Giving the Gift of Dignity

Oct 26, 2022

Dhwani Parikh gets great joy from giving people back their dignity and believes that is the gift an occupational therapist (OT) can offer people with a life-limiting illness.

“A terminal disease or aggressive cancer means clients can lose the ability to provide for their
own daily needs and care for themselves. Many feel they are losing their dignity and I have the
privilege and opportunity to give it back to them,” Dhwani said.

She fondly remembers a client with an aggressive lung disease who had been bedridden for four months before she met him. Breathlessness and anxiety had a big impact on his health and the thought of becoming breathless would provoke a panic attack. So, although Dhwani assessed that he had the strength to go to the bathroom, his mental state prevented it. Using her occupational therapy training, Dhwani was able to teach the patient some relaxation techniques and provide him with access to equipment, a referral to a physiotherapist (who worked on this breathing) and for a medical review to provide medication to address his symptoms.

“After a few weeks of intensive therapy, he was able to toilet himself and he was enormously grateful to us for that,” Dhwani said.

Fatigue can also impact a patient’s ability to participate in their own care so Dhwani might prepare a management plan that enables an individual to conserve energy for meaningful and enjoyable activities. This might mean using a wheelchair for shopping instead of walking so they can enjoy the shopping experience or plan their day differently, focusing on the things they love.

“Many people associate occupational therapy in palliative care with equipment prescription, but OT’s can provide a lot of non-pharmacology interventions to relieve pain, restlessness and anxiety,” she explained, adding that giving people back their dignity and enabling them to live well motivates her at work.

“Many think of medications for these symptoms first, but there are other options. OT’s work on symptom management and pain relief through different pieces of equipment like wedges, pillows, cushions and different styles of seating. We can also modify their routines so that medication is timed to enable more activity.

Dhwani says a lack of sleep can cause fatigue for clients and then this impacts their ability to participate in their own care. She regularly helps individuals formulate a healthy sleep environment and provides them with a relaxing pre-sleep routine.

People rarely talk about death and dying in Dhwani’s birth country of India, as followers of her Hindu religion believe talking about the end of life hastens it. Despite this, she found herself drawn to palliative care. She joined PCSE six years ago and now talks about dying every day.

“I was initially apprehensive about the role because I didn’t have any real personal experience of death amongst my family and friends and I wasn’t sure I could handle the pressures of the grief and loss process but I like to challenge myself so I thought I would give it a go,” Dhwani said.

“Palliative Care South East is not just about care for the actively dying but provides support and comforts proceeding through the trajectory of a life-limiting illness that becomes terminal.”

“I realised that I could have a significant impact on the person and family during this time and I began to feel a lot of satisfaction. I saw that something as small as being able to walk to the shower or sit up and feed themselves in bed can be a chore for our clients and that I could change this. I also realised that I had the right attributes – patience, compassion, kindness and resilience – to work in palliative care, which is such a challenging environment,” she said.

Working in a Culturally and Linguistically Diverse (CALD) region like the South East of Melbourne has a lot of opportunities to work with different cultures and religions and individuals who have different ideas about and approaches to death and dying.

“In the Hindu philosophy, which has a belief around reincarnation, if you have done bad deeds in a previous life then you will endure suffering for those deeds in your current life and it’s your Karma to endure that suffering to ‘pay’ for those deeds. Hindus believe that if you avoid it, you will get the suffering in the next life,” she explains.

Dhwani adds that when Hindus die at home, they believe the spirit of the deceased needs facilitation for spiritual freedom so it can look for another life.

“We never say Rest in Peace in my culture because we don’t consider that the soul does rest in peace.”

Since joining PCSE, Dhwani has completed a specialist palliative care postgraduate diploma at the University of Melbourne and researched end-of-life care in various Culturally and Linguistically Diverse (CALD) communities.

When not caring for clients, Dhwani can be found indulging her passion for Indian dance.

“As a palliative care clinician, it’s important to practice self-care and to maintain work life balance. My love for dancing, not only gives me an opportunity to exercise and remain fit, but also provides me with a way to release all of my stress, express negative thoughts and feelings and it is very therapeutic,” she said.

To find out more about our staff and the amazing work we do, check out our latest Annual Report.

