Hospice Palliative Care in Canada
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Questions and Answers

What is the primary goal of care according to 'The Way Forward' framework?

  • Comfort in the last weeks or months of life
  • Living well until death (correct)
  • Curing illnesses
  • Providing advanced medical treatments

    • According to the document, what is the focus of care when all curative treatments have been exhausted?

    comfort

    Illness trajectories are static and do not change according to 'The Way Forward' framework.

    False

    What conditions does Mary have?

    <p>Mary has diabetes, hypertension, chronic renal failure, and osteoarthritis.</p> Signup and view all the answers

    What triggered Mary to be hospitalized for acute renal failure?

    <p>NSAIDS for hip and knee pain</p> Signup and view all the answers

    True or False: Mary did not want to have dialysis again.

    <p>True</p> Signup and view all the answers

    An integrated palliative approach to care integrates key aspects of hospice palliative care into the regular care people are already receiving in their _____ .

    <p>primary care provider's office</p> Signup and view all the answers

    Match the following aspects of palliative care with their descriptions:

    <p>Palliative Care = provides relief from pain and other distressing symptoms throughout the duration of an illness Hospice Palliative Care = engages individuals and their families in planning for the care they want at different stages in their illness based on their own goals and values</p> Signup and view all the answers

    What benefit could everyone who is becoming frail or faced with a chronic illness receive?

    <p>Access to palliative care services</p> Signup and view all the answers

    What significant shift is required to ensure all Canadians have access to integrated palliative care?

    <p>System-wide shift</p> Signup and view all the answers

    True or False: Palliative care is only about care at the end of life.

    <p>False</p> Signup and view all the answers

    Only a small proportion of Canadians require complex hospice palliative care services, while the rest can benefit from an integrated ______ approach into their care.

    <p>palliative</p> Signup and view all the answers

    What is the purpose of an integrated palliative approach to care?

    <p>To close the gap in care and meet the complex health and psychosocial needs of Canadians and their families.</p> Signup and view all the answers

    Canada is the only jurisdiction exploring the potential of an integrated palliative approach to care.

    <p>False</p> Signup and view all the answers

    What is a benefit of an integrated palliative approach to care?

    <p>All of the above</p> Signup and view all the answers

    What is the average age of death in Canada?

    <p>74</p> Signup and view all the answers

    Most Canadians die at home surrounded by their loved ones.

    <p>False</p> Signup and view all the answers

    What is a goal of an integrated palliative approach to care?

    <p>To provide seamless care across different settings</p> Signup and view all the answers

    What is the vision of the National Framework for an integrated palliative approach to care?

    <p>All people in Canada who are aging and/or have chronic conditions will receive the benefits of an integrated palliative approach to care.</p> Signup and view all the answers

    What is provided to an older person when they begin to become frail or someone is diagnosed with a chronic condition?

    <p>Open and sensitive communication, advance care planning, psychosocial and spiritual support, pain and symptom management, and referrals to expert hospice palliative care services.</p> Signup and view all the answers

    Where can an integrated palliative approach be provided?

    <p>In all settings in the community where the person lives or receives care, including primary care provider's office, at home, in long-term care facilities, hospitals, and shelters.</p> Signup and view all the answers

    Who will provide an integrated palliative approach to care?

    <p>The same practitioners providing the person's care now, including primary care physicians, nurses, home care nurses, personal support workers, long-term care staff, hospital staff, and people responsible for healthcare in shelters and prisons.</p> Signup and view all the answers

    What is the role of expert palliative care teams?

    <p>To provide lead care when people have complex, intensive, or tertiary end-of-life needs, and to support and educate primary care providers.</p> Signup and view all the answers

    An integrated palliative approach is a specialized set of services.

    <p>False</p> Signup and view all the answers

    An integrated palliative approach can be provided in ___________ settings.

    <p>urban, rural, and remote</p> Signup and view all the answers

    What are some elements of palliative care that should be routine aspects of care delivered by any practitioner?

    <p>Aligning treatment with a patient's goals and basic symptom management.</p> Signup and view all the answers

    What does advance care planning involve?

    <p>thinking about the kind of care you want, talking about it with others, and documenting your wishes in an advance care plan.</p> Signup and view all the answers

    Why is it important to engage Canadians in ongoing advance care planning?

    <p>To empower individuals in making informed decisions about their care.</p> Signup and view all the answers

    First Nations, Inuit, and Métis in Canada have unique heritages, cultural practices, and spiritual beliefs.

    <p>True</p> Signup and view all the answers

    Most First Peoples prefer to pass away in their home community and not in a ___ far from family and friends.

