While many supports are available for people who are terminally ill and their families in Powell River, hospice and palliative care advocates say gaps still exist.
Powell River does not have any dedicated palliative care beds within Powell River General Hospital (PRGH). In a report on meeting the needs of Canada’s aging population, Senator Sharon Carstairs recommended that communities have one dedicated palliative care bed for every 5,000 people in a community.
A community-based hospice society has been created and is continuing a program of social and emotional support services for the terminally ill and their families. Heather Baldwin, president of Powell River Hospice Society (PRHS), said the newly formed society is looking toward creating a hospice facility that could potentially offer palliative care for Powell River. However, the society first needs to build community support and stable funding before it is able to undertake operating such a home.
Dr. David May, a Powell River general practitioner who specializes in palliative care pain management, is dedicated to the idea of enhancing end-of-life care and hospice in Powell River.
May undertook a three-month leave from his practice for professional development in palliative care and to spend time working in Victoria Hospice, one of Canada’s longest standing hospice and palliative care facilities. Since 1980 the hospice has helped countless people with end-of-life care. While the hospice does have a 17-bed in-patient facility, care is also offered in patients’ homes. Several hundred trained volunteers provide companionship and support for the terminally ill and bereavement support for families following the death of loved ones. Half of the facility’s $7-million operating budget comes from Vancouver Island Health Authority and the rest from the community in the form of donations, foundation grants and fundraising.
Formalized palliative care did not come to Canada until the mid–1970s when teaching hospitals in Winnipeg and Montreal set up the first Canadian hospices on the model established a decade earlier in the United Kingdom.
“The terms ‘hospice’ and ‘palliative care’ can be confusing since they go hand in hand, but they are different,” said Sandra Tonn, PRHS vice-president. She explained that palliative care primarily means taking care of a terminally ill patient’s end-of-life medical needs, whereas hospice can mean both the volunteer movement and philosophy to give dying people social, emotional and spiritual support aimed at providing an improved quality of life and death. Also hospices are places where palliative care is provided, like Victoria Hospice.
“So, a person may be a hospice client, be receiving palliative care and be in a hospice,” Tonn added.
While there may not be any dedicated palliative care beds in Powell River, a program of home nurses is organized through PRGH.
“It’s important to stress that hospice is only one piece of a bigger system of palliative care that we already have where dedicated nurses go out to people’s homes,” May said.
Since 2000, PRGH has had single point registration for home care nurses and other supports which allows the terminally ill the ability to die at home with a measure of comfort.
The challenge for Powell River is finding a place for longer term palliative care patients, if they are not able to stay in their homes. According to May, long-term care facilities and the hospital are not usually a good fit for these patients. He added that acute palliative care, treating unpredictable disease trajectories and pain management, can be as demanding as caring for patients in an intensive care unit.
Only about 15 per cent of people who require palliative care services in Canada have access to them and the Canadian Hospice Palliative Care Association estimates that more than 70 per cent of Canadians who die each year would benefit from palliative care programs and services.
This is part two of a three-part series on hospice palliative care.
