Deathbed promises launched master’s research

Lorrianne Topf had already spent 19 years as a nurse when a profound experience about a broken promise convinced her she needed to go back to school.

Working as an oncology nurse in her hometown of Vernon, she encountered an elderly married couple in a hospital room. The husband was very close to death. His wife was in tears, desperate because she was unable to keep her promise of allowing him to die at home.

“I realized there was something wrong with the expectations that people put upon themselves,” said Topf. “Couples promise that they will take care of each other until death, but they are unable to keep that promise.”

“This couple really didn’t know what supports are available. That conversation had not occurred. And that put me on the path of researching how are we supporting people who really want to stay at home to die.”

Topf enrolled in the Master’s of Nursing program at UBC’s Okanagan campus. Her thesis is called When a desired home death does not occur: Family caregiver experiences. It was considered ground-breaking research, and received funding support from the Canadian Association of Nurses in Oncology, the Canadian Nurse Foundation and Psychosocial Oncology Research Training.

Topf’s academic supervisor, Associate Nursing Professor Carole Robinson, says it takes a special person to conduct this type of research. Topf’s background and experience prepared her in many ways to interview family caregivers.

“Lorrianne’s research has the potential to significantly change the way we support family caregivers,” says Robinson. “It is particularly timely, given the trend to frame home deaths as the gold standard.”

Topf says her research reveals an issue people face in every culture. Health-care providers have a strong role to play in counselling and advising family caregivers.  “It may be that Plan A is to be at home until death, and Plan B  is to be home as long as possible. The question is understanding how to help caregivers work that through, and accept it.”

Topf continues her nursing career in palliative care and is currently Palliative Care Coordinator, North Okanagan Community Integration Health Services, Interior Health, in Vernon. Aside from a year when she was supported through the Bryce Carnine Memorial Prize scholarship, Topf has actively worked as a nurse during her return to school.