We believe that it takes a society to create better treatments, better care, and better support for people living in Canada. Part of making further advancements is offering recommendations to federal and provincial governments that can make supports for people with cancer more accessible, like palliative care.
Palliative care focuses on the quality of life of people who have a progressive, life-limiting illness. It involves pain and symptoms management, skilled psychosocial and bereavement counselling, spiritual support and comfortable living conditions. Palliative and hospice care can both be provided in hospice residences. But where hospice care is for people who are near the end of life and for their families, palliative care should be provided early and introduced progressively with other therapies.
Palliative care is essential to any cancer experience. By surveying 4 departments of the federal government, 11 provincial and territorial governments, and 13 community organizations, we have created the report Analyzing Hospice Palliative Care Across Canada: A report on federal, provincial, territorial and community actions . Our findings will allow us to provide a response to government for how to improve care across Canada and ease the suffering of people affected by cancer in the future.
Read our findings below:
1. Canada still lacks the capacity to consistently deliver palliative care in communities, particularly in hospice.
Best practices identified by the Auditor General of Ontario and others suggest that Canada should have 7 hospice beds per 100,000 people. By our count however, as of 2022, Canada only has 3.97 hospice beds per 100,000 people. Only British Columbia and Yukon exceed the 7 beds per 100,000 target.
To fix this, the Canadian Cancer Society is partnering with community groups, starting in Ontario and Manitoba, that are actively seeking to build local hospice residences. Community groups who, like us, also want to bring hospice residences closer to home.
The Canadian Cancer Society also encourages provincial governments to expand services in hospices using investments made by the federal government. Provincial governments in Manitoba, Saskatchewan and British Columbia would also benefit from launching their own strategies to improve care that reflects their own healthcare systems. The priorities that should be included in plans going forward are outlined in Health Canada’s Action Plan on Palliative Care.
2. There are significant social barriers to talking about death and dying, and confusion about the benefits of palliative care.
There is still no common Canadian definition for palliative care. There are also no widely accepted methods to track services across the country. Not having a widely accepted definition for palliative care can greatly affect Canadians’ understanding of the supports that are available.
We believe that it is important for the federal government to play a leadership role in establishing national standards and widely recognized supports of palliative care. Doing so would improve tracking for the types of care that people across the country receive and whether people are happy with their care. National reporting would also more clearly show who is being underserved by the healthcare system.
3. All provinces and territories noted that more could be done to improve cultural safety in palliative care, including grief and bereavement supports.
The Canadian Cancer Society believes that all people deserve access to supports that assist in a life-limiting illness, including grief counselling. CCS also welcomes further investments made by the Government of Canada to expand access to mental health services.
Investments into innovative plans for funding that meet the needs of vulnerable populations, such as unhoused people, are greatly encouraged. We also hope that the Government of Canada continues to take actions that address the culturally sensitive needs of First Nations, Inuit and Metis communities. Programs should take into consideration children, racialized communities, Francophones and 2SLGBTQQIA+ people.
Additionally, CCS supports initiatives by the British Columbia Hospice Palliative Care Association to expand affordable community counselling. As a result, we hope more existing barriers to palliative care in British Columbia are eliminated. Furthermore, we welcome solutions like digital programs that are available in Ontario, such as virtual care visits, for improving access to care in rural and remote communities.
4. Access to palliative care would be enhanced with additional training of healthcare professionals in more healthcare settings.
The COVID-19 pandemic demonstrated that palliative care support was needed not just in hospices and hospitals. Human resources were stretched and care providers were redeployed, causing additional pressures. As a result, ongoing efforts to ensure access to programs and services in hospices, home care, long-term care retirement homes and other community settings remain a priority.
To ensure that palliative care reaches those who require it, there needs to be a shift in the awareness and understanding of services for everyone, including providers, caregivers, and patients. There also needs to be an increased understanding of the landscape of palliative care services across Canada. The palliative care needs of a population cannot be met by palliative care specialists alone.
We hope that the Government of Canada develops strategies to ensure providers are fully equipped in all care settings. Further cultural training among healthcare providers should be considered as well, for families to have earlier and more frequent conversations throughout cancer treatments.
When facing a life-limiting illness, it is essential that access to information, education and supports remain available. And CCS remains committed to advocating for the best physical and emotional supports possible to ease the suffering for people affected by cancer and their caregivers.