As health care professionals, hospice organizations, volunteers, policy makers, individuals, we all think we know what we’re talking about when we discuss palliative care. But do we? When we dig right down to the heart of the matter, are we all talking about the same thing?
The truth is, likely not.
As research continues to advance our understanding of how it benefits patients, families and the health system, the definition of a palliative approach to care continues to emerge.
The World Health Organization’s defines palliative care as:
An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
But what does it mean?
The aims of palliative approach sit at the heart of the essence of medicine. Palliative approach to care works alongside other treatment plans and looks at the whole person to improve quality of life from an individual perspective. It complements disease-controlling treatment, it doesn’t replace it. A palliative approach to care puts the person and their family at the centre and asks, “What matters most to you?” in the context of any serious illness that is causing suffering and impacting quality of life.
|44% of adults 20+ have at least 1 common chronic disease
6 million people in Canada (19% of the population) report a form of chronic pain
Of the 270,000 Canadians who die each year, 90% die of chronic illness, such as cancer, heart disease, organ failure, dementia or frailty
–CHPCA Fact Sheet 2021
Move it upstream
It’s time to move a palliative approach to care upstream and fully integrate it into all care settings. By moving palliative care upstream toward the time of diagnosis and away from thinking about it as end-of-life care, patients have improved quality of life and better outcomes.
Research backs up this shift: cited in Access to Palliative Care in Canada, Canadian Institute for Health Information (2018), one project used a guide to pose questions for care providers to help identify people who could benefit from palliative care. The project resulted in:
a 40% reduction in hospital readmissions/admissions
more palliative patients dying at home (54%), compared with patients not identified as palliative (35%)
improved patient and family experience at end of life, including less anxiety because of better planning and earlier conversations with their loved ones.
A palliative approach to care also has a measurable impact on health care resources. With better symptom management and treatment plans that align with a patient’s wishes and values, there is a shift to community-based care, fewer emergency visits and reduced inpatient costs due to less time in hospital, all while seeing more satisfied patients and families.
Don’t just take our word for it…
The benefits of the palliative approach to care are well established, and there are wonderful publications and materials available from organizations near and far. Here are some of our favourites:
World Health Organization. Definition of palliative care. 2013. Available from www.who.int/cancer/palliative/definition/en/.
Philippa H. Hawley. The Bow Tie Model of 21st Century Palliative Care. Journal of Pain and Symptom Management. DOI: https://doi.org/10.1016/j.jpainsymman.2013.10.009
BCCPC resources for individuals and families – clearly outlines the definition and principles of palliative care and includes useful videos
Palliative Care Australia: It’s more than you think – easy to use videos on the benefits of early palliative care, and informative FAQs
Canadian Hospice Palliative Care Association Myths About Palliative Care – engaging infographic tackling 10 of the most common palliative care myths with video resources addressing the common myths and misperceptions about palliative care, including Canadian statistics.