February 4, 1967 ee arr MEDICINE IN FACE OF DEATH By JUDY CREIGHTON Canadian Press People don't change fundamentally when they discover they are dying, says Harry van-Bommel, author of a handbook on terminal illness. “In fact, finding out about terminal illness changes people less than it does the people around them,” says van Bommel, who has experienced the death of loved ones first-hand, “Family and friends will treat someone who is dying differently unless they are made aware that the person) has not changed dramatically.” Van Bommel, 31, a Toronto consultant to nursing homes, has compiled a handbook entitled Choices — For People Who Have a Terminal Illness, Their Families and Their Caregivers (NC. Press Ltd., $9.95). Van Bommel helped his parents and grandparents fulfil their wishes to die at home. These painful yet positive experiences showed him there is a great need to provide practical information on alternatives to standard care of the terminally ill. DON’T CHANGE “Because someone is terminally ill does not mean that she or he is unable to work, play, talk, sing, tell jokes, laugh, swear, have sex, eat favorite melas and be the person he or she has always been,” van Bommel said in an interview. “If they were happy and able to communicate openly before finding out that they have terminal illness, they will probably continue to do so. If they are quiet and reflective by nature, they will probably stay that way. Nan Bommel, who also works as a consultant to, ies on developing employees’ skills, doesn’t mike light of impending death. But he brings into perspective the need to share feelings and wants with others during a difficult emotional time. He says people have the right to choose how to cope with terminal illness. “Some patients will choose to leave the major medical decisions to their caregivers — their doctors, nurses and other health practitioners. Others will want a more active role in directing their medical care.” CAUSE TENSIONS In the past few years, says Van Bommel, there has been a heightened awareness that, when the patient and family work together with their physician, everyone benefits. However, increased pressures on caregivers — forse responsibilities to other medical personnel, intervention by governments and insurance companies / Gnd di i: fend tension. “Open and honest communication relieves the patient's family’s anxiety, while the physicians feel the job satisfaction and less personal stress,” he says. Van Bommel adds that many physicians are uncomfortable with patients who are dying. After all, he says, medical training is designed to cure patients, not help them die. ds by or; ions — cause a lot of MORE HUMANE Van Bommel is an avid advocate of palliative or hospice care — that is, care in a special centre dedicated to the terminally ill. He believes such an approach is “a return to a more humane, patient-oriented system that encourages people with terminal illness, their families and caregivers to work together and, where possible, permits a person to die at home. “Hospice care is as much a philosophy as it is a program or an institution. It is a multi-disciplinary, clerics, psychologists and volunteers to work with patients, their family and the community. iy In: fact, van Bommel says, hospice care often Jops naturally in ities where citizens have long worked together with local medical professionals, family, neighbors and fellow church members to provide total care for people who have terminal illness. There are now approximately 350 hospice proggams in Canada. Van Bommel suggests that information ut, programs and admitting procedures be obtained from physicians, a local hospital or The Palliative Care Foundation, 33 Prince Arthur Ave., Toronto, Ont. M5R 1B2. FEW CHANGE | Invention spur JEMSEG, NB. (CP) = andy ‘McLaughlin always considered himself stupid, hardly the inventer type — just a guy with a soft spot in his heart for those in pain. Seeing his brother-in-law suffer from @ problem com- mon to kidney disease, vic- tims who receive home dial- ysis, he was spurred to in- vent .a remarkably simply device that's attracting in- ternational attention. Most of thé estimated 12,000. Canadians who re- ceive at-home dialysis of kid- ney fluids use a heating pad or electric blanket to warm the fluid precisely to their body ture, If the fluid is too warm when it enters the body it can cause infection, If it's too cold, as, MeLaugblin wit- nessed with his now-deceas- ed brother-in-law, “he would just actually sit there and shiver.until the body warmed itself up.” Home treatment, — which patients receive four times a day to remove body im- purities their gliseased kid- neys can no longer filter, can be as cumbersome as the treatment's full name: contin- uous ambulatory .peritoneal dialysis. ‘McLaughlin, a 57-year-old shop foreman at a tractor and equipment dealership in nearby » found it s int ai erest trolled heater that warmed “But I had a feeling, a soft hard to believe no one had | come up with a portable de- vice that would reliably warm the fluid to frat body temperature. ‘The first unit was “a little rough,” McLaughlin recalls. “But it worked well. My brother-in-law used it and thought it was a wonderful thing.” The insulated tin box, cap- able of holding 10 litres of dialysis fluid, contained a small . thermostatically-con- Canadian. Kidney Foundation also took notice and carried a description of the unit in one ‘of its news- letter. / With provincial support, McLaughlin set up E and A Industries Ltd. in, Jemseg to build and market'the device, out there that need the same thing.” ' tivity Council, which refined it to a point where McLau- ghlin hopes to have it avail- able commercially early in Japanese develop chicken pox vaccine TORONTO (CP) — A safe, effective vaccine has been developed for chicken pox, the last common serious childhood disease for which there is no protection. Dr. David Sheifeld said the vaccine, developed in Japan, will probably be approved for use in the United States within the next few months and in Canada about a year later. Sheifele, head of the divi- sion of infectious diseases at British Columbia's Children’s Hospital, said most Canadian children get chicken pox, a viral disease characterized by an itchy rash. Most of the 400,000 children who. con- tract chicken pox annually recover quickly with no long- lasting effects. For every 1,000 victims, about 100 will visit the doc- tor, one or two will require a hospital stay and about 100 will later develop shingles, a painful rash that can appear decades after the original illness. In the United States, where there are 3.5 million cases of chicken pox each year, it has been estimated that an effective vaccine could have an economic bene- fit of $260 million per year, Sheifele told the conference, sponsored by the Canadian Public Health Association. One consideration in ap- proving the vaccine in Can- ada is deciding whether it will leave adults more vul. nerable to the disease, Shei: feld said. It is not known how long the vaccine’s protection lasts. ONLY ONCE People get’ chicken pox only once because an attack leaves the body with protec- tive, lifelong antibodies against the virus. Adults who do not contract the disease in childhood can have a more serious bout later in life. Although adults make up only two per cent of chicken pox cases, they ac count for 48 per cent of the new year. Couneil technicians impro- ved the heating unit, re- placed the tin box with a light, molded plastic brief- which will sell for $326 under the trade name X-actemp. He's applied for trademark registration and admits that the experience has whet his More BIG. elites Kighiny Sine ENB. sexe nursing needed OTTAWA (CP) Not AUTOMOTIVE DIRECTORY enough new mothers breast feed their babies, and those who do don't breast-feed long enough, says a certified lac tation consultant U Joan Fisher said a study conducted by Ottawa Gen eral Hospital last year indi cates only 40 per cent of 125 women who left hospital nur sing their infants were still doing so when they reported ‘i Bear Creek Road. Trail inn. cpphity biglary