Tuesday, March 4, 2025

Life & Death

As a PSW in palliative care, Local 303 member Nicole Cooper brings comfort and compassion to patients in their last days

Guide magazine

By Alison Brown

LOSING A LOVED ONE IS not easy. It’s scary, painful, and fraught with complex emotions. If we cannot be present with them as they pass, our hope is that they’re surrounded by kind, loving people who can usher them into death with comforting care. Our hope is for someone like Local 303 member Nicole Cooper, who considers her job as a personal support worker (PSW) in palliative care her passion.

Last summer, CLAC ran a contest on social media where we asked members to send in a selfie and tell us what makes them smile these days—especially if it’s related to their job or workplace. Nicole was one of our weekly winners, and her submission warmed our hearts. It read: “What makes me smile is getting to work in the community with palliative patients and getting to keep them comfortable and loved during their last moments of life.”

I sat down with this extraordinary and passionate healthcare worker to learn just what it takes to offer folks dignity and care in their dying days.

Where do you work?

I work for the Victoria Order of Nurses [VON] in London, Ontario. I’ve been there for over three years. Prior to that, I worked as a PSW in a hospital, but I burned myself out there quick, so I decided to give homecare a try.

How did you end up in palliative care?

Palliative care wasn’t something I ever saw myself being a part of, but at the time I had a friend who was doing it, and she told me to give it a shot. I work as a healthcare technician for our e-shift/Hospice at Home program with patients who have complex needs, pediatrics, and the dying.

What are the educational/training requirements for your job?

To be hired as a PSW, you need your PSW certificate. Then our company offers additional training for the equipment and medications we administer.

What does a typical day look like for you?

I get a wide range of patients each day, so there’s no typical day. Some days, I’m only with someone for one hour and they pass away in that hour. A lot of our patients have a prognosis of six months, so we could either be sitting at their bedside on their last few days or even hours of life while they are unconscious, or we could be still getting them out of bed and spending the day with them doing whatever they need from us. Every day is different.

What kind of clients do you take care of? What are their needs?

I take care of dying patients and complex pediatrics. Working with children is usually a respite service to families to give them a break so they’re able to go out and take care of themselves for a while. We take care of palliative patients once they are discharged from the hospital and decide they want to die at home, and/or they’re waiting for a bed in hospice.

Is it a challenge to balance your work life and personal life?

It can be really challenging to ignore what just happened in your day when you return home from work. It’s a very emotional job.

What kind of safety issues do you deal with?

We don’t work with any other coworkers in the home, so we are able to check a care plan before visiting a home for the first time to see if there’s any safety issues, such as clutter, aggressive pets, or patients with dementia who have a history of harming a certain gender of worker.

How does palliative care differ from long term care?

Homecare is different because there’s no other staff to call on if you need help, and if the patient is alone, you have to figure out how to deal with things by yourself. But a lot of patients live with family who are willing to lend a hand if needed.

What sort of temperament best suits palliative care?

Very close to the end, it’s very common that patients become confused, restless, agitated, or delirious. We administer a medication called haloperidol to help keep them calm, so they aren’t a harm to us or themselves. It’s important to keep calm in those moments and remain patient and kind.

Do you get attached to the patients you care for or their families?

Absolutely! I have been with some patients for over a year and made amazing connections with them and their families. But it actually makes it mentally and emotionally easier if we are only with them a day or two before they pass away so there’s less of an attachment.

How do you cope when a patient passes away? How do you take care of your mental health?

VON is amazing at providing free counselling through their EFAP/EAP program, and they’re always encouraging us to use this service. We just have to remind ourselves that it’s not our own family member who passed away, even though it can feel like it sometimes.

What is a good death?

A good death is when a patient is calm, comfortable, and surrounded by the people they love.

Who are some of your most memorable patients?

I have worked with every age group ranging from a one-year-old, a 16-year-old, and even a lady who was 102! I love working with a wide range of people because it’s always a different experience. I got to be there for a baby’s first steps. I got to be there for a 16-year-old’s birthday before she passed. I’ve gotten to take seniors out for a walk in their wheelchairs before they pass. It’s all different and incredible.

What is the best part of your job?

Meeting amazing people and caring for someone when they might need it the most, especially when a patient has no friends or family to be there for them.

What is the worst part of your job?

