NEWS
Jack Lawson, CMAJ
February 20, 2014
Canada is facing a severe crisis surrounding end-of-life care due to the stigma surrounding it and funding concerns, Dr. Louis Hugo Francescutti, president of the Canadian Medical Association told the Economic Club of Canada in Ottawa, Ontario on February 19.
The end of life is difficult to face at the best of times, but Canadians need to open a "dialogue about death," said Francescutti. This is particularly important in light of the upcoming vote on Quebec's Bill 52: An Act respecting end-of-life care. With terms like palliative care, physician-assisted suicide and advanced care directives coming into play there's plenty of room for confusion.
"We all need to be comfortable talking about the latter days of life because we're all going to get there," said Francescutti.
Palliative care "puts quality into the end of a life,"for both patients and families, said Francescutti. Unfortunately, palliative care is currently only available to 15%–30% of Canadians. Yet, the Canadian Hospice Palliative Care Association reports that 73% of people who will die this year could benefit from an improved quality of life before death.
"We need to develop palliative-care centers so that people are comfortable talking about [it], so that they're comfortable developing these end-of-life plans," said Francescutti. "Then, more importantly, we need to give them access to these things. Ideally in a home environment."
To help deal with the stigma and lack of understanding surrounding the lexicon of end-of-life care, the CMA will host five town-hall style meetings across the country. New organizations such as the Canadian Society of Palliative Care Physicians, which was formally recognized in November 2013, are attempting to tackle the same issues.
The crisis around end-of-life care also has financial aspects. In 2008, there were an estimated 1.7 million unnecessary hospital bed days in Canada, a problem that could be partially countered by investing in long-term care facilities, according to Francescutti. If there is a simultaneous investment in programs to help seniors live at home the system could save $1.4 billion to $2 billion a year.
Currently, 14% of Canadians are over 65. By 2021, that figure will climb to 19% and by 2036, it will hit 25%. Although a difficult topic, Canada's ageing population, and their impact on the health care system, is something which needs to be dealt with, says Francescutti.
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