Hospice and Palliative Care in Times of Crisis

Despite all challenges and in true (virtual) team fashion, the National Initiative for the Care of the Elderly’s (NICE) head office is launching the new corporate website with enhanced functionality and interactive features on time today. CONGRATULATIONS – and thank you so much for all your enthusiasm for and support of (End-of-Life Issues) Theme Team activities over the years!

In existence since the inception of the organization in 2005 under a grant from the Networks of Centres of Excellence - New Initiative Program, the End-of-Life Issues Theme Team (EoLITT) is dedicated to working on evidence-based tools to assist terminally ill persons, their families, friends and caregivers with various aspects of this important phase of life. Its informational caregiver brochure entitled ‘What to Expect When Someone Close to You is Dying’, for example, is directed toward caregivers/the general public and offers information and advice along the (often) most challenging journey anyone needs to take. Divided into five concise chapters:

1) Things A Person Nearing the End of Life Might Need from You,

2) What Happens During the Final Moments?,

3) Pain Control and Opiate Use,

4) Advance Care Planning and Substitute Health Care Decision Making, and

5) Other Things You Can Do to Help, it is currently available in four languages: English, French, Spanish and Portuguese.

Comprised of a diverse group of members from a multitude of different disciplines and backgrounds, the EoLITT is currently engaged in a number of knowledge synthesis projects (including a series of scoping reviews in collaboration with the Quality End-of-Life Care Coalition of Canada (QELCCC) of which NICE is a member).

A featured presentation on caregiving at the end of life, recorded for the Canadian Home Care Association (CHCA)/Carers Canada National Carers’ Day activities, can be accessed here. The next area of focus is end-of-life care in the non-cancer domain, including dementia.

Despite an increased need for palliative care service provision due to an aging population with multiple chronic conditions, access to and availability of palliative care services remain challenging in Canada and within provinces/territories and their respective (health) regions.

With the onset of the COVID-19 pandemic, palliative care has become an even more critical component for patients and families as its role is multifold and includes:

· advance care planning,

· goals-of-care conversations,

· pain and symptom management, and

· expertise in end-of-life care.

Defined by the World Health Organization (WHO) as “… an approach that improves the quality of life of patients [adults and children] and their families facing the problems associated with life-threatening illness…” it is holistic in nature, impeccable assessing and treating “… pain and other problems, physical, psycho-social and spiritual.”

Unfortunately, though gaps in (hospice and) palliative care service provision persist across the nation and have been further exposed by the COVID-19 pandemic: e.g., (long-term care) facilities with hardly any workforce preparation in palliative/end-of-life care, challenges in access to specialist support teams, lack of palliative care physicians/teams in many communities and hospitals, and (still) inadequate palliative care in medical and nursing school curricula, etc. A concerted effort is needed toward a palliative approach to care and a national Framework on Palliative Care in Canada.

As patients and families (!) have multiple and varied needs - which are often addressed by an interprofessional palliative care team - the pandemic (especially at the onset) has left many patients face isolation because of visitor and travel restrictions, etc. Furthermore, overstretched health care teams have been challenged to spend time at the bedside, often negatively affecting perception of care.

The Canadian Hospice Palliative Care Association (CHPCA) has championed compassionate visitation protocols in this regard that will help Canadians to get a chance to say their good byes meaningfully and deal with (impending) loss in a way that both protects the safety of frontline healthcare workers and prevents the transmission of COVID-19.

In order to spread hospice and palliative care awareness/knowledge and as a platform to honor international leaders in the field of hospice palliative care, NICE (via the EoLITT) is hosting the 2020 edition of the World Hospice and Palliative Care Day Special Lecture online in collaboration with the Institute for Life Course and Aging (ILCA) and Pallium Canada on Thursday, October 29, 2020 from Noon to 1 PM.

Esme Fuller-Thomson, PhD, Professor, Factor-Inwentash Faculty of Social Work, University of Toronto and Director of the Institute for Life Course and Aging, will provide a short overview on recent Institute developments and introduce the honoree.

Dr. Sandy Buchman, Associate Professor, Family and Community Medicine, University of Toronto and Freeman Family Chair in Palliative Medicine/Medical Director of Palliative Care, North York General Hospital is the distinguished 2020 Special Lecturer. His talk will address hospice and palliative care service provision in time of crisis and link to the theme of the World Day: My Care – My Comfort.

To secure a spot for the live online lecture, please RSVP by Tuesday, October 27, 2020 here.

An archived version of the webcast will be made publicly available online via ehospice Canada after.

For further information on the NICE End-of-Life Issues Theme Team and its activities, please visit our webpage and/or contact Christopher Klinger, PhD (Chair) by clicking here.

Christopher A. Klinger, PhD