0.00 0.00
Daisy Day 0.00 1,296.16
Restitution Payment 1,500.00 1,488.20
Miscellaneous (Note #1) 3,433.65 8,917.73
Ina Cumming’s Bursary 0.00 0.00
Deferred Revenue 1200.00 0.00
Totals: 40,954.24 46,778.65
CHPCA Annual Fee 350.00 350.00
CHPCA Membership Stipend 1,205.00 2,725.00
Spring Conference 5,115.00 5,000.00
Annual Conference Admission Cost 0.00 3,030.00
Executive/Board Meetings/Conference (Note #2) 2,626.80 4,030.72
Annual Report/Newsletters (Note #3) 4,458.68 3,176.99
Admin/Clerical Support 1,880.84 1,362.75
Office Expenses (Note #4) 1,728.99 2,078.00
Website Maintenance 1,432.35 1,439.78
Board Insurance 418.10 475.00
Registry of Joint Stocks 0.00 25.00
Provincial Advocacy 766.14 12,871.61
Miscellaneous (Note # 5) 816.49 9,176.88
Dr. Ina Cumming’s Bursary (Note # 5) 0.00 3,000.00
Palliative Care Volunteer Initiative 0.00 598.33
Advocacy Initiative (Brochure) 1,481.45 4,315.93
Prepaid Expenses 1835.20 0.00
Totals: 22,279.84 57,184.30
Excess of Revenue Over Expenses 18,674.40 (10,405.65)
Balance Forward Beginning of Year 29,522.55 39,928.20
Balance Year End 48,196.95 29,522.55
Surplus Year End 48,196.95 29,522.55
Nova Scotia Hospice Palliative Care Association
Year Ended – March 31, 2009
Current Bank Balance 10,815.49 29,522.55
Prepaid Expenses 1,835.20 0.00
Investments (GIC’s) 40,000.00 0.00
Total Assets 52,650.69 29,522.55
Liabilities and Funds
Deferred Revenue 1,200.00 0.00
Investment Fund 40,000.00 0.00
General 11,450.69 29,522.55
Total Liabilities 52,650.69 29,522.55
Nova Scotia Hospice Palliative Care Association
Notes to Year End Financial Statements
Squires Pharma contributed $1000
Five Hills Health 100.00
PCM SW Meeting 3000.00
Transfer from old Acct 309.07
Deferred revenue of $1200.
Cash received prior to YE for the 2009 NSHPCA Conference.
The cost of printing our brochure was $1481.45
The cost of establishing Point of Sale (POS) Credit Card and Debit capabilities was $1835.20. This cost
was paid prior to Year End and will be credited to 2009/2010.
Communication’s Committee Report
Committee members: Nancy Cameron, Co‐Chair; Kathryne Phillips, Co‐Chair; Alyson Currie, Member‐
at‐Large – Caregivers Nova Scotia; Gerry Helm, District Director; Mary Hatcher, Member‐at‐Large –
ALS Society of Nova Scotia; Debbie Ross (in part), Newsletter Editor; Krista Anderson, Newsletter
Publisher and Web Master.
The membership of the Communications Committee was almost completely new as we began the
2008‐2009 year. Many thanks are extended to those who helped us to achieve our goals and we are
especially indebted to Janet Carver, Past Chair of this committee and extend our gratitude to her. We
also extend special mention to Krista Anderson, our Newsletter Publisher and Web Master, for her
kindness and assistance, and to Debbie Ross for her timely help at the beginning of the year.
The following are the Communication Committee Goals set by the committee for the year 2008 –
2009. Activities related to each goal are summarized.
1. To publish the NSHPCA newsletter 3 times per year
The newsletter was published three times during this past year: July, November, and March. With
the leadership, patience and generous help of Janet Carver and Krista Anderson we managed to
publish the summer issue of the newsletter. The subsequent issues in November and March were
more easily achieved.
We focused on a few particular elements in the newsletters: introduction of members of the Board of
Directors; invitation to Hospice Societies and Foundations to share their experiences, achievements,
and progress; focus on articles highlighting topical palliative care issues of national and provincial
interest; inclusion of resource reviews; our President's message; and district updates.
Krista Anderson, as publisher, has also transformed the look of the newsletter to reflect the graphics
and colour scheme represented on the exceptionally attractive NSHPCA Brochure.
The length of the newsletter is an issue when we look at production and printing costs. Efforts to
streamline the March issue resulted in a more compact reporting while maintaining the integrity of
the newsletter itself. One initiative for the committee next year is to try and engage some company
to help sponsor the newsletter.
