HEALTH CARE
SHIFTING TOWARDS AN
INTEGRATED PALLIATIVE APPROACH TO CARE
Submitted by the Canadian Hospice Palliative Care Association
A
ccording to Statistics Canada, projections show Canada
will have an exponentially increasing elderly population in the near future. In 2009, there were roughly 1.3 million people age 80 or over. It is projected to increase to 3.3
million by 2036.
That’s a whole lot of potentially underprepared Canadians
facing the challenges of aging and the subsequent health
decisions that go along with increasing age. Many elderly
Canadians have life-limiting diseases, or co-morbidities that
have a significant impact on quality of life, but have not had
important conversations about their goals of care and future health care wishes.
At the Canadian Hospice Palliative Care Association (CHPCA),
a number of resources and initiatives have been developed
that emphasize the importance of including an integrated
palliative approach to care for these patients, combining
treatment with access to palliative resources, and enabling
important discussions between patients, families and the
health care system.
According to the Canadian Hospice Palliative Care Association, currently only 16 to 30 per cent of Canadians currently
have access to or receive tertiary or specialist hospice palliative and end-of-life care services, despite the fact that a
vast majority of Canadians support an integrated palliative
approach to care.
But what exactly constitutes an integrated palliative approach to care and how is it implemented?
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“An integrated palliative approach to care focuses on meeting a person’s and family’s full range of needs – physical,
psychosocial and spiritual – at all stages of a life-limiting illness, not just at the end of life – this includes physical, psychosocial and spiritual care along with usual medical care,”
said Leanne Clarke, Project Manager on The Way Forward,
an initiative funded by the Government of Canada that has
developed a national framework with action steps for providers across settings of care.
The integrated palliative approach to care provides key
aspects of palliative care at appropriate times during the
person’s illness, focusing on open and sensitive communication about the person’s prognosis and illness, advance
care planning, psychosocial and spiritual support and pain /
symptom management. Most of this care can be provided
in the community, however patients with complex medical
needs may require referrals to more specialized palliative
care services.
An integrated palliative approach to care is a shift away
from thinking about palliative care for the end of life and
when a prognosis of death is within weeks or months of life.
Many people with chronic and life-limiting illnesses can be
cared for in the setting of their choice by their care providers with the support of specialized palliative care experts as
needs arise.
A vital component of integrated palliative care is Advance
Care Planning (ACP), the process of reflecting and communicating about future health care wishes, and naming a substitute decision maker who can speak for someone if they
cannot speak for themselves.