Canadian Hospice Palliative Care Association
The CHPCA is the national voice for Hospice Palliative Care in Canada. Advancing and advocating for quality end-of-life/hospice palliative care in Canada, its work includes public policy, public education and awareness. Established in 1991, its volunteer Board of Directors is composed of hospice palliative care workers and volunteers from Canadian provinces and territories as well as members-at-large.
What is Hospice Palliative Care?
The following definition was taken from the Canadian Hospice Palliative Care Norms of Practice following extensive national consultation.
Hospice palliative care aims to relieve suffering and improve the quality of living and dying.
Hospice palliative care strives to help patients and families:
- address physical, psychological, social, spiritual and practical issues, and their associated expectations, needs, hopes and fear.
- prepare for and manage self-determined life closure and the dying process
- Cope with loss and grief during the illness and bereavement.
Hospice palliative care aims to:
- treat all active issues
- prevent new issues from occurring
- Promote opportunities for meaningful and valuable experiences, personal and spiritual growth, and self-actualization.
Hospice palliative care is appropriate for any patient and/or family living with, or at risk of developing, a life-threatening illness due to any diagnosis, with any prognosis, regardless of age, and at any time they have unmet expectations and/or needs, and are prepared to accept care.
Hospice palliative care may complement and enhance disease-modifying therapy or it may become the total focus of care.
Hospice palliative care is most effectively delivered by an interdisciplinary team of healthcare providers who are both knowledgeable and skilled in all aspects of the caring process related to their discipline of practice. These providers are typically trained by schools or organizations that are governed by educational standards. Once licensed, providers are accountable to standards of professional conduct that are set by licensing bodies and/or professional associations.
A Model to Guide Hospice Palliative Care
© Canadian Hospice Palliative Care Association, Ottawa, Canada, 2002.
In the Canada the approach has been slightly different than discussed on the International page. In 1975, a palliative care unit was opened at the St. Boniface Hospital in Winnipeg and weeks later a similar palliative care unit was opened at the Royal Victoria Hospital in Montreal. Dr. Balfour Mount, a pioneer in hospice/palliative care in Canada, used the words “palliative care” rather than the word “hospice” because from the history of early lower Canada the word “hospice” in
Quebec was commonly considered a place of last resort for the poor or derelict. The word “palliative” comes from the latin meaning “to cover or cloak, as in to care for”. As a result, the terms have been used interchangeably across Canada. This can be particularly confusing when we speak of the “Palliative Team” referring to the medical professionals, there may be an assumption that Hospice is involved or when we refer to a palliative unit or room in a hospice which may or may not be associated with Hospice.
The Palliative Care Foundation in Toronto released an official definition of hospice palliative care in 1981, stating that “Palliative care is active compassionate care of the terminally ill at a time when there is no longer responsive to traditional treatment aimed at cure and prolongation of life and when the control of symptoms, physical and emotional is paramount. It is multidisciplinary in its approach and encompasses the patient, the family and the community in its scope.” Two years later, the University of Ottawa created Canada’s first University Institute for research and education in palliative care. The Canadian Palliative Care Association was established in November, 1991 and opened its first office in Ottawa in February 1994. The organization later changed its name to the Canadian Hospice Palliative Care Association (CHPCA) due to hospice care and palliative care no longer being recognized as separate entities.
While in theory they are one and the same, in British Columbia there has been a separation in the delivery of these programs requiring us to once again be clear about our terminology. Since 1981, the B.C. Ministry of Health has supported a community palliative care project, starting with an inpatient unit at the Royal Jubilee Hospital in Victoria and the second unit at Vancouver General Hospital. The Ministry of Health has also provided home care support to enable terminally ill patients to remain in the comfort of their own homes. However in general hospice programs in communities throughout BC must raise their own funds to financially support their individual programs.
In BC as is elsewhere there are five different organizational structures.
- Community based hospice palliative care: This program does not have a facility of its own, other than an office. The program centers around the client, whether he/she is in the home or in a health facility ; using a multidiscipline team approach to provide physical, emotional and spiritual support for the client and the family. Hospice Society of the Columbia Valley will begin using this model.
- Hospital based: This is a unit, floor or wing within the hospital specifically allocated for the terminally ill patient to die in, if he/she so chooses; for symptom management and for respite. It may have a totally independent staff or have staff members who rotate from the main floor. In Invermere we have a single palliative care room attached to a regular hospital room (rooms 6&7) at the end of the urgent care hallway.
- Hospital –based team. This team has no designated place in the hospital but there will be a specific number of designated beds scattered throughout the hospital to be used for palliative patients. Patient care is given by the regular staff on that area, and the team sees the patient on a daily basis, making suggestions for care as they assess the need. This is how the palliative room is attended in Invermere.
- Hospice Bed: This is a bed designated in a location outside of a hospital. The multidisciplinary team used for the community base is utilized here as well. Hospice Society of the Columbia Valley is working to secure a Hospice Bed in the coming year.
- Free-standing hospice: The free-standing hospice is housed in its own building and served by a multidisciplinary team. A 6-12 bed hospice is a long term goal for the Hospice Society of the Columbia Valley.
|History Quick Links|
|International History of Hospice|
|British Columbia Hospice Palliative Care Association History|
|Hospice Society of the Columbia Valley History|