Katherine Frances Murray

I came to hospice nursing as a child. A few of my earliest recollections of death include a dead rat found in our basement and a lovely transparent dead maple leaf. I tried to nurse both back to life--unsuccessfully. When my siblings and I found a dead robin we decided that we were not doing well in the resurrection department, so we opted for burial.

As a teenager, I lived with my Aunt Frankie--the master family caregiver. During my years with Frankie she cared for my grandfather, my uncle's parents, my great aunt and uncle, a neighbour and friends during their aging years and then their dying process. She taught me that when someone needs help, you respond.

In high school and at university I encountered death and learned that even the young die. I learned that people die from cancer, accidents and suicide. By my mid-twenties, my father, my uncle and a few dear friends had died. I had come to know death as a part of living.

I completed my BSN at the University of British Columbia and it was then that I became intrigued with the growing hospice movement.

In the late 1980's we moved to Victoria and I began work at Victoria Hospice. It was there I learned that to 'help' I would need to provide more than just a 'compassionate response'. I needed to learn about diseases, symptom management and the dying process. I needed skills to assist people through transitions. I needed to feel comfortable when talking about death, and to develop a deep understanding of loss and grief. While gaining this knowledge, I increased my competence in providing care. Mostly, I learned that some physical suffering I witnessed in my earlier years could have been prevented with adequate education and skill.

In the early 90's I started a private education practice providing workshops on care of the dying. I studied. I read. I taught. I hoped that education would make a difference to the caregivers and to the dying.

While obtaining my Master's in Thanatology, (the study of death, dying and bereavement), I became increasingly aware that the majority of our dying population is cared for outside of specialty hospice/palliative care programs. I also became aware of how few courses in hospice/palliative care were available to students in professional and paraprofessional programs, and to family members providing care for people who are dying. I decided that I would work to address the needs of these direct care providers.Footnote

In the 1990's, while speaking to a national hospice palliative care organization I stated, "What we need is a book that is so easy to read and interesting that a caregiver working in an isolated location would take it off the shelf and read it, even if they did not have access to onsite workshops." I hoped that "someone" would write this. I definitely did not expect or plan to be one who would attempt to write it!

When I wrote the first edition of the manual, it was to strengthen the handouts I gave to community health workers, resident care assistants, and nurses attending workshops I developed. I hoped that six months down the road, in the middle of the night, when their brains were on "night shift," the manual would be a ready resource and would remind them of the content we had covered.

Since publishing the first edition, I have received feedback from many individuals, suggesting that the manual was helpful to them in their practice, and that it was in fact, an easy to read, easy to understand book. (I think people like the vignettes the best!) The comments from individuals using the manual showed me that it was a useful tool. My favourite comment is the one I have received at least a dozen times from family caregivers, "I think I can do this now!"

"Essentials" was written for caregivers who are new to hospice palliative care and perhaps new to caregiving. It is a resource for the generalist versus the specialist in hospice palliative care. This is not an advanced textbook. Some sections contain complex information which at first glance may appear to be 'too much' for some caregivers. However I have tried to present the material in a way that will engage the reader at an experiential level, inspire them to understand, stimulate them to apply the knowledge and theory to practice, and help them identify when to reach out for on-site support.

It is my belief that all individuals have the ability to learn complex information as long as it is presented in a manner that is meaningful to the student and if the teachers are available to support students as they make meaning of the new concepts and information.

I hope that 'Essentials' will stimulate your thinking, link you with further resources, help you identify questions to ask, and overall, I hope it will increase your capacity to provide excellent care for those in your circle of care who are dying.

All the best to you in your journey of caregiving.

Kath Murray