What is Palliative Care?

About 80% of palliative hospice care actually takes place where the patient lives.

Palliative care is a philosophy of care with a focus on helping people feel and function as well as possible while living with a progressive, usually incurable illness.
 
  • Personalized to each patient’s and family’s needs
  • Care is flexible as needs change over time
  • Involves a team:
    o    Rural Palliative Consultation team
    o    Family physicians and AHS Homecare
    o    Hospice society volunteers
    o    Other professionals: nutritionist, occupational therapist, physiotherapist, home health aides, spiritual care providers, PCN RN’s

End of life care is special palliative care provided to an individual and their family when they are approaching a period of time closer to death.  Services aimed at comfort are intensified. This can occur at home, in a hospice, or in the hospital.
Palliative Care: YOU Are a BRIDGE

This video animation compares palliative care to the foundation of a bridge. While illness may weaken the foundation, the palliative care team provides a stronger layer of support.

When does Palliative Care start?

I could not have walked without you all
There may come a time when attempts to cure a disease many no longer be helpful.  At this time, a comfortable way of life may be more beneficial.  The aim of palliative hospice care is to assist in making life as fulfilling as possible in what little time remains.


Signs that may indicate palliative care should be considered:
 
  • Multiple hospital stays for similar symptoms
  • Recurring emergency room visits
  • No longer attempting to cure the illness, or attempting to just slow it down
  • Unable to recover after a medical setback
  • Desire to spend more time at home and less time with medical services
Benefits of early palliative care

How can Palliative Care help?

The beauty of palliative hospice care
Palliative care aims to help patients and their families deal with physical, emotional, social, spiritual and practical issues at any time during the illness and provide family support after the patient has died.
 
  •   Pain and symptom management
  •   Grief, anger, confusion
  •   Need for information
  •   Difficult decision-making
  •   Coordination of resources
  •   Movement to a different setting of care (eg. hospital, hospice, home)

Palliative and End of Life Care
Bill's story

Planning your care in advance

Palliative hospice care helps patients
This is called Advanced Care Planning. Your health care wishes can be documented in a Goals of Care sheet. Your wishes for different levels of care usually change as you progress through your palliative care journey.  This is to be expected.  It’s just important that you let others know what your wishes are.

Goals of care need to be signed by a doctor, as it is a medical order, just like ordering antibiotics or fluids. A Personal Directive is a legal document signed by you to ensure your wishes. Your family is able to speak for you when you are unable.

Both the Goals of Care sheet and Personal Directive sheet can be found in an AHS Greensleeve. It is available at your doctor’s office or at the PCN (Primary Care Network). Sometimes, your Will might already include a Personal Directive, along with your Enduring Power of Attorney (which deals with your financial and legal matters). Check with your lawyer if you’re unsure.

AHS Advance Care Planning
Five Steps of Advance Care Planning

Too many Canadians don't have a plan for their future healthcare. But Advance Care Planning is easy! There are just five steps.

Living and dying in your home and community

Viewing palliative hospice care as a gift
Let your family physician and health care team know that you’d like to spend as much time as possible in your own home.  They can assist in bringing extra resources to help you and your caregiver:
 
  • Wheatland & Area Hospice Society: Bedside Respite, Navigation. 403-934-8199
 
  • Homecare (Community Care Access) Nurses, occupational therapists, physiotherapists, respiratory therapists, health care aides. 403-361-7181 or by referral from your family MD.
 
  • WFCSS: Light housekeeping, companion care. 403-934-5335
 
  • FCSS: Light housekeeping, companion care, driving. 403-934-9090
 

Once End of Life Care is needed, other resources are available to help:
 
  • Wheatland & Area Hospice Society as well as Bedside Respite: Local trained palliative volunteer, often someone from your own community provides evening respite care, giving family and caregivers a chance to rest and rejuvenate. Palliative Navigation: A local palliative volunteer, who can identify supports and get plans set for you and your family.
     
