JUST ONE IN TEN

Palliative care
Edmonton Journal - October, 2, 2001
'Just one in 10' can get palliative care:
Carstairs in Edmonton for talks amid work on national guidelines
By Hanneke Brooymans

Only a small fraction of Canadians dying of incurable diseases have access to the specialized care they need to properly ease their pain, a conference was told Monday. Manitoba Senator Sharon Carstairs said a mere five to 10% of Canadians have access to quality end-of-life care. She was speaking to about 400 people gathered at the Fantasyland Hotel in Edmonton for two days of talks ending today on palliative care.

Carstairs, who was given special responsibility for palliative care by Prime Minister Jean Chretien, has made it her mission to help formulate new national guidelines to guarantee equal treatment of all Canadians. She hopes to incorporate standards the Canadian Palliative Care Association will set later this month.

Cities such as Edmonton, Winnipeg, Ottawa and Victoria already provide excellent access to care. But in rural areas, distances present challenges, and a lack of uniformity in funding and standards doesn't help.

In Alberta, each region makes its own decisions about how palliative care is funded, said Trish Clark, a palliative care clinical nurse specialist at Calgary's Tom Baker Cancer Centre. Clark spoke about helping families face life-threatening illnesses. She said later she didn't know how families coped if they couldn't access the home care, hospice beds, palliative care hospital beds and specialists available to people in many urban centres. All families cope differently, but rural families should at least have the option of using the care, she said. "We have to have this type of care. It's not an option. And we need support at all government levels."

While funding is a stumbling block to proper palliative care, Clark said, education is also insufficient. "One of the primary reasons palliative care isn't as accessible as it could be is because there hasn't been the education in medical schools and nursing schools," said Penny Parker, manager of the palliative home care program for the Capital Health region.

Carstairs said she is pushing to have palliative and pain management training included at all medical and nursing schools in the future. She is currently on a tour of the country's best palliative care centres, collecting information so she can put together a list of best practices for countrywide use.

PALLIATIVE CARE - Palliative care is the special care of someone whose disease can't be cured.

- The palliative care program for the Capital Health region was developed in 1995. Its aim is to make a terminal patient's last days of the highest quality possible.

- There are 14 beds in the unit and 57 hospice beds in care centres scattered across the region. The beds in the unit have a 92% occupancy rate, with an averge stay of 21 days.

- Before the program started, advanced cancer patients took up 22,000 hospital days per year. Now the number is down to 7,000 a year. The proportion of advanced cancer patients dying in acute care beds decreased from 80% to 50%.

- The aging baby boomer population is expected to mean a greater demand for palliative care beds. One estimate forecasts a need for 10% to 20% more hospice beds in five years.