2. To encourage the NSHPCA Board of Directors to regularly submit articles and information for
inclusion in the newsletter and for the website.
We can congratulate ourselves for 100% representation in one issue and 100% participation over the
year. Finding time to write up a report is often difficult when life is spinning and demands are great
in our lives.
3. To oversee the quarterly updates and maintenance of the NSHPCA website.
Krista Anderson is an extremely valuable member of our communications team. Not only does she
make our newsletters shine, she manages and updates our web site. Using the beautiful format and
colouring of our new association brochure, Krista has updated the design of our site as well as the
content. Having established a new web service, Krista has the facility to upload and update our site
more frequently and on an "as needs" basis – a significant improvement to our past capability. We
want to utilize the web site for newsletter links and updates to new resources and conferences.
Having the ability to access the site more frequently definitely gives us an advantage. We are only
limited by volunteer time and availability.
People continue to submit petition entries on the website in support of the Advocacy Campaign,
surely a sign that our continuing work is both appropriate and necessary.
4. To oversee the administration of the web master's contract and to re‐negotiate the contract
when it comes up for renewal.
We will be continuing our association with Krista Anderson and look forward to establishing new
dimensions to her role as our Newsletter Publisher and Web Master. Our current contract is based
on a specific number of web updates which limit our opportunity to update information more
frequently. With Krista's new web service, we have the facility to keep our web site updated with
more timely and pertinent information.
5. To review the list of NSHPCA newsletter recipients (beyond the membership of NSHPCA), and
revise as necessary.
With the help of Carolyn Irving, our new association administrative assistant, we are reviewing the
recipients of the newsletter and have added new contacts. Conference participants who do not
currently hold a membership will also receive complimentary Association news by e‐mail for the rest
of this year and an invitation to join the association in 2010.
6. To circulate at every board meeting, the Board of Directors contact information list for revisions.
Ensure revisions are circulated with each set of minutes.
Keeping our contact listing up‐to‐date permits others to have access to those who have work to keep
alive the ideals and mission of the association. The Board of Directors listing is updated on the web
site on a regular basis.
7. To revise the Provincial Directory of Hospice Palliative Care Programs and Services and update on
NSHPCA web site.
Keeping a Provincial Directory up‐to‐date is a daunting task! Work has begun on the review of
contacts and many changes have already been noted. This directory appears on the association web
site and our web master has added a "click here" button to permit viewers to simply e‐mail changes
they discover when reviewing the document for resource people. We will also be working on an
addition process by which updates may be more easily achieved.
The achievement of this Directory in itself was a huge undertaking for which we extend thanks to
Janet Carver and the members of the previous Communications Committee.
8. To make Districts and Hospice Societies/Foundations aware of National Hospice Palliative Care
Week & Daisy Day
This is a goal we have set for ourselves in the coming year. Please keep an eye out for this
information. Congratulations to those who have actively participated in this year's events.
Nancy Cameron & Kathryne Phillips
Co‐Chairs, Communications Committee
Education Committee Report
We are pleased to present the Education Committee Annual Report on behalf of the following
members of the Committee: Peter MacDougall, Nancy Castlebury, Mark Scales, Tracey Meade,
Monica Flinn, Judy Simpson We are indebted to each of them for their dedication and enthusiastic
input over the past year.
One of the primary initiatives of the NSHPCA, which falls under the mandate of the Education
Committee, is the annual provincial conference. The 2009 conference under the leadership of and
supported by a dynamic planning committee is taking place in Cornwallis, April 30‐May 2nd. The
conference is entitled quite appropriately Peace Talks.
Other initiatives of the Education Committee include:
o Overseeing the Dr. Ina Cummings Bursary, an annual bursary that recognizes Dr. Ina
Cummings, a retired Nova Scotia Palliative Care Physician, former President of the
Canadian Hospice Palliative Care Board and former NSHPCA Board Member.
o Assisting in the administration of the Gillian MacMicheal Bursary, a bursary set up by
Gillian’s family and administered by the QEII Health Sciences Foundation
o Overseeing the Provincial Hospice Volunteer Training Program review and revision in
partnership with Cancer Care Nova Scotia
o Assisting with the annual orientation for new NSHPCA board members.
This year, Dr Gerri Frager was the successful applicant for the Dr. Ina Cummings Bursary. The
committee will again begin promotion of the bursary in the fall to continue this important bursary
for educational and research endeavours throughout Nova Scotia.
