Title: Transforming Our Understanding of Hospice Palliative Care
1Transforming Our Understanding of Hospice
Palliative Care
2Acknowledgements This slideshow is a compilation
of information/slides from a number of experts in
hospice palliative care
- the Palliative Pain and Symptom Management
Consultants Cathy Joy, Janet Noble, Marie
Palmer, Diane Reid, Chris Sherwood, and Marsha
Wolowich - Canadian Hospice Palliative Care Association and
the Pallium Project
3Agenda
- View Dying For Care Towards Quality End-of-life
Care (16 minutes) - Review of CHPCA Model to Guide HPC
- Debrief about common myths, barriers and issues
impeding quality care
4View Dying For Care
- A compilation of insights with Hospice Palliative
Care leaders conducted in late 2005 - Reflects perspectives from a cross-section of
professions and leaders from coast-to-coast. - Provides insights into some of the things that
might impede our abilities to work effectively
with health care professionals in Hospice
Palliative Care work.
5Prior to Antibiotics
Slide compliments of Dr. Frank Ferris Oct 2005
High
- Sudden, Unexpected
- infections
- accidents
- adults lived into their 60s
Health Status
Death
Low
Time
61940s 1980s
Slide compliments of Dr. Frank Ferris Oct 2005
High
Decline
- Prolonged Dying
- predictable decline
Health Status
Death
Low
Time
7Disease, Aging in 2006
- Sometimes cured
- Most often controlled
- Life expectancy 10 - 20 yr.
- Canada 80 yr.
- USA 78 yr.
- India 64
Frank Ferris Oct 2005
8Hospice Palliative Care in Non Cancer Illness
- Few of us will die acute deaths
- 90 of us will die with one or more chronic
illnesses - 29 of us will die of cancer
- 36 will die of heart or vascular disease
- By age 85, 47 of us will suffer from dementia
- 2004 Dr. Larry Librach
9Exacerbations and Sudden Dying
High
Mostly Chronic Heart and Lung Failure
Function
Death
Low
Time
10Prolonged Dwindling
High
Frailty and Dementia
Function
Death
Low
Time
11Traditional Model
Â
Â
Curative
Palliative
Death
Active
Terminal
Earliest Model of Palliative Care developed Dame
Cicely Saunders 1960s 1970s
12Current Model
Frank Ferris Oct 2005
End-of-lifeCare
Therapies tomodify disease
Hospice Palliative Care
Presentation
Death
Therapies to relieve suffering and / orimprove
quality of life
BereavementCare
13Hospice Palliative Care
- Hospice Palliative care is not
- A person/resident/patient
- A place
- A program
C. Sherwood, PPSMC, 2004
14Hospice Palliative Care
- Hospice Palliative care is
- provided to a person/resident/patient
- provided in a place
- provided by health care practitioners, program,
service etc.
C. Sherwood, PPSMC, 2004
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16Hospice Palliative Care (HPC)
- A philosophy of care and range of active,
supportive services provided across several
settings of care (home, hospital, hospice, LTC/CC
and settings of marginalization) to enhance the
quality of living, dying and surviving. - Appropriate for any patient and/or family living
with, or at risk of developing, a
life-threatening illness due to any diagnosis,
with any prognosis, regardless of age, and at any
time they have unmet expectations and/or needs,
and are prepared to accept care.
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18Start with the end in mind
- What are we trying to achieve?
- Canadians should be able to live well and die as
free of pain and suffering as possible in the
setting of their choice, surrounded by loved
ones. - Adapted from Quality End of Life
Coalition of Canada Care
19Rethinking Palliation
- Need to broaden our understanding of palliation.
- Hospice Palliative Care (HPC) as introduced in
2002 Model provides a pathway for improving care
which addresses Chronic Progressive Illness. - HPC as a philosophy/model of care is broader than
the earlier palliative care services provision
model. - Each dying process/death event impacts at least 8
others directly considerable hidden health
risks/costs. - Emerging opportunities to provide different
supports at the community-level (e.g., practical/
advanced care planning transportation
bereavement support).
20A Growing Need
- Around 250,000 Canadians will die this year as
many as 165,000 could use hospice palliative care
services. - Not just about cancer, but other major causes of
expected death including - End-stage organ failure (e.g., heart, lung,
renal) - Neurological illness (e.g., Alzheimers, ALS, MS)
- Immunological illness (e.g., HIV/AIDS)
- Many people are living much longer with illnesses
which will lead to an expected death, often with
pain/suffering. - At present less than 15 of Canadians have access
to hospice palliative care services in Canada.
Rural and remote Canada is generally doing much
worse than most cities.
21The Current Reality
- Canadians are living longer, Baby Boomers are
aging if we arent meeting the needs today what
will we do in 20 years? - 33 more deaths by 2020
- Most Canadians say they would like to die at home
or stay at home as long as possible yet 75 die
in acute care beds or long term care homes(2000) - Increased use of acute beds, unnecessary pain and
suffering, and misuse/overuse of health delivery
system when families are not supported with
quality services.
22Specific Things We Can Do
- Recognize that living well until death is not
black and white it is often many shades of
grey involving complex care and needs provided by
many. - Recognize that many health care professionals
might find these issues difficult - Learn to reframe hope for the long-view.
- As Family Council members????
23A Starting Point for Resources
- HNHB Hospice Palliative Care Network
- http//www.hnhbhpc.net/
- Canadian Hospice Palliative Care Association
(CHPCA) - www.chpca.net (see CHPCA Marketplace link)
24Thank You
- Diane Reid, Palliative Care Consultant Niagara
- Diane.reid_at_hospiceniagara.ca