Dennie Hycha enjoys gazing out her office window and taking in the picture-perfect view.
The registered nurse is not looking out the window of a multi-level hospital or skyscraper in the city, rather Hycha’s office is her blue Ford Escape. She regularly enjoys the changing landscape in her travels across rural Alberta as Covenant Health’s senior director of operations for Rural Health Continuing Care. In this role, she works in partnership with communities and health professionals to help maintain local health-care services.
“I love driving in rural areas,” said Hycha, who has travelled from High Prairie to Medicine Hat—and most places in between throughout her 43 years in nursing. During those years, she has served in variety of roles including post-secondary educator and consultant. Home base for Hycha is a grain farm located west of Ponoka where she lives with her husband.
This [community palliative care work] was so meaningful; it changed my life … [Patients] and families were going through the [end-of-life] experience and it was me giving them the support, the tools, and the perspective so … they [could make informed decisions].”
– Dennie Hycha, registered nurse
She recalls sharing her “view” during a teleconference (with her headset on of course) as she headed home one day.
“I just have to tell everybody what I’m looking at … I [can] see the foothills in the background, the sky is a beautiful blue, and the canola fields are incredibly yellow,” she told call participants.
It was while commuting to provide home care to patients on a casual basis in Rimbey that the concept of palliative community care piqued her interest.
Hycha eventually headed back to school to complete her masters degree in palliative care, during which she developed a framework for palliative care in rural areas. At the time (in the ’90s), end-of-life care was fairly well established in urban hospitals and hospices, but hadn’t yet reached the community level.
Two years after completing this framework, David Thompson Health Region (now Alberta Health Services Central Zone) officials approached Hycha to implement the concept in central Alberta.
“[The framework] was really focused on the individual and the family. It was not just [about] episodic care; it was seeing [the patient] through a [period] of their life, which was the end of their life.”
Implementing the framework proved to be a challenging time. It required sharing information, building relationships, and balancing the needs of families that desired in-home palliative care with those of the health professionals providing that care.
“This [community palliative care work] was so meaningful; it changed my life … [Patients] and families were going through the [of end-of-life] experience and it was me giving them the support, the tools, and the perspective so … they [could make informed decisions],” she said.
Hycha recalls a particularly difficult case where a public health nurse requested advice about a terminally ill newborn whose family wanted him to remain at home.
“The mother and grandma were the primary caregivers so [I] was to teach them how to look after this baby and to work as the liaison between [them] and their pediatrician,” she said, noting pain medication was eventually arranged to be administered by a pump in the home. The newborn boy was not expected to live long, but in the end received palliative care at home for more than a year.
Hycha strongly believes the boy’s life was extended much longer due to receiving palliative care from family at home.
From experiences like these, Hycha was able to help develop A Caregiver’s Guide, a pocketbook filled with key information for distribution across Canada. This resource was designed for home-care nurses to share with caregivers to initiate the conversation on palliative care.
“One of my … proudest contributions is being able to give a tool to family members so that they can understand what’s going on and … have something they can refer to to become more knowledgeable and to draw upon for information when they needed support,” explained Hycha.
Much of the content came from scribbled or photocopied explanatory notes that home-care nurses shared with caregivers over the years, as well as from the experience of former caregivers and patients regarding end-of-life care.
Hycha was delighted to hear about the 20-year-old care guide being tucked into a Canadian woman’s pocket when she volunteered recently in Haiti.
“I was just so thrilled … that [the book] still has value. The concept [of a caregiver’s resource] is still the same. I’m really, really proud of that book … and I was just one of many people that contributed to it.”
— Lorena Franchuk
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