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Mapping a New Philosophy of Care: The State and Future of Implementing a Palliative Approach Across Canada

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Hospice Palliative Home Care and Bereavement Support

Abstract

We need to rethink how we provide hospice palliative care as we experience transformations in the global demographics of aging populations and the rising demands for high-quality and cost-effective healthcare. In Canada, there has been a major push toward an integrated palliative approach to care that goes beyond specialist care, crosses care settings, and is available to all people with life-limiting conditions in their homes and communities. Through The Way Forward project and follow-up surveys, the Canadian Hospice Palliative Care Association consulted with a wide range of stakeholders across Canada and abroad to identify current models, priorities, and actions toward implementing a palliative approach to care in Canada. The results of these consultations indicate that Canada has made many steps toward integration but has many steps to go toward better awareness among the Canadian public, education and training for health professionals, measurement and monitoring of outcomes, and access to tools and resources to support implementation.

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Notes

  1. 1.

    Available via: www.hcpintegration.ca. Accessed 1 Mar 2019.

  2. 2.

    More information about the national Speak Up initiative is available via: www.advancecareplanning.ca. Accessed 1 Mar 2019.

  3. 3.

    Information about Compassionate Communities in Canada is available via: https://pallium.ca/work-with-us/launch-a-compassionate-community/. Accessed 1 Mar 2019.

  4. 4.

    A resource toolkit for implementing palliative care programs in First Nations communities is available via: http://eolfn.lakeheadu.ca/. Accessed 1 Mar 2019.

  5. 5.

    The QELCCC included 35 full national members and four associate members as of February 2017. The list of current members is available via: http://www.qelccc.ca/about-us/coalition-members.aspx. Accessed 1 Mar 2019.

  6. 6.

    P/T jurisdictions who noted a provincial or policy framework included: BC, AB, SK, MB, ON, NS, PEI, NWT, YK.

  7. 7.

    Snapshots from Quebec and Nunavut were not provided and therefore are not included.

  8. 8.

    Available via: https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/palliative-care/framework-palliative-care-canada.html. Accessed 1 Mar 2019.

References

  1. Canadian Hospice Palliative Care Association. A model to guide hospice palliative care: based on national principles and norms of practice. Ottawa, CHPCA. 2013. http://www.chpca.net/professionals/norms.aspx. Accessed 1 Mar 2019.

  2. World Health Organization. Strengthening of palliative care as a component of integrated treatment throughout the life course. J Pain Palliat Care Pharmacother. 2014;28(2):130–4.

    Article  Google Scholar 

  3. Bekelman JE, Halpern SD, Blankart CR, et al. Comparison of site of death, health care utilization, and hospital expenditures for patients dying with cancer in 7 developed countries. JAMA. 2016;315(3):272–83.

    Article  CAS  Google Scholar 

  4. Glare PA, Virik K. Can we do better in end-of-life care? The mixed management model and palliative care. Med J Aust. 2005;175(10):530–3.

    Google Scholar 

  5. Hawley P. The bow tie model of 21st century palliative care. J Pain Symptom Manag. 2014;47(1):2–5.

    Article  Google Scholar 

  6. Canadian Hospice Palliative Care Association. The Way Forward National Framework: a roadmap for an integrated palliative approach to care. 2015. Ottawa, ON: CHPCA. http://hpcintegration.ca/resources/the-national-framework.aspx. Accessed 1 Mar 2019.

  7. iPANEL. Initiative for a palliative approach in nursing: Evidence and leadership. 2012. http://www.ipanel.ca. Accessed 15 Feb 2019.

  8. Quill TE, Abernethy AP. Generalist plus specialist palliative care – creating a more sustainable model. N Engl J Med. 2013;368(13):1173–5.

    Article  CAS  Google Scholar 

  9. World Health Organization. Cancer control: knowledge into action. WHO guide for effective programs. Module 5: palliative care. 2007 Geneva WHO. https://www.ncbi.nlm.nih.gov/books/NBK195248/. Accessed 15 Feb 2019.

