Bringing comfort to end-of-life-care
Healthy aging covers a wide spectrum of issues, from promoting mobility to providing support for growing old at home. It also extends to the way we support individuals to face the end of life. Just as important as helping our families, friends and neighbours age with dignity is our ability to ensure everyone can be comfortable, pain-free, and surrounded by loved ones in their final days.
Improving end-of-life care has been identified as a priority by the BC Ministry of Health, and an MSFHR-funded program is working to address this need across the province.
iPANEL (Initiative for a Palliative Approach in Nursing: Evidence and Leadership) is a multi-year research program that is creating new knowledge to help nurses integrate palliative philosophies and services into end-of-life care across all settings.
When most of us think of palliative care, we think of specialized units and hospices that treat those with terminal illnesses. While such facilities play an essential role in end-of-life care, they are not appropriate for all persons facing life-limiting chronic conditions. Many British Columbians die in other settings – such as residential care facilities, general hospital wards, and at home – without accessing palliative services.
A study by the Canadian Institute for Health Information confirms this point, noting that 70 percent of British Columbians who die are not identified as people who could benefit from services associated with palliative care.
iPANEL is working to change that by equipping nurses to offer a palliative approach in multiple care settings and at earlier stages of illness. Such an approach can provide comfort-focused care through the many transitions of chronic conditions and help to reduce suffering. Increasing the availability of palliative services can also help reduce hospitalizations and related costs by allowing individuals to receive the support they need at home or in other non-specialized settings.
Funded through MSFHR’s BC Nursing Research Initiative, iPANEL is working to gather evidence that will further advance integration of a palliative approach into the health system. Through partnerships with practicing and academic nurses across BC, the initiative has created a cycle that allows clinical practice to inform research and vice versa.
One recent study, co-led by UBC Okanagan nursing associate professor Barbara Pesut and Selkirk College nursing instructor Gail Potter, investigated how to best prepare nurses and health care assistants in rural areas to provide palliative care. The research project aimed to use research evidence to develop, offer, and evaluate a palliative educational curriculum that meets the needs of rural nurses.
Another project, led by Trinity Western University nursing professor Richard Sawatzky and UBC adjunct nursing professor Patricia Porterfield, sought to synthesize knowledge from the nursing literature about how palliative care can be integrated into practice. Their findings suggest a system with supportive management, clear communication, effective interdisciplinary team work, and appropriate clinical tools will greatly assist nurses to integrate a palliative approach into their practice.