Before COVID-19, palliative care was generally provided in-person within hospitals or other healthcare settings. Now, many end-of-life care that were previously mainly available in a hospital setting can be provided through a home or community-based care model. The changes to hospice and palliative care services caused by COVID-19 were unexpected and pervasive. As such, Health Canada published a report in June 2021 that highlights some of the barriers and inequities involved in home and community-based palliative care as well that includes tools and best practices that have been established to ensure patients receive high quality care in any setting.
The report is divided into eight categories. Within each category barriers, responses and tools are described. The categories are sedation, equity, space, systems, stuff, staff, separation, and communication.
Figure 1. Graphical representation of the eight categories discussed from Home and Community-Based Palliative Care: Shaping the future from lessons learned during the COVID-19 pandemic
Some of the impacts COVID-19 had on community palliative care include:
- Decreased support and resources for caregivers resulting in an increase in caregiver stress and responsibilities
- Medication, medical equipment and personal protective equipment shortages.
- Staff shortages leading to higher workloads and increased workplace stress.
- Increase in demand for grief and bereavement services.
- Amplification of pre-existing inequities within the healthcare system limiting individual’s access to appropriate services
Suggestions to improve home and community-based palliative care:
- Integration of culturally safe palliative homecare for Indigenous peoples through creation of policies and programs in partnership with Indigenous communities and clinicians
- Increase interprofessional collaboration to better utilize local services
- Increased communication between health care providers and patients to best meet patient preferences
- Supports and resources for family caregivers to allow patients to remain at home
- Improve access to palliative care training for staff
- Integration of virtual palliative care services when appropriate (i.e., virtual visits, advanced care planning, education, grief support).
This report provides over 70 tools to address the barriers to community-based palliative care during COVID-19. The tools range from compassionate workplace campaigns, mental health resources for caregivers, information about grief and bereavement supports, research articles and infographics. The authors suggestions and comprehensive toolkit included in this report are intended contribute to improving palliative care services both during and the COVID-19 pandemic through prioritizing patient care as well as caregiver and clinician well-being.
Home and Community-Based Palliative Care: Shaping the future from lessons learned during the COVID-19 pandemic. (2021). Health Canada. Retrieved from: https://www.cspcp.ca/health-canada-report-on-home-and-community-based-palliative-care-lessons-learned-during-the-covid-19-pandemic/