Conversations about Death are Important in Life

“Dying is a part of living, and we need to talk about death while we’re still alive.”

These words are at the very core of Sandra Andreychuk’s role at Hamilton Health Sciences. As Project Manager of the Serious Illness Conversation Program, Sandra works with health care providers across Hamilton Health Sciences, providing instruction and guidance regarding conversations with palliative patients about quality of living and dying.

“It’s important to have meaningful conversations with patients about what they value most and what they want to see happen in their remaining days,” she says. “The Serious Illness Conversation Program provides health care professionals with new tools to effectively engage in these conversations and help them ask the important questions.”

Individualized care

No two patients will have the exact same values or wishes on their palliative journey. Some may wish to extend their lives for as long as possible, even if it means opting for ongoing medical interventions – whereas others may decide against further treatment and prefer to focus on quality of life while allowing nature to take its course.

“A major goal of the program is the early integration of these conversations to support a palliative approach to care,” says Sandra. “It’s vital to have these conversations while the patient is able to speak for themselves. When a patient is too unwell to have these conversations, it’s much more difficult to determine what they really want.”

When patients are able to speak with health care providers about the direction of their palliative care in a deep and meaningful way, they often experience less anxiety and depression. It also helps their families with the process of bereavement.

“It’s about getting to know who patients are as human beings – not just talking about treatment options for an illness,” explains Sandra. “The program is designed to increase resiliency in staff, develop their skills and increase the capacity at Hamilton Health Sciences to engage patients with these difficult conversations.”

On the path of learning

Roleplaying is one way that Sandra works with health care providers and builds their skillset. A roleplaying session typically involves three people, with one person playing the health care provider, one person playing the patient and the third person acting as an observer.

These roleplaying sessions, which are being done virtually because of the pandemic, often lead to interesting and enlightening discussions afterward.

“Playing the patient helps to put a care provider in the mindset of the patient and it helps to build empathy,” says Sandra. “Roleplaying also provides a safe environment where you can make mistakes and learn from them.”

Sandra, who worked at Hamilton Health Sciences for 32 years as a Nurse Practitioner and Health Care Ethicist, began her role with the Serious Illness Conversation Program in July 2021. The creation of this new, six-month position was made possible by funding from Hamilton Health Sciences Foundation.

“I find it extremely gratifying knowing that I can enable others to have more meaningful conversations with patients around death. Even if my work benefits a single family, then my work has been worthwhile.”