    <p>hospital</p> Signup and view all the answers

    What does the term 'family' include in the context of person and family-driven care?

    <p>People the person has chosen to assist with his/her care</p> Signup and view all the answers

    What is a key goal of an integrated palliative approach to care?

    <p>Identifying and responding to physical, psychosocial, and emotional needs early</p> Signup and view all the answers

    The National Framework encourages consistency so all Canadians have equitable access to an integrated palliative approach.

    <p>True</p> Signup and view all the answers

    A standard set of relevant ______ and tools are used to assess whether people are receiving an integrated palliative approach to care.

    <p>measures</p> Signup and view all the answers

    Who is responsible for providing some health services directly in Canada?

    <p>federal government</p> Signup and view all the answers

    What framework has the United Kingdom developed for optimizing end-of-life care?

    <p>Gold Standards Framework</p> Signup and view all the answers

    The Gold Standards Framework is focused on helping providers identify ______ earlier.

    <p>people</p> Signup and view all the answers

    Governments could make guidelines and standards of care a requirement for hospice palliative care.

    <p>True</p> Signup and view all the answers

    What is required to determine whether we are successful in providing an integrated palliative approach to care?

    <p>Specific measurable goals</p> Signup and view all the answers

    What should be developed to support the shift to an integrated palliative approach to care?

    <p>Outcome measures and monitoring tools</p> Signup and view all the answers

    What should be ensured when adapting an integrated palliative approach to care with and for Aboriginal Canadians?

    <p>All of the above</p> Signup and view all the answers

    What is required to shift the healthcare system from its current focus on treating illness to an integrated palliative approach to care?

    <p>Action at all levels and within all sectors and settings</p> Signup and view all the answers

    Front-line organizations need to wait for federal, provincial/territorial or regional action to start an integrated palliative approach.

    <p>False</p> Signup and view all the answers

    What is needed to create the conditions that support the shift to an integrated palliative approach to care?

    <p>Certain key activities</p> Signup and view all the answers

    What guides care and mandates the use of programs such as the Gold Standards Framework and the Liverpool Care Pathway for the Dying Patient?

    <p>The End-of-Life Care Strategy for England</p> Signup and view all the answers

    What is required from federal, provincial and territorial governments to support the framework for action?

    <p>Strong leadership and policy support</p> Signup and view all the answers

    What is needed to support the change to an integrated palliative approach to care?

    <p>Government support</p> Signup and view all the answers

    What should be available to individuals with complex symptoms and end-of-life care needs that cannot be managed in other settings?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    The Way Forward: A Roadmap for an Integrated Palliative Approach to Care

    Preface

    • The Way Forward is a collaborative initiative to create a roadmap for an integrated palliative approach to care in Canada.
    • The initiative engaged healthcare sectors, professionals, and governments in creating a roadmap for an integrated palliative approach to care.
    • The framework was funded by the Government of Canada and supported by the Canadian Hospice Palliative Care Association.

    Vision, Goals, and Impact

    • Vision: All people in Canada who are aging and/or have chronic life-limiting conditions will have the opportunity to benefit from an integrated palliative approach to care.
    • Goals:
      • Canadians will talk with their care providers about advance care planning.
      • People who are aging, frail, and/or have chronic illnesses will receive hospice palliative care services integrated with their other care in the setting of their choice.
      • People who are aging, frail, and/or have chronic illnesses will receive consistent, seamless integrated care if/when they must change care settings.
    • Impact:
      • All care settings will be able to provide holistic care that respects the person's values and preferences.
      • More people in Canada and their families will have access to high-quality integrated palliative care services.
      • People can move seamlessly from one care setting to another if their needs change.

    The Need for a System-wide Shift

    • Ensuring that all people in Canada have access to an integrated palliative approach to care requires significant shifts throughout the healthcare system.
    • To achieve this, we must:
      • Promote and support a shift in practice culture.
      • Establish a common language.
      • Educate and support providers.
      • Engage Canadians in advance care planning.
      • Create caring communities.
      • Adapt an integrated palliative approach to provide culturally-safe care, including with and for Canada's First Peoples.
      • Develop outcome measures and monitor the change.