As in past years the Gillian MacMichael Bursary will be awarded to recipients during the banquet
at the Conference in Cornwallis. Recipients will be named in future NSHPCA newsletters. This
marks the sixth year that educational bursaries have been awarded. The NSHPCA Board supports
the Gillian MacMichael Bursary by having two of their members on the selection committee. The
association is indebted to Arlene and Stephen Waymire and to the MacMichael family for their
dedication to palliative care education.
The orientation for new board members will begin in June, 2009. Through the orientation process
new board members are provided with information on the board structure and key activities as
well as the roles and expectations of board members.
Planning for the 2010 NSHPCA Conference will begin soon, following the usual rotation of
conferences the Eastern part of the province will be hosting the event. As dates and more
information become available they will be shared with members via the website and the
As in past years there have been many educational initiatives throughout the Province. Front‐Line
Education for front‐line staff and students and numerous district palliative care education sessions
promote a deeper understanding of palliative care issues for professionals, volunteers, and the
general public. The NSHPCA Education Committee is indebted to all those throughout the province
who are providing education for palliative care.
We have enjoyed working with the Education Committee this year, and look forward to working
together in the future.
Marianne Arab & Grace MacConnell
Co‐Chair, Education Committee
* Please note that this year has been one of change as Marianne, Co‐Chair of the Education
Committee accepted a position with Cancer Care Nova Scotia and became a member at large
representing that organization. The Board, and particularly Grace, her co‐chair extends special
thanks to Marianne for continuing to assist in the work of the Education Committee during her
Membership in Nova Scotia Hospice Palliative Care Association has decreased slightly over the
past year. We are indebted to the executive, district directors and members for renewing their
membership and for their continuing efforts in encouraging new members to join the
association. The following is a summary of the membership up to April 18, 2009.
Table 1: Membership Information
Number of Unpaid Members (2007) 71
Number of Unpaid Members (2008) 84
Number of Paid Members (2009) 123
Total Number of Members in Data Base 278
Points of Note:
1. All members 2009 are considered to be paid members.
2. All members 2007 & 2008 are now considered to be unpaid members.
Paid Unpaid Unpaid
Table 2: Breakdown of Membership by Region
(2009) (2008) (2007)
DHA 1 (South Shore Health) Members 9 6 4
DHA 2 (Southwest Health) Members 9 4 6
DHA 3 (Annapolis Valley Health) Members 12 9 3
DHA 4 (Colchester East Hants Health) Members 4 6 3
DHA 5 (Cumberland Health) Members 5 3 3
DHA 6 (Pictou County Health) Members 8 7 7
DHA 7 (Guysborough Antigonish Strait Health) Members 18 14 11
DHA 8 (Cape Breton District Health) Members 15 10 8
DHA 9 (Capital Health IWK Health Centre) Members 39 16 24
Non NS Members 1 2 2
Nomination Committee Report
The nominating committee for 2008/9 is Judy Simpson, Shelagh Campbell‐Palmer, Dave
Henderson, and myself as chair. The following board members’ terms are complete or were
not able to complete their term due to personal reasons:
Vacant Positions are:
Co chair Education (1)
District Directors ‐ 6
A slate of nominees will be presented to the membership at the AGM.
Chair, Nomination Committee
DHA 1 – South Shore Health
The South Shore Health Palliative Care Service continued to experience a number of challenges associated
with an adequate staffing complement. However, starting in May 2009 the service will be back to its normal
This past year saw the retirement of Heather Cooke, Consultation Nurse, for Queens County. As we were
unsuccessful in securing a replacement for her, Anna Claire Mac Adam, Casual Consultation Nurse assumed
this role for a seven month period. Beginning in May 2009, Heather Cameron will be joining the Team as the
Full‐Time Consultation Nurse for Queens County.
After a few staffing changes in Lunenburg County, Louise Blackie joined the Team, in August, in a Temporary
Full‐Time Consultation Nurse position. This temporary position will continue until October 2010.
In addition, funding was secured to modestly enhance the Palliative Care Social Work position from a 50% to a
60% position. Sharon Snow continues in this role.
We were pleased that Tom Burt was able to step‐up and assume the responsibilities for the Coordination of
the Palliative Care Volunteer Program. He has taken on this role in a volunteer capacity. This has proven to be
Unfortunately, our hopes for a part‐time Administrative Assistant were dashed due to severe financial
constraints within the district. We will continue to advocate for this key position in the next fiscal year.
Last April and May, an eight‐week Volunteer Training Program was held at Fishermen’s Memorial Hospital,
Lunenburg. Eighteen individuals participated in this training program.