When a death isn’t so peaceful, and you have to watch them suffer. Sometimes—due to religious beliefs or other reasons—someone might not accept all the help offered. One of the most important medications we give is hydromorphone or morphine. There’s a huge misconception that this drug is used to sedate someone or make them confused, which is why some people will refuse it. But it’s used for pain and shortness of breath.

Do you find your job rewarding?

Yes! I receive wonderful feedback often, which makes a difference. I feel I’m exactly where I’m meant to be.

Who was one of your most memorable patients?

I briefly had a 12-year-old pediatric patient who was born blind, and his hobby was to “watch” scary movies. For him they were funny, and he’d laugh at them as if he was watching a comedy!

If you could change one thing about your workplace what would it be?

I love my job and I love the company I work for. The only thing I would want to change would be to make sure everyone is trained properly to do this job and has the compassion to do it to the best of their abilities. The way you treat patients and their families leaves a long-lasting impression, and they will remember you for the rest of their lives. You need to make their experience a good one.

What is the biggest misconception about your job?

People think that it’s scary and depressing and hard to watch someone die. I find it a very peaceful and positive experience.

Celebration of Life

Nineteenth century French author Guy de Maupassant said “the only certainty is death.” While inevitable, death is a painful subject that many would rather not deal with or discuss. How one views death and the afterlife is heavily influenced by one’s culture and religious beliefs, and some cultures see death as an opportunity to celebrate with customs, festivities, and rituals that accompany it.

7 Cultures That Celebrate Death

1. Mexico – Día de los Muertos

Also known as Day of the Dead, this Mexican holiday takes place annually on November 1 as a time for families to welcome back the souls of their deceased loved ones for a brief reunion that includes food, drink, and celebration. During the holiday, there are parades and people dress in bright, colourful clothing. The common symbol associated with Day of the Dead is the sugar skeleton, which is why people dress in skeleton costumes or with their faces painted as skeletons.

2. Ghana – Fantasy Coffins

In Ghana, fantasy coffins are crafted to represent the profession that individuals held in their lifetime (e.g., an airplane coffin for a pilot or a truck coffin for a truck driver). Families may also pick coffins that represent an attribute possessed by their relative, such as a lion coffin for a fearless leader or an owl coffin for a wise elder. Funerals in Ghana usually consist of music, dancing, and dining. Pallbearers carry the fantasy coffins on their shoulders while dancing and wearing bright, colourful clothing.

3. Madagascar – Famadihana

Every five to seven years in Madagascar, Famadihana occurs, which is a time when a loved one’s bones are unearthed, and their burial clothes are removed and replaced with fresh ones. During this time, family members come together to share memories and stories of their deceased loved ones and eat meals together consisting of rice and pork.

4. Bali – Ngaben

Death is a celebration in Bali because it represents a soul’s entry into reincarnation, and Balinese people believe bodies have no significance beyond providing a temporary dwelling place for the soul. Ngaben is a cremation ceremony where there is no weeping or mourning, and caskets are formed in the shape of an animal such as a bull, cow, or lion. There is an all-day celebration of music and dancing, after which the body’s ashes are sent away to sea as a way of returning them to nature.

5. New Orleans, USA – Jazz Funeral

Known as the birthplace of jazz, New Orleans is famous for its parades and celebrations that include lively music and dancing. Jazz funerals in New Orleans gained popularity in the 19th century as funeral attendees engaged in a procession. Mourners would follow a jazz band to the church or funeral location as the band played somber music. After the funeral, the music would change as the band would play more lively and upbeat music as an intentional celebration of the individual’s life.

6. China – Qingming

Known as tomb-sweeping day, Qingming is a day dedicated to ancestral worship. Families visit the tombs of their deceased loved ones to bring food, drink, and money as offerings. The festival involves the use of willow branches to ward off evil spirits, and families will place the branches on gates or front doorsteps to protect them from spirits that might be wandering around during the festival. Families will also fly kites during the day and into the evening, and lanterns are even tied to kites to illuminate the night sky.

7. Japan – Obon Festival

Much like Qingming, the Obon Festival is a time to pay respects to the dead and honour ancestors. During this three-day festival, it is believed that the spirits of ancestors reunite with the living. Families will visit their ancestors’ graves to tidy and offer food and drink sacrifices. There are also carnivals and festival foods, and traditional dances are performed to taiko drums.

Sources: eterneva.com, history.com

Nicole Cooper

Life & Death

Celebration of Life

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