Chronicle 2018

By Naomi Buck 1990

R eflecting on her current work as director of the Ontario Palliative Care Network, Angelika is reminded of rowing on the Havergal crew. While the tasks are quite different – one to reshape the culture of dying in this province, the other to pull through water – Angelika says that both draw on the same skill: to recognize the strengths of each team member and to work together towards a common goal. After graduating from Havergal, Angelika studied history and sociology at Dalhousie University and began working in the English publishing industry in Montreal. As that industry gradually migrated south of the border, she began working for an internet platform – a novel concept at the time – for physicians engaged in continuing medical education. She was immediately interested in the challenges facing doctors and decided to do an MBA at McMaster University, specializing in health-care administration. For her final co-op placement, she was assigned to a Local Health Integration Network, one of 14 bodies across the province that plan and manage health- care services at a local level. Angelika was intrigued by the challenge of managing health care and worked her way up through the system. In 2015, when the Ministry of Health created the Ontario Palliative Care Network, Angelika was named as its director. The network has been tasked with addressing a fundamental problem: while the vast majority of Ontarians say, when asked, that they would like to die at home, most are dying in

hospital – many in intensive care units, some in hallways. Furthermore, the experience of dying varies tremendously across the province’s geography and socio-economic strata. Only about a third of Ontarians receive palliative care in their final stages, reflecting a glaring disconnect between supply and demand: 200 palliative care specialists in Ontario are available to meet the needs of 14 million people. “What do we need to enable Ontarians to die at home regardless of where they live?” is the question that Angelika and her team are trying to answer, and a big part of the answer, she feels, is the need to reconsider our attitudes toward end of life. “Death in the West has been institutionalized,” Angelika says. “We’ve put our faith in science and technology, meaning that death is hidden from view.” Not so long ago, Granny would have been laid out on the dining room table; now, she disappears behind closed doors at a hospital. Angelika says that we need to change the conversation: to accept the inevitability of death, to prepare for it and talk honestly about it. Is this work not depressing? “I find it invigorating. Travelling around the province and hearing people’s stories makes me want to change things. The way we die should reflect the way we’ve lived. People should have real choices.” Angelika is optimistic that if the team – in this case, hospital CEOs, nursing associations and all levels of government – pulls together, it will accomplish its goal of offering Ontarians the deaths they want.

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PHOTO: NIAMH BARRY 2009