Many Canadians in their last year of life could benefit from palliative care, but only 5% are receiving it. It is revealed by the Canadian Institute of Health Information that those who receive palliative care obtain it too late and too many patients are subject to multiple transitions of care as they are repeatedly moved around from their home, hospital and nursing home in their final days of life. Many individuals wish to die at home, but if they are not provided access to palliative care at home or are constantly being shuffled around, it is rare for their request to occur. Only one in four terminally ill patients who are hospitalized receive palliative care and half of them die while waiting to be discharged to a more suitable setting. The majority of Canadians die in hospitals where a peaceful and dignified death is rarely possible. The primary problem of palliative care in Canada is the lack of timely access and the distress caused by the lack of coordination between different parts of the health care system. Basic planning is the key to efficient palliative care. For example, cancer, cardiovascular disease, chronic obstructive pulmonary disease and diabetes account for majority of deaths and they all have predictable courses in the terminal phase; therefore, providing palliative care should be a priority. Moreover, Picard proposed a solution to easily resolve all the problems. Paramedics can provide palliative care which eliminates hospital transfers and doctors or nurses can be sent to the patients home or nursing home to have more hospital beds available. Overall, a change is required in the Canadian health care system of how palliative care is provided to support many patients at home, in nursing homes or in the hospital (Picard, 208).
It is rare for Canadians to receive palliative care at home in their last year of life. Of the adults who died in 20
6-207 for Ontario and Alberta, 66% received some type of home care service in their last year of life and fewer than in 6 people (5%) received palliative home care. It would be beneficial for the patients and the health care system if palliative care could be integrated earlier. Most individuals who had palliative care in the year of 206, only received it in their last month of life. Access to palliative care in long term care homes in limited as, 24% of the residents who died in 206-207 were identified as having less than 6 months to live and of those residents, only 6% received palliative care in their last year of life. It is reported that patients who received palliative care earlier on were less likely to visit the emergency department as palliative care in long term care homes helps to prevent hospital transfers. Of the residents that received palliative care in long term care and died in 206-207, 97% of them died in their residence and 2% died in hospital. On the other hand, 77% of the residents who did not receive palliative care died in the long term care home and 8% died in hospital. Also, if patients could receive palliative care earlier on, it would decrease the amount of patients who are admitted to intensive care units for aggressive treatments. In 206-207, 25% of people who died in an acute care hospital received palliative care and 44% were initially admitted for an acute health issue, but once the problem worsened they were then designated palliative care. Majority of the time when patients received primarily palliative care in the hospital, it was unplanned or the patient was admitted through the emergency department. Following this, patients had to wait about 9 days to be discharged to a more appropriate setting for palliative care. Overall, palliative care is a current issue in Canada in terms of access and appropriate setting (CIHI, 208).