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Palliative Care

The in-patient Palliative Care Unit provides expert end-of-life care to people experiencing life-threatening illness, within an environment that promotes clinical excellence, education, and research.  Our Palliative Care Program focuses on patient and family-driven decision-making to maintain comfort, quality of life, spirituality, autonomy, and dignity of each dying person while supporting families through this difficult period and in bereavement.

Palliative care services are directed to patients and their families/circle of supporters and respects that everyone approaches death from their own unique perspective based upon their individual values, spiritual beliefs, cultural roots, family dynamics and life experiences. Palliative care is active care which focuses on maintaining the quality of life, comfort, autonomy and dignity of each patient through the prevention, assessment and management of potentially distressing symptoms.

Palliative care can be provided in all phases of illness, from early in the course of illness to bereavement. It is recommended that patients begin receiving palliative care support as early as possible, even at the time of diagnosis.

Care We Provide

  • Provides relief from pain and other distressing symptoms;
  • Affirms life and regards dying as a normal process;
  • Intends neither to hasten nor postpone death;
  • Integrates the psychological and spiritual aspects of patient care;
  • Offers a support system to help patients live as actively as possible until death;
  • Offers a support system to help the family cope during the patient’s illness and in their own bereavement;
  • Uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated;
  • Will enhance quality of life, and may also positively influence the course of illness;

The focus of care may change with the addition or continuation of some treatments and may mean stopping other forms of treatment.
At HHS we have a number of palliative care resources to support our patients, families, staff and physicians with.

Program Criteria

Our Patients Must Meet All Six Criteria:

  1. Require the expertise of an on-site, palliative care interprofessional team to manage symptoms and distress:
    • Require a treatment regime to address pain and symptom management
    • May be experiencing complexities associated with their end-stage disease including delirium, aggression, agitation, etc.
    • Require involvement of a palliative trained physician 1 to 2 times per week / daily skilled nursing interventions / active interprofessional goals involving some other professionals, such as: SW / OT / PT / Chaplain / Pharmacy / Dietitian / SLP / Therapeutic Recreation, etc.
    • Significantly decreased functional abilities (Palliative Performance Scale (PPS) score of 50% or less)
  2. Are in the final stages of a life threatening illness (e.g.- metastatic cancer, end-stage cardiac or lung diseases, end-stage neurological disorders, end-stage organ failure, end-stage HIV/AIDS, etc.) –
  3. Have goals of care promoting a comfort approach rather than aggressive treatment (a completed POST / Advanced Directives is encouraged)
  4. Have a life expectancy ranging from several hours up to several months duration
  5. Have care needs that cannot be met at home or in another setting with the available resources (cannot be eligible or referred to LTC)
  6. Are aged 18 years or older

Goals of Care

Our patients may have any of the following goals of care:

  • To receive comprehensive assessment and ongoing management of distressing symptoms: pain, nausea/vomiting, shortness of breath, restlessness, confusion, etc.
  • To receive short-term intervention to bring symptoms under control and allow discharge home.
  • To receive 24 hour supportive care during the actively dying phase of illness.
  • To receive temporary placement to provide caregiver relief/respite.

Our patients may have very complex care needs, such as:

  • Various modalities for pain management (including – epidurals & PCA Pain Pumps)
  • Management of IV therapy (peripheral & central lines)
  • Hypodermoclysis
  • TPN
  • High flow oxygen therapy + BIPAP & CPAP
  • On-site blood transfusions
  • Management of complex skin wounds
  • Ongoing management of chest tubes
  • Specialized ostomy care (including – pigtail catheters & nephrostomy tubes, etc.)
  • Specific complimentary therapies for pain management (TENS, etc.)
  • Determination of specialized therapeutic mattresses, seating & support surfaces
  • On-site bloodwork, X-rays & EKGs
  • Our patients may be receiving Shared Care, coordinated by us, such as:
  • Day visits for Palliative radiation therapy and/or chemotherapy at the Juravinski Cancer Centre
  • Follow-up visits with their specialist physician

Eligibility & Referrals

Any individual in a patient’s care, who has obtained appropriate patient / substitute decision maker consent, may make a referral:

  • Family Physician
  • Specialist Physician
  • CCAC Case Manager or community based health care professionals
  • Health care professionals from Hospital or Long Term Care
  • Family member or friend
  • Self-referral

Urgent admissions from home to the St. Peter’s Palliative Care Program can usually be arranged within 48 hours following a referral.