Hospice Palliative Care Ontario (HPCO) is an organization whose members provide end-of-life palliative care to terminal patients in the province of Ontario, Canada. It is the result of an April 2011 merger of the Hospice Association of Ontario (HOA) and the Ontario Palliative Care Association (OPCA). [1] It is one of twelve primary care practitioner units participating in the development of advance care planning in Canada led by the Canadian Hospice Palliative Care Association and partly funded by the Canadian Institutes of Health Research. [2]
By the 1980s, Ontario lagged other provinces with respect to the development of palliative care. [3] It was a foundational decade for palliative care in the province, by the end of which two separate palliative care organizations were operational. [4] The Hospice Association of Ontario was more focussed on residential hospice organizations, whereas the scope of operations of the Ontario Palliative Care Association was more broadly represented by organizations tending to dying patients in hospital and other settings. [4]
Hospice Association of Ontario was founded in 1989 with eight members; as of April, 2005, it had over 150 member hospice facilities. It was primarily based on volunteer efforts. In 2000, hospice agencies in more than 400 communities throughout Ontario organized over 12,000 volunteers under the auspice of HAO, most through private funding. [5]
By 2004, Cancer Care Ontario "identified palliative care as a priority area". [6] In 2005 the Government of Ontario announced an "end-of-life care strategy" to be implemented by the Ministry of Health and Long-Term Care to improve the availability of home-based and community palliative care services. [6] The three-year project invested Can$ 115.5 million to establish a hospice palliative care network in each of the 14 Local Health Integration Networks throughout the province, increase home care nursing and support services, and to expand residential hospices and their volunteer networks. [6]
In 2008, the Hospice Association of Ontario membership grew significantly, partly a result of the end-of-life care strategy and increased community acceptance of palliative care. [7]
The members of the organization operate hospice services that "relieve suffering and improve the quality of living and dying". [8]
In 2009, the two organizations established the Quality Hospice Palliative Care Coalition with Cancer Care Ontario, Hospice Palliative Care Networks, and the Ontario College of Family Physicians. [7] It is a provincial consortium whose goal is to advance and integrate palliative care throughout the province. [7]
The End-of-Life Information Service is a telephone service which offers information about hospice palliative care services and resources, including:
It is funded by the Government of Ontario Ministry of Health and Long-Term Care.
An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. In the U.S. it has a legal status in itself, whereas in some countries it is legally persuasive without being a legal document.
Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
Marie Curie is a registered charitable organisation in the United Kingdom which provides care and support to people living with a terminal illness and those close to them, and campaigns for better support for dying people. It was established in 1948, the same year as the National Health Service (NHS).
Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.
The Canadian Partnership Against Cancer is an independent, not-for-profit organization funded by the Canadian government to facilitate action on cancer control in Canada. The Partnership works with cancer experts, other charitable organizations, all levels of government, cancer agencies, national health organizations, cancer patients and survivors, and others to implement the Canadian Strategy for Cancer Control. The Partnership's work ranges from prevention and screening, research, supportive care, knowledge transfer, public engagement, and analysis of the cancer system. It uses a collaborative approach that is mindful of patient perspectives, and strives to be responsive to the needs of priority populations, including First Nations, Inuit and Métis peoples, rural and remote communities, and others facing barriers accessing health care in Canada.
End-of-life care refers to health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
Rainbow Hospice and Palliative Care, founded in 1981, is one of the oldest and largest non-profit hospice and palliative care providers in Illinois.
In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.
Diane E. Meier, an American geriatrician and palliative care specialist. In 1999, Dr. Meier founded the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. She continues to serve as CAPC's Director Emerita and Strategic Medical Advisor. Meier is also Vice-Chair for Public Policy, Professor of Geriatrics and Palliative Medicine and Catherine Gaisman Professor of Medical Ethics at the Icahn School of Medicine at Mount Sinai Hospital in New York City. Meier was founder and Director of the Hertzberg Palliative Care Institute at the Icahn School of Medicine in New York City from 1997 to 2011.
Pallium India is a national registered charitable trust formed in 2003 aimed at providing quality palliative care and effective pain relief for patients in India. Dr. M. R. Rajagopal is the founder and chairman of Pallium India. Pallium India works in collaboration with several national and international organisations to improve the accessibility and affordability of pain relief drugs (opioids) and other low-cost medicines, to ensure the availability of palliative care services in India and to improve the quality of palliative care services provided by the healthcare and allied health care professionals. In February 2016, Pallium India was accredited by Social Justice Department of Government of Kerala.
Carondelet Health Network is a large Catholic health care provider based in Tucson, Arizona. It has five facilities: Carondelet St. Mary's Hospital, Carondelet St. Joseph's Hospital, Carondelet Neurological Institute, Carondelet Heart & Vascular Institute, and Carondelet Holy Cross Hospital in Nogales, Arizona.
Together for Short Lives is the UK registered charity for children's palliative care. Together for Short Lives’ vision is for children and young people in the UK with life-limiting and life-threatening conditions and their families to have as fulfilling lives as possible, and the best care at the end of life.
A death midwife, or death doula, is a person who assists in the dying process, much like a midwife or doula does with the birthing process. It is often a community based role, aiming to help families cope with death through recognizing it as a natural and important part of life. The role can supplement and go beyond hospice. Practitioners perform a large variety of service, including but not limited to creating death plans, and providing spiritual, psychological, and social support before and just after death. Their role can also include more logistical activities, helping with services, planning funerals and memorial services, and guiding mourners in their rights and responsibilities.
The Worldwide Hospice Palliative Care Alliance or WHPCA is an international non-governmental organization based in the United Kingdom. In official relations with the World Health Organization (WHO), the WHPCA works in conjunction with over 200 regional institutions and national partners for the global development of palliative care and advancement of pain relief. It advocates for changes in public policy on accessibility of pain relief in end-of-life care and integration of palliative care into national health agendas. In 2014 it released the Global Atlas of Palliative Care at the End of Life in a joint publication with the WHO.
Mhoira E.H. LengFRSE MBChB MRCP(UK) FRCP(Ed and Glas) is one of the first Scottish specialists in palliative care, who has developed the palliative care services internationally, working in Eastern Europe, India and Africa and advises international institutions and agencies on palliative care in the developing world. In 2021, Leng was admitted as one of the new female Fellows of the Royal Society of Edinburgh.
Naheed Dosani is a palliative care physician based in Ontario, Canada, who founded and leads the Palliative Education and Care for the Homeless (PEACH) program. For his efforts in providing mobile healthcare to individuals with vulnerable housing or are homeless, Dosani has received a Meritorious Service Cross from the Governor General of Canada (2017), and a Canadian Medical Association Award for Young Leaders (2020).