Empowered By Knowledge

June Scales was raised at a High Country Station in Tekapo. Very much a hands-on, spending long days mustering and sleeping outside in all types of weather childhood, she was brought up driving a grader, trucks, and other types of farm machinery. June was incredibly practical and very brave. Her daughter, Wendy, says “She could do anything as well as any man could. She was a wonderful cook and the best wife to Dad. My parents were very, very close. Like two peas in a pod. She was a wonderful mother and we were best friends. We all miss her terribly.”

June was 79 when she died and fit as a fiddle before she was diagnosed with melanoma, so much so that she was still doing handstands up until a few years ago. What the doctor had initially thought was a cough turned out to be the melanoma that had already spread into her liver, so it was only six months from her diagnosis until she died.

Wendy picked her mum up from Nelson Hospital to bring her home to Golden Bay in July 2022, shortly after she had been given the news that she was now a palliative care patient. The doctor who discharged her gave Wendy a “huge list” of medications that June would need to take. Wendy found this quite overwhelming, knowing that she and her dad would be the ones who would be looking after June at home (with support and help from June’s two sisters, Maryann and Claire). The next day, however, one of the district nurses from Golden Bay Community Health came, sat down, and went through all of the medications with Wendy. What they were for, how much to give and when, making the big, overwhelming list from the doctor, understandable. The nurse also had with her a “big suitcase” full of the medications that would be used closer to June’s end of life. Having that conversation and knowing the care that was available, Wendy says, took away the fear that she had that her mum might suffer and her worry about how she was going to cope. The nurse gave the reassurance that the medicines were there, that the team would help every step of the way and that Wendy and her dad wouldn’t be alone. Knowing that the support and expertise were there, was very comforting.

Wendy says that she asked “so many questions all the time” as she is the kind of person who likes to know every possibility of what might happen, and how to deal with situations as they arise.

The palliative care services provided by the Golden Bay Community Health team are supported by Nelson Tasman Hospice and district nurses started by visiting once a week, or more often if required. Wendy told us that each and every nurse they had that was involved with the care was fantastic. They took the time to answer every question and she was given the knowledge that she needed. She found that invaluable. Not only did that give her peace of mind, but it was also great for her mum to know that Wendy and her dad felt confident in caring for her.

Dr Juliet Fleming, who is based at Nelson Tasman Hospice in Stoke, visited June on one of her trips to Golden Bay early on after the terminal diagnosis. June had issues with her skin being very sensitive and itchy due to her illness and this was a big problem for her. She couldn’t sleep well and was very uncomfortable. Juliet was able to prescribe a medication that worked immediately. Juliet also had some difficult conversations with June about her diagnosis and how she felt about it, as well as some planning for the future and what was going to happen. Wendy says “Juliet was fantastic, she didn’t avoid talking about the hard things and I think that those conversations were a good thing for mum.” The way that Juliet was able to answer questions that Wendy and her dad had was also really appreciated. Once when Dr Juliet couldn’t get to Golden Bay due to slips on the Takaka Hill she did a Zoom consultation with the family. She visited another time in person closer to the end too.

Wendy says she just can’t praise the team enough. “They are all very calm and calming.” They were completely on hand if she ever called, and it was made very clear early on that the family could ring whenever they needed to. Wendy says they had “every resource they could possibly need”.
Wendy says the team went out of their way to help them and they never forgot anything.

“We asked whether it might be possible to have the use of a wheelchair, and it was there the next day, the same with a chair for in the shower and a commode. Anything that we could have possibly wanted, we got, and anything that we couldn’t even think of that we wanted, we got.”

June was supplied with a specialist bed which meant she was able to be with the family in the main living area but still rest. The family were given the use of a specialist air mattress after the first week which June thought was wonderful! The air mattress meant that she never got any bed sores, or felt uncomfortable from lying all the time. Having the specialist bed on wheels, also meant they could push June out onto the deck to enjoy the sunshine.
“All of the equipment meant that we could look after Mum at home and it really helped her quality of life.” The district nursing team were problem solvers and did everything they could to make June comfortable. Wendy says they always stayed in touch and came when they said they would. They cared about everyone and how they were feeling and they cared about the carers too.

Wendy and her dad cared for June full-time at home for three months. “I was lucky, actually mum was lucky, that she didn’t need to be in a hospital and her time wasn’t painful and horrible.” It was invaluable for them to be able to contact the team when they needed to, and they felt empowered to care for June.

“If I had to do without them, I don’t know how I would have done, to be honest. It’s a scary time. You don’t know what’s going to happen. But the team is amazing and all of the conversations over the months prepared us. Juliet and everyone had talked to us about how it was likely going to happen and exactly what they said and did. When she actually died, it made her passing easier. I knew what to expect because it had all been explained to us.
The team was constantly in contact with us to offer their support and let us know they were there. But because it was all happening as we had been told it would, we didn’t even feel that we needed one of the nurses there right at the end. I’d been given the knowledge and I felt confident to deal with what was in front of me.”