Brantford’s palliative care floor was familiar to me, I could remember looking at the fish tank here some years ago while my grandmother was dying; the rest of the details escaped me.

The floor was quieter than I’d imagined. A mural of cherry blossom trees covered in butterfly shaped plaques welcomed visitors as they came off the elevator. Each of the butterfly plaques was decorated in the names of patients who had died in the unit.

In the center of the unit is a pseudo living room with three couches and beige walls. A man sits in here passing time.

A hallway runs adjacent to that of the elevator; in this hallway are the six rooms in which palliative care is performed in Brant County.

Two crying women pass me, despite the fact it is the morning, their exhausted eyes imply that it has already been a full day.

A window at the end of the hall is brimming with lively plants; a stained glass butterfly lamp is nested amongst the flora. The butterfly lamp is identical to the one they light at the local hospice to symbolize the passing of a patient, but Chris Borrows explains to me that there is no ritual associated to the lamp in this hallway.

Borrows is a longtime Brant County palliative care nurse, and is the acting shift lead.

Borrows tells me that her favorite feature of the unit is the old photos of local hospitals and memorabilia that hang on the green papered walls of the hallway.

One framed document is a description of requirements for nurses in 1896. According to the piece, nurses made six dollars a month for their first year of work, could not be married and could not catheter a man. There is a small line about applying leaches.

Borrows loves to study these documents and photos when she has spare time.

Borrows has been working for the Brant County palliative care program for fifteen years, although she began her career as a palliative care nurse working in homecare initiatives.

According to Statistics Canada, 70 per cent of Canadians are dying in hospitals.

In Brant County palliative care is open for 24 hour visiting and patients are settled into large private rooms.

Borrows lets me see a private room.

The room is quite large, and is equipped with a flat screen TV and ample cupboard space. The dark brown wood exterior of the cupboards is homey and modern. A soft corduroy upholstered pullout couch sits facing the bed. The couch is convenient for family members who want to stay overnight with their loved ones.

The bed is surrounded by a curtain, and is parallel to a series of large windows.

A body rests in the bed. He died that morning.

His disposable blue razor sits on the edge of the sink in the private ensuite bathroom, implying that not too long ago, day-to-day routines of living had been performed in this space, a space that is now home to death.

To qualify for palliative care in Brant County it must be determined that a patient is likely to die within the next 90 days. There are currently six palliative care beds and two assessment beds available in the unit.

“Occasionally we have empty beds, but they tend to fill up quite quick,” Borrows said.

For Borrows, death should be recognized as a process as inevitable as birth.

“Most people, any time you say you work in palliative, they say ‘well how do you do that? How do you deal with death all the time?’ And I don’t know, to me, it’s just a part of life. Babies are born, people die,” said Borrows.

Borrows explained that a lot of the patients who enter palliative care are often medicated or unconscious, in turn much of a palliative care nurse’s responsibilities revolve around working with families.

Of the patients, Burrows explains, “They’re not that with it anymore by the time they get here, so it’s mostly the family that you’re dealing with.”

“It’s talking to families and making sure they’re comfortable and know what to expect because you want to take their anxiety away.”

Families are not always easy to carry through the process of a dying loved one. Nurses are often left having to help families organize visitation schedules in order to mitigate tensions.

“You can get everything you know. Sometimes they’re like half-families and there’s a feud and you become like a referee.”

Borrows has not seen any unusual practices integrating into the unit’s model of care, from what she has seen the green and home funeral movements and other cultural oriented practices are rare. She notes that as the years pass fewer families are performing strict religious traditions surrounding the care of their dead.

“The thing that I tremendously notice is that our patients are getting younger and younger,” Borrows explained.

Most of the patients that Borrows sees are dying of cancer or Chronic Obstructive Pulmonary Disease (COPD), an obstructive lung disease.

Borrows believes that her career has helped affirm her as a believer. Watching patient’s transition from life to death can be a very spiritual experience, people in the death industry often describe the dying as having a foot in each world.

“I think that a lot of the Willet has it’s own ghosts,” Borrows explained (the palliative care program for Brant County used to be housed out of the Willet hospital in Paris).

“My number one time that I remember, and it was a priest actually that had come in to give the last rites for the person. We were sitting at the nurses station and he came flying out of the room and came and sat at the nurses station, and he was white as a ghost, and I says, ‘are you alright? Do I need to get you some water?”

“And he says, ‘I just saw an angel.’

And this is a priest! A priest who is supposed to believe in angels and everything, and he was as white as a sheet! He said, ‘when I went in the room, there was an angel hovering over the bed at the same height as the head looking down at the patient.’ I still get goose bumps.”

Borrows explains that it’s hard to believe these stories but she has had her fair shake of practice navigating the odd events that surround the experience of dying.

“When you experience it, there’s no denying it.”