Innovations in palliative care could improve access for Canadians

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Innovations in palliative care could improve access
WATCH: With Canada's assisted dying bill tied up in the Senate, doctors are calling for better access to palliative care so patients can make informed decisions about their life and death. As Shirlee Engel reports, some innovations could improve access to palliative care for all Canadians – Jun 7, 2016

OTTAWA — A chronic shortage of palliative care services across the country could be alleviated through innovations in training across the health care spectrum, according to a leading Canadian palliative care doctor.

Dr. Jose Pereira, scientific officer of Pallium Canada and director of research at the College of Family Physicians of Canada, told Global News health care workers don’t get enough training in the essentials of palliative care, leaving patients to wait for specialists.

“Most of the patients do not experience very, very complicated issues,” said Pereira. “So, they can benefit from palliative care earlier in the illness provided by these professionals.”

READ MORE: Palliative care: The elephant in the room in the assisted dying debate

His organization, Pallium Canada, which is funded by the federal government, has developed a specialized course called Learning Essential Approaches to Palliative and End-of-Life Care (LEAP). Since 2014, some 8000 doctors, nurses, pharmacists, social workers and other health care workers have been trained across the country.

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“So what you’re seeing is scaling up,” said Pereira. “We believe we can increase access significantly.”

According to the Canadian Hospice Palliative Care Association, only 16-30 per cent of Canadians currently have access to palliative care.

READ MORE: Canadian study suggests the term ‘palliative care’ needs rebranding

But health care workers are just one part of the puzzle.

Canada’s hospices, which offer both residential and day palliative programs to the terminally ill, rely heavily on volunteers.

WATCH: Shirlee Engel reports on a palliative care crisis in Canada
Click to play video: 'Palliative care crisis in Canada'
Palliative care crisis in Canada

Lisa Shishis, clinical care manager at Hospice Care Ottawa, said recruiting volunteers isn’t a problem.

But training them in a timely manner is an issue because the mandatory 30-hour course is only offered once or twice a year.

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“If a volunteer missed a session, they would have to wait a full year to do the makeup session,” she said. “And then only after they do that, they would be able to volunteer with us.”

But that is about to change, too.

A new online training course developed by Saint Elizabeth Health Care, in partnership with Hospice Palliative Care Ontario, promises to boost the volunteer pool in that province by 1,000 volunteers within the next year.

That will greatly improve volunteer capacity for hospices — especially in rural and remote areas throughout the province.

“We couldn’t function without the support of our volunteers. They are in every aspect of what we do here in hospice,” Shishis said.

READ MORE: Gaps in palliative care hurting patients, increasing healthcare costs: report

Another aspect of improving the system is cutting down unnecessary emergency room visits.

An innovative program in Prince Edward Island and Nova Scotia is doing just that.

The Paramedics Providing Palliative Care at Home Program began in December 2015. All paramedics now have specialized clinical training on pain and symptom management for palliative patients. They also learn about communication, decision making and care in the last days and hours of life.

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Over the past six months, there has been a 50-per cent drop in transports to the emergency room for patients registered in the palliative care program.

“The patients have been able to stay at home and we’ve been able to help them and keep them at home as that’s their wish,” said advanced care paramedic Jeremy Measham.

The challenge now will be to decide which innovations to implement across the country.

Health Minister Jane Philpott said the government will be making investments in palliative care through the health accords.

“We need to find the mechanisms that the federal government can work with the provinces and territories to make that possible,” she said.

Note: An earlier version of this story misstated Dr. Jose Pereira’s title. This has been corrected.

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