Instead of treating death as a natural part of life’s evolution, medicine and our modern society can prolong life at all costs. While we may not yet be able to control death, we can control how we choose to approach it.

Palliative care—also known as end-of-life care—is a type of health care that aims to relieve suffering and improve the quality of life for people who are living with, or dying from, advanced illness.

Usually an integrated approach involving medical care and pain management, palliative care also places a strong emphasis on supporting the loved ones of patients by acknowledging that the process of illness affects not only the patients, but also their families.  

Taken as a whole, palliative care “addresses the psychological, social, cultural, emotional and spiritual needs of the person and family,” says Anthony Milonas, Chief Operating Officer of CBI Health Group.

Home health services

For most people, dying in a home-like setting surrounded by family and friends can be a peaceful and comforting experience.

“People are often more comfortable when they are in a familiar environment surrounded by family and loved ones,” says Rosanna Dolinki, National Senior Manager of Clinical Practices at We Care Home Health Services, part of CBI Health Group. “Having care provided at home can offer a more comfortable alternative for the person and family.  Like the home itself, the care provided there incorporates all aspects of a person’s life and well-being” she says.

“Evidence clearly shows that when people have candid planning conversations, their families experience less stress and less anxiety at end-of-life and following the death of their loved ones.”

And with continued advancements in the field of palliative care, patients can now receive nearly the same level of support at home as in a hospital—including visits from doctors, social workers and psychologists.

“Someone may have a personal support worker who helps the client with getting ready for the day. That could include very basic things such as feeding or bathing or clothing,” says Ruth Wilcock, Executive Director of the Ontario Brain Injury Association.

“Some people may be fine to get up and to dress and feed themselves, but they might have other needs. So they’ll have an occupational therapist who comes in or a physiotherapist or a nurse. What it comes down to is the level of need. In palliative situations, that need may change from day to day.”

Advance care planning

While most people would prefer to die at home, very few actually plan for it. A 2012 Ipsos-Reid national poll found that 86% of Canadians have not heard of the term advance care planning, and less than 50% have had a conversation with a family member or friend about their wishes should they not be able to communicate themselves.

“Death is a taboo in our society. We don’t like to talk about it,” says Louise Hanvey, Director of Advance Care Planning for the Canadian Hospice Palliative Care Association (CHPCA). “But evidence clearly shows that when people have these conversations, their families experience less stress and less anxiety at end-of-life and following the death of their loved ones.”

For that reason, a big focus of advance care planning has been to raise awareness of the importance of having an end-of-life plan.

“Advance care planning means reflecting on and talking about our wishes for end-of-life care while we still can. And, very importantly, deciding who will speak for us if we can’t speak for ourselves,” says Hanvey.

“If I get to the point where I can’t speak for myself and make decisions about my health care, who’s going to speak for me and make sure that my wishes are being met? All of these questions are critically important,” she says.

Moving forward

While work has been done recently in Canada by CHPCA and others to help increase awareness and promote the benefits of advance care planning, addressing the taboo surrounding death remains one of the top priorities for palliative care providers.

The key to this is informing, educating and engaging physicians, clients and families on the importance of this sensitive topic.

“Bringing awareness to the benefits of palliative care planning and educating the general public on how the system works is the first and foremost priority for health authorities,” says Milonas.

“These organizations play an active role in demystifying the topic of dying, so families, patients and the elderly population feel comfortable to discuss subjects like advanced care planning for example, as early as possible.”