Who is involved in the planning and provision of End-of-Life Care in Canada?

Current policy regarding this issue is disjointed and for the most part underdeveloped. However, the ground work has been done. As mentioned in earlier blog postings, the previous government of Canada initiated what was meant to become an inclusive, exhaustive piece of policy that would ensure the rights of Canadians to die with dignity and with respect of their wishes and those of their chosen family. The research and final report was overseen by the Honourable Sharon Carstairs, a member of the Senate and Chair of the senate sub-committee studying “Quality End-of-Life Care: The Right of Every Canadian”. The final report was taken to the senate in 2000. As an agent of the federal government, she was instrumental in the development of hospice palliative care, working with the provinces, territories and NGO’s to ensure the needs of those individuals and their families facing imminent death were met adequately. The Canadian Hospice Palliative Care Association (CHPCA) honoured Ms. Carstairs in 2003.

Following this report, Health Canada granted funding to the University of Alberta for a study entitled “Integration of End of Life Care: A Health Canada Synthesis Research Project”. The research was conducted from October 2002 to September 2003 with the final report being presented in March 2004. Clearly the federal government and its branches (Health Canada) had a determined interest in better managing end-of-life care. As well, many provinces took their own initiative to broaden the scope of end-of-life care – with British Columbia, in my estimation, leading the way. There is a role for governments of every level to be involved in the planning, supervision, funding and provision of services for this vulnerable population.

Provinces have a major function in that they are the ‘distributors’ of health care, in all areas – institutionally (hospitals, LTC facilities), in the community and at home (Homecare, Hospice, etc.). Some programs and services have been added in recent years (2004), such as “Compassionate Leave” for workers who need to take time away from work to care for a dying loved one. Unfortunately, as is the case in so many government programs, the criteria were so tight that very few people managed to acquire the funding needed to use the program. Somewhere in the neighbourhood of 90% of the amount tagged for the program, went unused in the first couple of years. This provincially funded program has recently been revamped, however, it is still not enough. In reality, it may take a lot longer than six weeks for a loved one to die – never mind the ensuing bereavement!
Municipalities also lend a hand in service provision and funding. As well, not-for-profit agencies, staffed predominately by volunteers, exist to fill the gaps. We know the gaps remain too wide when only 15% of dying people have access to hospice palliative care across this country. It is a travesty.