Issues facing British Columbians
The population of British Columbia is experiencing an important demographic shift; by 2036, one-quarter of the province’s residents will be aged 65 and over. Research indicates that older adults want to age and experience end-of-life at home and in their communities. However, the province’s healthcare and social systems are not currently equipped to adequately provide the necessary practical and psychosocial supports for ensuring that individuals living with serious illnesses can age and die in the place of their choosing.
Individuals Facing Serious Illness of End-of-life and Hospice Care in BC
- End-of-life experiences for individuals living with serious illnesses and their caregivers can be physically and emotionally painful, and often involve many difficult personal decisions about autonomy, care planning, and death. Addressing the psychosocial and practical dimensions of living with a serious illness, frailty, and/or grief is a central component to enhancing wellbeing and quality of life for individuals and their caregivers.
- The psychosocial needs of individuals living with serious illnesses and their caregivers can include supports for spiritual wellbeing, coping mechanisms, isolation and loneliness, grief, cultural sensitivities, and other emotional needs. Their practical needs may include housework, physical care, system navigation, informational needs, equipment retrieval and setup, financial and legal support, and respite care.
- Hospice Palliative Care (HPC) provides comfort and support to individuals, their families, and loved ones during a serious illness, in the last stages of life, or while coping with grief and loss. HPC services aim to help these individuals have the best quality of life possible by taking a person-centered approach to meeting their psychosocial and practical needs.
- There are currently over 70 community-based, not-for-profit hospice organizations across British Columbia. According to a 2019 survey conducted by the British Columbia Centre for Palliative Care, these hospices support over 10,000 individuals monthly as well as over 300 hospice beds across various care settings and facilities in the province.
- Hospice services encompass diverse psychosocial dimensions such as palliative support, vigil support, spiritual support, complementary therapies, assistance with activities of daily living, symptom management, day programming, grief support, caregiver support, and respite programming. The majority of hospices also deliver a variety of education sessions focused on enhancing the general public’s self-care skills and supporting their engagement with advance care planning.
The Path forward for Hospice Care in BC
To achieve a future where hospice organizations are meaningful and recognized partners in the provision of accessible, adaptable, accountable, and sustainable HPC that improves the quality of living and dying for all individuals with serious illnesses across BC, health care professionals have written a report: Hospice Care in British Columbia: The Path Forward. This first-of-its-kind report was developed consultation with stakeholders and hospice care experts including 71 hospice societies and 38 key stakeholders.
A key recommendation of the report is the development of the Hospice Care Alliance British Columbia (HCABC). HCABC’s role will be to empower hospice organizations to assume a more integral role in addressing the increasing demand for person-centered HPC and lead the implementation of the 10-step path forward integral to the report. These steps include:
- Design a strong, integrated structure for the Alliance over the next few years.
- Secure reliable funding for hospice organizations.
- Advocate for a provincial policy and strategy for hospice palliative care in BC.
- Establish a common definition of hospice palliative care in BC.
- Establish standards and an accreditation program for hospice palliative care to ensure quality and consistency in hospice services across the province.
- Raise public awareness of the importance of person-centered care and advance care planning education provided by hospice organizations in BC.
- Establish core competencies and a provincial education program for hospice staff and volunteers.
- Develop an effective volunteer engagement strategy.
- Leverage technology to facilitate networking, training, and knowledge exchange.
- Explore and facilitate opportunities for meaningful partnerships between hospice organizations with underserved communities in the province.