September saw the re‐location of our offices on all three hospital sites. This made for a busy and challenging
A successful “Celebration of Life” service was held in mid‐October at the Days Inn, Bridgewater. The event
concluded with the release of three white doves. It was a breath taking moment! Approximately, 90 family
members attended along with 40 health professionals, volunteers and senior administrative staff.
Also, in October the South Shore Health District participated in the Accreditation Canada Survey process. The
results, for the Palliative Care Service, indicated that five standards required additional information and
evidence. The Team has met every Wednesday afternoon, over the winter months, in an effort to complete
this task by May 2009. Good progress has been realized.
Alisha Oickle, 4th year Dalhousie Nursing Student, completed a twenty‐week practicum with the Palliative Care
Service. Irene Hirtle, Consultation Nurse, served as her preceptor. Throughout Alisha’s time with the service
she researched a number of assessment tools and along with the Team was able to test many of them.
However, the tools tested require further refinement so she along with Bonnie Sweet, Consultation Nurse, will
continue to work on this project over the summer and fall months.
An In‐Patient Palliative Care Unit Committee was established. There is great enthusiasm within the district
regarding this endeavor! Three site visits have taken place including the St. John Regional, New Brunswick;
Aberdeen, New Glasgow and the QEII – Victoria General Hospital Site, Halifax. It is hoped that a visit to the
Cape Breton Regional in Sydney may be realized this coming spring. These site visits have been extremely
helpful. The Program Manager, Palliative Physician, a Volunteer as well as a family member of a former
palliative care patient are among the members of this committee.
Palliative Care Volunteers represented the service, at three local health fairs this past year. It is an excellent
way to promote awareness about palliative care and what services are offered in the local area.
Two Consultation Nurses, Louise Blackie and Anna Claire MacAdam, successfully completed the three month
Palliative Care Distance Course offered through St. Francis Xavier University.
Individuals within this district have been busy working on a number of activities for the up‐coming 2009
NSHPCA Provincial Conference. We are looking forward to networking with our colleagues from across the
province at the end of April.
Janet R. Carver, R.N., B.N
South Shore Health
DHA 2 ‐ South West Health
For the first time, Palliative Care was reviewed as its own program by Accreditation‐Canada. Undergoing this
process, with site visits the end of September to each of our 3 hospitals, helped us consolidate as core and
extended teams, recognize our strengths and also provided us with recommendations to improve our service.
An example of positive change resulting from the Accreditation Team’s Palliative Care Standards was the
introduction of Bereavement Debriefing sessions for staff involved with especially difficult palliative cases.
With the incentive of Accreditation, we also have piloted a Patient/Family Satisfaction Survey.
Another first for us was our Daisy Day campaign which we held in 4 locations in the district during National
Hospice Palliative Care week.
Use of the Symptom Relief Kit (SRK), a collaboration among SWH, VON, Long Term Care, Continuing Care and
2 local pharmacies, has continued to provide palliative patients with help at home for acute symptoms. We
consider this resource a success in that we have ongoing buy‐in by the physician community, good
cooperation among the collaborators, relatively problem‐free process and most importantly, positive feedback
from grateful families.
Our team has provided palliative care education this past year by hosting a PC Frontline Education workshop
in Yarmouth and by assisting 2 area Community Colleges in their workshops. Staff provided Lunch & Learn
sessions on a variety of palliative care topics to 3 separate long‐term care facilities in the district. We were also
asked to speak at the Dalhousie School of Nursing new Palliative Care class, which we understand will now be
required course for the R.N.
Five staff, including our PC physician, attended the Canadian Hospice Palliative Care Association Annual
Conference in PEI in October. The program sponsored one of our volunteers to participate as well.
Transitions have happened for our Volunteers with 2 new and excellent coordinators‐one for Yarmouth
County & one for Digby County‐‐coming on board with VON.
Group bereavement sessions by staff consisted of an annual Holidays & Hope session at the Christmas season
in Digby and a first‐ever Night of Remembrance session in Shelburne. Both these sessions involved
collaboration‐‐ with VON for the Digby session and with 2 local ministers for the Shelburne session. A district
champion of group bereavement care has been Bertha Brannen, director of a long term care facility: she
periodically offers a program that has met with much success.
Yarmouth County Hospice Society, chaired by Shirley Hubbard a stalwart champion and hard worker for
palliative needs, continues to provide support to palliative care services in South West Health, including via
advocacy as well as sponsoring a nurse to attend the CHSPCA conference.