Meet Nurse Practitioner Rob Molenaar

Oct 20, 2022

Robert Molenaar with client Kathy George

Robert Molenaar is a quiet achiever in the clinical care team at Palliative Care South East (PCSE). He loves his job and believes the opportunity to support individuals with a life-limiting illness to live well, receive end-of-life care at home and die peacefully is his calling.

Whilst nursing in the oncology departments of major public hospitals, Robert saw patients suffer the severe side effects of treatments that had a very low chance of any tangible results and believes this marked a turning point in his career.

“It made me think, what can I do to enrich their life and ensure they enjoy what time they have left and that was the palliative care philosophy and it meshed with my values,” Robert said.

“I saw patients undergoing treatments that had limited efficacy, caused major side effects and reduced their quality of life. Sometimes, the effects from the chemotherapy left them so unwell that important time, that could have been spent with their family, was spent stuck in hospital and they died there and that didn’t sit well with me or align with my values.”

So, after more than a decade as an oncology nurse, Robert joined the palliative care team at the newly opened McCulloch House in Clayton and found his calling.

He moved into community palliative care when he joined PCSE in 2004. Ten years later, he completed a Masters degree to become a Nurse Practitioner which is an advanced practice nurse that holds additional qualifications and skills to support the care of individuals who have complex needs.

“I can’t see myself ever leaving the community sector. I like that I have more autonomy and my results are more tangible here because I can write scripts and refer patients to other health practitioners, and I can do it in a timely fashion whilst having the support of the (PCSE) team. I can also be a source of support for other staff.”

Robert enjoys working closely with individuals and their families to ensure they live well, can stay in their homes for as long as they wish and that their end-of-life care reflects their wishes and values.

“The most enjoyable part of my job is meeting people in their homes and helping them. It is as simple as that,” he said.

Whilst many in the community seek out palliative care in the last few weeks of life, Robert says the best palliative care focuses on the last year of an individual’s life. It supports them and their families and carers to live well by managing their pain and other symptoms, enabling them to be comfortable so they can enjoy doing the things they love and time together. The nursing care is complemented by allied health services that will improve their quality of life and help them prepare for the end of life. Robert says good palliative care supports clients to live well and have a peaceful death in the place of their choice.

Read more stories like this in our latest Annual Report

Celebrating Carers

Oct 17, 2022

“Caring leaves its mark on us. No matter what we do to prepare ourselves, the hole left behind looms large” 

Dale L Baker, author of More Than I could Ever Know: How I survived Care Giving

Counsellor and Art Therapist Linda Espie shares some thoughts for Carers Week

Anyone can find themselves in a support role as a family member, friend, neighbour or colleague.

One in eight people at any one time provide unpaid care or support to someone in need. There are 2.65 million carers in Australia and, according to Carers Victoria, one million Victorians will be unpaid carers in 2025, that’s one in every seven Australians.

Supporting others in any capacity, can be very rewarding. It may also take its toll physically, emotionally, socially, psychologically and spiritually, on those in support and caring roles and that’s why we support our clients, their carers and families.

As a partner, sibling, friend, grandparent, daughter, son – regardless of the relationship – caring for someone requires carers to take care of themselves too. Health and wellbeing of all in palliative care is our business.

Our commitment to ensure best practice in the delivery of all of our services for those accessing PCSE is central to our mission. Our ethos encompassing Responsiveness, Empowerment, Collaboration and Kindness underpins our focus of engagement with all.

As well as the valued outcomes of caring for others, carers may experience isolation, fatigue, grief, mixed emotions and/or financial concerns.

Our team at PCSE provides support for carers including counselling, social work, spiritual care, art and music therapy, respite, volunteer support. For more information, click here.

Erebus Motorsport donates merchandise to PCSE

Sep 30, 2022

Dandenong based Erebus Motorsport will be participating in the Bathurst 1000 Supercars race starting Sunday 9th October and, to mark the event, they have generously donated merchandise to help raise funds for palliative care in Melbourne’s south east.

Everyone who donates $10 or more to us online between now and the end of October, and writes “Bathurst 1000” in their donation comment, will go into a draw for the prizes. For every $10 you donate, you gain an entry into the draw so a $50 donation will get you five entries!

The prizes include the original signed brake rotor from the Erebus supercar driven by Anton DePasquale and Brodie Kostecki two years ago in the 2020 Bathurst 1000 and an Authentic model 1:18 Erebus Motorsport #99 Holden ZB Commodore Supercar – 2018 Sandown 500 Retro Round valued at over $200. To make your donation click here now.