Back to Index|
The establishment of the Kenora Rainy River District Palliative Care Volunteer Program began as a need identified by the Palliative Care Program at the Lake of the Woods District Hospital in Kenora. Physicians and nursing staff of the Hospital identified a need to improve the care of the dying; particularly in the areas of pain and symptom control and supportive care for both patient and family. A Palliative Care Task Force Committee was subsequently established and following extensive interdisciplinary and community consultation and collaboration, a formalized Palliative Care Program was introduced in January 1982. This committee placed a strong emphasis on education specific to Palliative Care and was characterized by 2 key components; an interdisciplinary Palliative Care Consultation Team approach to patient care and a bereavement follow-up process. Both components are current practices as is the original process for referral. Essentially, referral to the Palliative Care Program at the hospital occurs by physician request while bereavement services may be accessed by families regardless of prior involvement with the services of Palliative Care. In 1984, a formal Pastoral Care Program was introduced in the Hospital with a mandate to provide spiritual and supportive care to patients, families, and staff in accordance with identified needs. In 1985, the need for a Palliative Care Coordinator position was formally recognized by the allocation of a .5 fulltime equivalent Registered Nurse to palliative Care from the Hospital’s operating budget.
The major partner in the provision of Palliative Care Services within the community was the Community Care Access Centre formerly known as the Northwestern Home Care Program. Palliative care referrals to the Home Care Program were made by the attending physician. Consultation with the Discharge Planning Coordinator, the Palliative Care nurse, social worker, pastoral representative, pharmacy and a representative from Home Care participated in team conferences once a week. Admissions to and from the Community were well coordinated.
A "Community Palliative Care Committee" was established in Kenora in 1991 and served to identify and plan for the palliative care needs of patients, families and staff in the Hospital and community with the emphasis still on education.
In December 1992, the Minister of Health (MOH) announced funding for new initiatives in community palliative care, the care of dying patients and their families. These were aimed at improving the care available to such patients in their homes and in institutions by means of four initiatives:
· Interdisciplinary education for service providers’
· Education of family physicians
· Supporting and maintaining hospice volunteer visiting programs
· Establishing pain and symptom management teams in all areas in Ontario
In Northwestern Ontario these initiatives meant; NECAH (Northern Education Centre for Aging and Health), now known as CERAH—Centre for Research in Aging and Health assumed responsibility for interdisciplinary education of service providers and education of family physicians; the establishment of the Regional Pain and Symptom Management team located in Thunder Bay; and the establishment of funding in 1998, through the District of Kenora Home for the Aged – Community Support Program for the Kenora/Rainy River District Palliative Care Program.
In October 1995 a proposal was written and submitted by the Community Palliative Care Committee and the Tri-Municipal Volunteer Bureau to the Kenora-Rainy River District Health Council to establish Kenora as a Central Resource for the Palliative Care Volunteers for the Kenora and Rainy River Districts.
A Program Director, Lorna Myles, was hired for the Kenora catchment. Volunteers in Kenora were recruited, screened, completed police checks, completed a 10-week training course, and developed an outline for a detailed plan of action for delivery of service. Clients were matched with volunteers in January 1997.
In 1997 funds were received to hire a Regional Coordinator but it was felt that the region was too large for one person to tackle and two coordinators were hired for a 6 month period; Rob Rheault for the Kenora District and Wilma Sletmoen for the Rainy River District. During this period the coordinators established/confirmed Palliative Care Volunteer Committees in Kenora, Dryden, Ear Falls, Atikokan and Rainy River District. Each community expressed concern that without a full time Regional Coordinator the Program would not succeed. A proposal was written to the MOHLTC through the District of Kenora Home for the Aged – Community Support to continue with the Program and Wilma Sletmoen, Regional Coordinator was hired in May 1998.
The Regional Coordinator is responsible to each of these programs; Atikokan; Dryden; Kenora; Rainy River District; and Ear Falls/Red Lake and links them together. Although no formal committee or volunteer service exists in Sioux Lookout, contact has been maintained with this community and education and promotional opportunities are offered there. In 2005, the Ear Falls program extended to include Red Lake. In March 2006 a Coordinators Handbook was completed; prepared by Elizabeth Dykalski and Wilma Sletmoen. This handbook established a "common resource directory" for coordinators to use. Included in the manual; Mission Statement; Goals and Objectives: Policies and Procedures: Overview of the Roles and Responsibilities; information for recruiting and training Volunteers; tips on Getting Organized, Record Keeping, Conducting Interviews, dealing with Difficult situations, Cultural Competence, Self Care and common forms for administrative duties and service coordination; handouts; internet resources; a glossary of terms related to Palliative Care and a contact directory.
With the establishment of the End-of-Life Care Strategy across Ontario the MOHLTC funded CCAC’s to establish EOL Care Networks and develop service delivery models at the community level. Wilma Sletmoen moved from her role as Regional Coordinator for the Volunteer Program to the position of End-of-Life Care Coordinator with the CCAC for Kenora & Rainy River Districts. Shortly after Lee Dartiailh was hired as the Regional Coordinator for the Program and moved the regional office to Kenora. Lee resigned her position in Janary of 2007 and in June of that year Pauline Cowen was hired as the new Regional Coordinator.
Regional meetings were held in Dryden and Thunder Bay in February 2005 and an End-of-Life Care Network was established. The Network is a voluntary collaboration of stakeholders, supporting service delivery—providing a regional forum for collaborating, sharing ideas, setting agreed-upon standards and best practices; doing what community programs can’t easily accomplish themselves.
In her role as End-of-Life Care Coordinator one of Wilma’s tasks will be to assist communities in Northwestern Ontario develop their service delivery models for palliative or end-of-life care. The goal is interdisciplinary, integrated EOL care that improves access to appropriate services, including pain and symptom management, 24-hour on-call health services and home care services, a coordinated point of entry for clients and the application of technology in innovative ways to meet consumers needs. The established Palliative Care Committees will serve as her starting blocks in this process and the Volunteer Program is and will continue to be involved in this process, and in the End of Life Care Network.
Up until May 2006 the Volunteer Coordinators in each community were "volunteers". Their dedication to the Program was unparalleled. Each coordinator gave of their time to: perform administrative duties; Service Coordinator; Program Promotion; and attend workshops and conferences as well as being a sounding board for volunteers, clients and their families. In 2005/06 the MOHLTC monetarily recognized the contributions made by the Volunteer Coordinators in the budget and five coordinators were contracted as "Community Coordinators" in: Atikokan, Dryden, Emo/Red Lake, Kenora, and Rainy River District.
Each community continues to recruit, screen, complete police checks and provide a 30 hour training course for the volunteers. They also promote their services and educate their communities to the benefits of using a Palliative Care Volunteer.
As the Kenora/Rainy River District Palliative Care Program moves into a new chapter our focus remains the same; providing the highest quality volunteer service and support to members of the community and their families during their time of need.
Back to Index