  10. Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the project ENABLE II randomized controlled trial. JAMA. 2009;302(7):741–9.

    Article  CAS  Google Scholar 

  11. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010;340:c1345. https://doi.org/10.1136/bmj.c1345. Accessed 1 Mar 2019.

    Article  Google Scholar 

  12. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008;300(14):1665–73.

    Article  CAS  Google Scholar 

  13. Lussier D, Bruneau MA, Villalpando JM. Management of end-stage dementia. Prim Care. 2011;38(2):247–64.

    Article  Google Scholar 

  14. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med. 2010;363(8):733–42.

    Article  CAS  Google Scholar 

  15. Fowler R, Hammer M. End-of-life care in Canada. Clin Invest Med. 2013;36(3):127–32.

    Article  Google Scholar 

  16. Klinger CA, Howell D, Marshall D, et al. Resource utilization and cost analyses of home-based palliative care service provision: the Niagara west end-of-life shared-care project. Palliat Med. 2013;27(2):115–22.

    Article  Google Scholar 

  17. Meyers FJ, Linder J, Beckett L, et al. Simultaneous care: a model approach to the perceived conflict between investigational therapy and palliative care. J Pain Symptom Manage. 2004;28(6):548–56.

    Article  Google Scholar 

  18. Smith TJ, Temin S, Erin R, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol. 2012;30(8):880–7.

    Article  Google Scholar 

  19. Sanders C, Rogers A, Gately C, et al. Planning for end of life care within lay-led chronic illness self-management training: the significance of ‘death awareness’ and biographical context in participant accounts. Soc Sci Med. 2012;66(4):982–93.

    Article  Google Scholar 

  20. Brumley R, Enguidanos S, Jamison P, et al. Increased satisfaction with care and lower costs: results of a randomized trial of in-home palliative care. J Am Geriatr Soc. 2007;55(7):993–100.

    Article  Google Scholar 

  21. Lynn J, Forlini JH. "serious and complex illness" in quality improvement and policy reform for end-of-life care. J Gen Intern Med. 2001;16(5):315–9.

    Article  CAS  Google Scholar 

  22. Canadian Hospice Palliative Care Association (CHPCA). What Canadians say: the way forward survey report. 2013. Ottawa, CHPCA. http://hpcintegration.ca/resources/what-canadians-say.aspx. Accessed 1 Mar 2019.

  23. Canadian Hospice Palliative Care Association. The way forward survey: general/family practitioners and nurses in primary care. 2014. Ottawa: CHPCA. http://hpcintegration.ca/resources/health-care-professional-research/primary-care-research.aspx. Accessed 1 Mar 2019.

  24. Canadian Hospice Palliative Care Association. Innovative models of integrated hospice palliative care, the way forward initiative: an integrated palliative approach to care. 2013. Ottawa: CHPCA. http://hpcintegration.ca/resources/discussion-papers/innovative-models.aspx. Accessed 1 Mar 2019.

  25. Canadian Partnership Against Cancer. Palliative and end-of-life care. 2017. Toronto, CPAC. https://www.systemperformance.ca/report/palliative-end-of-life-care/. Accessed 1 Mar 2019.

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Authors and Affiliations

  1. Canadian Hospice Palliative Care Association, Ottawa, ON, Canada

    Chad Hammond & Sharon Baxter

Authors
  1. Chad Hammond
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  2. Sharon Baxter
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Correspondence to Chad Hammond .

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Editors and Affiliations

  1. College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada

    Lorraine Holtslander

  2. College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada

    Shelley Peacock

  3. College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada

    Jill Bally

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Hammond, C., Baxter, S. (2019). Mapping a New Philosophy of Care: The State and Future of Implementing a Palliative Approach Across Canada. In: Holtslander, L., Peacock, S., Bally, J. (eds) Hospice Palliative Home Care and Bereavement Support. Springer, Cham. https://doi.org/10.1007/978-3-030-19535-9_5

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  • DOI: https://doi.org/10.1007/978-3-030-19535-9_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19534-2

  • Online ISBN: 978-3-030-19535-9

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