And from the ranks of the Hospice Society, we recently have been adopted by a very special fundraiser has
held a silent auction as well as a raffle to raise monies to target the needs of those who cannot afford
transportation to & from hospital or at times cannot pay for nutritional supplements at home or cannot pay
for meals while sitting vigil in hospital. As well, we are fortunate to continue to receive support for those
needy cases via much‐appreciated individual memorial gifts as well as a donation from the South Ohio
Community Volunteer Society.
We’ve had a good year!
Nancy Castlebury, District Manager
DHA 3 – Annapolis Valley Health
Work with community partners continued to be a strong focus of the Palliative Care Program in Annapolis
Valley Health (AVH) – VON, Continuing Care, Valley Hospice Foundation and Mid‐Valley Palliative Care. The
Annapolis West Health Foundation, Western Kings Memorial Health Society, Valley Regional Hospital
Foundation, the Eastern Kings Memorial Health Foundation and the Port Williams Health Auxiliary
continue to be significant supporters of the program.
Two palliative care beds at Annapolis Community Health Centre continue to exist as a partnership between
the Annapolis West Health Foundation and Annapolis with funding for the staffing portion of the program
coming from the foundation.
The Valley Hospice Foundation in collaboration with Annapolis Valley Health continues to work toward the
establishment of a hospice in the valley. A joint capital campaign with the Valley Regional Hospital
Foundation (raising funds for an infrastructure revitalization project already underway in the district) is
The Palliative Care Task Group under Nova Scotia Health Transformation is being co‐chaired by AVH district
Manager Shelagh Campbell‐Palmer. Each of the task groups under transformation has a District Health
Authority and a Department of Health Co‐Lead. The DOH Lead is Sheila Scaravelli.
The AVH team was delighted to welcome Dr. Lori Burgess in December 2008. Dr. Burgess joins the team on
a 75% basis. Dr. Catherine McNally continues in a 75% capacity also. Two Palliative Care Consultation
Nurses round out the team, one working in Annapolis County and one in Kings County.
The team now has a 70% Administrative Support position.
The team continues to be busy having processed 201 new referrals in 2008/09.
Education is a priority for the AVH Palliative Care Team. Programs were provided this year to VON staff,
AVH Nurses and Allied Health Professionals, Clergy & Pastoral Care, physicians and various community and
Front Line Palliative Care Education has been provided again this year April 8, 15, 22 & 29th.
Palliative Care volunteer service continues to be provided across the district by VON and Mid‐Valley
Fall of 2008 was Annapolis Valley Health’s Accreditation Canada survey visit. The district and the Palliative
Care Program fared well during the survey.
Ongoing quality improvement over a three year cycle is now part of the accreditation program.
Family satisfaction survey now being used providing valuable feedback to program.
Late referrals to program continue to be a challenge to the team.
Population distribution and vast geography in parts of the district create challenges.
DHA 4 – Colchester East Hants Health
Reflecting over the past year… each year seems to go by quicker and 2008 certainly maintained that
pace. Palliative Care staff in our health district continue to work hard providing end of life care to
residents in all our communities; being involved in palliative care advocacy work; attending educational
events to maintain their palliative care specialization and doing all this well maintaining a health work ‐
life balance. I would like to acknowledge just how much a privilege it is for me everyday to work with a
team of Palliative Care professionals that are so dedicated and passionate about the work they do… you
are all truly an inspiration to me in my work!
We are so excited in our health district, to see the construction begin of the new regional hospital here
in Truro. The foundation has been set and the steel frame of the building structure is constructed. With
a little imagination I can actually envision what the new CEHHA Palliative Care Unit will look like. The
new Palliative Care unit will include a new “Solarium Project” as part of the unit’s design. The solarium
will be located at the end of the Palliative Care unit and will provide both an indoor and outdoor space
to be used by clients and their family members. Generous donations from community residents of our
Health Authority over the past number of years to the CRH Foundation on behalf of their loved ones
have made the Solarium Project possible… are communities are a part of everything we do and we are
thankful to them for their continued support. The new CEHHA hospital is on scheduled to open in the
fall of 2011.
In 2008 we welcomed to our Palliative Care team Karen Eaton MSW, RSW. Karen is our Research
Assistant with the 3 year research project we are partnered with Laval University on entitled “Palliative
Care in Canada: The Economic Perspective in Rural Areas”. This project explores the economic costs
taken on by families who are providing end of life care for a loved one at home. We have also welcomed
a number of casual Palliative Care Consult RN’s to our team this year… welcome to Dawn Martell RN,
Erin Volker RN and Valerie Reid RN. We are also bidding farewell to our team member and Palliative
Care, Continuing Care Coordinator Megan Connors OT. We wish Megan all the best with her continued
pursuit of further post secondary educational goals. With Megan’s departure we welcome Jennifer
McGill to the roll of Palliative Care Continuing Care Coordinator.
