Chapter 10

Pulling It Together

How do we apply what we have learned?

   First you concentrate on what is actually possible for you to do and do those things in positive ways.

   In other words, you cannot individually change the systems of care to ensure that each of your patients and their families has excellent care. You need to concentrate on what is possible within your authority and work on those aspects of care as best you can.

   Consider working with others to make systemic changes. Just as maternal care became more personalized and less technological when women in the community changed the thinking of medical providers, you can make changes within your community both at work and as a health care consumer.

   All of us will die so this is one of the few health care issues that will touch every single one of us.

What you don't understand, let others teach you. None of us can know everything about providing excellent care in all situations with all people. Find those people who can teach you and learn from them. Then pass it on. What you know well, teach and role model to others.

   We only change our behavior when we hold ourselves accountable. So:

  1. 1.What one or two things can you do differently after today?

  2. 2.What one or two thing can you do more often?

  3. 3.How can you help/teach even more than you do now?

  4. 4.Who is your role model for providing excellent care?

  5. 5.Are you someone's role model? How can you help/teach them even more?

  The greatest motivator in the world is to feel useful and appreciated. Recognize that each day of your personal and professional life, you can make a significant and life-affirming difference in other people's lives and, therefore, a difference in your own life. These are mutual gifts we can offer and accept. Few things will have as profound impact on your personal life and the life of your community.

What HOSPICE CARE Means to Me

© 2006 Harry van Bommel

Heal my wounds after my tests, treatments, and diagnosis

    so I can live fully until I die

Organic care of my family and me so we are seen as whole,

    as we are, rather than diseased, or as systemic 'units

    of care'

Spiritual care sees us all as children of God rather than as

    patient and caregivers

Physical care takes away my pain and suffering while

    providing comfort and support

Information care helps me understand my options

Compassion is “walking with me” and being present

    in the moment

Emotional care supports my living on a roller coaste

     of feelings and thoughts

Communicate with me (not at me) and my family in a

     “common” verbal and body language of understanding

Aggressive palliative supports so that I can concentrate

    on my family and friends

Responsibly concentrate on your part of my care and

    advocate for me with others

Eternal consequences of your care affects you

    and me forever.

Thank you!


CHPCA April 10, 2006 Monthly Update e-newsletter and May 2006 Fact Sheet of CHPCA statistics at for most current statistics.

Dass, Ram and Gorman, Paul. (1987). How can I help?: Stories and reflections on service. New York: Alfred A. Knopf.

Expert Advisory Committee on the Management of Severe Chronic Pain in Cancer Patients. (1984, 1987). Cancer pain: A monograph on the management of cancer pain. Ottawa: Ministry of Supply and Services. Excellent summary of modern pain control techniques; distributed to all Canadian physicians.

Hospice Journal, 1995, Vol 10, #1 pages 1-13.

Ley, Dorothy C.H. with Harry van Bommel. (1994). The heart of hospice. Toronto: NC Press,

dedication page.

van Bommel, Harry. (2006). Caring for loved ones at home. Toronto: Legacies Inc.

van Bommel, Harry. (2006). Family hospice care: Pre-planning and care guide. Toronto: Legacies Inc.

The World Wide Web (Internet)

The following Internet links may be helpful for people interested in more information about hospice/palliative and home care. I have picked just a few sites that have excellent resources and extensive links to other related sites. These organizations deserve a lot of credit for the effort they have put into their Web sites.

A note of caution: There are thousands of Web sites offering health care information. The information on some sites may not be accurate or current. Check to see who produces the Web site, their qualifications and their credibility before assuming their information is correct.

Also, when checking the Web or other sources, for health care information, expect to find information that might be unsettling. The information may tell you things you didn't expect or didn't want to know and it may have been written for a professional audience rather than for patients and families.

Our own web site has many free online resources available to the readers. Visit to find resources on all aspects of health and hospice palliative care.

For general health information, Health Canada’s Information Site:

An extensive site with many links to other reputable sites.

Canadian Health Network

A general health information site with links to many other health related sites.

The Association for Death Education and Counseling and the King's College Centre for Education about Death and Bereavement are useful sites for those interested in teaching or learning more about death, dying and bereavement.

Centre for Disease Control and Prevention

Dr. Koop’s Community

An interactive health site with daily updates and news. Dr. Koop was for the former U.S. Surgeon General.

The Institute of Palliative Care in Ottawa has an extensive links section to organizations around the country and globe Their whole site is worth a visit.

Mayo Clinic.Com

An outstanding site for general health information

The National Hospice Palliative Care Organization in the U.S. provides many links to hospice programs throughout America and other organizations.

Hospice Association of Ontario Lifeline (Toronto) has many sources and links at

Results Not Intentions is a Legacies Inc. website to highlight professional research on the inequality of patient care and how we might address those inequalities to ensure excellent care for everyone.


A clinical reference for physicians who subscribe but also includes patient information that is updated regularly.

The World Health Organization is another extensive site for health related information

Gift of Care

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Copyright © 2007, 2008 Harry van Bommel

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical copying, recording or otherwise, except with the prior written permission of the author or under license from the Canadian Copyright Agency.