Over the next four weeks, we’ll examine aspects of palliative care, like funding, caregivers’ roles, and helping loved ones through their final stages of life. This first installment talks about the palliative care services that are available.
National Hospice Palliative Care Week may have kicked off the month of May with a variety of fundraisers, but money is needed all year long, not just during the spring.
These fundraisers are an important part of palliative care services, because without the support of the communities, there would be limited services available to patients and their families as they live out their final days with dignity.
Palliative or end-of-life services in Canada have traditionally been provided at home until the care becomes so complicated or overwhelming that admission to hospital is required.
“During the course of illness it is not unusual for a person to seek treatment in emergency rooms and/or to be admitted to hospital a number of times until they reach a point when they cannot be released due to the severity of illness or inability of their family to care for them at home,” said Doug Burt, member of the Community Home Support Lanark County board of directors.
While some Canadians die at home, the majority of them spend their last days in hospital. This results in a great deal of stress for patients and families as well as unnecessary use of costly hospital beds for people who could be better managed at home or in a hospice.
Smiths Falls, Perth and parts of Almonte/Carleton Place are located in the South East Local Health Integration Network (SELHIN) one of 14 LHINs in Ontario. SELHIN covers a huge area from Prince Edward County in the South to the Hastings Highlands in the North and East to Edwardsburgh, Innisville, Montague, etc. Interestingly, Lanark County is split between SELHIN and Champlain LHIN which covers other parts of Carleton Place, Almonte and Kemptville and necessitates special arrangements between the two LHINs for some services.
Within the communities and counties of SELHIN and Champlain LHIN, the need for palliative and other support services has long been understood. Consequently, communities acted to establish a variety of services. Some of these have been recognized and funded to some extent by the LHINs.
Municipalities and county councils have provided funds for some services as well. Within the Perth and Smiths Falls corner of SELHIN, Community Home Support, Lanark County (CHSLC) provides a number of services including three palliative care services: the Volunteer Hospice Visiting Service, the Day Hospice and Bereavement Services.
There are nine community hospice organizations across SELHIN. These hospice organizations have been achieving positive results by providing essential assistance to people with life-limiting and palliative diagnoses and to their families.
These services include trained hospice volunteers who go to homes to provide respite opportunities for caregivers, usually a family member.
The day hospices are places where clients can go to share their experiences with others having similar challenges. Day programs provide fun activities as well as invaluable psychosocial support to the clients and their families. Some clients say these programs provide them with an opportunity to forget they are sick. Most hospice services also provide bereavement services.
Approximately 45 per cent of the cost of the palliative care programs provided by CHSLC is funded by SELHIN, the rest comes from the generosity of the community which recognizes the importance of these services.
With some variations in the LHIN funding, this is the case for all hospice services across SELHIN and generally for all Ontario hospice services.
While these programs are only partly funded by SELHIN it must be noted that SELHIN provides substantial funding to the Community Care Access Centres (CCAC) to provide nursing and personal support worker (PSW) support to clients in their homes as well as some equipment and medical supplies.
These services combined with the hospice services provided by volunteers are intended to help clients remain at home and out of hospital as long as possible. The vast majority of palliative clients express the wish to be able to stay at home and to die surrounded by their loved ones.
Over the past years many communities have looked at the role residential hospices play in some countries, for example in the United Kingdom where there is a longstanding tradition of residential hospices for patients in their final weeks or days rather than admitting these patients to costly hospital beds.
Across Canada there are many communities that have decided the needs of their loved ones are best met by community-based residential hospices once care at home is no longer feasible.
There are some successful residential hospices, usually in larger towns and cities where there is a large base of citizens. However, Canada is made up of many small rural communities where it is difficult to find the funds to build and maintain residential hospices.
To view the full article, please visit Inside Ottawa Valley.