McMaster and St. Joes grant dying wishes, and comfort comes cheap

Since January 2013, researchers from McMaster University and clinicians at St. Joseph's Healthcare Hamilton have been granting dying wishes for patients in palliative and critical care. What they found was amazing — most people's wishes could be granted for under $200.

Most dying wishes at St. Joes can be granted for under $200, study finds

Frieda Rowan suddenly ended up on life support and in the ICU at St. Joseph's Healthcare Hamilton last August. It was there that her family was introduced to the hospital and McMaster University's joint Three Wishes project. (Ingrid Thompson)

Frieda Rowan's favourite flowers were sunflowers.

Their glow captivated the 75-year-old, who was in good shape for her age, her daughter Ingrid Thompson says. She had no health problems – she wasn't even on any prescription drugs.

That's why it was so shocking when Frieda suddenly dropped to the floor, convulsing, at a Fortinos last August. She suffered a catastrophic brain aneurysm and ended up in the ICU at St. Joseph's Healthcare.

- Research coordinator Marilyn Swinton

That's where her daughter was introduced to McMaster University and St. Joe's Three Wishes Project – courtesy of a huge vase of sunflowers.

The premise is just what it sounds like –  since January 2013, researchers and clinicians have been granting wishes for patients in palliative or critical care. What they found is that most people's wishes could be granted for under $200 — as they or their families requested small personal comforts or momentos, not grand or extravagant acts.

"She was blessed to be in that ICU," Thompson said. "I can't even really describe it."

The project is the brainchild of Deborah Cook, a professor at the Michael G. DeGroote School of Medicine and a staff physician in St. Joe's ICU.

Honouring the dying

"We wanted to honour the lives of these people we were taking care of," Cook told CBC News. "It calls forth everybody's compassion."

In some cases it was the patients themselves who made the wishes, in others where they couldn't communicate, it was their families.

But in every case, the wishes managed to humanize the death process in a sterile hospital environment, and bring some measure of comfort to people in their most vulnerable moments, Cook says.

Unlike the grandiose wishes many of us might make if given the opportunity while healthy, these people and their families just wanted small comforts – which ended up being the most important.

Some people wanted cherished mementos by their bedside, while others wanted personal tributes like a charity donation or a tree planted in their name. Some wanted to reconnect with long lost relatives, while still others wanted to renew their wedding vows before they died. Many of the wishes cost nothing. Almost none cost more than $200.

Researchers interviewed patient's families after they died, as well as the clinicians who worked on the project.

Their research, published Monday in Annals of Internal Medicine, found that asking for and honouring last wishes helped create meaning, memories and closure at death. There were 40 dying patients involved in the process.

In Thompson's case, the wish process was almost imperceptible. Her mother ended up in hospital extremely quickly, and wasn't responsive. While Frieda was on life support, Cook mentioned the wishes project, and started asking her questions about her dying mother.

Cook told her about her mother's love for sunflowers, and how much she enjoyed classical vocal music. The next day, her daughter was amazed to find a huge vase of sunflowers in her mother's room, and lilting choral music playing through a set of speakers.

Wishes granted

Those little touches – alongside others like facilitating organ donation – made her mother's short stay in the ICU before she was taken off life support much more bearable, Thompson says. "They were just so incredibly caring and compassionate," she said.

Research coordinator Marilyn Swinton says there were a lot of hugs and tears between families and doctors when they came back to talk about the wishes project for the research paper.

"They were so very appreciative of the care they received and the voice to express their wishes," Swinton said. St. Joes plans to continue the project, even though the research component is finished.

"It's true – the simple things in life are what matters the most," she said.

Nowhere is that more true than for Frieda Rowan — because for just a few extra days, she had sunflowers.

adam.carter@cbc.ca | @AdamCarterCBC


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