What is palliative care?
Hospice palliative care is aimed at relieving suffering and
improving the quality of life for persons who are living with, or
dying from, advanced illness or are bereaved.
Palliative care is a special kind of health care for individuals
and families who are living with a life-limiting illness that is
usually at an advanced stage. The goal of palliative care is to
provide comfort and dignity for the person living with the illness
as well as the best quality of life for both this person and his or
her family. A "family" is whoever the person says his or her family
is. It may include relatives, partners and friends.
An important objective of palliative care is relief of pain and
other symptoms. Palliative care meets not only physical needs, but
also psychological, social, cultural, emotional and spiritual needs
of each person and family. Palliative care may be the main focus of
care when a cure for the illness is no longer possible. Palliative
care services help people in later life who are ill to live out
their remaining time in comfort and dignity.
Palliative care services are helpful not only when a person is
approaching death but also during the earlier stages of an illness.
Palliative care may be combined with other treatments aimed at
reducing or curing the illness, such as chemotherapy. Families also
benefit from support when their loved one is dying and after his or
What is the definition of hospice palliative care?
Hospice palliative care is aimed at relief of suffering and
improving the quality of life for persons who are living with or
dying from advanced illness or are bereaved.
What is the Canadian Hospice Palliative Care Association?
The Canadian hospice Palliative Care Association (CHPCA) is a
non-profit association whose membership is comprised of individuals
and hospice/palliative care programs from all ten provinces and
three territories. Funding comes from membership fees, corporate
and individual donations, project grants and contributions from
charitable organizations and foundations. The volunteer board of
directors includes appointed representatives from each of the
eleven provincial associations and five elected members at large.
Standing committees and ad hoc committees carry out a number of
The Canadian Hospice Palliative Care Association is the national
association, which provides leadership in hospice palliative care
The CHPCA offers leadership in the pursuit of excellence in care
for persons approaching death so that the burdens of suffering,
loneliness and grief are lessened.
The CHPCA will strive to achieve its mission through:
- collaboration and representation;
- increased awareness, knowledge and skills related to hospice
palliative care of the public, health care providers and
- development of national standards of practice for hospice
palliative care in Canada;
- support of research on hospice palliative care;
- advocacy for improved hospice palliative care policy, resource
allocation and supports for caregivers.
Is there a difference between palliative care and hospice care?
In Canada, both terms are used to refer to the same thing - this
specific approach to care. However, some people use hospice care to
describe care that is offered in the community rather than in
Who benefits from palliative care?
Individuals and families living with life-limiting illnesses
benefit from palliative care. Many people who receive palliative
care have cancer. Palliative care also helps those living with
other diseases such as advanced heart, respiratory and kidney
disease, Alzheimer disease, AIDS, ALS and Multiple Sclerosis.
What is involved in palliative care?
1. Pain management - People living with
life-limiting illness may experience pain, causing concern among
families who seek to relieve it. Health care providers work with
patients and their families to find out what is causing the pain
and the best ways to relieve it. Pain may be managed with narcotics
and other drugs and by other means such as massage therapy and
2. Symptom management - Often people have to
deal with a variety of other symptoms. These can include loss of
appetite, nausea, weakness, difficulty breathing, bowel and bladder
problems and confusion. Palliative care can help relieve these
symptoms that may be very distressing.
3. Social, psychological, emotional and spiritual
support - The health of the whole person is important in
palliative care. Because of this, palliative care services provide
many different kinds of support to both the individual and
4. Caregiver support- People may be concerned
about whether they will be able to look after their ill family
member, especially when the person is being cared for at home.
Palliative care services that help the family cope include:
- advice and assistance from health care providers such as nurses
and doctors who are skilled in providing palliative care.
- instruction on how to care for the person. For example, how to
give medication, how to prevent skin problems, how to recognize
when the person is close to death and what to do at that time.
- home support services that provide assistance with household
tasks such as meal preparation, shopping and transportation.
- relief for the caregiver. Sometimes a volunteer stays with the
person so the family caregiver can go out. In other situations, the
person who is ill may go to a day program or enter a hospital or
long-term care facility for a short period of time.
What is bereavement support?
Palliative care services provide support for family members to
work through their own emotions and grief regarding the death of a
loved one. Bereavement support may begin when the grieving process
starts. This may be before the death of the family member.
