Dear Editor:
I read the recent article, “Stettler County advocates on behalf of local hospice” (June 28) with great interest but was also concerned by some misconceptions regarding “hospice palliative care.” I was a family physician in Rimbey for 23 years and a medical advisor on the palliative care team in Central Alberta from 2005-16. I now practice home palliative care in St. Catharines, ON.
The modern hospice/palliative care movement began in London, UK, with the opening of St. Christopher’s Hospice by Dr. Cicely Saunders in 1967. Dr. Balfour Mount, a urologist in Montreal and cancer survivor himself, was inspired by her work and went to London to learn firsthand from Dr. Saunders how she was transforming the care of the dying by giving attention to all aspects of their lives (physical, emotional, social and spiritual), improving their quality of life through impeccable symptom management and family support.
St. Christopher’s was a stand-alone hospice, but when Dr. Mount brought these ideas back to Canada in 1974, he decided to start one of the first palliative care units in his home hospital, the Royal Victoria in Montreal. Alongside the inpatient hospital unit, he developed a home visitation service, research, education and a bereavement program. He was the one that coined the phrase “palliative care” for the rest of the world, after being cautioned by his francophone colleagues that the word “hospice” had a negative connotation in the French language. With this, “palliative care” took root in Canada, but despite the name, the philosophy was identical to its “hospice” origins and remains the same today.
“Hospice palliative care” is an approach to care, not defined by a place (such as hospital or hospice) and not limited to the final weeks or months of life. It seeks to improve the quality of life for people with life-limiting illnesses – cancer, ALS, dementia, advanced heart, lung or kidney disease to name a few. This approach can be done in the home, in hospital, in long-term care (LTC), in hospice facilities, or on the streets for the homeless.
My own work now is focused on caring for people who want to die at home, and as Dr. Drummond states, this is difficult without great support from family and a team of dedicated professionals, including family doctors, home care nurses, psychosocial clinicians, and specialized palliative care teams like the one I was privileged to be a part of in Central Alberta for over a decade.
Both here, and in Alberta, teams such as ours work to provide care to people in the final stages of life (days, weeks, or many months), in their preferred care setting. I applaud the efforts to improve the care of those facing the end of life in your community, whether it be in their homes, future “hospice” beds, LTC facilities, or in hospital, but this care takes a compassionate community and a dedicated team that is integrated across all care settings.
Dr. Kim Adzich, MD, CCFP (PC)
Niagara Palliative Care Community Outreach Team
Niagara Falls, ON