Frequently Asked Questions

There is a common misconception that Palliative Care only refers to the last days of one’s life. This is not true. Palliative Care refers to care provided to anyone with a terminal diagnosis, regardless of how much, or how little, time they have left. In cases where there is no formal terminal diagnosis but an individual has a poor prognosis, or has decided not to pursue any active treatments, Palliative Care can be provided. You may have heard the terms comfort care, supportive care, or symptom management used to refer to Palliative Care. Basically, anyone who chooses to not pursue any active treatments for a medical condition, but rather to focus on comfort and quality of life, is choosing Palliative Care.

End of Life Care is centred more around the last hours to weeks of life. Typically, symptom management and quality of life are the focus of the care provided. Often, at this point, quality of life becomes about sustaining a balance between providing sufficient symptom management and maintaining an acceptable level of alertness. For example, many people opt for complete pain control, even if it means sedation, whereas others are willing to tolerate some pain in order to be as alert as possible in their final days. This is why Advance Care Planning is essential. Having a discussion with your family about what is important to you helps them make decisions when you no longer can.

Other aspects of End-of-Life care centre around maintaining your skin integrity, for example, keeping your skin clean and dry to avoid skin breakdown, slight repositioning to avoid pressure sores, and mouth care to keep your mucous membranes moist.

As overwhelming as this stage may seem, the staff of Stepping Stones Palliative Concierge Services have guided others through this stage countless times. We can help you too.

We have experience with caring for people whose families or POAs live far enough away that they are not able to be a physical presence. You can rest assured that we will provide the highest level of care, maintaining our client’s integrity and supporting their independence as safely as possible. We will communicate with you regarding their current condition and care needs and keep you abreast of the information needed to make all the decisions that come with this stage of one’s life.

Yes we do! It is never too early to complete an Advance Care Plan and share it with your Power of Attorney or family members. Also, our Legacy work projects can be a fun family bonding activity that can be completed at any time. In fact, it is easier to complete these two when everyone is able to fully participate.

Advance Care Planning Canada states on their website “It's About Conversations,
It's About Wishes. Advance Care Planning is a process of reflection and communication. It is a time for you to reflect on your values and wishes, and to let people know what kind of health and personal care you would want in the future if you were unable to speak for yourself.” https://www.advancecareplanning.ca/

We know it can be difficult to discuss what you would like the end of your life to look like, especially when you may not have experience with the changes that can occur when an illness is present. However, having these discussions ahead of time allows for a more peaceful transition. When everyone is aware of your wishes, it alleviates stress and often curtails disagreements between well-meaning family members.

The staff at Stepping Stones Palliative Concierge Services are well-versed in the changes that come at the end of one’s life. We can guide you in completing an Advance Care Plan and inform you of situations that often arise so that you may make thoughtful, informed decisions. The goal is always to bring as much peace as possible, peace of mind, a peaceful environment, and a peaceful transition.

A person’s final days may be as unique as they are. Often, however, the process takes longer than one would expect. As someone approaches the end of their life, they tend to sleep much more, eat and drink less until they eventually stop altogether, and experience changes in their breathing patterns. The appearance of one’s skin may also change, becoming more pale, waxy in appearance, or exhibiting mottling. Urine production also decreases, and the urine becomes darker in colour. The body does continue to produce stool, even if someone has not eaten for a few days. It’s important to know that as different body systems begin to shut down, one’s energy decreases.  This is why it is so important to have important discussions while someone on a palliative journey is still alert and strong enough to participate. Peaceful deaths occur when loved ones have said what they’ve needed to and prepared themselves for what lies ahead.

The “Vigil” is one of the most difficult parts of the end of life journey. It occurs in the final days and hours when someone is most likely no longer conscious enough to participate in conversations. Their loved ones may gather as a group or take turns staying with the dying. This often entails “holding space” for someone, which means allowing them to go through their journey without bringing your own issues to the situation. The best way to vigil is to keep a calm and peaceful atmosphere. Of course, this doesn’t necessarily mean a quiet atmosphere. Does the dying love music? Then continue to play the music they always loved, or if they always loved being surrounded by family and conversation, then do so. Sometimes, however, the best way to vigil is to sit quietly with the dying. Slipping your hand underneath theirs is also a way to let them know you are present, but allows them to move their hand away if they wish.

The physical aspects of the Vigil are also important. Providing mouth care to keep mucous membranes moist, slight repositioning with pillows to relieve pressure areas and keeping someone cool or warm depending on their preferences and their temperature. These can seem overwhelming, but we can show you how to confidently perform many of these tasks, or we can take over the responsibility of these physical tasks while supporting you in being a calm presence for your loved one.