End of Life & Palliative Care
Palliative care means care that is given to a person with progressive, advanced disease in which there is no realistic prospect of cure; the primary goal is to maintain the quality of life. The first objective of palliative care is the relief of pain and other symptoms. In addition, palliative care is designed to reach beyond a patient's physical needs to the psychological, social, cultural, emotional and spiritual needs of a terminally ill person and his or her loved ones.
For those who are critically or terminally ill, a palliative care team will be available to provide the best quality of life possible, ensuring their comfort and dignity. The team will usually include nurses and a physician with specialized palliative care skills, the family physician, a social worker, a spiritual counselor and a pharmacist. Other health professionals such as nutritionists, physiotherapists, occupational therapists, and home support workers may be added to the team, as needed.
Although discussions about terminal illness are usually very difficult, it can be helpful, at the end of life, to have advance directives or 'living wills', preferably in writing. In the event that your loved one is unable to say what he/she wants, family and health care providers will then know their wishes.
Pain Management
People living with a life-threatening illness often experience pain. Health care providers work with the patient and their family to identify the source of pain and find ways to relieve it. Pain may be managed with drugs or by other means, such as massage therapy and relaxation techniques.
Symptom Management
Often people have a variety of distressing symptoms, which can include loss of appetite, nausea, weakness, breathing difficulty, bowel and bladder problems, and confusion. The palliative care team will work to relieve these symptoms and make the patient more comfortable.
Social, Psychological, Emotional and Spiritual Support
Palliative care focuses on the person as a whole, offering a wide range of support services to both patient and family members.
Caregiver Support and Relief
Caregivers may be concerned about whether they will be able to cope with what lies ahead, especially when the person they are caring for wishes to die at home. Palliative care services can be enlisted to help in the home, by having professionals visit regularly to provide medical services and monitoring, or by instructing caregivers in routine nursing care, such as preventing skin problems, giving medications, or recognizing signs of difficulties. Also of great assistance are home support services that provide help with household tasks, such as meal preparation, shopping, and transportation. A crucial requirement of palliative care in the home is adequate relief for the caregiver(s). Sometimes a volunteer can be recruited to stay with the ill person so the family caregiver is relieved. In other situations, the patient may go to a day program or enter a long-term care facility for a short period of time.
Where do People Receive Palliative Care?
Palliative care is offered in a variety of places, including home, long-term care facilities, hospitals, and hospices. Individuals and their families need to be informed about available options.
At Home
Palliative care may be provided in people's homes through home care programs. These programs offer professional nursing care and a variety of home support services. Other services may be available in some communities to help people remain at home. These can include specialized volunteer services; day programs that the patient can attend in the community; pain and symptom management teams; and 24-hour response teams to help with urgent needs on a short-term basis. Being at home allows people to remain close to their families and live as normally as possible, with more freedom to make choices about their care. This option, however, should be agreed upon by both the patient and the caregiver(s), as it is a serious undertaking for everyone.
In Long-Term Care Facilities and Hospitals
Long-term care facilities, such as nursing homes, may offer palliative care services in some situations. In general, however, hospitals are more likely to have specialized palliative care units, or a certain number of beds set aside in different units for people needing palliative care.
In Hospices
In Canada, there are only a few residential hospices (separate buildings or apartments in the community) where palliative care is provided in a home-like setting. Some people move into such hospices to receive palliative care on a 24-hour basis.
Who Pays for Palliative Care?
Palliative care is paid for in different ways across the country. It is important that those requiring palliative care find out as soon as possible who pays for what and what additional financial assistance may be available. Who pays often depends on whether care is being provided at home or in the hospital.
Palliative care costs at home may or may not be covered by the provincial health plan as part of a home care program. These plans do not always include the costs for drugs and equipment used at home, and some allow only a certain number of paid hours of professional and home support services. After the hours are used up, people will be forced to look for other ways to cover the costs. Some private insurance plans will cover palliative care services at home, and sometimes there is assistance available from social agencies, service clubs, local cancer societies, and other similar organizations.
Palliative care provided in a hospital is usually paid for by provincial health plans. These plans typically cover most care, including drugs, medical supplies and equipment, while the person is in the hospital.
In long-term care facilities, residents are usually required to pay for some of their palliative care. Costs vary among facilities.
There is usually no charge for bereavement support. It is often provided as part of palliative care services and is offered in hospitals or by non-profit or volunteer organizations in the community.
How Can I Find out About Palliative Care Services Available in My Community?
You can obtain information from your family doctor or medical specialist, home care nurse, hospital social worker, spiritual counsellor, or national, provincial or local palliative care association. Also contact local seniors' groups, the Cancer Society, or other organizations concerned with specific diseases (such as heart disease or Alzheimer's disease). The Government of Canada - End of Life Care site also lists contact information and links for end-of-life care resources by province and territory.