  • Rural Palliative Health Care Consult Team: Provides specialized advice to you, your doctor, and homecare team. They can come to your home, or your Homecare Nurse can link with them by Facetime.
     
  • EMS Refer, Assess, Treat Protocols: WADEMSA may be able to come to your home to give medications for sudden, urgent, and unexpected symptoms of pain, shortness of breath, or delirium. If you choose, you can continue to stay in the comfort of your home, rather than be transported to the Emergency Department.
     
  • Intensive Palliative Care Unit, Foothills Hospital: Short stay admissions for complex symptoms or issues, followed by discharge home or to appropriate place to be cared for.
     
  • Hospice: Transfer to hospice can be accessed from home, or hospital. The Palliative Team will do the referral process. An ambulance can take you there.

Home, Hospice or Hospital?

Mountains cannot be surmounted except by winding paths
Often, the plan to where you wish to die may change as you progress through the stages of illness and approach death, and may even vary with the ebb and flow of emotions, medically urgent episodes, and the availability of palliative support in your home.  This is expected, and is part of the dying process.  It’s important to share your thoughts and feelings with your caregivers and physician.  Remember, nothing is ever written in stone, and helping you and your caregivers do what’s most important for you is the goal of your palliative care team.


Home

80% of people would prefer to die in their own home, but are afraid to be a burden to their family.  If you are considering dying at home, your family and community will carry the bulk of your caregiving needs. Homecare will provide 15 -30 hours of care per week. Private nursing care is occasionally available, but may be limited by availability of staff and travel time.  The cost is usually $35-45 per hour, more in the evenings and nights.  Funds to help pay for private nursing are available from Alberta Health Services to a maximum of $10,000. One way to help stretch your caregiving resources is by requesting the Wheatland & Area Bedside Respite volunteers, or asking friends and neighbours to help.  Reach out, and they’ll reach in.
 
  • Bayshore Healthcare: www.bayshore.ca
  • Nurse Next Door: www.nursenextdoor.com
  • Bedside Respite Program: On referral from palliative homecare nurse. 
    The Bedside Respite Program is a partnership between Alberta Health Services (AHS) and WAHS. The goal of the program is to provide volunteer support to palliative care patients and their caregivers. Volunteers provide companionship to palliative care patients and respite to their families. This could be as simple as a good night’s sleep or maybe an evening out. They could visit patients in their homes or in hospital, during their last months of life. These volunteers would not replace family or primary caregivers, instead, they would enhance the care experience of the patient. Volunteers are not able to provide personal care or medication assistance.
    Referral to the Bedside Respite Program is coordinated by the Rural Palliative Home Care nurse.
  • Palliative Care Myths: http://palliativecare.org.au/myths
Hospice allowed my wife and i to make the days count
Hospice

If you are considering Hospice Care, exploring and planning in advance is helpful.
 
  • Hospice care usually occurs in the last 2 weeks to days of life.
  • You will need to list your top three locations rather than just one.
  • You may have to wait 2 or 3 days until you will be transferred there.
  • While there is no charge for hospice stays, incontinence supplies and co-pays on medicines may still occur.
  • Most hospices offer Virtual Tours online. Here is a list of hospices in the Calgary Zone:

    •  Agape Hospice – 1302 8 Avenue NW
       403-282-6588  www.agapehospice.ca

    •  Rosedale Hospice – 920 7A Street NW
       403-284-5195  www.hospicecalgary.com

    •  Sarcee Hospice – 3504 Sarcee Road SW
       403-685-6460  www.carewest.ca

    •  Chinook Hospice – 1261 Glenmore Trail SW
       403-258-0040  www.intercarealberta.com

    •  Southwood Hospice – 211 Heritage Drive SE
       403-252-0620  www.intercarealberta.com

    •  Foothills Country Hospice – Box 274 Stn Main, Okotoks
       403-995-4673  www.countryhospice.org

    •  Dulcina Hospice – St. Marguerite Manor,
       110 Evanspark Manor NW
       587-230-5500  www.covenantcare.ca