End of Life Issues

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End of Life Issues
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Home and Community Care

• The Ministry of Health considers high quality
  end-of-life care services to be a critical part
  of health care services.
• Nearly 56 per cent of people who die in B.C.
  spend their final hours in a hospital, despite
  the fact that nearly 90 per cent of Canadians
  report they would like to stay at home during
  their remaining time. With good planning and
  appropriate services, the province believes many
  more people will be able to spend this time, with
  the support of family and friends, in the comfort
  of their own homes or specially designed hospices
  (including residential care facilities).

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Home and Community Care

• As only 10 per cent of all deaths each year in
  B.C. are unexpected 75 per cent of deaths are
  among seniors advance planning is vital to a
  well-managed health care system. And, as the
  ability to manage chronic diseases such as heart
  disease, stroke, respiratory disease and cancer
  improves, more British Columbians will live
  longer and need support at the end of their life.
• By 2026, one in five British Columbians will be a
  senior. With an aging population, comes the need
  for end-of-life care planning.

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• B.C.s Framework for End-of-Life Care
• To improve the quality of end-of-life care, in
  2001 the Ministry of Health engaged a panel of
  experts to examine how home and community care
  services can better serve palliative care
  clients. The ministry also consulted with people
  across B.C., family caregivers, palliative care
  professionals and volunteers providing hospice
  and other support services. Their feedback formed
  the basis of a broadly-circulated discussion
  paper.

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Home and Community Care

• Using further research-based evidence from B.C.
  and other provinces, the ministry has developed
  the policy document, A Provincial Framework for
  End-of-Life Care. This framework is a guide for
  health authorities, service providers,
  communities and individuals in developing and
  delivering services for people who are dying and
  their families.

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Home and Community Care

• Services
• Whether a senior or young person with a serious
  illness, most people nearing the end of their
  life want to have as enjoyable a quality of life
  as possible in their circumstances.
• End-of-life care is supportive and compassionate
  care provided during the remaining days, weeks or
  months of a clients life. It is provided
  wherever the client is living -- in their home,
  in hospital, a hospice, residential care facility
  or an assisted living residence.
• Specialized care services preserve the persons
  comfort, dignity and quality of life.

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Home and Community Care

• Palliative Care
• Palliative care services relieve, eliminate
  and/or control symptoms so those facing death,
  and their loved ones, can devote their energies
  to embracing the time they have together.

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Home and Community Care

• Community-based Care
• Community services include palliative care
  co-ordination and consultation, professional
  nursing services, community rehabilitation
  services, home support and respite for the
  caregiver.

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Home and Community Care

• BC Palliative Care Benefits Program
• The BC PalliativeCare Benefits Program supports
  individuals of any age who have reached the last
  six months of a life-threatening disease or
  illness and want to receive palliative care at
  home.

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Home and Community Care

• Eligible patients receive
• coverage of medications used in palliative care
  through the PharmaCare BC Palliative Care Drug
  Program, and
• medical supplies and equipment through the local
  health authority.

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Home and Community Care

• B.C. residents who are enrolled in the Medical
  Services Plan can request that their physician
  assess their medical eligibility for the program
  and submit an application on their behalf.
• For more information, see the patient information
  sheet (PDF 31kb).
• Detailed information for physicians is available
  on the PharmaCare Downloads Web page.

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Home and Community Care

• Some B.C. Examples
• Victoria Hospice Society, the first integrated
  palliative care program in B.C., has provided
  end-of-life care to patients and their families
  since 1980. Their services include expert
  physical care, as well as counselling, spiritual
  care and bereavement services. A palliative
  response team on South Vancouver Island supports
  clients in their homes. After-hours medical
  support is provided to palliative units and
  through home care nurses in Nanaimo and Victoria.

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Home and Community Care

• Richmonds first community-based hospice, the
  Salvation Army Rotary Hospice House, provides
  home-like care during the final stages of a
  clients life. The project is an innovative
  partnership with Vancouver Coastal Health, which
  covers a portion of the annual operating costs.
  The hospice is also funded through the assistance
  of donations from the Rotary Club of Richmond,
  community groups and individuals. Capital funding
  is provided by Canada Mortgage and Housing
  Corporation and BC Housing, under the Canada-BC
  Affordable Housing Agreement.

