WWLHIN Media Release
New Advance Care Planning Program to Improve Coordinated End-of-life Care
Kitchener, ON, February 25, 2015 - The Waterloo Wellington Local Health Integration Network (WWLHIN) Board of Directors approved an investment of $1.2 million over 3 years to Hospice of Waterloo Region to enhance the quality of care and the patient/family experience at end-of-life through improved Advance Care Planning for residents of Waterloo Wellington.
An Advanced Care Plan (ACP) is a plan that provides the resident, their family and caregivers an opportunity to consider what medical and social care a person would prefer, or refuse, during a time of crisis or end of life. This plan is more than a single document; it is an holistic view of the needs and wishes of a person during end of life care and should help to define the persons’ personal desires regarding their end of life. An ACP helps to facilitate conversation, provide direction and reflects a person’s wishes.
Many residents have difficulty thinking about their end-of-life wishes and therefore they do not have conversations about advance care planning. This initiative will increase public awareness, provide education and tools for having these important conversations, and help health care and other service providers build skills in supporting residents in building and communicating their plans.. With more information, residents of Waterloo Wellington can have discussions that will inform their substitute decision maker about their wishes for end-of-life care.
Under this three-year project, standardized ACP protocols, language, and forms that are used by health care practitioners will be consistent with Ontario legislation and will be promoted to ensure the same practices are used and communicated across the continuum of care.
“Our government is pleased to see the implementation of the Advance Care Planning Education Program (ACPEP) in conjunction with Hospice Waterloo Region and the WWLHIN, as this project will support families and loved ones in the difficult but important process of determining appropriate end-of-life care. Ultimately, this will allow a greater degree of choice, comfort, and dignity for residents and families right here in our own community.” Daiene Vernile, MPP Kitchener Centre
“We are very excited about this project. It will offer our community information they need to decide about their end-of-life care. We know that we need to also engage other community stakeholder groups such as legal, insurance and financial to build their knowledge and contribution to promoting Advance Care Planning,” says Judy Nairn, Executive Director of Waterloo Hospice.
“Improving end-of-life care is a significant priority in health care both at the provincial and local level. One of the key components of improving this care is engaging more residents in a conversation about their end-of-life care wishes. That is why we have invested in the Advance Care Planning Education Program to increase awareness of the importance of having such conversations to improve the care experience for residents and their families across our community,” says Joan Fisk, Board Chair, Waterloo Wellington Local Health Integration Network.
“We know that when asked, many residents would prefer to die at home surrounded by their loved ones rather than in hospital. Unfortunately, this isn’t happening as often as it could. Improving Advance Care Planning practices in Waterloo Wellington will help more residents experience the end-of-life care that best matches their wishes.” says Bruce Lauckner, CEO, Waterloo Wellington Local Health Integration Network.
- A Canadian survey carried out by Harris/Decima in 2013 found out that 55% of Canadians had never had a discussion with a family member, doctor, lawyer, friend, or financial advisor about their end-of-life care preferences
- According to a report by the Health Quality Ontario, by 2026, the number of Canadians dying each year will increase by 40% to 330,000 people, and each of those deaths will affect the wellbeing of an average of 5 others, or more than 1.6 million people.
- Of hospitalized Canadian elderly, 70% reported wanting comfort measures rather than life-prolonging treatment, but more than two-thirds were admitted to intensive care units.
Backgrounder: New Waterloo Wellington Advance Care Planning Education Program
Jane’s husband Bill was admitted to hospital following a terrible accident. Like any other person, Jane expected her husband to live. Both she and Bill were not yet retired, living a healthy life and had never thought of having a meaningful dialogue about their preferences for the end-of-life. Bill had been on life support for more than a week when the doctor said, “I’m sorry, the news is not good. We have tried an operation to relieve pressure and drugs to reduce swelling. There are no other options to consider.” It was suggested that he be removed from the breathing machine.
Now was the time for an inevitable family meeting as Jane wanted to consult with her daughter and son on what decision she should make. None were prepared for this difficult conversation, it was very emotional talking in the hospital corridor and furthermore Jane didn’t know Bill’s wishes. Her children agreed with the doctor’s decision but Jane was not convinced that it was time yet. And so her husband continued to be in the intensive care unit with monitors and machines for a few more days while Jane questioned herself on what he would want if he could make the choice. Eventually Bill’s heart stopped two weeks after the accident. Jane and her family left the hospital emotionally drained and questioning whether the right decisions had been made.
(Story has been used to demonstrate situations that reflect common experiences when people have to make difficult decisions about end- of-life care.)
Why does Advance Care Planning Matter?
Jane’s story represents the reality for many residents in Waterloo Wellington. Health care decisions are being made at a most emotional time without clear knowledge of the wishes of the patient. This is why the Waterloo Wellington Advance Care Planning Education Program is essential. To help people like Jane and Bill and their family have earlier conversations about what kind of care they would want for themselves in the future should they become incapable of consenting to or refusing treatment and who they want to make those decisions on their behalf. Communicating those wishes to one’s family and health care providers is important.
The benefits of Advance Care Planning for individuals and their families include:
- Comfort in being prepared
- Enhanced autonomy of the patient
- Reduction of stress for substitute decision-makers
- Personal wishes are respected and followed
- Decreased potential for conflict within the family system
In Waterloo Wellington, there is the need for:
- Greater awareness and more consistent training for local health and social care practitioners and collaborations that connect to end-of-life care
- Standardized ACP protocols that are consistent with Ontario legislation
- Greater engagement of residents in ACP to increase understanding and awareness of patient rights, as well as reduce anxieties and uncertainties about planning for potential incapacity at the end-of-life.
- Greater engagement of the community stakeholders including lawyers, insurance brokers, and bankers to build their knowledge and contribution to promoting ACP
To address the identified needs, Hospice of Waterloo Region will appoint a Project Lead, Health Care Engagement Director and Community Engagement Director to continue work on this program ensuring involvement of the broadest number of people across the Waterloo Wellington area.
For more information:
Elliot Fung, Interim Director of Communications and Engagement
519.650.4472, Ext. 246
Toll free 1 866 306 5446