This is part of a series of stories profiling members of the Niagara Health team and the work they are doing as part of our response to the COVID-19 pandemic. Meet Dr. Andre Maddison, Internist physician and Project Lead for Niagara Health's Palliative Care Program.
For Dr. Andre Maddison, the biggest clinical challenge with COVID-19 has been the uncertainty, in particular with our palliative patients.
As an Internist and Project Lead with Niagara Health’s Palliative Care Program, Dr. Maddison says the hardest part of working through the pandemic is not knowing what the outcome will be for each patient.
“Patients are often alone, fragile and balancing multiple health issues,” he says. “The challenge has been the profound isolation, loss of function and depression that has been part of our patients’ journey through COVID.”
When the pandemic started, the Palliative Care Team knew they had to come up with a way to keep patients connected to their loved ones. Nurse Practitioner Andrea Lehal, who is part of the palliative care team, quickly began coordinating virtual visits through FaceTime connecting patients with their loved ones. “Andrea has had an immense impact on our patients and families,” says Dr. Maddison. “Coordinating virtual visits was better than any medication we could offer.”
Niagara Health’s Palliative Care team consists of a group of physicians and nurse practitioners who offer in-person and phone consultations to patients and families on a referral basis. The team works across Niagara Health’s Greater Niagara General, Welland and St. Catharines sites.
The Palliative Care Consultation Service – a new service at Niagara Health – provides patient care services, including managing symptoms, organizing home or hospice care, and social and emotional support. A similar service exists for outpatients at the Walker Family Cancer Centre at the St. Catharines Site, and this new program expands on these services to include patients admitted to hospital and Emergency Department patients. Since March, the program has seen more than 300 patients.
Dr. Maddison, who has been an Internist with Niagara Health for two years, completed his internal medicine residency in 2018 with a special interest in palliative care.
What has changed in the palliative care program during the pandemic?
While face-to-face family visits subsided through the peak of COVID, we’re now seeing more families visit as we gradually lift visitor restrictions. Palliative care is done at the bedside, and ideally, with loved ones in the room. I think virtual care will continue to have a role in palliative patient care – especially for out-of-town family members – however family presence at the bedside makes such as a difference for our patients.
Describe how the team has performed during the pandemic?
Andrea Lehal - a star on our team - has impacted countless patients and family members helping them navigate this scary time. She has been the cornerstone of this program coordinating virtual visits for patients and loved ones, and has been a remarkable role model especially when COVID was at its worst.
What precautions has the palliative care program taken to enhance safety during the pandemic?
We’re taking the normal precautions - following the guidance of Infection Prevention and Control and Public Health - but we’re still safely seeing patients at the bedside on a daily basis.
Has your partnership with home care and community services changed due to the pandemic?
It has definitely been complicated, as there are health and safety restrictions everywhere. We have to balance the risks and benefits for each patient, determining what works best for each of them. We’ve really enhanced our communication between all partners – hospital, physicians, hospice, home care and community healthcare services – discussing ideas about how we can make the best of this time.
What inspired you to become a physician?
I started my undergraduate education in business, as both my parents were physicians, and I originally thought I wanted to have a different career. However, when my mother retired as a small-town family physician, I was able to see the impact she had on our community. At that time, I decided to change paths.
What has been the biggest challenge for you personally through COVID?
Like anyone, there is the worry about being at work and then going home. My wife, a family physician on maternity leave, is at home taking care of our three young children. It can be very stressful at times, and you worry about keeping your family safe. My wife and I have worked through different strategies to get through this, realizing COVID is going to be a marathon not a sprint.
How do you wind down after work?
I do my best to cycle to work, especially since the weather has been nice. The 20-minute ride home allows me to leave work at work. The biggest distraction is playing with the kids, trying to be present and leaving phones and work distractions behind. We have fun and act silly, and try not to think about the next day.
Learn more about our palliative care team and program here.
