Palliative care in critical condition: report

New health accord must guarantee proper care for all Canadians, says Canadian Cancer Society 

TORONTO, Jan. 12, 2016 /CNW/ - A new Canadian Cancer Society report released today says critically ill Canadians are falling through the cracks when it comes to palliative care. Improvements are desperately needed to Canada's costly and inconsistent patchwork of palliative care, which is bad for patients and for the sustainability of our healthcare system.

"Many of our sickest and most vulnerable citizens are not getting the kind of care they need when they need it most," says Gabriel Miller, director of public issues at the Canadian Cancer Society. "It's time to fix Canada's failed approach to palliative care, which is inconsistent and has a hefty price tag."

The report, titled "Right to Care: Palliative Care for all Canadians," found that in the absence of other options, large numbers of patients are turning to emergency wards and intensive care units, which are often not equipped to provide comprehensive and specialized palliative care. At the same time, these patients are occupying scarce acute care hospital beds.

The issue is becoming more urgent as Canada's aging population faces a projected 40% increase in the number of new cancer cases over the next 15 years. About 8 out of 10 people who receive palliative care are cancer patients. The report is a call to action to governments and highlights the inconsistent and inadequate access to palliative care across the country. Only Quebec has passed legislation that guarantees palliative care for those with a terminal illness. For example, in Ontario, 40% of cancer patients do not receive a palliative assessment in the last year of life. In regions of Atlantic and Western Canada, data shows that less than half of people who die in hospital receive any palliative care. Meanwhile there are many jurisdictions in Canada where a lack of data collection means we do not know how many Canadians are receiving palliative care. This data is necessary to effectively hold the healthcare system accountable to make positive changes.

The report makes a number of recommendations including:

• guarantee access to palliative care for all Canadians through federal and provincial legislation
• invest to improve access to high-quality palliative care
• minimize the financial impact for patients and family caregivers and ensure they are equipped with the information they need to understand palliative care

"All Canadians should have a guaranteed right to timely, high-quality palliative care," says Miller. "As our federal and provincial governments start hammering out a new national health accord, they need to put fixing palliative care at the very top of their to-do list."

Quality palliative care provides patients and families with the care they need in the setting of their choice. It benefits not only patients and their families, but is an efficient use of healthcare dollars, which can help create a more sustainable healthcare system.

Our report shows that the costs of palliative care during the last month of life can be $1,100 a day in an acute care unit as opposed to $770 a day in a palliative care unit and under $100 a day in the home. This means that palliative care not only leads to better pain management, comfortable surroundings, psychological and spiritual support and more positive patient and family outcomes, but also has the potential to reduce healthcare costs.

With the federal and provincial health ministers meeting on January 20, the Society hopes to bring this important matter to their attention. "We want to deliver a strong message to the federal and provincial governments who told us they are ready to improve healthcare," says Miller. "Quality palliative care is not just a 'nice-to-have.' It has to be the law."

A caregiver's perspective

When Susan Cron's mother was diagnosed with advanced cancer in her neck, she spent weeks being shuffled from ward to ward in a hospital until a bed in her local cancer centre became available. During this time, Cron's mother was suffering from diarrhea and nausea, and adjusting to a nasogastric feeding tube. Her family was upset by how little information they were receiving from the doctors.

"We didn't know what her prognosis was and no one would tell us. Mum frequently asked 'is this terminal?' without receiving an answer," says Cron. When her mother was eventually moved to a hospice, it was only 9 days before she died.

As the chief operating officer of the Society's Alberta/NWT Division, Cron felt that she was in a better position than most when it came to navigating the system, but still found it very difficult.

"To truly understand what it's like, I'd ask our decision-makers to spend 1 or 2 nights bedridden in a cancer ward and see if they can imagine ending their days in a system that is quite simply overwhelmed. Something needs to change."

About palliative care

Palliative care focuses on quality of life of patients with progressive, life-altering illness. Palliative care includes expert pain and symptoms management; skilled psychosocial, emotional and spiritual support; and comfortable living conditions with the appropriate level of care – whether at home, in a hospital or any other settings of patients' choice. Palliative care is applicable early in the course of illness, in conjunction with other therapies, and uses a multidisciplinary team approach to address the needs of patients and their families.

View media backgrounder: Right to Care: Palliative care for all Canadians

About the Canadian Cancer Society

The Canadian Cancer Society is a national, community-based organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of people living with cancer. Thanks to our donors and volunteers, the Society has the most impact, against the most cancers, in the most communities in Canada. For more information, visit cancer.ca or call our toll-free bilingual Cancer Information Service at 1-888-939-3333 (TTY 1-866-786-3934).

SOURCE Canadian Cancer Society (National Office)

For further information: Rosie Hales, Communications specialist, Canadian Cancer Society, [e-mail], 416-934-5338