We look forward to the Nova Scotia vision for Palliative Care Services being lead and developed by the
DoH Health Transformation Office and more specifically through the work of the provincial Palliative
Care Task Group. It is clear to me that 2009/2010 will provide us with an excellent opportunity to move
forward with planning and developing a provincial blueprint for Palliative Care Services for all Nova
Mark Scales B.Sc., BSW, MSW, RSW
Manager, CEHHA Palliative Care Services
CEHHA Palliative Care
The Society is pleased to inform the NSHPCA members of the developments that have occurred during
the past year.
The CEH Hospice Society is a community based charity providing care and support to families living with
life threatening illness and grief. CEH Hospice Society works closely with our Palliative Care team and
other community care providers to offer flexible and responsive programs and services that augment
the care provided. The society is lead by a strong and active Board of Directors and has three staff:
Cathrine Yuill, Executive Director, Cathy Bernard, Grief Support and Volunteer Coordinator, and Dianne
Pyke, Administrative Assistant. Current programs and services include:
• Palliative Volunteer Visiting: in hospital and in the community
• Practical Assistance:
o Food From the Heart: providing food vouchers to palliative individuals who are also facing
o Specialized Equipment Rental
o Other Financial Assistance
• Hospice Wishes
• Grief Support Services
o Bereavement Follow‐up calling
o Memorial Services
o Grief Walking Club
o 6 Week Support Groups
A variety of annual special events are held to raise awareness and funds including:
HUGS ‐ February
Food from the Heart Drive with Sobey’s – twice each year
Volunteer Appreciation Pancake Breakfast ‐ spring
Hike for Hospice ‐ May
Daisy Days in Tatamagouche ‐ May
Hospice Palliative Care Week ‐ May
Volunteer Training – once or twice each year
Annual Hospice Palliative Care Conference in Truro ‐ fall
Angels Remembered ‐ December
DHA 5 – Cumberland Health
CUMBERLAND CO. HOSPICE \ PALLIATIVE CARE SOCIETY ‘BIG WINNERS’
Amherst Curling Club on March 20TH/2009 was the place to be. The 4th Annual Charity Curling
Challenge took place between the Good Lookin’ Guys vs. the Better Lookin’ Guys. Both skips Don Smith
and Carl LeBlanc said they were looking forward to the game. Other members of the teams are Robert
Bird, Joe Dupuis, Brian Wood,Mitch Estabrooks, Curt Speight and Stu Colson. These 8 Guys arranged the
whole event including Chilli / Rolls for supper, Gift Basket Draw, silent auction, music by the band
Coolwater, and open ice time for those who wanted to curl.
Everyone enjoyed the curling, the music and fun, at the end of the evening a check for 10,000+
DOLLARS was presented to Gerry Helm, chair Cumberland Co. H.P.C. SOCIETY.
Gerry thanked the Good Lookin’ and the Better Lookin’ Guys on behalf of the patient/ clients this
money would help. She also thanked all those who helped in any way, donations of time, money, articles
for the baskets etc.
We, the community are so lucky to have these Guys who see a need and go above and beyond to
help. We wish them continued success in the future and will be there to cheer them on.
SDHA 6 – Pictou County Health
Highlights over the past year within our Palliative Care Program:
• The Palliative Care Unit at the Aberdeen Hospital now has a new nurse manager; Cathie Watson
recently took over the position. Prior to working with Palliative Care, Cathie was the manager for
Maternity and Children’s and Medical Day Unit. We welcome her and look forward to working
• The Interdisciplinary Team continues take part and host “Take 40” Education Sessions for the
staff and volunteers throughout our district.
• With near full capacity at all times, the Palliative Care Unit is very busy and is much appreciated
by clients and families. Volunteers are present seven days a week with two shifts per day from
10 am – 1 pm and 3 pm – 6 pm; their presence is very comforting and there are plenty of
wonderful aromas, as most of them always bake a tasty treat for everyone. Volunteers also are
present in the community with our clients.
• Community Clients continue to be well served by the Palliative Care Interdisciplinary Team. The
team meets for rounds every Tuesday morning and those present include: Palliative Care Doctor,
Consult Nurses, Unit Nurses and manager, Continuing Care, Social Worker, Spiritual Care,
Nutrition, VON, Pharmacy, Cancer Patient Navigator, and Volunteer Services.
