Palliative care research given fresh boost

Despite the vast knowledge already gathered surrounding palliative care, gaining even greater insight is never a bad thing and is the premise behind a new research hub at Hamilton’s McMaster University to advance education and service delivery.

“The research allows us to get even smarter and better informed on what the best ways are to continue to build capacity among health care professionals and within our communities to provide palliative care,” said Jeffrey Moat, chief executive officer of Pallium Canada, which is partnering with McMaster in establishing the hub which was announced last month.

Pallium Canada is a national organization focused on building professional and community capacity to improve quality of and access to palliative care as an integral part of the health system. The research hub is named after Dr. Joshua Shadd, who was working with Pallium “to really foster these opportunities to advance research, specifically on palliative care education and service delivery,” said Moat. Shadd was director of the Division of Palliative Care at McMaster and an assistant professor in the Department of Family Medicine who died suddenly in December 2018.

With the passing in Canada of so-called Medical Assistance in Dying (MAiD) legislation in 2016, end-of-life care has been brought to the forefront in Canada. Palliative care has been an option for many years, and was a key part of the Canadian bishops’ platform in fighting against MAiD, but has only recently been gaining more attention, particularly with Canada’s aging demographics.

“It’s everybody’s business,” said Moat.

The research shows the benefits of palliative care at the end of life, but data shows little is being done to make it available despite all the lip service being paid to expand its access. Studies suggest that up to 89 per cent of Canadians who die might have benefitted from palliative care, yet only 15 per cent are actually receiving it. 

Most of these people, instead of palliative care, are being referred to “overburdened specialist care teams and that’s unsustainable,” said Moat. But people want to receive home treatment and avoid hospitals if they can, research shows.

In the last year alone Health Canada has tabled its framework on palliative care and developed its action plan, and in 2018 the Canadian Institute for Health Information released its Access to Palliative Care report. 

“The information is out there, but what are we doing with it?” asks Moat. “The time for action definitely is now. We have the information, we know what needs to be the focus. We have the framework, we have an action plan.”

The idea behind this research hub is to “bridge the gap in equipping health care professionals with knowledge and skills in palliative care,” he said. The reality is it won’t take a whole lot more training.

“We can make more with the resources we already have in place,” said Moat. “That’s just good common sense as far as we’re concerned.”

The initial research will focus on educational curriculum design, including research on evaluating what design best supports inter-professional learning, from doctors and nurses through PSWs (personal support workers) and pharmacists, even clergy, and evaluating Pallium’s LEAP (Learning Essential Approaches to Palliative Care) courses. 

It will also look at the availability and impact of palliative care services across Canada and take leadership for the Canadian Palliative Care Atlas project which looks at the status of palliative care and its needs in every region across country.