Palliative care co-considers means of treatment in the home

By co-creator/ actor and spokesperson on “MNF Today” Dr. Michael Spence

I recently read in the Canadian newspaper Le Devoir the text of a letter sent from the medical community and health authorities in Quebec to Health Minister Gaétan Barrette. And that letter seems to be every health professional’s prayer wish.

The letter emphasizes the urgent need to take care of the public’s health, and asks for innovative policies to close this gap. Some of those policies, according to the letter, “should be considered immediately.”

I would like to suggest other strategies that the Quebec government should implement. In a country known as a medical pioneer, we should be taking greater stock of European-style “co-primary care.”

As part of a comprehensive plan on the delivery of health care in Canada, the World Health Organization recommends that primary care be the primary goal and the principle approach. Rather than shying away from palliative care and caring for the dying in hospice, a partnership between palliative care and primary care can be a good way to give Canadians more peace of mind while also speeding up end-of-life care.

The focus is on how to relieve the pain and suffering that people end up living with because of advanced illnesses. Since so many Quebecers are dying with cancer, the government should be setting up an expert task force on palliative care. We also need to look at palliative care as part of cancer care.

In Switzerland, cooperation between primary care and palliative care has resulted in dramatic improvements in the standard of health of patients in intensive care units. But since palliative care is too new to be in place in Geneva, there are co-coordinators between the two camps to focus on strategies for both the palliative care team and the intensive care teams.

In similar European countries, the partnership is so strong that professionals from all sides of the health care spectrum work together for the benefit of patients. A palliative care specialist in the ICU and a general practitioner in the family office provide the team that explains what the patient needs and where the treatment would take place.

There is a definition in palliative care of “coordination,” or mutual cooperation and well-being of the individual, family, and the institution. Here, in Canada, there is currently too much duplication of efforts when it comes to care from an academic perspective.

As part of the Canadian End-of-Life Care Coalition, which includes specialists from across the board, we have asked the government to lead the country in funding programs that promote palliative care.

It is also important to ensure that palliative care is becoming part of the broader mix of long-term care services. That would assure that families have the same opportunities and levels of care that they should have, so that the dying person can have peace of mind.

We need to eliminate the barriers that put limits on access to palliative care, so that all Canadians have access to the care they need.

For that to happen, the government of Quebec must think differently about how health care in the province should be approached. This will require all of us – from specialists to bureaucrats – to come together to solve the problem.

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