• The Aberdeen Palliative Care Society has been very active in raising funds and awareness for the
area. Over the past year money has been raised with Easter and Christmas baskets, Christmas
Memorial Tree, viewing of the film “Griefwalker”, memorials and donations.
• The Time of Remembrance Service was very well attended by friends and family of those who
were part on the Palliative Care Program and have since died. Last May 201 names were read
aloud for the period of March 1, 2007 to February 28, 2008.
• A new bereavement program has been initiated and is very much appreciated by family
members. Those interested in taking part go through an eight week group process with our
social worker and trained volunteer.
DHA 7 – Guysborough Antigonish Strait Health
●The GASHA Palliative Care Nursing Network meets monthly under the direction of Charlene Porter,
District Manager, Cancer and Supportive Care. The network prepared for the national accreditation
review in November, 2008. They partnered with other members of the palliative care team to complete
●The GASHA Nursing Network met with Heather MacDonald, the newly appointed Palliative Care
Provincial Coordinator, at their monthly meeting in March, 2008. It was a wonderful opportunity to
share ideas and build relationships. Welcome, Heather, to the palliative care world!
●The GASHA district interagency group for Palliative Care is working on updating the home chart. There
is representation from acute care, long term care, continuing care, palliative care, and VON.
●St FX University is hosting a workshop on April 24 and 25, 2009. The focus will be the use of
information technology in palliative care in the rural setting. The GASHA palliative care front line staff
has been surveyed by the St FX information technology students in preparation for this event.
●The GASHA Nursing Network has been reviewing a patient booklet about organ and tissue donation for
●Palliative Care Front‐line education will be offered in April from St Martha’s Regional Hospital. This will
be telehealthed to Eastern Memorial Hospital, Canso.
●A CCNS Interprofessional Core Curriculum: Management of Symptoms and Metabolic Imbalances will
be offered at St Martha’s Regional Hospital on April 7 and telehealthed to Strait Richmond Hospital.
Facilitators are palliative care team members: Dr. Mike MacKenzie, Dr. Michael O’Brien, Charlene Porter,
and Rochelle Sparks.
Nancy Cameron, District Director
DHA 8 – Cape Breton Health
2008‐2009 has been extremely busy for DHA‐8, Cape Breton District Health Authority for both the
Palliative Care Services and the Hospice Palliative Care Society in the District.
The highlight of the year was the opening of An Cala – the long awaited Palliative Care Unit at the Cape
Breton Regional Hospital, which took place April 8, 2008. The 9 bed unit was opened by the Honorable
Chris D’Entremont, Minister of Health and Mr. John Malcom, CEO of the Cape Breton District Health
Authority. It is the result of the tremendous community support by the Cape Breton community and
tireless efforts of the Hospice Palliative Care Society of Cape Breton, under the leadership of Chair,
Patricia Jackson and Dale Orychock, Director of the Palliative Care Services.
It has proven to be the “Safe Harbour” which its Gaelic name suggests. Patients and families are
comforted by the surroundings as well as by the attention of the staff and volunteers.
Palliative Care Services has gone through an organizational change in the last year at the Cape Breton
Regional Hospital. Dale Orychock retired in June 2008 after many dedicated years of service and is
enjoying well deserved time with her family. Mona Baryluk has been appointed Director of the Cape
Breton Cancer Center and Palliative Care Services. Brenda Yates is the new Program Manager of
Palliative Care Services. Both have settled into their roles and have many plans for Palliative Care service
delivery. Accreditation was held in November 2008 and was an opportunity to review what we’ve
accomplished and plan for the future.
The Hospice Societies continue to be very active in their areas, with fund‐raising activities, advocacy and
support for the needs of patients with life threatening illness, as well as their families. The societies
have funded education for staff, volunteers and community members. A highlight of the education
events this year was intensive education for the new Palliative Care staff as well as presentation of the
Front Line Education Series.
Some highlights of the societies include the annual Daisy Day – a successful fundraiser and palliative care
awareness event held throughout Cape Breton in May.
The Cape Breton County Palliative Care Society continues to support equipment needs for patients as
well as grief and bereavement support for family members, volunteer support and patient comfort
initiatives. As well the annual memorial service was held in December 2008 and there are two memorial
services planned for 2009.
The Hospice Palliative Care Society of Central Inverness will be participating in Daisy Day again this year.
The Society continues to support patients and their families by providing education, supplies and
assisting with travel costs. The Sheen Co‐Op Board Members and the Inverness Branch of the Royal
Canadian Legion held a benefit dance for Palliative Care, where $2200 was raised. There was an
education session held for the small option homes of the area regarding Palliative Care Services.