    A Case for an Integrated Palliative Approach to Care

    • Dying is Part of Living: Treatment advances have helped extend our lives, but we will all still die.
    • The Challenge: Only 10% of people die suddenly, and 90% of us will require care and support at the end of life.
    • The Opportunity: Only a small proportion of Canadians (about 15%) will need complex hospice palliative care services, while the rest can benefit from integrating a palliative approach into their care.### The Changing Face of Death and Dying
    • In the past, many Canadians died suddenly from infectious diseases, heart attacks, strokes, or organ failure, or had a recognizable terminal phase.
    • Today, most people die with chronic illnesses, such as heart disease, cancer, and AIDS, which have no specific terminal phase.
    • 70% of all deaths are due to chronic diseases.
    • Six in ten Canadians either suffer from a chronic illness or have someone in their immediate family with a chronic illness.

    The Challenges of Chronic Illness

    • People with chronic illnesses may live for months or years in a state of fragile health or "vulnerable frailty."
    • As they age, they become more frail and vulnerable to infections or falls that could lead to death.
    • Their complex health needs can lead to sudden deterioration or periodic crises.

    The Need for an Integrated Palliative Approach

    • An integrated palliative approach integrates key aspects of hospice palliative care into regular care.
    • This approach acknowledges that people want to be informed about their illness and prognosis, and have open and honest discussions about their health and care goals.
    • It recognizes that people's care goals and preferences may change over time, and encourages them to revisit these goals and discuss how they may change.
    • An integrated palliative approach provides active comfort-focused care, reduces suffering, and promotes understanding of loss and bereavement.

    The Benefits of an Integrated Palliative Approach

    • People report fewer symptoms, better quality of life, and greater satisfaction with their care.
    • The healthcare system reports more appropriate referrals, better use of hospice care, fewer emergency room visits, and less use of ineffective intensive interventions in the last days of life.

    The World Health Organization's Definition of Palliative Care

    • Palliative care is an approach that improves the quality of life of patients and their families facing life-threatening illnesses.
    • It relieves suffering through early identification and impeccable assessment and treatment of pain and other problems.
    • Palliative care engages individuals and families in planning for their care based on their own goals and values.

    Where and Who Will Provide an Integrated Palliative Approach

    • An integrated palliative approach will be provided in all settings in the community, including primary care providers' offices, homes, long-term care facilities, hospitals, and shelters.
    • Care teams will include community resource people, Elders, and cultural advisors as fully recognized members of the care team.
    • The same practitioners providing care will provide an integrated palliative approach, with expert palliative care teams providing support and guidance.### Palliative Care
    • Palliative care should be culturally responsive and align with a patient's goals, including basic symptom management.
    • Some skills in palliative care, such as negotiating difficult family meetings, require years of training and experience.

    Integrated Palliative Approach to Care

    • In an integrated palliative approach, expert hospice palliative care teams take the lead only when people have complex, intensive, or tertiary end-of-life needs.
    • Primary care providers in different settings should have the confidence and skills to integrate palliative services into their patients' care.
    • The expert team shifts to a shared-care role, including educating providers, assessing individuals, and providing advice to primary and community care providers.

    Benefits of Integrated Palliative Approach

    • Improves health and quality of life for people who are aging, frail, or have a chronic illness.
    • Gives people a greater sense of control over their lives and care.
    • Makes more effective use of health resources.
    • Provides seamless transitions between care settings.
    • Enables people to receive consistent care, even when they have to move from one setting to another.

    International Comparisons

    • The US Institute of Medicine has proposed a mixed management model that allows for active, life-prolonging treatment and hospice palliative care to occur in parallel.
    • The World Health Organization has called for palliative care to be integrated across disease trajectories and settings.

    Health Outcomes

    • Studies have shown that an integrated palliative approach to care leads to better outcomes, including fewer symptoms, better quality of life, and greater patient satisfaction.
    • An integrated palliative approach is associated with positive effects on emotional wellness, less suffering, and greater longevity.

    Resource Use

    • An integrated palliative approach to care can reduce the use of intensive care services and hospital stays.
    • A study in the United States found a net cost saving of $4,855 per patient when palliative care services were integrated with other care.
    • A study in Canada found that providing enhanced palliative care team-based homemaking and nursing services for people dying at home cost $117.95 a day, significantly less than the $1,100 cost per day for hospital care in Ontario.

    National Framework

    • The National Framework for an integrated palliative approach to care will vary depending on local needs, resources, systems, and jurisdictions.
    • The framework includes goals, principles, and a vision for all people in Canada who are aging or have chronic conditions to receive the benefits of an integrated palliative approach to care.
    • The goals include encouraging Canadians to talk about their wishes and care plans, receiving consistent and seamless care, and having equitable access to health services.

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    Related Documents

    The Way Forward National Framework PDF (March 2015)

    Description

    This quiz is about the national framework for integrated palliative care in Canada, aiming to provide care to Canadians when and where they need it.

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