"When we did work talking to patients and care partners and providers, a lot of patients and care partners weren't aware of frailty as an idea or concept. But once it was explained to them, they felt much better and understood what was happening.

We all seek understanding and explanation in some way, and I think that can really help people really understand what's happening to their loved one, but also understand what's happening to themselves."

Doctor Zahra Goodarzi is an academic geriatrician and an Associate Professor in the Department of Medicine and Department of Community Health Sciences at the University of Calgary, where she is also the Division Head for geriatric medicine, the medical lead for specialized geriatric services and transition services, and the Program Director for Leaders in Medicine, Dr. Goodarzi's current work looks at the development of clinical pathways for mood disorders, dementia, and frailty across the care continuum in clinical care, emergency, and long-term care.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"When we are talking about culturally safe care, it's really having that background, that trauma-informed care approach. And that's for any person, it's not Indigenous-specific. To make it Indigenous-specific is to understand that Indigenous people in Canada have had a very different history. Every single Indigenous person that you have met or spoken to in Canada has been affected by the residential school system, as the last one closed in 1996.

It's a reflective practice .... looking at our physical care, mental, emotional, and spiritual care, and every single person as an individual. And that's an Indigenous way of thinking and doing. And I think that would benefit anybody going through the system." - Gloria Ranger

Valerie Jensen is a regional palliative care clinical coach with the Northwest Regional Palliation Care Program at St. Joseph's Care Group in Thunder Bay and is a registered nurse working as a palliative care clinical co-lead with Ontario Health Northwest.

Barbara Persky is a primary care nurse practitioner and a palliative care clinical coach for Kenora's Chief Advisory and Indigenous primary care program in rural areas around Kenora.

Gloria Ranger is the manager of Indigenous Cultural Safety and Education at St. Joseph's Care Group in Thunder Bay.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"There's a lot of love and respect for our elders, but for ourselves too, as individuals. Generosity and humbleness and the teaching from our elders. I really like to look at them as our teachers in the way we care for people and how we treat people. It's a part of my drive to make sure that our elders are cared for in the best way."

Renate Goodstriker is a proud Blackfoot First Nations woman and a registered nurse who manages a licensed long-term care home for the Blood Tribe Department of Health in Kainai, Alberta. She feels honoured to care for her community and roots her work in compassion, respect, culture, and a deep love for the people she serves every day.

Learn more: https://btdh.ca/program/long-term-care/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"One Green Care home that I just loved was kind of messy and untidy. You had the feeling that life was happening all around you, and it was busy enough that not everybody could tidy up entirely ... a little bit of what we did yesterday, reminding us today of what we did yesterday, which actually with dementia is a very good idea.

And the woman who had initiated it identified that the culture had three elements to it: One was 'do with, not for'. Two was 'joy and purpose every day'. And the third one was 'live till you die.'

Five years after her husband's death, Fay Martin visited Green Care Farms in the Netherlands, a non-medical residential setting for people in fifth stage of dementia.

The visit ignited a recognition and an articulation of the principles that governed how she had cared for her husband as he slid into dementia.

It also helped to explain why his dementia 'wasn't that bad', why it lacked many of the behaviours that we believe to be inherent in the disease. She now wears more confidently the role of author of her soon-to-be-launched book, Dementia Widow, a memoir about love, death and survival.

Learn more about Fay and her work: https://www.faymartin.ca/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"Stories in Motion are a way to give the unspoken a voice. Because so often with the people I'm working with, they've not had that voice...but if we can put it into a story, if we can put it into a world where anything can happen and people can say anything, then those unspoken thoughts, feelings get transposed and transformed into something for the person who creates, and for the person who receives it."

Learn more about Stories in Motion: https://www.thecreativecocoon.com/

As a registered expressive arts practitioner, Fay Wilkinson is passionate about stories, both hers and others. Known as a storycatcher, Fay works with people who have life shortening illnesses, mental health challenges, and dementia. Their stories are co-created into a metaphorical story using traditional and digital formats, an offering known as Stories in Motion.

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"If I had one wish of what the healthcare system knew about end of life doulas, it would be that if you embed end of life doulas into your healthcare settings, not as healthcare professionals, but as social emotional supports that their job would be a lot easier. People would be aware of advanced care plans, and people would be aware of actually just thinking through what they want. Families would be more educated, so families would be calmer and more understanding, and they would know what the death process looked like... together we could really help each other."

Jennifer Mallmes has worked as a caregiver and advocate for quality end of life care in Canada for over 25 years. She has worked extensively in community home care, finding deep purpose in supporting individuals to remain at home as they near the end of life. Jennifer is the co-founder of the End of Life Doula Association of Canada, and the creator and lead instructor of both the End of life Doula program and the Indigenous End of Life Guide program at Douglas College. Jennifer's passion is rooted in the belief that all individuals should have the right to self-determination in their end of life care. Through her work, she strives to ensure that people are empowered to consciously live and die with dignity, choice, and compassion.

Douglas College End of Life Doula program

End of Life Doula Association of Canada

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

"There are people who are saying we can't continue to do what we've always done. Don't tinker around the edges and make things a little bit better in the same old template that you've always had. Get rid of that. Change it radically, be bold, move forward."

Elroy Jespersen envisioned a different type of community where people living with dementia could live their own best life. His vision has resulted in The Village Langley, a groundbreaking community designed for people living with dementia and memory related conditions that offers cottage style living surrounded by five acres of walking past gardens and farm animals.

Learn more about The Village Langley: https://verveseniorliving.com/the-village/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

How does architectural design impact the quality of life for residents in long-term care? And how does design influence a palliative approach to care? We spoke with two architects at Montgomery Sisam Architects who have a particular passion for thoughtful design in long-term care.

Neda Basharat has been focused on creating home-like environments for seniors within the long-term care sector for over a decade. Her recent work explores innovative models in long-term care, which supports and promotes autonomy for residents, as well as prioritizing both improved resident quality of life and staff wellness.

For almost two decades, Tony Ross has been focused on projects that create a home and provide care for the elderly. A large portion of this work has been supporting innovation in long-term care, working and learning with others to create buildings that pursue normal and the highest quality of life for residents.

Learn more about their work: https://www.montgomerysisam.com/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/