In 2017, the Act providing for the development of a framework on palliative care in Canada, was passed by Parliament (Health Canada, 2018). After consulting with Provincial and Territorial governments and various other groups, Health Canada eventually provided the foundation for the “Framework on Palliative Care in Canada” (Health Canada, 2018). One of the features of the framework was the formation of guiding principles that are fundamental to the provision of high-quality palliative care in Canada (Health Canada, 2018).
The Guiding Principles of Palliative Care in Canada
- Palliative care is person- and family-centred care.
- Death, dying, grief and bereavement are a part of life.
- Caregivers are both providers and recipients of care.
- Palliative care is integrated and holistic.
- Access to palliative care is equitable.
- Palliative care recognizes and values the diversity of Canada and its peoples.
- Palliative care services are valued, understood, and adequately resourced.
- Palliative care is high quality and evidence based.
- Palliative care improves quality of life.
- Palliative care is a shared responsibility.
(Health Canada, 2018)
Issues Facing Palliative Care in Canada
Although there have been changes and improvements to palliative care in Canada since it was first introduced in the mid-1970s, various reports have demonstrated gaps in access and quality of palliative care across Canada. A report by the Canadian Institute for Health Information (CIHI) (2018), for instance, found that:
- While 75% of Canadians would prefer to die at home, only about 15% have access to palliative home care services.
- Recipients of home palliative care services are 2.5 times more likely to die at home and are less likely to receive care in an emergency department or intensive care unit.
- Cancer patients are up to 3 times more likely to receive palliative care, even though approximately 89% of people with life-limiting illness, such as a progressive neurological illness, organ failure, or frailty, were not able to benefit from palliative care.
Several recommendations have been made by palliative care organizations to overcome these gaps in access and quality of care. They include “establishing consistent definitions and measures of palliative care, improving palliative education for health professionals, ensuring adequate training for caregivers and increasing awareness among patients and their families” (CIHI, 2018, p. 41).