Joanne Terry is a Respiratory Therapist with Community Respiratory Services, who treats clients with problems related to breathing, such as lung disease, in the community.
Joanne shares with us how a discussion about what a diagnosis means to a client can be turned into a dialogue about what’s most important in life and how to preserve that through Advance Care Planning.
I am a Respiratory Therapist in the Community Respiratory Services program, who loves working in the community, as I get to build relationships with clients through both short and long term visits. Often our clients are diagnosed with more terminal illnesses, while others have a slower decline and our relationship is allowed more time to grow. My skills with Advance Care Planning have developed over the years: starting out as very apprehensive, thinking this is not really my role, to now seeing advance care planning as a vital part of my role.
Some of the more memorable conversations I have had with people regarding Advance Care Planning have been with those clients with new onset terminal diagnoses. I had a client a few weeks ago who was planning to retire in the next few years to relax and enjoy her life. She was then given a diagnosis with a shortened lifespan - her pulmonary fibrosis was very progressive and she was not a candidate for transplant. She had been working, looking after grandkids and parents, and overall busy with the things she "had to do", never really thinking about what she enjoyed or loved to do. She never really thought about what was important to her and what brought her the most happiness. We sat down and talked about her diagnosis, what it meant, what was important for her to do, what she would be willing to do to extend her time, and any goals she had.
This was a unique situation, as this was only my second visit with her, but our relationship and trust grew quickly. After a very heartfelt conversation, she made some plans and ‘action items’. By my next visit, she had managed to move her parents into a care facility, had her grandchildren go to daycare, quit her job and made a list of things for her and her husband to do to enjoy their time together. Her list was simple, comprised of tasks she was still able to do. She wanted to spend the rest of her time focused on herself, enjoying the things she liked to do. Things as simple as going to McDonald's for coffee brought her much enjoyment, so every morning she and her husband went to McDonald's for coffee and a muffin.
In my role, Advance Care Planning often begins as a discussion about a client’s diagnosis but I now ensure that opens up a discussion about what is important to them, how they understand their disease and what are their fears. Once you have this conversation, you are able to form relationships with your clients to help improve their quality of life, and with our aging population who have so many chronic illnesses, that is what is most important.