The difference of understanding between the newly formed Stettler Hospice Society and Palliative Care professionals as to when hospice palliative care should begin and how it should be delivered is an important topic, especially as we face a looming tidal wave of ageing Canadians and tight government budgets.
Until recently, our health care system has been focused on treating illnesses, even for patients with life-limiting conditions. In a study entitled, ‘End-of-Life Care in Canada’ (Fowler R., 2013), it was found expensive invasive procedures in the last year of life accounted for 18 per cent of Canadians’ lifetime healthcare costs.
Many of us have personal experience with loved ones enduring invasive procedures which did not prolong life but caused untold pain and agony.
The way we die has changed. Before medical advancements in diseases such as cancer, AIDS, heart or pulmonary, the length of time remaining was more predictable and short-term hospice care met that need.
Today we live longer with chronic illnesses and are more likely to die with lost mobility, physical limitations or memory loss. Hospice palliative care is no longer about a few days or weeks, it’s most often about years. Governments have been proactive on this file.
The federal government funded a three-year undertaking to develop an integrated palliative hospice approach to care.
In 2013, a draft of the ‘Way Forward Initiative’ was distributed widely and revised based on feedback from governments, medical providers, agencies, policymakers, First Nations, families and caregivers. The final report was published in March 2015.
The Alberta Government accepted the findings and today the Central Zone has a Palliative Care team of physicians, nurses and pharmacists who work closely with home care teams, spiritual care providers, family physicians, local pharmacists and volunteers to care for those with chronic illnesses and ageing.
It has been found that Integrated Palliative Care reduces the use of intensive care services, emergency room visits and hospital stays resulting in significant cost savings. The burden on caregivers is also mitigated as they, too, share in the benefits of a supportive Palliative Care team.
The Integrated Palliative Care model empowers people facing ageing, frailty or chronic illness to take ownership of their care plan. Working with a Palliative Care team, they are able to have a strong voice in their care options that better reflect their goals and values for end-of-life care.
Patients and family members report improved quality of life for those difficult years of dying and are better prepared for death when supported by an Integrated Palliative Care team. Dying is part of living and we must build a caring and sustainable end-of-life care strategy.
The Integrated Palliative Care model has many successes in Canada and around the world and appears to be a practical and compassionate direction to address current medical realities.