Palliative care: Do we know enough about end-of-life care?

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The Canadian Hospice Palliative Care Association (CHPCA), the national voice for hospice palliative care in Canada, estimates the demand for hospice palliative care will increase over the next 40 years. Canadians are living longer than ever with the average life expectancy of over 80 years. However, Statistics Canada has projected that the mortality rate will also increase by the year 2020 by about 33 per cent from 2004. About 90 per cent of the people that die can benefit from palliative care.

Hospice palliative care is a service delivered by an interdisciplinary team of health-care providers with a goal of relieving suffering and enhancing the quality of living and dying. It aims to help patients and families address their physical, social, psychological and spiritual issues, address needs and fears, prepare for the inevitable and cope with the loss and grief during the disease and bereavement.

“Hospice palliative care is a support system that gives more control for people with life-limiting illness during their final days and supports their families,” explains Sharon Baxter, executive director of the CHPCA. In addition, palliative care complements regular care and can start immediately after diagnosis and is cost-effective, reducing the number of emergency visits as well as the length of hospital stays.

“Canadians are living longer – but with severe illnesses,” says Baxter. “Without hospice palliative care, people with serious illness often suffer unnecessarily and these services should be available from the time of diagnosis until death and into the bereavement period.”

“However, there is lesser access to high quality palliative care in remote areas of Canada. Access to high quality care should be available regardless of where a person lives,” adds Baxter. People living with life-threatening illnesses in areas where best practice programs are available, will experience greater quality of life to death compared to those living in areas without such care.

To continuously improve end-of-life care for Canadians, the Quality End-of-Life Care Coalition of Canada (QELCCC), a group of over 30 national stakeholders developed the Blueprint for Action 2010 to 2020, a working document outlining the progress, current gaps, and priorities in end-of-life care for the next 10 years. One of the priorities focuses on encouraging Canadians to plan for end-of-life. The QELCCC’s goal, along with providing Canadians with high quality hospice palliative end-of-life care, is to provide increased support for caregivers, provide professionals and volunteers with necessary skills, promote research and educate Canadians about the issue.

“How do we know we are making progress with providing quality end-of-life care? How do we make sure we cover the gaps and address the issues for the future? The detailed progress report developed by QELCCC gives us answers we need by outlining the successes, failures and steps towards the future,” says Baxter. 

Death is inevitable; however nobody wants to talk about it. So, instead of fighting the losing battle with death, it is advisable to plan for the inevitable. Dr. Daren Heyland, a professor of medicine and epidemiology at Queen’s University, says, “An unplanned death is a poor-quality death.”

“Death of a loved one generally affects about five other people. The need to engage in advance care planning is thus central to improve the end of life outcomes for patients and family members.” adds Baxter.

Advance Care Planning in Canada: A National Framework and Implementation is a five-year project of the CHPCA. The goal is to raise awareness among Canadians about the importance of advance care planning, provide necessary resources and prepare and engage healthcare professionals in advance care planning.

On April 12th, 2011 the CHPCA will be launching the first National Advance Care Planning Day and the Speak Up – Start the conversation about end-of-life care campaign – A national awareness campaign to encourage Canadians to talk about and plan for the end of life. For more information about the campaign visit www.chpca.net.