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What Is Palliative Care?

By: The Canadian Virtual Hospice Team

What is palliative care?

Palliative care supports people who are living with a life-threatening illness, condition, or health situation. It treats the whole person and their family and not just the disease, condition, or body part. Palliative care can be provided to people of any age, in any setting, by healthcare providers, family members, and other caregivers. It is provided for as long as needed – hours, days, weeks, months, or years. Palliative care might also be referred to as comfort care, supportive care, or symptom management.

Palliative care:

Helps the person live as fully and comfortably as possible, to the end of their life.
Supports their family and others who care about and support them. Family includes biological and chosen family and is everyone the person says is family.
Addresses physical concerns such as pain, nausea, shortness of breath, and emotional, spiritual, and social concerns of the person and their family.
Respects and helps to honour the person’s culture and traditions.
Assists the person – and their family – to make important decisions about their health and treatment and share those decisions.
Provides grief support for the family after the death.

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When is palliative care provided?

Palliative care can be offered from the time someone is diagnosed with an advanced or life-limiting illness.
Palliative care is provided until the person dies. Depending on the health situation, this might be hours, weeks, months, or years. Grief support may be provided before and after the death. In the case of a very serious accident or a medical emergency such as a stroke, palliative care might be provided for a few hours.
It can be provided at the same time as treatment to cure a person’s illness, such as chemotherapy.
Palliative care can be provided without being enrolled in a palliative care program.

Who is responsible for palliative care?

In Canada, most healthcare is delivered by the provinces and territories. Services are also different between the urban, and the rural and remote areas. The Government of Canada is responsible for delivering healthcare services to First Nations living on reserve, Inuit, members of the Armed Forces, eligible Veterans, people living in federal penitentiaries, and some refugees. As a result, palliative care programs and services differ across the country and within provinces and territories.

Who provides palliative care?

Healthcare providers

Palliative care can be delivered by physicians, psychologists, nurse practitioners, nurses, social workers, spiritual care providers, physio and occupational therapists, respiratory therapists, music and art therapists, grief specialists, children’s grief specialists, speech-language pathologists, child life specialists and play therapists, dieticians, pharmacists, paramedics, home care aides, personal support workers, and others. The needs of the person who is ill and their family, and the services that are available in their area, determine which healthcare providers are involved in providing care.

Many large urban centres have palliative care teams, which include a variety of members listed above, who have advanced training in palliative care.

Family and other unpaid caregivers

Palliative care is provided by family and other unpaid caregivers. It is estimated that family caregivers provide 70-90% of palliative care.

Volunteers

Volunteer services are often provided in healthcare facilities and through provincial palliative care associations. Volunteers are carefully screened and selected. They may be trained to offer emotional, spiritual, and practical support to the person who is ill, and their family. These services may include in-person, telephone, and online support, and connections to other resources.

Where is palliative care provided?

Palliative care can be provided in many places including a person’s home, a hospice, a hospital, community-based residential care facility, or a long-term care facility. The location of care depends on what is available in the community that best matches the person and family’s needs.

Palliative care at home

Some people choose to stay at home to receive care for all or most of their illness. Remaining at home depends on a number of factors including:

The kind of care required. Some care can only be provided in a healthcare facility.
Whether the family or other unpaid caregivers are available and prepared to provide care.
The services available to support care in the home, such as home care and equipment.
Transfer to a health facility maybe required if:
The person’s care needs change.
The person wants to be moved to a facility.
If caregivers can no longer support them at home.

Hospice

A hospice is a facility that provides palliative care in a home-like setting. Hospices may also provide short-term respite care or in-home volunteer programs and grief support. These facilities have admission criteria that may include:

How long the person is expected to live.
Whether the person’s care needs can be met in the facility.

Unfortunately, there are not enough hospices to meet demand and they are seldom found in rural and remote areas. Hospice care isn’t always covered by the public health system so families may have to pay a daily charge. Private insurance may cover these costs.

Hospices offer different services and levels of support. It’s important to contact the hospice or a local palliative care program directly, to inquire.

Hospital

A hospital does not need to have a specialized palliative care unit or beds to provide palliative care. Palliative care can be provided in any unit or section of a hospital, including the emergency room.

Palliative Care Units

Some hospitals have palliative care units for people who are experiencing difficult symptoms. These units:

May offer a more home-like environment but are not intended for long-term stays.
Focus on bringing symptoms under control so people can then be transferred to another area of the hospital, hospice, or home.

Long-term care facilities

Also known as nursing homes, these facilities can provide palliative care. Long-term care facilities may:

Have care provided by family physicians or nurse practitioners who aren’t typically specialized in palliative care, but are still able to provide this kind of care.
Have access to specialized palliative care teams within the facility or from an outside service or program. A healthcare provider can request a consultation from a palliative care specialist for advice regarding symptom management or family concerns.

Palliative care programs

In some communities, care is provided by a team of healthcare providers who specialize in palliative care. Each program or service has different policies about program enrollment or consultation support.

Programs may provide support:
- From the early stages of illness through to death, including offering family grief support.
- Alongside treatments to cure illness or prolong life.
- To people whose life expectancy may be unknown.

Supporting care at home

Many communities have services to support care at home, including:

Home care programs
- Most offer palliative care support services.
- Often include a case coordinator, nursing, and other support workers.
- May also include hospital equipment, medical supplies, and transportation.
Palliative care programs – delivered through health facilities
- Some offer home visits from nurses or doctors who specialize in palliative care.
- If in-home services are not provided, consultations with healthcare providers may be available for managing pain and other symptoms.
Support services
- All provinces, some territories, and many communities, have not-for-profit hospice, palliative care, or caregiving organizations that provide a variety of supports which might include education, visiting and caregiver support, as well as grief support.
Respite programs
- Short-term care for several hours or days to give caregivers a rest. Check for availability in your area.
Private companies
- Part-time or around-the-clock services may include cooking, cleaning, companionship, and transportation.
- These are usually services that are paid for out of pocket or by private insurance.