The founding of Palliative Care Services Worldwide

From within the walls of the Royal Victoria Hospital (RVH), and under the leadership of McGill Physician Dr. Balfour Mount, came the first Palliative Care Service in the world.

In the early 1970s, palliative care was virtually nonexistent—not just in Canada, but worldwide. “In those days the focus of all academic hospitals was on investigating, diagnosing, prolonging life and curing,” says Dr. Mount. “The needs of the terminally ill, for whom prolongation of life or cure were no longer relevant goals, were totally outside the perspective of the caregiving team.” It was time for a change.

Following the results of a 1973 committee set up by Dr. Mount to evaluate end of life care, a two-year pilot project was established to test a Palliative Care program with four clinical arms: the 12-bed palliative care ward, a consultation service, a home-care program that followed terminally ill patients and their families in the community, and a bereavement follow-up program.

The goal was to enhance patient quality of life through a broadening of the traditional healthcare mandate to include a wider spectrum of concerns, specifically rigorous symptom control, and focused attention on the psychosocial, spiritual and existential challenges of advanced disease, an approach which would eventually be called “whole-person care.”

Building on this reputation for excellence, the McGill University Health Centre (MUHC) established the “ward of the future” for palliative care patients and their families at the Montreal General Hospital this past year. The new unit houses 14 private rooms and one double room. A sitting room, a therapeutic bathroom, an office locale for the multidisciplinary team, space for consultation and medication preparation, and a conference room are also part of the modern package. Compared to the previous surroundings the new unit offers a more healing environment for patients and families and more efficient work space for staff.

Beyond the patients’ environment, the palliative care team offers a one-stop milieu for people who need interventions such as pain blocks, interventional radiology, cementing cracks in bones and other requirements to reduce pain, shortness of breath, nausea, and overall improvements to quality of life in the palliative stage.

“Because patients are living longer with disease, such as cancer, there are more therapies required to prolong life and to improve quality of life,” says Dr. Borod, MUHC director of Palliative Care. “Our department is seeing the results of these advanced strategies.