Pat Carfra: 35 Years of Care at Victoria Hospice
As we celebrate 35 years of care at Victoria Hospice, the history goes back even further than that. Before Victoria Hospice, a grassroots movement known as the Victoria Association for Care of the Dying (VACD) started to evolve in 1978. One of the founding members of VACD, Pat Carfra, describes her experience and the reasons why she wanted to be involved in such an important mission.
It all started for Pat when she was a student nurse at the Royal Victoria Hospital in Montreal. She remembers that end-of-life care was never talked about except in clinical terms, but the emotional needs of the patients were never addressed. Pat still carries with her the faces of a few patients who reached out to her during this time and saw the fear in their eyes about what was going to happen to them during their last days; “They wanted comfort from me which I couldn’t give.” When she thinks about this today, it makes her cringe. It was always assumed that the more senior nurses would take care of those patients.
It was when Pat read Dr. Kübler-Ross’ book On Death and Dying that she realized that no one was meeting the needs of those patients – “everyone was afraid of what would be asked of them and we had no resources.” In Pat’s particular case, she saw that no one took the time to listen to their needs and realized that was what people needed most. Pat also had the opportunity to attend a conference where Dr. Kübler-Ross was speaking, and was so moved that it made her realize there must be some better way.
“I knew that there was an urgent need in every community because no one was addressing the dilemmas of patients and their families; people were dying badly.”
Pat decided to call the Royal Jubilee Hospital and spoke with the Supervisor of Nursing who set up a meeting that included Dr. Peter Coy, Director of the Victoria Cancer Clinic. Pat recalls that the three of them were aware of the need and agreed it was time to take initial steps. Dr. Coy was very instrumental in the establishment of the organization of the VACD. They were joined by Margaret Farley, a social worker in his clinic, and together they made a good team.
“We talked with many people and figured that the best thing we could do right off the bat without any real funding would be to train volunteers who could go into homes and to hospital bedsides to support those who were nearing the end of their lives and their families. We did that by hiring a psychologist, Nancy Reeves, who trained the volunteers. Peter found funds – he was wonderful at that sort of thing – and we were able to rent office space with two rooms. Someone donated chairs and a desk and presto! Nancy had a place to interview and train volunteers. This was a first step toward our ultimate goal of creating a hospice facility, a place where dying people could be cared for that was not in an acute care setting. Throughout this process, we learned of other groups and individuals who had been quietly going about supporting dying people in their communities. Liz Bristowe, with the Ministry of Health, was a strategic advocate. She was all for establishing a hospice so could promote the idea from the inside. It was, indeed, an idea whose time had come.”
Because the timing was right, VACD was able to get some good publicity. There was a one-woman play at the McPherson Playhouse about end-of-life and VACD was able to have a booth in the lobby which generated a lot of interest. There had been coverage in the local newspaper and a community meeting was held to explain what VACD was trying to do. It was very well attended and much support was shown. There were those who objected to the bluntness of the name of the organization because it focused on ‘the Care of the Dying,’ but they were trying to be clear in a society that did not like to talk about dying. The first Board was soon formed and was representative of many parts of the community. The VACD was established as a grassroots movement working in the community with a focus of a facility having the hospice philosophy.
In 1980, Victoria Hospice was established, and VACD was absorbed into the larger organization.
“I was delighted to be a member of the first Board of Directors. Though we had no ‘home’, at first, it was acknowledged by the powers that be that a facility was the ultimate goal. The next steps were building the infrastructure at many levels, a fascinating process with both ups and downs. We were even required to have research to prove that hospice care would cost no more than regular hospital stays. I remember the Nurse-Manager of the program, Ruthella Graham said, (after a discouraging episode) ‘The first patient who actually crosses the threshold into our Hospice unit is going to get a great, big kiss from me’! And of course it finally happened.”
So here we are, 35 years later. Pat agrees that the impact of having Victoria Hospice in our community was been enormous on so many levels from the personal to the professional.
“I look at what it is now and I am so proud to have been part of its beginnings. At the time, there was scarcely a family untouched by the hard death of a family member. Hospice has made a difference, has provided a whole new approach to death and dying with dignity. In fact, my own mother, father and husband used the hospice services at the end of their lives. As we were creating Victoria Hospice, it never occurred to me that my own family would benefit many years later.
To think that over 60 places in BC now provide hospice palliative care in one form or another – more than any of us envisioned away back then. The expansion of services into the community and the teaching that has emanated from our hospice into the province and across the country – I am so impressed.
My late husband used to say ‘Be careful when you press Pat’s hospice button, because she can go on forever.’ I dare say I have, but I have enjoyed the remembering.”