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Home and Community Care

• Hospice care is about providing a commitment to
  the whole person the physical, emotional,
  social and spiritual and helping individuals
  who are dying to face their death with personal
  integrity and truly living until they die.
  Honourable Linda Reid, Minister of State for
  Childcare and MLA for Richmond East

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Home and Community Care

• An after-hours response pilot project, in
  partnership with BC NurseLine, provides advice
  and support to Fraser Health hospice palliative
  care clients and their families when regular
  health offices are closed. A new 11-bed tertiary
  palliative care unit at Burnaby Hospital acts as
  a regional referral centre for the health region.
  In addition, community-based hospices are located
  in Burnaby, Port Moody, Surrey, New Westminster
  and Mission.

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Home and Community Care

• Interior Healths regional palliative care
  strategy has led to enhanced services and new
  hospice beds in the Okanagan, including Vernon
  and Penticton, and in Kamloops, located in the
  Thompson Cariboo Shuswap region.

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Home and Community Care

• Northern Health is working towards a palliative
  care network of services. The network will be a
  model of excellence for palliative and
  end-of-life care within rural and northern
  communities.

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Home and Community Care

• The Victoria Conservatory of Music music therapy
  program uses singing, instrument playing,
  composing, active listening and movement-to-music
  activities to support children, youth and adults
  coping with life-threatening illnesses or
  grieving the loss of a loved one. Music therapy
  can
• assist with pain management
• lessen anxiety, agitation and insomnia
• reduce depression and loneliness
• facilitate emotional expression
• encourage life review and reminiscence
• provide spiritual support and
• ease family tensions and decrease caregiver
  stress.

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Home and Community Care

• Useful Links Care Services and Support for
  Palliative Care Clients, Family Members and
  Friends
• BC HealthGuide Program - Provides reliable,
  confidential health information and advice you
  can trust, including
• BC HealthGuide Handbook 2005 English edition is
  available free of charge at local pharmacies and
  government access centres. This revised version
  contains new information on healthy aging,
  including tips for caregivers.
• BC HealthGuide OnLine
• BC HealthFiles Available at www.bchealthguide.org
  or through local public health units or
  departments.

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Home and Community Care

• BC NurseLine Provides 24-hour-a-day confidential
  health information and advice on a variety of
  topics, including caring for people nearing the
  end of life.Call toll-free in B.C. 1 866
  215-4700In Greater Vancouver 604 215-4700Deaf
  and hearing-impaired 1 866 889-4700

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Home and Community Care

• Hospital, hospice and home-based palliative care
  programs Visit this link to locate palliative
  care resources by health authority.
• British Columbia Hospice Palliative Care
  Association Leadership for organizations and
  individuals to ensure quality of care for British
  Columbians faced with a life-threatening illness,
  death or bereavement.
• Victoria Hospice Society Physical, emotional and
  spiritual care and bereavement services for
  Victoria patients and their families.

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Home and Community Care

• Planning for the End of Life
• Advance Care Planning - Advance care planning
  gives British Columbians the opportunity to make
  choices about their future personal care,
  including end-of-life care. It helps capable
  adults to prepare if the time comes when they are
  unable to make decisions on their own behalf.
  Through advance care planning, family members and
  health care providers are helped to understand
  and respect the persons choices.

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Home and Community CareAdvance Care Planning

• Frequently Asked Questions (Ministry of Attorney
  General website)
• Factsheet on advance directives (PDF 34 Kb)
• B.C.s health authorities are developing
  web-based resources on advance directives. For
  information, visit
• Vancouver Coastal Health (PDF )
• Fraser Health
• Vancouver Island Health Authority
• Interior Health
• Northern Health

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Home and Community Care

• BC Transplant Society - Online or fax
  registration for organ donors and information on
  organ donations. A list of bereavement resources
  is also available on this website.
• BC Vital Statistics - Information on steps to
  take when a death occurs and obtaining death
  certificates.
• Public Guardian and Trustee of British Columbia -
  Information on managing an estate when there is
  no will or executor and on wills and estate
  planning.