Posts tagged Canada

Compassion in Canada

Sometimes when you think outside the box with the right intentions, things happen for the good. The session “Showcase Canada: Introducing Canadian Initiatives in Hospice Palliative End-of Life Care was a great overview of such a vision. The presentation was dispersed with great facts about Canadians and great pictures of many areas I want to add for my next trip.

In Canada, the current median age is 40 and the life expectancy is 81.29 years with 80% of the population living in an urban area. Health care is publically funded with very little private insurance. Did you also know that Canadians like to talk about famous Canadians such as Justin Bieber? Baby, Baby, Baby OH or is that eh?

Interestingly I took a trolley tour of Vancouver yesterday, the tour guide spoke of how he is covered by his wife’s medical plan and that if he had to buy insurance it would only cost him $110.00 per month and all things are covered including medications. He stated even surgery for any diagnosis. I have not formally checked this, but this made me wonder, how can this be possible?

I was intrigued because in many conversations in the United States we compare ourselves to this system and currently in a health care reform period. So how can you cover someone for $110 a month and they feel supported and cared for according as my trolley driver? I am open to discussion.

In 1990, the Canadian Hospice Palliative Care Association was established and in 2004 Compassionate Care Benefits were enacted, a Canadian federal program providing income for caregivers. It has limitations:

  • Limited to 6 weeks; and
  • patient should have 6 month diagnosis; but
  • the benefit can be used by multiple family members.

A Canadian national program allows a 6 week paid leave by the employer but no protection for the job, different from those who live in the United States who can apply for FMLA (Family Medical Leave Act) which is a 12 week program that does not pay for your time away from work, but does protect your job. There is also another program (at least in California) CESLA which allows for use of sick time (percentage) and not vacation time, to be away and care for family members. The CESLA program was unknown to me until I needed to care for my father last year and is not just for end of life care. It appears no matter where you live there is no perfect answer but that there are different levels of support. I think many programs are not known about until the need arises which makes our understanding and knowledge of these programs even more important to help families care for their loved ones.

I think with all the efforts put forth and as we try different options outside the box, we will someday be able to provide such support. I think this supports the palliative care programs as they try to bridge the care of patients from diagnosis to death. In the meantime, Canada has an online resource for that provides “Support and information on palliative and end-of-life care, loss and bereavement for patients, families and health care providers” at www.virtualhospice.ca. Part of the website has an “Ask the Professional” where anyone can ask a question and within 3 days receive an answer. Check it out. You can also follow their efforts on Facebook as well with the continued development Their efforts continue with the expansion of their Model to Guide Hospice Palliative Care to now include pediatrics.

Thanks to Vancouver for hosting the conference and for sharing their hard work.

Every continent except Antarctica

Julie Bruno, Director of Education, AAHPM

I had the opportunity to represent AAHPM at the 18th International Congress of Palliative Care in Montreal in early October. This was my first time at this Congress and, with the help of AAHPM member and Congress attendee, Dr. Nancy Hutton, we talked with people practicing palliative care from every continent of the world except Antarctica at the opening reception. (Thank you, Nancy!) Many stopped by to learn about AAHPM and many were interested in our educational resources: The Primer of Palliative Care, Unipac QR, the Unipac Series, the newly released recording of the AAHPM Intensive Board Review Course and the upcoming Annual Assembly in Vancouver. It was interesting as a staff member to consider how AAHPM resources may serve a more international audience. I also appreciated greeting several AAHPM members who dropped by to say hello.

I would like to thank AAHPM President Dr. Sean Morrison for spending time staffing the AAHPM booth with me. Throughout the week, we talked with attendees about Board certification and on line resources – both the AAHPM website for professionals as well as the patient family website, palliativedoctors.org . The Congress was trilingual (Spanish, French and English). If we think we struggle with a clear definition of hospice and palliative care in the US, imagine the challenges at this international conference!

Two stories from my time at the conference are staying with me… Mr. Li Ka-shing has developed National Hospice Service Program in Mainland China through the Li Ka Shing Foundation (LKSF). They have 220 field staff, 31 hospice units and have served 94,212 patients as of August 2010. They target underprivileged patients and provide free home-based care with a key focus on pain relief. The LKSF foundation has donated a total of US$ 40M, 89% spent on medications. He concludes his story by saying that they are serving 1% of the people who are dying in China. (www.hospice.com.cn) That took my breath away!

The other story came from Susan Kristiniak from Abington Memorial in Philadelphia. She shared the story of attending the 2009 AAHPM and HPNA Annual Assembly in Austin along with some of her colleagues. They were so energized by the conference that they went home and developed a four-hour nursing in-service training with a goal of reducing unrelieved pain. Using hospital data, they were able to prioritize need and started with the post-surgical unit that included 77 nurses who were mandated to attend this training. The unit showed a significant reduction in pain scores. Based on the feedback from the nurses on that unit, the training has been refined and is being rolled out on the orthopedic unit. To learn more about this project, Susan welcomes emails at skristiniak@amh.org.

The International Congress happens every other year. It is worth the experience.