Yesterday afternoon, the House of Commons almost unanimously voted in favor of Motion M-456, recognizing that there is a need for national strategies, frameworks and blueprints in hospice palliative and end-of-life care. The motion also recognizes the need to support caregivers, improve the consistency of home care, and encourage Canadians to plan for end of life by starting conversations about advance care planning.
“We are thrilled that all parties supported and voted in favor of this urgent issue,” stated Sharon Baxter, Executive Director, Canadian Hospice Palliative Care Association. “Our population is aging, and this motion shows us that all parties realize that we immediately need national, provincial, territorial and community action to ensure that all Canadians plan for and receive high quality end-of-life care in the setting of their choice.”
Currently, only 16-30% of Canadians have access to high quality hospice palliative and end-of-life care.[i] The majority of Canadians receive their end of life care though primary care and we can do much better to bring the palliative approach to community settings. Furthermore, a recent Harris Decima survey found that the majority of Canadians (73%) feel that the provincial governments place too little priority on this end-of-life care, including over one-third (35%) who feel that it is far too little.[ii] The study also found that support for hospice palliative care amongst Canadians is almost unanimous, with the vast majority of Canadians (96%) being supportive, including 66% who are very supportive.[iii]
“This motion shows us that we are ready to discuss end-of-life care at the national level, and that it’s also time to get Canadians to discuss their wishes in advance of becoming gravely ill,” added Louise Hanvey, Director, Advance Care Planning in Canada, “it’s time for a national campaign where we encourage people to speak up and start the conversation about end-of-life care.”
Although the majority of Canadians indicate that the advance care planning process should begin when a person is healthy, only 13% have an advance care plan prepared.[iv] Advance care planning is a process of reflection and communication, a time to reflect on values and wishes, and to let others know future health and personal care wishes in the event that you become incapable of consenting to or refusing treatment. It also involves naming a Substitute Decision Maker – someone who will speak for you if you cannot speak for yourself.
The full motion reads as follows: That, in the opinion of the House, the government should establish a Pan-Canadian Palliative and End-of-life Care Strategy by working with provinces and territories on a flexible, integrated model of palliative care that: (a) takes into account the geographic, regional, and cultural diversity of urban and rural Canada; (b) respects the cultural, spiritual and familial needs of Canada’s First Nation, Inuit and Métis people; and (c) has the goal of (i) ensuring all Canadians have access to high quality home-based and hospice palliative end-of-life care, (ii) providing more support for caregivers, (iii) improving the quality and consistency of home and hospice palliative end-of-life care in Canada, (iv) encouraging Canadians to discuss and plan for end-of-life care.
[i] Canadian Institute for Health Information, Health Care Use at the End of Life in Western Canada. Ottawa: CIHI.
[ii] A quantitative online research survey of 2,976 Canadian adults. Completed using Harris/Decima’s proprietary online panel so is precluded from reporting a margin of error. Data were collected between July 5 and August 7 2013. Survey data were weighted using 2011 Census to reflect general population (gender, age and region). 49
[iii] Ibid. 46
[iv] Ibid. 33, 35