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BC invests millions in hospices, creates action plan for end-of-life care

B.C.'s minister of health today committed millions of dollars to four hospices in the Lower Mainland, and announced an action plan for the future of end-of-life care in the province.

"[When someone is dying] it can be a time where there is grief and sorrow, but it can also be a time of joy and celebration of that person's life, so I think for me, the important thing about the announcements we're making is it's not about dying, it's about living," said Health Minister Margaret MacDiarmid today at a press conference inside the Vancouver Hospice Society hospice home in Shaughnessy, a new hospice that will now open its beds to patients due to the funding boost.

The action plan, which so far has no committed funding, outlines goals for the province to help improve the quality of life of individuals with life-limiting illnesses. It addresses the fact that people prefer to die at home or close to home in comfort rather than in the clinical setting of a hospital. However, while in-home care is often desired, it is not always feasible.

"You get to the point where you don't have the ability to care for someone; you run out of things you can do as a layperson at home," said Vancouver Hospice Society board member Stephen Roberts, who cared for his mother in-home when she had pancreatic cancer.

Services that could be built on or expanded identified in the action plan include telehealth (which uses videoconferencing and phone technology to monitor a patient's condition at home) to manage care at a distance, providing information for health care providers and families on the palliative care approach, and training tools and education for providers.

"There already is excellent care in this area; it's having it be accessible for people where they are in the province. I believe there are some areas in the province where it's not as accessible as we would like," said MacDiarmid.

Telehealth provides outreach for people in more isolated communities who aren't near a hospice facility and don't want to die in a hospital. MacDiarmid said that telehealth has already made a huge difference in that regard.

John Kerr, who took care of his wife, Dale, at the end of her life in their home in remote Tatlayoko Lake, B.C., is an advocate for health care in rural communities.

"I'm a big fan of telehealth kind of things; I'm a big technology guy, but at the same time I find it hard to replace face-to-face stuff," Kerr said in response to the announcement today.

"I think that everybody, in an attempt to save money, is jumping on telemedicine. Somehow or another, you're going to deal with people, particularly grief issues. I don't know how you're going to do that in a 'telehealth' kind of way," he said.

The government also said it would create a provincial centre for excellence for end-of-life care. Overseen by the Fraser Health Authority, it has a $2-million funding commitment. The centre is intended to help streamline policy, practically apply research and educate about best practices throughout B.C.

The Vancouver Hospice Society hospice home, which got a funding boost today, provides services like bereavement counselling, home visitation to people with care aids, and relief from care for the day or afternoon at the hospice.

"[The] cost of a hospice is about half the cost of acute care, so this is a really quality and cost effective alternative to acute care," said Carolyn Tayler, director of End of Life Care Fraser Health.

The hospice was lacking an operational budget and some equipment, such as lifts for patients with little mobility. It had already raised 77 per cent of its budget, and with the government's investment of $950,000 it will be able to hire the necessary staff and open its beds by late summer.

"We couldn't hire a nurse without knowing how we're going to pay them," said Roberts.

The hospice has six beds available and patients will be placed there according to registration in the BC Palliative Care Benefits program and doctor referrals.

As part of today's announcement, Marion Hospice in Vancouver will receive $2 million, Peace Arch Hospice in White Rock will receive $3 million and Canuck Place Children's Hospice will receive $2 million.

The investments were possible because of leftover money in the $16-billion health care budget at the end of the fiscal year.

"When you think about it, you could never manage down to the penny when it's $16 billion. There always has to be a little bit of money that's not actually spent in the case of a major emergency like SARS or something, because the ministry cannot go into deficit," said MacDiarmid.

More Ministry of Health funding announcements will be made in coming weeks, she said.

Carly Rhianna Smith is completing a practicum at The Tyee.

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