No Voice for the Dying - Palliative Care Province by Province
Palliative Care Province by Province
We at Aspen Care feel there is plenty of ambiguity on Palliative Care across the country. This month, we did some research into palliative care and provincial benefits. Overall, there is a lack of a common definition of palliative care, as well as limited resources and funding, which all contribute to patients having limited access to early and integrated palliative care 1.
Palliative care, or in other words, end-of-life care ranges from province to province and territory. Each province or territory has a different framework and have different parties involved in the development, planning and delivery of palliative care. “These parties range from the funders of services by governments and foundations, and provincial, territorial or sometimes regional and local health departments.” With so many responsible parties, and individual organizations working from their own palliative care framework, there are many differences across the country on how people receive palliative care 2.
“Canadian families frequently shoulder 25% of the total cost of palliative care, due to costs associated with home based services such as nursing and personal care services.” 3. In addition, “a survey conducted in 2013 found that 75% of Canadians who had a preference, would choose to die in their home.” However, most Canadians do not end up dying at home. “In 2015, 61% of Canadians died in the hospital while only 15% died at home.” 4. Without subsidized palliative home care, dying at home is not a viable option for many. “Residential Hospice palliative care programs are still at least 50% funded by charitable donations, and families must bear part of the cost of dying at home, in long-term care – almost anywhere outside a hospital 5. Some provinces are trying to change this statistic, and are now offering some publicly funded palliative home care benefits, but Canada still falls behind other countries in terms of overall palliative care funding.
This blog post will look at palliative care in each province and territory.
British Columbia
British Columbia has a Palliative Care Strategy in place. To review B.C.’s Palliative Care framework, please visit the Government of BC Health Website.
In B.C., there is no cost for community nursing services or community rehabilitation services if you are receiving care at home. Some medications and palliative supplies and equipment are available free of charge for eligible patients through the B.C. Palliative Care Benefits Program. Palliative Care Benefits are offered to residents of any age who have reached the end-of-life stage, and would like to receive palliative care in their homes rather than in a hospital. Eligible patients receive benefits that cover approved medications, equipment, and supplies (upon referral from a local health authoritative).” 6. The maximum duration for receiving palliative home care is 12 months, with a review required at the end of each year. To register for benefits in B.C., please visit their website to register.
Alberta
Alberta has a Palliative Care Strategy in place. To review the Alberta Palliative Framework, please visit the Alberta Health Services website.
In Alberta, health-care spending has risen, and over the next four years the province plans to spend 20 million on palliative care 7. This spending includes the Palliative Coverage Program. This program provides subsidized benefits for those who are diagnosed as palliative and remain at home or in a hospice where access to publicly funded medications and ambulance services are not included. For more information on Alberta Palliative benefits and registration for benefits, visit: Alberta on Palliative Care.
Saskatchewan
Saskatchewan currently does not have a Palliative Care strategy or framework. However, they have committed to providing $16.9 million towards palliative care enhancements as part of their shared health platform. Currently, only offer Palliative Care Drug Coverage program, which covers the cost of prescription drugs for palliative patients. To apply for the program, or for more information, please visit the website.
Manitoba
In Manitoba, there is no provincial framework or strategy for palliative. Only regional health authorities provide their own respective palliative care programs. The only benefits program in Manitoba is the Palliative Care Drug Access Program (PCDAP), which provides deductible-free drug coverage for individuals who choose to remain at home for the final days of their life. For more information on the program, please visit the Manitoba Health website.
Ontario
In Ontario, there is a Palliative Care strategy and framework in place. To review this framework, please visit the framework document.
Palliative care is completely publicly funded in Ontario. This means that as long as you qualify for OHIP (Ontario Health Insurance Plan) and qualify to be admitted into a hospital, a hospice, or a long-term care home, you won't need to pay for palliative care services provided in these settings. At-home palliative care is also publicly funded by the Local Health Integration Network in Ontario if you are eligible. Click the link for more information.
Quebec
In Quebec, there is a Palliative Care strategy and framework in place. For review, please visit the Quebec Palliative Care Framework. There is limited information on palliative care benefits and programs.
New Brunswick
There is a Palliative Care Strategy and framework in place in New Brunswick, to review, please visit the New Brunswick Palliative Care Framework. There is limited information on palliative care benefits and programs.
Nova Scotia
There is a Palliative Care Strategy and framework in place in Nova Scotia, to review, please visit the Nova Scotia Palliative Care Framework.
Nova Scotia introduced the Palliative Care Drug Program to help cover the cost of drugs needed for end-of-life care at home. For more information on the program, please click the link. Palliative home care services are funded based on your income therefore you may or may not be required to pay a fee for service.
Newfoundland & Labrador
There is no current framework or strategy for Palliative Care in Newfoundland & Labrador.
Palliative care at home may be paid for by the provincial health plan as part of a home care program. Services provided in the last month of life include the cost of drugs and equipment used at home and 219 paid hours of home support services. After these hours are used up, people need to look for other ways to pay such as Community Supports Home Program, or out of pocket 8. Other services like residential hospice and day programs are not publicly funded in Newfoundland.
Prince Edward Island
There is a strategy and framework in place in Prince Edward Island: Health PEI Palliative Care Framework and Action Plan 2015–2020 . Only a portion up to the full amount could be paid for home care, palliative care, long-term care; addiction and mental health services, and drug programs. There is limited information on these benefits and programs.
Nunavut
There is currently no strategy or framework for Palliative Care in Nunavut. Nunavut does not have a hospice palliative care association at this time. The Home and Community Care (HCC) program in Nunavut provides residents with health care and support services. It is unclear if they offer palliative care services, or if they have coverage for palliative care. For more information on Nunavut’s HCC program, please click the link.
Northwest Territories
Currently, there is a strategy and a framework in place in the Northwest Territories. To review this document, please visit the Northwest Territories Framework.
Palliative care is available to all residents of the NWT, based on need and preference. Palliative care services are provided as a component of Continuing Care Services, in accordance with the NWT Continuing Care Standards (2015). Currently, services like residential hospice and day programs are not publicly funded in NWT.
Yukon
The Yukon has a palliative care strategy and framework in place, to review, please click this link. There is limited information on programs and benefits. However, there is a Palliative Resource team in the Yukon which can offer some guidance. Currently, services like residential hospice and day programs are not publicly funded in the Yukon.
As a result, many provinces still lack in palliative care funding and programs. Aspen Care’s mission is to help fill those gaps, and create as much awareness and provide information on this subject.
Links to the Provincial and Territorial Palliative Care Associations
You can also contact the national palliative care association or the palliative care association in your province or territory:
Association québécoise de soins palliatifs (in French only)