Dorothy's Teaching

Dr. Dorothy Ley had a passion for help individuals.  Her vision was to transform the health care system to recognize the value of emotional and spiritual care in providing patient support.  Her philosophy and methods are as pertinent today as they were when she began her work. 

At The Dorothy Ley Hospice, we have embraced her teachings.  They provide the foundation upon which we provide care, the way we work with each other and engage our partners in the community. 

Below, in her own words, are some of the core values she articulated.  You will find them reflected in our Mission, Vision and Values as well as our Model of Care.

Palliative care is about life
Palliative care is about living and the meaning of life. It's about loss and grief and joy. It's about giving and receiving. It's about tears and laughter. Palliative care is about life, not death. We must always remember that.

Hospice individuals have the power
People who practice palliative care must be aware of the differences between a patient and a terminally ill person. In the acute care system, patients, of necessity, give up their autonomy, their decision-making powers, to their caregivers. People in hospice should be able to take back that power. They -- and only they should have the right to choose the nature of the care they will receive and where it will be given.

The trans-disciplinary team
One of the great strengths of palliative care is the concept of the trans-disciplinary team. No one person can provide palliative care. Every member of the team is equal and the team includes the person who is dying, their family and every person involved in their care, from volunteers to housekeeping staff, care coordinators, doctors and nurses. Each one is equally important.

The importance of home care
It is said of Canadians that we are the most institutionalized society in the world. In Canada, we have emphasized institutionalized care to the detriment of community care. The institutionally based mindset has inhibited our ability to provide for the full development of active, integrated home care in palliative care, although this should be where the greatest emphasis is placed.

Supporting those left behind
There is a tendency, once a person dies, to pause in remembrance and then get onto the next person who needs care. The family is still there, still our responsibility, still has its needs for care. Every bereaved person, no matter how strong, how balanced, how well supported, needs to know that the people who cared for the person they loved, remember them in their grief and their loss.  

It's about choice

The individual and family should have a choice of care and of setting. It is impossible to provide good palliative care without freedom of choice. Unfortunately, in most of Canada, that choice does not exist. It must be the goal of all who work in palliative care to create a system in which it does exist.  

Ideal palliative care

How does one create an ideal system of palliative care? One of the main methods of creating ideal palliative care is to return to the philosophy of providing physical, emotional, spiritual and informational supports.  

Educated professionals

No system of palliative care can develop without educated professionals. But education is more than teaching doctors and nurses pain and symptom management. It is teaching all members of the team the principles. It is accepting volunteers as active, educated members of the team and providing them with standardized training. It is teaching health care professionals team dynamics, where everyone shares in the responsibilities and decision-making of the team. It is teaching them how to counsel and when not to. It is demonstrating handholding or not doing anything at all. It is, in fact, changing the way they view the people for whom they care.  

Spirituality is the heart of hospice

Death is a spiritual event. Its nearness creates a desire to identify and strengthen what is of value in one's life. We want to tidy up the ends, put first things first. To be unable to do so can generate a desolate feeling of meaninglessness. To me, that is the essence of spiritual pain  to feel that one is meaningless or that one's life has had no meaning. We are spiritual beings deep within ourselves and must bring that spirituality to palliative care. We must reach out beyond our narrow interests reach out from our inner selves to the people for whom we care all of them. For love is the litmus test of palliative care and spirituality is its heart.

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