Integrating a palliative approach into the management of chronic, life-threatening diseases: Who, How and When?
Palliative care has a great deal to offer individuals and families faced with chronic, life-threatening illnesses. Medical advances means that many people will live many years with these illnesses; however, most will eventually die of these diseases and should have the right and support to make informed decisions about their care at the end-of-life. rather than dimming people’s hope, frankdiscussions about the prognosis and trajectory of these illnesses can help people enhance theirquality of both living and dying with these diseases.
Over the past 15 years, canada has made progress in providing high quality palliative care —particularly in the last months of life — to more of its citizens, but palliative care is still not a mainstream service available to all. The current model of leaving responsibility for palliative carewith primary care providers is highly flawed. Instead, canada must develop a national policy —similar to other countries, such as Norway, that have used this approach to improve palliative care — explore different models to make the palliative approach to care available to more people earlier in the course of a life-limiting illness as well as in the last days andweeks of life. Whether this is done through specialized palliative care teams or through a shared-care model and more consistent education of practitioners responsible for managing chronic diseases should be the focus of research and evaluation.