Yellowknife (Feb 17/06) - A hospital room can be a sterile, unfamiliar place to die, so some people are choosing to die with dignity and spend their last days at home with loved ones.

Home care workers, from left, Karen MacCoubrey, Sheila Humphrey and Jo Ann Murray say the most rewarding part of their job is helping families ease a loved one into death, and make it as positive as possible. - Dez Loreen/NNSL photo

The Yellowknife Home Care program allows clients to do just that. The program offers palliative care - a kind of nursing care for those with terminal illnesses or situations - to those who choose to die at home.

There are many supporters.

"The program is a godsend," said Sherry Hernblad. "It made my mom's passing much easier for us."

Hernblad's father had died in a hospital room, which made the choice easier for her mother to want to stay at home.

This can be a difficult choice for persons coming to the close of life, because a hospital bed can offer the security of being at the same place any medical help will be, if needed.

But staying at home means living within comfortable, familiar surroundings.

"We both knew it was the right choice," said Hernblad of her mother's wish to stay at home.

For home care worker Sheila Humphrey, making the choice to work in palliative care was an easy one.

"If I can help the dying person be at ease, I've done my job, and it has its own rewards," said Humphrey.

Humphrey said that her current work is also good for the family of the patient.

"We are there to help the family in their time of impending loss," said Humphrey.

The role of the palliative care nurse also extends beyond the death of the patient, said nurse Karen MacCoubrey.

"We visit with the family after the passing as well," said MacCoubrey. "It's definitely an emotional experience: we're all human and can't help but be touched."

Dealing with death over and over again can take its toll on a person, and Humphrey said the trio of home care nurses have their own way of grieving.

"We sit as a group, and talk about how we feel," said Humphrey.

"Sometimes it involves taking time off work, too."

Part of the job is helping the family understand that caring for their loved one will take more than one set of hands because nurses cannot be at the private home all day. Family members will need to be capable of caring for the patient as well.

"Just help whenever you can," is the basic advice Humphrey offers. "Even if it's just doing the laundry. It still needs to be done."

The program is available in every community in the North, but resources can be limited depending on where you are.

Heather Chetwynd, manager of the dying with dignity care program, said that getting equipment out to remote locations can be difficult.

Although there are fewer people staying in hospital beds to finish their lives, the number of beds "freed up" for other types of patients cannot be quantified as a budget savings, said Donna Allen, director of patient care at Stanton Territorial Hospital.

In the south, hospitals have saved expenses by closing wards previously occupied by terminally ill patients who have opted to stay at home.

But the pressure to make use of Stanton is such that there are no "unused" beds, she said. "The beds are still being used by other sick people."

Jarvis Gray is another survivor of someone dear to his heart. His wife Sydney Cooke passed away in October 2004 from lung cancer.

But before she died, Gray and his wife attended a conference in January 2004 that focused on the advantages of dying at home.

"That was when we made our decision to stay at home," said Gray.

The next few months were physically and mentally demanding for both Gray and his wife as she fell deeper into her illness and was therefore unable to do the things she used to take for granted.

"At first she couldn't help with the housework, and soon she couldn't walk any more," said Gray.

The home care team brought a wheelchair for Cooke to use for mobility.

Gray said as his wife's lung disease progressed, another unforeseen complication arose: she developed diabetes during her sickness from the cancer. "The home care workers took extra care of her, and made plenty of visits," said Gray.

Home care nurses found themselves visiting Cooke four times a day to give her needed medication through a "drug pump": an device connected to the intravenous line that doles out pain medicine, for example, at a pre-set and consistent rate.

"We have all sorts of equipment for convenience," said home care nurse Jo Ann Murphy. This includes drug pumps, hospital-style adjustable beds, wheelchairs and other aids.

Murphy has been working in palliative care for the last three years and describes the work as a privilege and an honour to work so closely with families in their time of need. "It's like becoming a part of the family," she said. "Making the death a well-resolved experience is important."