Bereavement support is an important part of palliative care for
people who may have faced many losses over a short period of
Who provides palliative care?
The majority of people approaching end-of-life are cared for by
their family and friends. At certain times, they may need some
help. In these situations, palliative care is usually provided by
members of a palliative care team. When a team is involved, the
person and his or her family are encouraged to make choices about
the kind of care they want and to take an active part in planning
Who is on the team is determined by the needs of the person and
his or her family. The team often includes nurses with specialized
palliative care skills, the person's family physician; a physician
specialized in palliative care, a social worker, a spiritual
counselor and a pharmacist.
Volunteers play an important role in palliative care providing
support services such as companionship, relief for the caregiver
and transportation. When the needs of the person and family require
it, others may be added to the team, such as nutritionists,
physiotherapists, occupational therapists and home support
Where do people receive palliative care?
Palliative care is offered in a variety of places-at home, in
hospitals, in long-term care facilities, and occasionally in
hospices. Individuals and their families need to know about the
choices they have.
1. At home - Palliative care is often provided
in people's homes through home care programs. These programs offer
professional nursing care and a variety of home support services.
There may be other services available in some communities to help
people to remain at home. These include:
- volunteer services
- day programs offered for the ill family member in a variety of
places in the community
- pain and symptom management teams
- 24-hour response teams that help with urgent needs on a
Being at home may help people remain involved with their
families and live as normally as possible. Some people feel that
when they are at home they have more freedom to make choices about
their care. There may be situations where people cannot stay at
home to receive palliative care. Other options are available.
2. Hospitals - Some hospitals have special
palliative care units. Others set aside a certain number of beds in
different units of the hospital for people needing palliative care.
Hospitals may also have a palliative care team made up of health
professionals who are specialists in palliative care.
3. Long-term care facilities - Palliative care
services may also be offered in long-term care facilities such as
nursing homes. It is sometimes necessary for residents, who need
more specialized palliative care services, to enter a hospital.
Long-term care facilities are less likely than hospitals to have
specialized palliative care units.
4. Hospices - In Canada, there are only a few
residential hospices-separate buildings or apartments where
palliative care is provided in a home-like setting. Some people
move into hospices to receive palliative care on a 24-hour
Who pays for palliative care?
Palliative care is paid for in different ways across the
country. Who pays often depends on whether care is being provided
at home or in the hospital. It is important that people requiring
palliative care and their families find out as soon as possible who
pays for what and what additional financial assistance may be
Palliative care at home may be paid for by the provincial health
plan as part of a home care program. These plans do not always
include the cost of drugs and equipment used at home. Some plans
allow only a certain number of paid hours of professional and home
support services. After the hours are used up, people need to look
for other ways to pay for these services.
People may use private insurance or their own money to pay for
palliative care services at home. Some may receive assistance from
social agencies, service clubs, local cancer societies and other
Palliative care provided in a hospital is usually paid for by
provincial health plans. These plans usually cover most care
including drugs, medical supplies and equipment while the person is
in the hospital. In long-term care facilities, residents are
usually required to pay for some of their care. Costs vary among
There is usually no charge for bereavement support. It is often
provided as part of palliative care services offered in hospitals
or by non-profit or volunteer organizations in the community.
How can I find out about palliative care services available in my community?
The following resources may be helpful:
How can I make my wishes known about the care I would like to receive when I am facing a life-limiting illness?
You should talk over your wishes with your family and let them
know what you want. You can also put your wishes in writing so
that, in the event you are unable to say what you want, your family
and health care providers will know. Such documents are called
advance directives or living wills. You can seek advice within your
community about advance directives because the laws concerning them
vary from province to province.
For more information on starting the conversation about
end-of-life and for downloadable resources please visit Advance Care
How can I find out more general information about palliative care?
There are several resources available to you:
- You can call the toll free Hospice Palliative Care Information Line; (1-877-203-INFO).
- Your public library may have books and other material on palliative and hospice care.
- You can call telephone-help lines. For example, the Cancer Information Service. Call toll-free at 1-888-939-3333 or (905) 387-1153.
- The number of World Wide Web (www) sites on the Internet providing information about palliative care is steadily increasing - see our Other Linkspage.
The above information has been extracted from the CHPCA document "Palliative Care: A Fact Sheet for Seniors". This fact sheet has been produced by CHPCA for the Federal, Provincial and Territorial Ministers Responsible for Seniors. - May 1997