Local Journalism Initiative
ROACHVALE, GUYSBOROUGH COUNTY – “We had some hard times – but it was so good. I can’t explain; it was the last thing we could do for him, I guess,” Heather Hadley told The Journal about her recent experience with palliative care and the death of her husband John Meagher at home in Roachvale, Guysborough County, last month. In December, Meagher began to experience some pain, which he thought was related to an old injury. In the weeks that followed, he sought medical attention, leading to a diagnosis of lung cancer on January 7 of this year. “From the beginning we had Dr. Ranjini [Mahendrarajah],” Hadley said, adding that – due to Meagher’s quickly deteriorating condition – by February they had engaged palliative care, home care and continuing care services. “First, Allison Nickerson came for palliative care; the doctor had put it all in place—and she explained those programs. With palliative care, they register you with EHS (Emergency Health Services) – paramedics – and they come and do whatever nursing staff would do after hours … I was very surprised at the range of services that we had in this area, and that we were able to access … there was so much we didn’t know about,” said Hadley. Nurses came to the house and, at first, administered oral medication and later administered meds through a butterfly injection site. Home support bathed and shaved Meagher. Hadley said, “I had never shaved him before, and I had tried but they were so good … there was nothing you could find fault with. It was unbelievable.” Through palliative care, Meagher was also assigned a file number with EHS. “I called 911 and I gave them the number that palliative care had given me for John Meagher. He had his own number; they had all his records – what medication he was taking, what his diagnosis was. When they came, they gave him the medication and they stayed to make sure it worked, that he was settled. I can’t get over how good it was.” Meagher also received care in outpatients at the local hospital on several occasions after his diagnosis. Hadley said, “And the service in outpatients was remarkable.” She had similar comments for the service provided by the pharmacy in Guysborough. Along with the Guysborough-based health care team, which included both local doctors, Drs. Barbara Bell and Ranjini, Shelly Robertson from Antigonish palliative care also participated in Meagher’s care. “I talked to her one week that Allison was off. Shelly called me every day and, the day that John died Shelly and a continuing care nurse were at the house that day. Shelly didn’t just call; she came to the house. It was something you would never think – it made it so personal – they were right there,” said Hadley. “This was hard,” said Hadley, “It happened so fast. He was going down so quickly and needed his medication adapted and changed, and they were right there; the doctors and nurses were right on top of it for everything he needed. They have to be commended … They made me feel very comfortable. “The health care system made it possible to fulfill his wish to die at home and made it easier for me to have him at home because it was what he wanted, and I knew it was better for him. I knew that he had care that surpassed what he could get in the hospital because he couldn’t have had the one-on-one as steady as he did at home.” Having had this experience, Hadley wanted to let other people know of the support that was available; it was far more than she had thought could be expected. “I had concerns when he said that he didn’t want to go to the hospital. I had concerns that I couldn’t do it. I was very fortunate I had very strong family support – both my family and John’s. I have two sisters and two nieces that are nurses, and my daughter works in a nursing home. I had all kinds of support – I was never alone but he did say to my sister, ‘When I am too much for Heather, take me to the hospital.’ I wouldn’t have been able to do it without family and palliative care.” In addition to concerns about one’s ability to take care of a loved one at home with serious medical needs, those contemplating this path often have concerns about the financial strain. Hadley told The Journal that she had incurred very minimal costs over the duration of Meagher’s illness in part because he had medical coverage and, when the family needed a hospital bed in the home, the Antigonish Kinsmen Club covered the cost. When asked what she would say to families in a similar situation, Hadley answered, “I have no question that I would do it again. If anyone had a question about what it was like to have their loved one at home; I think it made it a lot easier on me. It was hard to watch him suffer but it would have been harder in the hospital (due to COVID-19 restrictions). “If someone was contemplating it and they didn’t know how it worked this (her story) might help them because I had no idea what to expect but once I tried it, I thought, ‘I think I can do this.’ I think that he would be very pleased because that’s what his wishes were.” In the evening of the day that Meagher died, “there was a knock on the door, and it was Dr. Ranjini and Erin Wright (an RN who had worked with Meagher). Erin wasn’t even working that day and Dr. Ranjini was on call and they took the time to come out – it meant so much,” said Hadley. Andrea MacDonald, manager of Cancer and Supportive Care Services at St. Martha’s Regional Hospital in Antigonish said that palliative care is a collaborative effort, working with physicians, families and patients, “to figure out what their needs and wants are.” Resources from central hospitals in Antigonish and Richmond, in cooperation with community hospitals across Guysborough County, the EHS system and local societies and foundations, come together to offer the best support and care for palliative patients and their families. This includes counselling, supply of medical equipment – such as hospital beds, medication costs, and medical care in the home. “With COVID we’ve had a 10 per cent increase in deaths at home. Guysborough is a community where most of the deaths were happening in hospital for many years, but in the last month there have been a few home deaths in Guysborough County,” said MacDonald, adding, “Continuing care has been amazing. They are the boots on the ground. Our service is a consult service. If the physician in Guysborough needs support in managing the care of a patient – either in hospital or at home – we have a nurse that can step in and help provide support ... They’d look at what their symptoms are, what has been bothering them, what’s impacting their life the most and what we can help them with. Often times, it is pain and symptom management; other times, it is a request for advance care planning.” Palliative care can enroll patients in programs such as the provincial palliative care drug program, the EHS special patient program, and provides “all kinds of print resources as well to help families understand what is going to happen to their loved one at end of life ... [it’s] almost a check list of what to do after the death of a loved one,” said MacDonald. Dying at home, with the aid and support of palliative care, is a choice more people are making in Guysborough County thanks to the resources available in the region. Lois Ann Dort, Local Journalism Initiative Reporter, Guysborough Journal