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End-of-life care (palliative care)

When chronic illnesses such as heart failure or those caused by valve disorders progress to a point when medical or surgical treatments won’t work anymore, palliative care, also known as end-of-life care, may be an option you and your family wish to investigate. Palliative care is a system of support services, which may involve healthcare professionals, home-care services and bereavement counsellors, depending on your needs.

What is palliative/end-of-life care?
What are the benefits of palliative/end-of-life care?
How do you know it’s time to seek palliative/end-of-life care?
Who provides palliative/end-of-life care?
Where can you access palliative/end-of-life care?
What financial assistance is available?
What are the legal and ethical issues? How can advance directives help?

What is palliative/end-of-life care?

Palliative or end-of-life care aims at improving the quality of life of those who are terminally ill. It focuses on: 

  • Relieving pain and symptoms. Medications and complementary therapies, such as massage therapy, acupuncture and physiotherapy can be used to treat symptoms, such as pain, fatigue and shortness of breath. 
  • Managing disability. Many patients can experience progressive disability and will depend more and more on others to take care of them. Home support services can provide meal preparation, cleaning service and transportation. You may also receive assistive devices that can help you to be as independent as possible. 
  • Psychological, social and spiritual issues. Depression and anxiety are common in patients with life-threatening chronic illnesses. Social support, spiritual and clinical counselling are important coping resources. Bereavement support can help families work through their grief.
  • Caregiver support. Instruction on how to care for a person or what to expect at end-of-life are types of caregiver support that can be helpful to your family. 

What are the benefits of palliative/end-of-life care?

End-of-life care specialists can help you and your family understand all types of palliative care services including your treatment options, ethical, legal and financial issues. It’s wise to make these important decisions when you can. You should also talk to your family about your wishes so they know how to make major decisions for you when you cannot. This can also relieve the burden on your loved ones during times of stress.

How do you know it’s time to seek palliative/end-of-life care?

End-of-life care can be a sensitive topic for some patients, families and doctors to discuss. They may have fears or misconceptions. Or they don’t know when it’s the right time to ask for it. Here are some signs that you may want to consider palliative care: 

  • Your doctor said you have a life-threatening or life-limiting illness.
  • You visit hospitals repeatedly.
  • You are unable to take care of yourself, or you depend more and more on others.
  • You want to get involved in your end-of-life care needs.

Who provides palliative/end-of-life care?

End-of-life care planning starts with you and your family. Nurses, doctors, end-of-life care specialists, social workers, nutritionists, physiotherapists, family members and volunteers can all be part of an interdisciplinary team. 

Where can you access palliative/end-of-life care?

Palliative care can be provided at home, in hospitals, hospices or long-term care facilities. Speak to your doctor about end-of-life care.

What financial assistance is available?

It is important for you and your family to find out what government assistance, employer benefits or personal financial sources, such as private health insurance, life insurance or reverse mortgage options you can use to cover your end-of-life care. Visit Health Canada and Public Health Agency of Canada to learn more about federal and provincial assistance. Find out what patient benefits and caregiver and survivor benefits you can get from Canadian Virtual Hospice.

What are the legal and ethical issues? How can advance directives help?

Making end-of-life decisions can involve conflicts that can come from varying personal or family values, cultural differences or inconsistent medical opinion. Advance directives can help resolve some of these issues.  You can make a living will to cover what treatments you want to receive or not receive. You can sign a Do-Not-Resuscitate (DNR) order to choose not to receive cardiopulmonary resuscitation (CPR). You may also name a healthcare proxy to make decisions for you. This is called Durable Power of Attorney for Health Care. When you have an advance directive, you can share it with your family and doctors. Learn more about advance directives from Canadian Virtual Hospice.

Resources

If you want to get more information about end-of-life care, talk to your healthcare providers. You can also visit the Public Health Agency of Canada and Health Canada. The Canadian Hospice Palliative Care Association has a directory of end-of-life care services across the country and a caregiver resource list. The Canadian Virtual Hospice has an Ask an Expert Service and a discussion forum where you can talk to end-of-life specialists and people interested in palliative care.

The PREPARE website helps you make medical decisions that reflect your values and effectively communicate your wishes with others. TheConversationProject.org has a starter kit to help you and your family to talk about your wishes for end-of-life.

Read our brochure Recovery road: An information guide for heart patients and their families to learn more about how to optimize your heart health, preparing for an emergency and much more.

Last modified: February 2013 
Last reviewed: August 2011