Are Canada’s palliative care workers at their limit?
A new report from the Canadian Society of Palliative Care Physicians (CSPCP) says that Canada urgently needs to double the number of its palliative care professionals in order to address the healthcare requirements of an aging population.
With the cohort of Canadians over the age of 65 expected to double over the next two decades, Canada’s healthcare system is facing a time of crisis, says the CSPCP, which points out that current palliative care specialists are retiring in greater numbers than are entering the workforce, creating a situation where today only 15 per cent of patients receive the palliative services they need, often for short periods prior to death.
“The demographics of Canadians show a marked increase in the number of seniors, many living with life-threatening chronic illnesses for prolonged periods,” says the report, which calls on the federal government to develop a national framework and a new national health accord involving dedicate funding for palliative care, saying that such measures will ultimately save money in the long run.
Investing in palliative care services could save the government as much as $8,000 per patient, says the CSPCP, as palliative services cut down the length of hospital stays, readmissions and visits to intensive care units.
And with the legalization of Medical Assistance in Dying on June 17 of this year, the number of Canadians requesting medical assistance to die is expected to jump to 62,400 in 2017 alone. The CSPCP estimates that it will take 170 full-time palliative care physicians to meet the new demand, twice the number currently working in Canada.
“We now have a legal right to access medical aid in dying but we don’t have same right to access palliative care,” says CSPCP President Dr. David Henderson, who points out that access to palliative care is a major problem in Canada’s remote communities. “When we plotted out people who had received their palliative care competencies, there was one physician in all of northern Canada,” says Henderson.
Palliative care aims to improve the quality of life for patients with life-threatening illnesses and their families by providing relief from pain and other symptoms and by offering support which helps families to cope with the psychological and spiritual challenges faced during a patient’s illness. Some of the primary disease groups which often employ palliative care services are advanced cancers, end-stage organ failures and neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), Huntington’s disease and Alzheimer’s disease.
The CSPCP says that while palliative care involves the acknowledgement that death is a natural process, it is nonetheless a life-affirming approach, one whose results can impact a patient’s decisions concerning medically assisted suicide. The group states that only one out of every six requests to die actually lead to the procedure, with the other five choosing not to pursue medically assisted suicide after receiving palliative care services.
“We see time and time again that people actually start to thrive,” Henderson says. “There’s a sense that you can die well.”
The federal government is in the midst of developing a new health accord, one which is expected to flag an extra $3 billion in healthcare spending for home care and palliative care services.