Palliative care when and where it is needed

People with advanced illnesses often share the same hopes: To be comfortable and free of pain and other symptoms, close to loved ones and well cared for in their own home. By providing this type of care, called palliative care, healthcare providers and caregivers can give our most vulnerable patients care that is catered to their preferences.

With significant gaps in palliative care education and training, many healthcare providers are uncomfortable initiating conversations to explore a person’s goals of care and are unaware of how to access palliative care services. Although there are pockets of excellence in the province, there is no roadmap to guide the scale and spread of models that deliver good palliative care across Ontario’s healthcare system.

When patients do not have access to well-organized, high-quality palliative care, they are more likely to have uncontrolled pain and symptoms, higher levels of stress and poorer quality of life. They are also more likely to have an unplanned emergency department visit in their last days of life and to die in hospital.

All Ontarians deserve the best palliative care that we can provide.

A framework to advance palliative care services

The Ontario Palliative Care Network is a partnership of community stakeholders, health service providers and health system planners (including CCO as a lead partner) from across Ontario. Since 2016, we have been working together to develop a coordinated and standardized approach for delivering hospice palliative care to patients across this province.

Our Health Services Delivery Framework (delivery framework), released in April 2019, outlines a model of care that will help adults with a life-limiting illness who are living at home or in community settings, and their family/caregivers, to remain at home as long as possible.

Key among the framework’s recommendations is the call to ensure that patients and their families/caregivers have seamless 24/7 access to an interdisciplinary palliative care team. Importantly, patients and their families/caregivers should be active members of this team, with care decisions aligned to their specific goals and wishes.

In parallel with the delivery framework, the Ontario Palliative Care Network has created goals of care resources to help patients and providers to engage in conversations about treatment decisions, tools to identify patients who would benefit from palliative care earlier in the course of their illness, and a guide to palliative care competencies required for care providers, from specialists to volunteers.

Confidence to remain at home

Too often, people worry that the only place they can receive care is in the hospital or in an emergency department.

With this framework, we envision a model that provides high-quality palliative care services when and where they are needed. Patients and their families will have confidence that Ontario’s healthcare system will support them throughout their entire lives.

Dr. Ahmed Jakda and Susan Blacker are the Provincial Clinical Co-leads of the Ontario Palliative Care Network.

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