Palliative care, often referred to as end-of-life care, is a holistic approach designed to significantly improve the quality of living and dying for individuals and their families facing life-threatening illnesses. The Wrha Palliative Care Program excels in providing this compassionate care within the Winnipeg Regional Health Authority, focusing on alleviating suffering and delivering essential physical, psychological, social, spiritual, and practical support.
This comprehensive care model is suitable for anyone, regardless of age, facing a life-limiting illness, irrespective of their diagnosis or prognosis. The WRHA palliative care program can be integrated alongside disease-modifying treatments to enhance overall well-being, or it can become the primary focus of care when curative treatments are no longer the goal.
Accessing Palliative Care through the WRHA Palliative Care Program
Palliative and end-of-life care are integral components of a complete healthcare journey. The WRHA palliative care program ensures that these services are accessible across various settings within Winnipeg and Manitoba. Whether you are at home, in a hospital palliative care unit, a hospice, a personal care home (PCH), or another healthcare facility, the program aims to reach you.
A key strength of the WRHA palliative care program is its 24/7 availability for individuals registered within the WRHA region. Beyond direct patient care, the program also extends its expertise through consultative services, supporting both patients and healthcare professionals throughout Manitoba. For direct palliative care within the community, home care services are available through regional health authorities. To learn more about accessing these services, contacting the palliative care program in your regional health authority is the recommended first step.
Hospice and Palliative Care Beds within the WRHA
Hospice facilities, such as Grace Hospice and Jocelyn House in Winnipeg, offer specialized end-of-life care in a comfortable and supportive environment. These facilities are ideally suited for individuals whose symptoms are well-managed and who do not require the intensive treatments provided in acute care hospitals. Hospice care is often considered when a patient’s prognosis is estimated to be within one to three months, and when home care is not feasible or preferred.
Within the Winnipeg Regional Health Authority (WRHA), access to hospice beds at Grace Hospice (www.gracehospital.ca/hospice/) and Jocelyn House (www.jocelynhouse.ca/) is coordinated through the WRHA Palliative Care Program. You can reach the program directly at (204) 478-6372 for more information and to discuss access.
For individuals requiring more complex medical care at the end of life, palliative care beds are available within acute care settings. In the WRHA region, Riverview Health Centre and St. Boniface General Hospital provide these specialized palliative care beds. Similar to hospice beds, access to palliative care beds in these facilities is also managed by the WRHA Palliative Care Program, ensuring seamless and appropriate placement based on individual needs. Contacting the program at (204) 478-6372 will provide guidance on accessing these resources.
Managing Medication Costs with the Palliative Care Drug Access Program (PCDAP)
The financial burden of medications can be a significant concern, especially during palliative care. The Palliative Care Drug Access Program (PCDAP) in Manitoba addresses this by providing deductible-free drug coverage for individuals who choose to spend their final days at home. Recognizing that Manitoba Health already covers drug costs for those in hospitals or personal care homes, the PCDAP extends this crucial financial support to those receiving palliative care in their own residences.
Administered by Manitoba Health, the PCDAP covers all eligible medications prescribed by an authorized healthcare provider. Enrolled individuals can fill their prescriptions at any pharmacy without incurring out-of-pocket expenses for covered medications. This program ensures that financial constraints do not hinder access to necessary medications during palliative care at home.
Eligibility for the Palliative Care Drug Access Program
Eligibility for the Palliative Care Drug Access Program is open to Manitoba residents who hold a valid Manitoba Health registration number. The application process begins when a healthcare provider, deemed eligible, makes a palliative diagnosis. An application form must be completed and signed by both the patient (or their guardian) and the healthcare provider. The healthcare provider then submits the completed form to the palliative care coordinator within the local regional health authority. If the patient meets the eligibility criteria, the application is forwarded to Manitoba Health for registration.
Eligible healthcare providers can obtain application forms from the palliative care coordinator within their regional health authority. Patients or guardians will receive notification of their acceptance into the program either from their healthcare provider or the palliative care coordinator. For comprehensive details about the program, please visit the official Manitoba Health website: www.gov.mb.ca/health/pcdap/.
Advanced Care Planning: Expressing Your Wishes
Advanced care planning (ACP) is a vital process that encourages individuals to reflect on their values, beliefs, and preferences for future healthcare. It often involves thoughtful conversations with family and friends to communicate these wishes, ensuring they are aware of your healthcare and personal care preferences should you become unable to speak for yourself. ACP can also include documenting your wishes and discussing them with healthcare, financial, or legal professionals.
