Palliative care is an approach to care that focuses on relieving suffering and improving the quality of life for people with a life-limiting illness and their families.
People with advanced kidney disease have challenges distinct from those with cancer or other chronic illnesses. They are often elderly with complex medical histories, and experience distressing symptoms including chronic pain, fatigue and stress.
To improve the quality of palliative care for people with chronic kidney disease in Ontario, we work to provide an integrated and continuous approach to care delivered earlier and across care settings.
- Established a working group with representation from multiple disciplines and specialties, and patients and families
- Developed a provincial framework and recommendations to guide the integration of palliative care into chronic kidney disease care
- Implemented person-centred decision-making across the province, and started collecting assessment data on goals of care, and treatment decision and informed consent
- Collaborated with Pallium Canada to develop and deliver Learning Essential Approaches to Palliative Care (LEAP) Renal across the province
- Identified a physician and a multidisciplinary care local champion in each of the 26 Regional Renal Programs
Person-centred decision-making takes place on a continuum. It helps keep treatment decisions in line with a patient’s wishes, values and beliefs. The continuum includes conversations about advance care planning, goals of care and healthcare consent. Having these conversations early and often helps make sure patients and their families are supported appropriately throughout their kidney care journey.
Our goal is that, by 2019, all people on dialysis in Ontario will have discussed their goals of care with their healthcare teams, and will have those goals re-assessed annually.
The successes were in the initiation of conversations up front, the plans in place and the services arranged to support Mom’s wishes.
Brian T. – His mother Doris died in 2015 at the age of 90, after choosing to withdraw from dialysis.