SERVING A DIVERSE COMMUNITY
Health care for a multi-faith global village
An extended Buddhist family watched as their elderly patriarch was dying of cancer at Markham Stouffville Hospital.
In their tradition and belief system, a Buddhist monk is supposed to chant day in and day out to help the spirit transition to the next life. In this man’s case, the family agreed when the hospital arranged for a taped version of the chanting to be played in his room.
When the man died, the family requested that his body not be touched for eight hours. In a busy hospital like Markham Stouffville, beds are at a premium. So how to accommodate the family’s spiritual practice?
The hospital’s social worker, Tanya Dubé, came up with a solution that the family could accept. She suggested that the body remain in its hospital bed while it was wheeled into a private room so the family could mourn. “We were able to respect the family’s wishes while balancing the hospital’s needs,” she says.
When Markham Stouffville opened its doors in 1990, it served a population of 77,000 consisting mostly of Mennonite farming families. Today, the community of 400,000 has undergone a dramatic change. The hospital is now surrounded by a multi-faith global village of Buddhists, Hindus, Muslims and Catholics.
Thanks to the hospital’s innovative diversity initiative, it has adapted well to the challenge of accommodating a variety of religious and spiritual practices. Says Don Shields, the hospital’s chaplain, an Anglican priest and registered psychotherapist: “Every family, no matter their culture, teaches us what they need. No two Muslims, no two Hindus are the same. We do not take a cookie-cutter approach to multiculturalism.”
Statistics Canada has documented the shift in York Region. Currently of the approximately one million people who now live in the area, 45 percent are born outside the country. By 2031, that percentage will rise to 55 percent.
“In the past, we had a minister come to the patient’s bedside and recite a few prayers,” says Shields. “Today, we have imams and monks and a variety of rituals that we accommodate as best we can.”
This change applies not only to patients who are dying, but also to diagnoses and prognoses. “We always start where our clients and their families are,” says Dubé. “We try to adapt and not make assumptions.” For example, in Chinese families, the eldest son is usually charged with the decisions regarding care. Dubé says a recent case was the exception to the rule.
A dignified Cantonese woman decided early on in her care at Markham Stouffville Hospital that she did not want any pain medication. She feared she would become addicted, even though she suffered intractable pain due to cancer.
The hospital respected her wishes. However, with sensitivity to the woman’s Chinese culture, Dubé helped her to understand that she could get a more restful sleep with the help of the medication. “When she finally agreed to accept the pain medication,” says Dubé, “she found a sense of serenity in the last few weeks of her life.” The night she died, she went peacefully. Her family was most appreciative.
Accommodating the diverse community also entails day-to-day care. With regards to Muslim women, the hospital is looking into purchasing hospital gowns that come with a head covering.
The need for translators is also a priority. If there is no one on staff who can speak a patient’s language, the hospital turns to a translation phone line they can access 24 hours a day. Similarly, the staff offers a series of picture cards to help patients point to signs for basic human needs like bathroom use. They use a scale chart to indicate level of pain.
Celebrations are also encouraged. Upon the birth of a child, the hospital allows clergy or elders to recite prayers for the babies and blessings upon the families. Birthday parties for sick children, as well as other milestone events, take place on a regular basis.
Once, a mother at the hospital was too ill to travel to Hong Kong for her daughter’s wedding. So they brought the wedding to the hospital’s chapel. Their community pastor presided. The mother was dressed in a beautiful purple silk blouse, says Dubé, and was wheeled into the chapel to witness her daughter getting married.
“That daughter will now be able to cherish the memories in photos of her mother attending her wedding,” she says.
Staff training in multiculturalism is ongoing. Recently, a woman from the Islamic community came to a lunch-and-learn to speak to the issue of caring for Islamic patients and their unique needs. Similarly, the hospital tries to provide female staff in order to respect Islamic modesty issues for women patients. Staff will receive a booklet on cultural sensitivities around Hindu rituals that evolved out of a lunch and learn given by the Hindu committee.
“We try to give our staff a sense of comfort in dealing with patients’ diverse needs,” says Shields.
>> This is the second in a series from Markham Stouffville Hospital. The next article appears Saturday, Dec. 5.