The National Advance Care Planning Task Group’s Speak Up Campaign website (www.advancecareplanning.ca/) offers valuable resources and information to guide you through the ACP process. Furthermore, the Winnipeg Regional Health Authority has developed specific tools and resources to assist with all aspects of advanced care planning, available on their website: www.wrha.mb.ca/acp/. Utilizing these resources can empower you to proactively shape your future care decisions.
Health Care Directives: Formalizing Your Healthcare Wishes
A health care directive, also known as a living will, is a crucial legal document that stems from advanced care planning. As a Manitoban, you have the autonomy to accept or refuse medical treatment at any point in time. The Health Care Directives Act provides the framework for you to formally express your wishes regarding the extent and type of healthcare treatment you desire should you lose the capacity to communicate these decisions personally. It also empowers you to appoint a proxy decision-maker, granting them the authority to make medical decisions on your behalf if you become unable to do so. Comprehensive information about health care directives, including sample forms, can be found at: www.gov.mb.ca/health/livingwill.html.
Mental Health and Spiritual Care: Holistic Support During Illness
Serious illness triggers a complex journey involving medical evaluations, treatments, and potential physical and emotional challenges. Each stage of a significant illness can have profound psychological effects. Active treatments may bring about distressing side effects, often with uncertain outcomes. Throughout this period, declining physical abilities, shifts in family and social roles, increasing reliance on the healthcare system, and the awareness of mortality all contribute to psychological stress.
However, research indicates that individuals who adopt proactive coping mechanisms, such as seeking social support, engaging in constructive problem-solving, and finding positive meaning amidst adversity, tend to adapt more effectively. Experiencing anxiety, sadness, grief, and anticipating loss are normal responses to a serious illness. For some, these emotions can become overwhelming, evolving into conditions such as depression or anxiety disorders. It’s estimated that approximately 25% of individuals with advanced cancer may experience depression or anxiety. Recognizing and addressing these mental health challenges is crucial as they can significantly impact symptom management and the overall end-of-life experience.
Support and assistance are readily available for both patients and their loved ones. The following resources provide starting points and contact information for various services and supports:
Additional Resources for Palliative and End-of-Life Care
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Canadian Virtual Hospice (www.virtualhospice.ca): A comprehensive online resource covering all facets of end-of-life care, including a dedicated section on emotional health and access to professional mental health support.
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Family Caregiving for People at the End of Life (www.chpca.ca): A valuable resource for caregivers navigating the stresses of supporting a loved one through end-of-life care.
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Mental Health Resource Guide for Winnipeg (mbwpg.cmha.ca/resources/mental-health-resource-guide-for-winnipeg/): An online guide offering self-assessment tools for depression and anxiety, and a comprehensive directory of mental health support and treatment options in Winnipeg, including crisis services and family support groups. It also includes the province-wide bereavement support line.
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Palliative Manitoba (palliativemanitoba.ca/): A key resource for individuals, families, and caregivers, offering programs, services, education, and information related to palliative care in Manitoba.
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The Canadian Mental Health Association (cmha.ca): This website provides information and resources on stress and mental health challenges, encompassing both general information and specific resources related to grief and bereavement.
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The Canadian Association of Psychology (www.cpa.ca/docs/File/Publications/FactSheets/PsychologyWorksFactSheet_EndOfLife.pdf): An online fact sheet offering insights into psychological distress and coping strategies for advanced illnesses and end-of-life, along with information on psychological treatment and support.
Financial Assistance Programs from the Government of Canada
The Government of Canada provides several financial programs to support Canadians caring for critically ill family members or those needing assistance after the death of a loved one. For detailed information and application packages, please contact a Service Canada Centre or explore the following links: www.canada.ca/en/employment-social-development/corporate/portfolio/service-canada.html.
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Federal Benefits for Parents of Critically Ill Children: Supports eligible parents who must take time away from work to care for a critically ill or injured child. Learn more at: www.canada.ca/en/services/benefits/ei/caregiving.html.
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EI Compassionate Care Benefits: Provides Employment Insurance (EI) benefits to individuals who need to temporarily leave work to care for or support a family member who is gravely ill with a significant risk of death. More information is available at: www.canada.ca/en/services/benefits/ei/caregiving.html.
Service Canada Centre: Support After Death
- Federal Benefits following a death: The Government of Canada website offers resources to assist you when someone passes away. Access information here: https://www.canada.ca/en/employment-social-development/services/benefits/family/death.html.
Further Information on Palliative and End-of-Life Care
- Government of Canada Site: For additional resources and options regarding palliative and end-of-life care, visit the Government of Canada’s dedicated page: https://www.canada.ca/en/health-canada/topics/end-life-care.html.
