Local officials agree: We need to take better care of the dying

A report released by the Canadian Cancer Society January 12 calls on the federal and provincial governments to guarantee, through legislation, access to high quality palliative care for Canadians facing the end of their lives.

The report comes as First Ministers prepare to meet Tuesday, in Vancouver, for the first time in several years in an attempt to forge a new health accord between Ottawa, the provinces and territories.

"We found that due to an absence of other options (proper palliative care), large numbers of patients (as Canada's population ages) are turning to emergency wards and intensive care units during their final days," wrote Carly Brown, the Canadian Cancer Society's Algoma and District Community Office volunteer engagement coordinator, in an email response to SooToday.

"Often these wards and units are not equipped to provide comprehensive and specialized palliative care, meaning that many patients are being treated in hospital rather than a home or community setting, at greater expense and without getting the care they need," Brown wrote.

Calling the health care system "out-of-date," Brown wrote "palliative care has been neglected because often it should be delivered outside hospitals, in many cases at home, but in most of Canada the health system won't properly fund services outside of hospitals."

Theresa Mudge, Algoma Residential Community Hospice (ARCH) executive director, told SooToday the report puts a welcome emphasis on the need for more palliative care, in hospices and at home, in Ontario and throughout Canada.

"This is a welcome finding as it recognizes the benefit of hospice palliative care for individuals and families…we welcome the recommendations," Mudge said.

"Hospice palliative care is humane, ethical and cost-effective care addressing physical, psychological, social, spiritual and practical aspects of care at the end of life by relieving pain and symptoms and assisting patients and their families to maintain quality of life, even at the very end of life."

"But, only about one third of the residential hospice beds needed in Ontario exist, so we welcome this finding," Mudge said.

Apart from providing the best comfort for terminally ill patients, whether in a hospice or at home, more palliative care makes good economic sense.

According to information provided by Mudge in an email to SooToday, the cost of a hospital bed for a terminally ill patient is three times more expensive than a residential hospice bed.

In 2014-2015 alone, residential hospices saved the health care system a minimum of $23 million because hospitals were able to admit patients to a hospice when it was evident they didn’t need acute care in a hospital.

Some help would seem to be on the way.

Sault MPP David Orazietti, in December 2014, announced $487,000 in funding for a Palliative Care Shared Care Team to ensure more terminally ill patients can spend their last days at home with their families with community supports from the North East Community Care Access Centre (CCAC) and Palliative Care Algoma. 

In Ontario, there are 21 residential hospice projects in the planning stages, for a total of 175 new beds.

These are in various stages of planning or development.

If all the planned projects proceed, Ontario would have 60 residential hospices, operating a total of 481 beds by 2018.

The Auditor General of Ontario's December 2014 report counted 284 hospice beds in Ontario, highlighting the need for 755 to 1,080 more hospice beds in the province.

"We'll continue to collaborate with our local health care partners to ensure that no matter where anyone passes away they have access to high quality palliative care, be it in hospice, hospital, in the home or in a long-term care facility," Mudge said.

"We're very fortunate to have a hospice here in Sault Ste. Marie and the high quality service we know it offers…but there are other places in Ontario and Canada that don't have the same access and it's important for us in Canada to have that high quality option at the end of life." 

The needs of ARCH residents and their families are seen to by Dr. Sharon Buehner (locally well-known and recognized for her work in palliative care), nurses and personal support workers, while non-medical facilities in ARCH's residential environment, such as a pleasant sitting area, kitchen, dining room and administrative area are attended to by a team of dedicated volunteers.

ARCH, located in a peaceful setting at 229 Fourth Line West, opened its doors in 2008 and has 10 beds for residents.

The maximum number of residents permitted in an Ontario hospice is 10 (it is felt by experts in palliative care that a greater number of beds in a hospice would detract from the residential atmosphere of a hospice and render it too 'institutional').

ARCH is one of 39 existing hospice facilities in Ontario.

In May 2015 the ARCH board approved the opening of hospice services to children (previously, hospice services were available only to residents 18 and over).

Approximately 50 percent of ARCH's funding comes from the province for payment of medical staff (nurses and PSWs).

The rest of ARCH's funding comes through the hospice's fundraising team, which gathers support from the community (individuals and businesses).

Currently, ARCH's annual fundraising target is $750,000 (for utilities and all other non-medical expenses).

"We have a dream to expand our facilities so that we can provide services that are currently provided off-site to on-site, such as our grief and bereavement services…(and) we're hoping to have space for a dedicated paediatrics suite, and a learning resource centre," Mudge said.