Dying with dignity at home with the help of Niagara EMS ‘angels’

Avi Hollo felt he was denying his father’s last wishes as he picked up the phone and called 911.

His father, Israel Hollo, wanted to spend his last moments alive in the comfort of his home with his family at his side, but as his condition quickly deteriorated Hollo said he felt he had no choice but to call for an ambulance to take him to hospital to ease his suffering.

Hollo said it felt like “an act of betrayal.”

He said the regret he felt was exacerbated by the look of disappointment in the eyes of his dying 75-year-old dad, who had been diagnosed 12 years earlier with lung cancer.

“He looked at us, kind of like: ‘No, that’s not what I want.’ But I didn’t know what else to do,” Hollo said.

Israel’s doctors gave him about four months to live when he was first diagnosed with lung cancer. Instead, he shared 12 more happy years with his wife Gila, his two children and five grandchildren.

As his father’s condition began to deteriorate during the summer months, his oncologist said nothing more could be done for him, Hollo said. Family began making arrangements for community palliative care services to allow Israel to die at home.

Getting the care he needed, however, took longer than he could wait. Despite his rapidly deteriorating condition, Hollo said his father continued to insist that he did not want to be brought to a hospital. But On Saturday, Aug. 27, when Israel was clearly in pain and too weak for his legs to support him, the family felt they had no choice but to call 911.

Hollo said he fully expected Niagara Emergency Medical Services paramedics to arrive and transport his father to hospital.

The paramedics, however, had something else to offer.

Those who arrived at the family’s St. Catharines home were part of a pilot project Niagara EMS has been running since 2019.

Although Hollo is not a religious man, he said he’s pretty sure those paramedics “were angels.”

Paramedics Jessica Coyne and Jill Banbury-Ward were two of those angels who responded. They ensured Israel was comfortable at home and visited the family throughout the weekend until he died on the Sunday.

He gave Israel the opportunity to share his final words with his son, simply saying: “Thank you.”

It was enough to give Hollo the feeling of comfort he longed for, knowing his father “was at peace.”

“At that moment, I felt at peace even though my father was dying,” Hollo said, struggling with emotion. “At the worst point in my life there was a sigh of relief.”

Banbury-Ward said the experiences of palliative care team members often bring tears to their eyes, as well.

“It’s very moving. Very emotional,” she said.

“A lot of our palliative patients we find want to die in the comfort of their home with their family holding their hand. I try to treat my patients as I would want my family treated.”

The palliative care paramedics are part of Niagara’s mobile integrated health team, which offers a variety of services beyond emergency medical care and transportation to hospitals, often responding to non-emergency calls related to mental health and addictions or falls, in addition to palliative care services .

Team leader Lisa Bath said these paramedics have additional training and carry medications specifically for palliative patients, to ensure they are comfortable during their final moments.

“We’re not doing the nursing stuff, but we are a gap filler if they can’t get a hold of their nursing personnel from the agencies,” Bath said.

While paramedics typically have limited time to spend on a call, she said that doesn’t apply when the call is related to palliative care.

“We’re there as long as we have to be, or until the nursing staff can get there to take over.”

Hollo said it’s a service too few people know about.

He wrote a letter to Niagara EMS, thanking paramedics for the care they provided.

“They deserve everything and all the recognition that they should get,” he said. “I’m sure there are people in a similar situation and this program needs to be known.”

Bath agreed that too few people know about the services her team offers.

Bath said Niagara and Dufferin County are the only two jurisdictions in Ontario that are sending palliative care teams in response to 911 calls when appropriate.

Bath said palliative patients can opt for hospitalizations if they choose.

“For those who wish to stay at home, it’s a much better alternative than being in an emergency department with a drape around you and family members sobbing,” she said.

Mobile integrated health commander Marty Mako said the program is part of a project run by the Center for Paramedic Education and Research that was recently extended until Jan. 1, 2024, to gather data about its impact.

Since its inception, Mako said, the Niagara team has responded to more than 500 calls from people facing situations like Hollo. He’s hoping the program will continue indefinitely.

The research being collected during the study supports extending it long term, he added.

“You’re serving people during their most vulnerable time of life, and we’ve had really positive feedback from families, we’ve been mentioned in obituaries. It’s some pretty powerful feedback that we’ve received,” Mako said.

“I think many people think of us as the lights and sirens that bring people to the hospital, but they are not aware that we have this innovative first in Ontario palliative program.”

Mako said people should contact a palliative care provider first if they need service.

“However, we know people have unexpected crisis and when they call their palliative care teams (during off hours) and they don’t answer the phone, people get scared,” he added. “In those cases, they call 911 and we’re always here 24/7.”


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