The changing face of palliative care

While the COVID-19 pandemic has affected all areas of healthcare sectors, it has also served as a catalyst for conversations about serious illnesses and how best to treat people.

“The COVID experience has brought to light the importance of talking about serious illnesses and quality of life,” says Carleen Brenneis, institute director of Covenant Health's Palliative Institute.

“This is not to downplay the enormous challenges all healthcare providers, including palliative care practitioners, are facing across the country in light of the pandemic, but awareness of palliative care at all levels is vital. Without it, people don't know what to expect from their care and don't know what resources to ask for,” she says.

Even before the pandemic, palliative care was a healthcare field in the midst of change. Long synonymous in most people’s minds with the final days of a person’s life, its scope has grown considerably as people are being seen earlier in their diagnosis and for longer as life expectancies continue to increase. It also encompasses a wide range of life-limiting illnesses such as heart disease, diabetes, dementia and frailty.

Covenant Health palliative nurse consultant Annie McClean has seen the steady transformation during her 14-year career in palliative care.

“This type of care truly touches every aspect of a person and family's life,” Annie says.

“Also, with the breadth of palliative care now well beyond what it once was, you really get to know your patients for a much longer period of time, as they’re starting treatment earlier and living longer. Palliative care is about giving people quality of life. It is not always the same thing as geriatrics or end-of-life care, and people are starting to realize this.”

While awareness of all that palliative care has to offer may be on the increase, much work remains to be done. A 2016 Ipsos poll revealed that 42 per cent of Canadians were unfamiliar with palliative care, while less than half of Canadian adults (43 per cent) reported having had conversations regarding their palliative care preferences.

These numbers matter, Annie contends, since lack of awareness translates into unnecessary stress for patients and their family members.

“In my opinion, there needs to be a greater focus on primary palliative care in our health system,” she says.

“Healthcare practitioners need to be ready to discuss palliative options with patients early on in their diagnosis, and that requires that practitioners have a good working knowledge of palliative care,” says Annie. “These discussions also offer a pathway into advance care planning-related conversations, which takes a tremendous burden off of families. Open conversations about your health preferences are absolutely crucial, and awareness is the key to facilitating this.”

The Palliative Institute recently launched awareness and educational initiatives, including a new palliative care competencies and education project to provide expanded training and educational support to healthcare workers. The Palliative Institute aims to ensure that those who have questions have access to information.  

“There are great resources out there for people,” says Carleen. “People just need to know what’s available, and practitioners need to be ready for those crucial conversations.”

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