Many Canadians do not fully understand hospice and palliative care. If we do not work in medicine, “hospice” and “palliative care” are terms we only encounter when we are faced with the difficult task of seeing a friend or loved one through a terminal illness. Often, the best place to start is with clear definitions:
Palliative care: Palliative care is comfort-focused care for people facing life-limiting illnesses. Palliative care can be provided in a hospital, at home, in hospice and in long-term care homes. Palliative care aims to provide quality of life for the person living with the illness and also for his or her family. Palliative care considers not only a person’s physical needs but also psychological, social, cultural, emotional and spiritual needs.
Hospice: A hospice is a home for people living with a life-limiting illness. Palliative care can be provided in hospice. The terms “hospice care” and “palliative care” mean the same thing and is sometimes referred to as “hospice palliative care.”
The changing conversation around palliative care in Canada involves a recognition that clinical spaces, like hospitals, may not be the place Canadians want to spend the last part of their lives. Many Canadians are more comfortable at home. Provinces are working to provide people with a choice of where palliative care is administered.
The idea of patient-centred care has gotten into every corner of Canada’s health care discussion, and palliative care is no exception. Patient-centred care involves engaging patients and families as members of the health care team when making care decisions. When patients are at the centre, the health care system revolves around their needs rather than the needs of health care providers or financial pressures. Patient-centred care also means Canadian patients and families are more responsible for managing and advocating for the care they want.
How does patient-centred care affect death?
Canadian families are strongly encouraged to have the difficult conversation about their choices for death and dying well before these choices seem necessary. This is called advance care planning. Advance care planning is a way to share wishes for future health care and to name someone who can speak for you if you couldn’t speak for yourself. Families can find a wide range of resources to facilitate advance care planning conversations on the Speak Up! website.
How can home care help with palliative and hospice care?
Since there is no single national palliative care program, training and availability can vary widely by province and jurisdiction. Needs, demographics, level of funding and organization of health care all affect what level of palliative care is available in your area.
Even if ideal hospice palliative care is available, it may not be possible to have someone with your loved one 24 hours a day without the assistance of home care. Home care agencies can provide personal support workers to help fill in the gaps in your family’s palliative care plan. Agencies like ComForCare can work with your palliative care provider to ensure your loved one is attended to at all times. Call 800 886 4044 to book a consultation.
Palliative care is managed differently in each province
Like all other health care in Canada, palliative care is managed on a province-by-province basis. For a central source of information, a great place to start is the Canadian Virtual Hospice, which is an online resource that lets you navigate and ask questions about palliative care anonymously. You can also contact the Canadian Hospice Palliative Care Association or reach out to the association in your province:
- Hospice Yukon Society
- British Columbia Hospice Palliative Care Association
- Alberta Hospice Palliative Care Association
- Saskatchewan Hospice Palliative Care Association
- Palliative Manitoba
- Hospice Association of Ontario
- l’Association québécoise de soins palliatifs (only available in French)
- New Brunswick Hospice Palliative Care Association
- Nova Scotia Hospice Palliative Care Association
- Hospice Palliative Care Association of Prince Edward Island
- Newfoundland and Labrador Palliative Care Association
Editor’s note: This article was originally published Nov. 15, 2017. It has been revamped and updated for accuracy and comprehensiveness.