It’s about living
QEII a national leader in the delivery of palliative care

This article was published June 15, 2018 in the QEII Times.
Author: Nicole Topple

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Dr. Drew Bethune (left), QEII surgical oncologist and medical director of the Provincial Cancer Program, and Cheryl Tschupruk (right), NSHA palliative care integration director, are working together to improve palliative care for Nova Scotians. (QEII Foundation)

Many Nova Scotians may be surprised to learn that palliative care actually has very little to do with dying.

“Ultimately, it’s about helping individuals live a better life throughout their illness — regardless of the final outcome,” says Dr. Drew Bethune, medical director of the Provincial Cancer Program and QEII surgical oncologist.

Whether it’s adjusting treatments or medications to reduce pain or providing psychological, emotional and spiritual support in tandem with clinical care, palliative care aims to improve the quality of life of patients and their families facing life-altering and life-limiting illness. According to Cheryl Tschupruk, NSHA’s palliative care integration director, excellent palliative care is an integrated and multidisciplinary approach that begins at the initial diagnosis of the illness or disease.

“It’s not a specialist team that simply comes into play during the last few months or weeks of a patient’s life to bring all of the pieces together,” says Cheryl. “The palliative approach is much bigger and involves everyone who supports patients and their families at all stages of their illness and care journey.”

This can include family physicians, oncologists, nurses, social workers, first responders, continuing care teams, psychologists and home care providers.

When introduced early, palliative care can be delivered in conjunction with life-prolonging treatments like chemotherapy and dialysis. As a patient’s condition changes or advances, their palliative care evolves — sometimes transitioning from aggressive therapies to pain and symptom management. At its heart, the palliative approach is ensuring patients and their families are making informed decisions about the kind of care they want and that it’s delivered in the setting of their choice.

“One of the biggest misconceptions about palliative care is that when patients hear the phrase, their initial reaction is that their care team is giving up on them,” says Dr. Bethune. “In fact, it’s the exact opposite and is designed to ensure that we’re supporting and empowering patients every step of the way — whether they have two months remaining, two years or longer.”

The palliative care approach has garnered recent media attention in Nova Scotia and is considered an area of utmost priority in health care; in part due to a rapidly aging population and the province facing some of the country’s highest cancer rates.

This May, Doctors Nova Scotia released a report with 10 recommendations to support and enhance the palliative care approach in our province.

While he acknowledges there is always room for improvement, Dr. Bethune feels the QEII Health Sciences Centre and the province as a whole is a national leader in palliative care.

“Initiatives like our EHS Paramedics Providing Palliative Care at Home Program — which was the first of its kind in the country — has been a benchmark example for other provinces and is now being adopted throughout Canada.” This program, which initially started as a pilot study in Nova Scotia and P.E.I., trains and equips paramedics so they can care for dying patients within their own homes if they wish — rather than transporting them to the hospital.

Dr. Bethune believes it’s these types of forward-thinking initiatives, those that disrupt the status quo in health care, that keep the QEII at the forefront of innovation and world-class care.

It’s a sentiment echoed by Cheryl, who also feels the province is paving the way. “Our counterparts across Canada are really looking to us to see how we’re training healthcare staff and what initiatives we’re developing and implementing next.”

Another way the QEII plans to set palliative care standards across the country is by establishing Atlantic Canada’s first Endowed Chair in Palliative Care.

Funded by a community of donors, endowed chairs at the QEII are world-renowned experts in their field who are appointed for a five-year term. The QEII Foundation is currently embarking on a $4-million campaign to fund the Endowed Chair in Palliative Care. Once the campaign is complete and the position is recruited, the Endowed Chair in Palliative Care will be dedicated to leading palliative research at the QEII and, ultimately, translating evidence-based findings into best practices and policies that will be adopted, here, at home — and both nationally and internationally.

The timing of this initiative couldn’t be better, according to Dr. Rob Horton who works as a palliative care physician with the QEII Integrated Palliative Care Service and volunteer board member of Hospice Halifax. With the development of the new Hospice Halifax underway, the Endowed Chair in Palliative Care will work in collaboration with and support expert caregivers and health professionals beyond the QEII.

“These initiatives, like establishing the province’s very first hospice and funding a dedicated chair, symbolize a groundbreaking moment for Nova Scotians,” says Dr. Horton. “An entire community is coming together to improve health care and ensure individuals and their families have the support and quality care required to live their remaining lives as fully and comfortably as possible.”

Dr. Bethune couldn’t agree more, “this endowed chair and the research potential it offers will be critical in addressing one of our greatest needs in Nova Scotia.”

Research conducted around the globe has already demonstrated that quality palliative care improves patient and family quality of life and well-being, reduces healthcare costs and in many instances, even prolongs life.

“Our chair will build upon these findings, establish the QEII as a true centre of excellence in palliative care and enable us to continue doing better for our patients,” says Dr. Bethune. “Donors should feel proud knowing their generosity will have such a meaningful impact on the lives of patients and their families.”