As the population ages, the prevalence of chronic and life-threatening illnesses will increase. In response, Canada must work towards an integrated palliative approach to care. When someone is diagnosed with a chronic, life-limiting or life-threatening illness, involving palliative care providers early can improve quality of life and reduce suffering. [i] [ii] This means that high quality hospice palliative and end-of-life care must be an integral part of health care, and available in all settings including hospitals, long-term/continuing care facilities, residential hospices, shelters and individual homes. It also means that an integrated palliative approach to care must be part of the treatment repertoire of any healthcare professional, supported by consultation or referral to a specialist palliative care team when necessary.
The need for an integrated palliative approach to care is not simply a health issue; it is a complex social and economic issue affecting patients, families, communities and the workplace. Hospice palliative care programs allow patients to gain more control over their lives, and manage pain and symptoms more effectively. They also provide support to family and caregivers. Health care across Canada was set up to address acute care but not chronic care. As a result, quality, end of life care is secondary and is not available for all Canadians.
Adopting an integrated palliative approach to care across settings is a goal that has been identified by leaders across Canada including the Quality End-of-Life Care Coalition of Canada,the Pallium Foundation, the Canadian Hospice Palliative Care Association,and The Honorable Sharon Carstairs, along with a number of Senate Committees. It is time to move forward.
You can find additional information on the current state of hospice palliative care in Canada, in the discussion papers written for this initiative.
[i] Aiken LS, Butner J, Lockhart CA, Volk-Craft BE, Hamilton G, Williams FG. (2006). Outcome evaluation of a randomized trial of the Phoenix Care intervention: program of case management and coordinated care for the seriously chronically ill. J Palliat Med. 2006 Feb;9(1):111-26.
[ii] World Health Organization. Palliative Care. Available at www.who.int/hiv/