September 19, 2018 — 12:01 a.m. ET Most Canadians (75%) want to die at home, and a new report by the Canadian Institute for Health Information (CIHI) reveals that people who access palliative home care services in their last year of life are 2.5 times more likely to do so.
The data, published in Access to Palliative Care in Canada, also shows that early palliative care reduced the number of visits to intensive care and emergency department visits for terminally ill Canadians in their last month of life.
“Our data shows that early integration of palliative services, especially home-based care, can improve the quality of life for those with life-limiting conditions and supports them through their final days in a place where they feel most comfortable.”
— Kathleen Morris, Vice President, Research and Analysis
Comfort in palliative
Palliative care refers to treatments and services designed to improve the quality of life for people who live with a life-limiting condition (such as advanced-stage cancer, organ failure or a degenerative disease) and for their families. It is most effective when delivered by an integrated team of specialists such as doctors, nurses and social workers, and includes services like pain relief, and psychological and spiritual guidance.
It is estimated that up to 89% of all Canadians could benefit from palliative care in their last year of life, but only 15% of people who died in 2016–2017 received publicly funded palliative home care (data is from Ontario and Alberta only).
When offered at the right time, palliative care can help reduce stress, improve quality of life and provide relief for terminally ill individuals and their families.
“I was really surprised by how comforting it was,” said Ing Wong-Ward, a 45-year-old Torontonian with inoperable colon cancer. “Suddenly it felt like we were in control again. For so long, we were lurching from one crisis to another. It was like this rollercoaster ride and suddenly I was in this office with this person who spent an hour listening to what I wanted, what my goals were, where I was at, and she basically indicated that her job was to shepherd me through what is the most difficult period of my life. It was, in the end, really reassuring.”
While stories like Wong-Ward’s show the value of early integration of palliative care, variation in services offered between provinces and jurisdictions means that many Canadians are not granted the same experience. In some cases, this can lead to distressing experiences for sick Canadians and the people they leave behind.
This is the first time CIHI is releasing a comprehensive report on access to palliative care across health care settings. The report provides baseline information on what we know about palliative care services in the last year of life.
Additional highlights from the data show that
- Few Canadians (15%) have early access to palliative care in the community.
- 62% of Canadians who received palliative care did so in an acute care hospital and mostly in their last month of life.
- Nearly half (47%) of palliative care patients in Canadian hospitals waiting to be discharged to a more appropriate setting (such as residential hospice or at home with support) died before they could be discharged.
- Canadians with cancer are 3 times more likely to receive palliative care than Canadians with other conditions, despite noted benefits for people with diseases like heart failure, dementia and chronic obstructive pulmonary disease.
- Canadians between the ages of 45 and 74 are more likely than younger adults and older seniors to receive palliative care.
- 3 out of 5 Canadian primary care physicians do not feel well prepared to help people in need of palliative care.
The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization that provides essential information on Canada’s health systems and the health of Canadians.
We provide comparable and actionable data and information that are used to accelerate improvements in health care, health system performance and population health across Canada. Our stakeholders use our broad range of health system databases, measurements and standards, together with our evidence-based reports and analyses, in their decision-making processes. We protect the privacy of Canadians by ensuring the confidentiality and integrity of the health care information we provide.
This report is part of a broader CIHI commitment to improve information on issues affecting seniors in the country, as described in our strategic plan.