A little bit about me

I started my palliative career 25 years ago as a social worker on the palliative response team in Interior Health and this work inspired me to later pursue a degree in Nursing. This degree afforded me the privilege to work in a number of palliative and hospice settings in Ontario and BC. Most recently, I have been blessed with opportunities to continue to learn, love and grow as a palliative care coordinator for Island Health’s Palliative and End of life program. It was through my work on this team that lead to collaborations with Dr Kelli Stajduhar and her University of Victoria research and advocacy team who were engaged in advancing the work of Equity and Palliative care. Admittedly, despite my deep roots in palliative care, I had very limited experience in caring for vulnerable people who lacked access to social determinants of health, including equitable access to palliative care. I always assumed that ‘others’ were doing this important work.

The opportunity to work with Kelli’s team enlightened me to the reality and consequences of inequitable access to palliative care. It was made clear that the burden of palliative and end of life care for people dying in the context of poverty, stigmatization, racialization, homelessness and unstable housing social care, was carried by mental health, social care and housing support workers. Moreover, these care providers were supporting dying on the streets and in shelters often without the benefit of education, support or adequate human and material resources. Despite the lack of preparation, support, or recognition, the care workers showed up no matter what and continually went above and beyond.

I was later invited to participate with a group of care providers brought together to create an action team who would go on to use their lived experiences to inform the supports and services that were needed to care for structurally vulnerable people. After establishing trust and safety within the group, it became clear that they too experienced trauma and grief when providing care, specifically when witnessing the pain and suffering of their clients at the end of life. In witnessing the vulnerability, the strength and resilience in their stories, I found a deep sense of purpose.

The work of this team culminated in the creation of Palliative Outreach Resource Team (PORT), a mobile team in Victoria, B.C., that supports patients with a life-limiting diagnosis who have complex needs due to mental health, substance use challenges, poverty, housing insecurity or other barriers to accessing palliative care services. PORT is comprised of an interdisciplinary team including a nurse, physician, outreach worker, and social worker with expertise in providing palliative care to these populations. I now have the privilege of working as the Palliative Care RN on this team where I get to work with a compassionate and skilled team caring with and for very special and inspiring individuals.

Today, as I work within the gritty streets and shelters where life’s forgotten ones live and die. I continue to gain clarity and meaningful perspectives from the souls who brave the challenges of each day with trauma, substance use disorders, and homelessness—the marginalized, the racialized, the invisible. Their stories are etched into my heart, and shape my understanding of compassion, resilience, and the fragility of existence.

The work has stretched me beyond the capacities and knowledge I developed over many years working in safe institutional care settings. It has also required me to confront my own fractured family history which is imbued with trauma, and substance use disorders. At a young age, I witnessed loved ones suffering at end of life with un-managed pain due to worries of ‘addiction’ and assumptions about being ‘drug seeking’. Like many others who have experienced inter-generational trauma, isolation and alienation have been part of my story; we do not talk about past trauma, and we certainly did not talk about death and dying, even as it was happening. This personal history drives my passion.

I am grateful to those who allow me to walk alongside them in their journey towards the end of their lives, and those who love, care for, and companion them.

I will probably never forget Olivia—an artist, a dreamer—whose emotional and existential pain could only be alleviated by illicit substances that could not be prescribed or permitted in the spaces she was cared for. When Olivia needed hospital admission for treatment of life threatening infections, her continued need to use substances for pain management caused significant tensions and conflicts with care providers. While her body surrendered to the relentless tide of illness, she stayed strong and was determined to care for herself and her body based on years of experiences living in unimaginable circumstances. Only through showing up continually would the timing eventually be right for her need to share the impact of her awareness that she was dying. For the first time since meeting months ago, she wept, not for the impending end, but for the unending struggle and losses that had led her here. Olivia’s body bore the scars of trauma and substance use, but her spirit clung to life.

And the memory of Tony will stay with me, a philosophical and intelligent man with many talents and limited tolerance for bullshit. Unfortunately, only a few care providers understood that shame underpinned his behaviour, and this resulted in care providers more often expressing consequences and warnings rather than understanding, compassion and compromise. Jason, his ex-partner and lifelong friend, was his devoted caregiver who eventually allowed me to enter their circle of care when he had reached his limit of his capacity for caregiving, and eventually was overwhelmed with anticipatory grief. I learned about the true value of listening to understand, and I was humbled by the stories of their lives, a mosaic of grief and devotion that will remain etched in my heart. 

The trauma of survivors echoes in the urban streets of my community. Their haunted eyes, trembling hands, weakened bodies—they carry stories of abuse, loss, and fractured innocence. As a nurse, I witness their pain, trying to understand and absorb fragments of their past. Sometimes in those fragments is where healing begins, often the ending comes before I can know if what I bring makes a difference, or if it is enough. The questions are left hanging. In their departure, those who care for these beautiful people are often left with pain and regret. It is hoped that they eventually come to experience the gifts of wisdom: life is transient, love is eternal. I know for sure that humanity transcends circumstance. As we walk the streets and enter shelters and dilapidated motel housing complexes, we carry their stories—their resilience, their longing, their quiet courage. And in their memory, I continue stay inspired, strong and resilient.

Would you like to hear more?

Join us April 2nd for the webinar with Shelley Tysick