The Hospice Palliative Care Society of Victoria County continues to be active in fund raising and public
awareness activities. They were saddened by the passing of Judith Fuller in April 2008, who was
instrumental in advancing Hospice Palliative Care in the local area and throughout Nova Scotia.
Anne Frances D’Intino
DHA 9 – Capital Health
Middle Musquodoboit, Musquodoboit and Sheet Harbour (Tri Facilites)
It has been just over a year since Joanne Babin has been hired as the Palliative Care Consultant in this
region. Joanne has continued to build relationships within the communities.
Dartmouth General Hospital
• Palliative Care Quality team continues to meet bimonthly to provide support, education and delivery
of Palliative Care at DGH
• The were a total of 146 consults to the team in 2008
Bereavement and Support Group:
A new Bereavement Coordinator has been hired to replace Marianne Arab, who was the successful
candidate for the Manager of Supportive Care with Nova Scotia Cancer Care. We are very grateful for
Marianne’s leadership in the development of this role, as well as her dedication and commitment.
Marianne followed 1476 families in 2008, providing grief support groups, one to one counseling and mail
out grief support, Memorial services and referrals to counseling services and volunteer grief support
phone calls.. Thank you Marianne. Roy Ellis, has been appointed as the Bereavement Coordinator and
has started his role on March 23rd. Roy brings a wealth of knowledge, experience, and dedication to his
new role and we are very pleased he has joined our team. Welcome Roy!
We have increased our Memorial Service to 3 per year. Most recent was held one in Feb, a second to be
held in June with a third scheduled for Oct. 20, 2009
Capital Health Front Line Education:
• Front line education is scheduled for May 2009.
• To date over 1000 individuals have participated.
In Patient Palliative Care Unit/Home Support and In House Consultants
• The In patient unit on 7A continues to operate at approx 96% occupancy with an average length of
stay between 10‐14 days.
• Palliative Care Physicians remain the Primary care physician while patients are on the unit.
Department of Family Medicine Residents currently are rotating through the program on a monthly
bases as well as clinical clerks.
• A permanent part time music therapist position has been posted for the program.
• There were a total of 1126 new consults to the Palliative Care Service for 2008
• Helen Searle Palliative Care Consultant has accepted a position in the Cancer Care Clinic and Glenna
Thornhill, Home Palliative Care Consultant has taken a leave of absence as she and her husband
Colin have traveled to New Zealand for a year. Glenna is currently working in a Bone Marrow
Transplant Unit. We wish her and Colin all the best for an exciting year ahead.
• A program evaluation is underway reviewing the Integrated Service. This task was taken on by the
Quality Committee of Palliative Care. It has been recommended that the committee put forth its
recommendations by the end of May 09. Vision the Legacy, cornea donation telehealth session held
in January under the guidance of Kate Hackett from the Tissue Bank.
Selected Program Data for 2008:
• New Consults to service – 1126
• Urgent New Consults – 359
• Average response time to new urgent consults – 1 day
• Average percent over targeted (2day) response to urgent consults – 9%
• Deaths on service – 1025
• Deaths in Hospital – 707
Palliative Care Week
A few things are underway to acknowledge Palliative Care Week May 5‐6, 2009. Poster displays will be
put up in the lobbies of HI and VMB with the third in the Victoria lobby by the Scotia Cateteria. Dr. Dave
Dupere will give a lunch and learn talk on May 7th during Oncology Rounds in the Bethune Ballroom.
Provincial Conference and National Conference.
• CHIPCS has sponsored one individual Joanne Babin to attend the Provincial Conference.
• Violet Cameron, Anne Butler and Linda MacDougall are being sponsored to attend the National
Conference in Nov. 2009 in Winnipeg.
Out of the Country Travel
Peter MacDougall and Barbara Stewart will travel to Onslow, Norway from May 15‐23. They will liase
with this International Palliative Care Service, and review key components of their program including
palliative care with long term care, palliative day care and hospice/palliative care education.
Oncology Nurses Day
A celebration in acknowledgement of Oncology Nurses Day is happening in room 5110 Dickson Bldg.The
first session will begin at 1215 and the second at 1300 The CANO poster board and video will be running.
Lunch is being provided.
7A Inpatient Unit Upgrades
10 new over bed tables were purchased and are in place on the inpatient unit. New dressers and night
stands are currently being ordered.
Capital Health Integrated Palliative Care Service
Health Services Manager
District 9, Director NSHPCA Board