Executive Summary

Palliative care is holistic, person-centered care for people facing life-limiting illnesses or disabilities. Palliative care neither hastens death nor unnaturally prolongs life. Instead, it focuses on giving patients their best possible quality of life despite illness or disability.

The Canadian Institute for Health Information estimates that up to 89% of Canadians could have benefitted from palliative care prior to death – almost everyone whose death was not sudden or unexpected. Despite this great need for palliative care, only 30% of Canadians who need it have access to palliative care, and only 15% have access to early palliative care in their community.

The expansion of medical assistance in dying (MAiD) in Canada is also dramatically altering the face of palliative care. Palliative care is founded on a right acceptance of the natural cycle from birth to death. But some palliative care facilities now offer MAiD on site, blurring the distinction between end-of-life care and actively ending the life of the patient. As Canada increases access to palliative care, it must ensure that a sharp distinction is made between palliative care and MAiD.

The specialized palliative care workforce is currently not large enough to meet the growing demand for palliative care in Canada’s aging population. Health care providers who are not palliative care specialists need to be able to provide basic palliative care. Recommendations include increasing training in medical schools, specialized training for paramedics, and other continued education to support palliative specialists by better equipping allied health care providers for palliative care discussions.

Rural and urban settings have different care needs, and within these contexts each community has unique needs, culture, and ideas on how to best care for their own members. ARPA Canada especially supports independent palliative institutions that meet distinct religious, ethical, or cultural preferences to provide choice in palliative care.

The goal of palliative care is not to prevent death, but to help people live well to the end of their life. COVID-19 revealed many structural weaknesses in our health care system and may represent a step backward in the prioritization of holistic patient-centered care. We need to reverse any damage that has been done in this regard.

Palliative care should be increasingly a standard part of medical care, introduced alongside diagnosis and engaged throughout treatment as well as through the final weeks and days of life. Together we can increase awareness and understanding of the benefits offered by a palliative care team and can build supportive and compassionate communities across Canada that are prepared to engage in excellent palliative care.

 

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