Primary Care Resources - Palliative Care

Palliative care is also referred to as hospice palliative care or end-of-life care.   It is an approach that improves the quality of life of patients and their families who face problems associated with life-threatening illness.   The focus of palliative care is the prevention and relief of suffering, by means of early identification, assessment and treatment of pain and other problems (physical, psychosocial and spiritual). (4)

Why is it important?

  • Palliative care provides relief from pain and other distressing symptoms
  • Affirms life and regards dying as a normal process; intends neither to hasten or postpone death
  • Offers a support system to help patients live as actively as possible until death
  • Integrates the psychological and spiritual aspects of patient care
  • Offers a support system to help the family cope during the patients illness and in their own bereavement
  • Uses an interprofessional team approach to address the needs of patients and their families, including bereavement counseling, if indicated
  • Will enhance quality of life, and may also positively influence the course of illness
  • Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life
  • Can take place in various settings, such as a hospital, long-term care facility (e.g., nursing home), home or hospice (2)
  • Hospice palliative care programs allow patients to gain more control over their lives, manage pain and symptoms more effectively, and provides support to family caregivers.
  • Hospice palliative care services and treatment can lead to better outcomes such as reduced caregiver burden and other costs (4)

Key Considerations

  • Significant disparities across Canada remain with respect to access to end-of-life care, quality of care and out-of- pocket costs to the patient. Only 16% to 30% of Canadians who die currently have access to or receive hospice palliative and end-of-life care services (3)
  • Depending on the estimate, expanding access to quality palliative care would have saved between $40 and $345.5 million between 2003 and 2011 in the province of Ontario alone (3)
  • 73% of Canadians turn to their family physician for more information on hospice palliative care services (3)
  • Patients with life-limiting advanced chronic disease identify that receiving honest information about their condition and having time to prepare for life’s end are key aspects of quality end-of-life care (3)
  • To provide high quality palliative care and services across care sectors, the use of common validated screening and assessment tools will improve patient care at the clinical and system level (1)
  • Current end-of-life care research increasingly suggests that Canadians prefer to die at home or in their home communities (e.g. in long-term care facilities) instead of in hospital settings (3)
  • One of the key challenges over the next ten years will be persuading Canadians that end-of-life care planning is important for everyone, not just those diagnosed with a life-limiting illness, such as cancer (3)
  • End-of-life discussions and advance care planning can reduce moral distress for healthcare providers; lead to better client outcomes, improve adherence to individual’s wishes and reduce caregiver burden (3)

References

1.  Cancer Care Ontario. Retrieved March 31, 2014 from:
     https://www.cancercare.on.ca/cms

2.  Health Canada. Retrieved March 31, 2014 from: 
     http://www.hc-sc.gc.ca/hcs-sss/palliat/res/index-eng.php

3.  Hospice Palliative Care in Canada. (2014). Canadian Hospice Palliative Care Association (CHPCA) Fact Sheet:
     Hospice Palliative Care in Canada
.  Retrieved March 31, 2014 from:  
     http://www.chpca.net/media/330558/Fact_Sheet_

4.  World Health Organization. (2014). Retrieved March 31, 2014 from:
     http://www.who.int/cancer/palliative