We just attended the Hospice Palliative Care Ontario 2016 Conference in Toronto. Wonderful event with nearly 800 attendees.
Much talk about PAD (Physician Assisted Dying) or MAID (Medical Assistance In Dying). The following day there was an interesting opinion piece in the Globe and Mail by Dr Tom Koch, a gerontologist and ethicist, who provides chronic and palliative consultations. The title of the article, “The next court challenge, the right to better care“.
Koch asks the question, “If the Supreme Court decision enshrines choice as a principle of Canadian justice, then what choice are we to be offered? If it is between constant pain and an early death, most of us would prefer the latter. Expert palliative care can mitigate physical suffering in, according to experts, perhaps 95% of all cases. But at present, that level of pain control is unavailable to many Canadians. Without its surety, the choice is limited, if not empty, and justice therefore denied because a real full choices is withheld. Similarly, all agree that end stage home care and hospice care can make the last stage of an illness more than bearable. But many Canadians who would choose this, can not, it is not available. And without its insurance, the choices they are offered to care to the end are limited.”
The most important discussion in hospice palliative care today is: How do we integrate palliative care principles, practices and philosophy of care, from time of diagnosis, for people with any life limiting illness, across all care settings?
With the current needs of the dying, and with the anticipation of the increase in number of death annually, it is imperative that we follow the lead of Palliative Care Australia, and recognize that care of the dying person and the family is everybody’s business! And every nurse, every health care worker, every member of the health care team needs to be able to provide, access or refer individuals to services that will address their needs.
In Canada and in the United States, most dying people do NOT receive the services of a specialty hospice and/or palliative care team. The good news is that most dying people do not require the services of a specialty team. However most people who are dying, and their family, can benefit from the integration of palliative principles in the care provided by their general primary care team.
Most dying people can benefit from the principles, practices and philosophy of hospice and palliative care being integrated in care delivered by their primary care providers.
The primary care team may include the nurse and the health care workers on the medical unit, in the emergency department, working in long term care, working in the community, working in the doctor’s office.
This is education that can and should be integrated in core curriculum for all health care workers and nurses (as well as all members of the health care team)!
Nurses and Health Care Workers (AKA PSWs, NAs, HCAs etc) need to know that caring for the dying is part of their work, and they need to develop the competencies to do so.
We have developed our resources for this purpose. And, last month I delivered a webinar, for nurse educators, looking at how they can “Integrate an Educational Approach in Palliative Care“. If you are looking for ideas or inspiration on educating the health care team, then you might want to check out the recording.
On the other hand, if you are a health care worker and want to explore how you can integrate a palliative approach in the setting where you are working, you might be interested in the text and workbook, podcasts and videos.
And finally, if you are a nurse looking for an easy to read, delicious and digestible palliative care resources – the new text, “Essentials of Hospice and Palliative Care: A Practical Resource for Every Nurse” will be available in July 2016!!