To find out more about palliative care contact:
Canadian Hospice Palliative Care Association - Tel. (613) 241-3663 or 1-800-668-2785
For those who are critically or terminally ill, a palliative care team will be available to provide the best quality of life possible, ensuring their comfort and dignity. The team will usually include nurses and a physician with specialized palliative care skills, the family physician, a social worker, a spiritual counselor and a pharmacist. Other health professionals such as nutritionists, physiotherapists, occupational therapists, and home support workers may be added to the team, as needed.
Although discussions about terminal illness are usually very difficult, it can be helpful, at the end of life, to have advance directives or 'living wills', preferably in writing. In the event that your loved one is unable to say what he/she wants, family and health care providers will then know their wishes.
Pain Management
People living with a life-threatening illness often experience pain. Health care providers work with the patient and their family to identify the source of pain and find ways to relieve it. Pain may be managed with drugs or by other means, such as massage therapy and relaxation techniques.
Symptom Management
Often people have a variety of distressing symptoms, which can include loss of appetite, nausea, weakness, breathing difficulty, bowel and bladder problems, and confusion. The palliative care team will work to relieve these symptoms and make the patient more comfortable.
Social, Psychological, Emotional and Spiritual Support
Palliative care focuses on the person as a whole, offering a wide range of support services to both patient and family members.
Caregiver Support and Relief
Caregivers may be concerned about whether they will be able to cope with what lies ahead, especially when the person they are caring for wishes to die at home. Palliative care services can be enlisted to help in the home, by having professionals visit regularly to provide medical services and monitoring, or by instructing caregivers in routine nursing care, such as preventing skin problems, giving medications, or recognizing signs of difficulties. Also of great assistance are home support services that provide help with household tasks, such as meal preparation, shopping, and transportation. A crucial requirement of palliative care in the home is adequate relief for the caregiver(s). Sometimes a volunteer can be recruited to stay with the ill person so the family caregiver is relieved. In other situations, the patient may go to a day program or enter a long-term care facility for a short period of time.
Where do People Receive Palliative Care?
Palliative care is offered in a variety of places, including home, long-term care facilities, hospitals, and hospices. Individuals and their families need to be informed about available options.
At Home
Palliative care may be provided in people's homes through home care programs. These programs offer professional nursing care and a variety of home support services. Other services may be available in some communities to help people remain at home. These can include specialized volunteer services; day programs that the patient can attend in the community; pain and symptom management teams; and 24-hour response teams to help with urgent needs on a short-term basis. Being at home allows people to remain close to their families and live as normally as possible, with more freedom to make choices about their care. This option, however, should be agreed upon by both the patient and the caregiver(s), as it is a serious undertaking for everyone.
In Long-Term Care Facilities and Hospitals
Long-term care facilities, such as nursing homes, may offer palliative care services in some situations. In general, however, hospitals are more likely to have specialized palliative care units, or a certain number of beds set aside in different units for people needing palliative care.
In Hospices
In Canada, there are only a few residential hospices (separate buildings or apartments in the community) where palliative care is provided in a home-like setting. Some people move into such hospices to receive palliative care on a 24-hour basis.
Who Pays for Palliative Care?
Palliative care is paid for in different ways across the country. It is important that those requiring palliative care find out as soon as possible who pays for what and what additional financial assistance may be available. Who pays often depends on whether care is being provided at home or in the hospital.
Palliative care costs at home may or may not be covered by the provincial health plan as part of a home care program. These plans do not always include the costs for drugs and equipment used at home, and some allow only a certain number of paid hours of professional and home support services. After the hours are used up, people will be forced to look for other ways to cover the costs. Some private insurance plans will cover palliative care services at home, and sometimes there is assistance available from social agencies, service clubs, local cancer societies, and other similar organizations.
Palliative care provided in a hospital is usually paid for by provincial health plans. These plans typically cover most care, including drugs, medical supplies and equipment, while the person is in the hospital.
In long-term care facilities, residents are usually required to pay for some of their palliative care. Costs vary among facilities.
There is usually no charge for bereavement support. It is often provided as part of palliative care services and is offered in hospitals or by non-profit or volunteer organizations in the community.
How Can I Find out About Palliative Care Services Available in My Community?
You can obtain information from your family doctor or medical specialist, home care nurse, hospital social worker, spiritual counsellor, or national, provincial or local palliative care association. Also contact local seniors' groups, the Cancer Society, or other organizations concerned with specific diseases (such as heart disease or Alzheimer's disease). The Government of Canada - End of Life Care site also lists contact information and links for end-of-life care resources by province and territory.
To find out more about palliative care contact:
Canadian Hospice Palliative Care Association - Tel. (613) 241-3663 or 1-800-668-2785
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toll free 1.800.667.0993
french toll free 1.800.561.1128
TTY 1.888.234.0414
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