Palliative care

Maintaining quality of life as long as possible…

Palliative Care

at a glance

  • Over the last 5 years referrals to the palliative care day hospital have increased from 1,000 to 1,500
  • Over the last 7 years there has been a five-fold increase in the number of interventions as a strategy for patients with advanced cancer pain
  • In the past year, there have been 989 consultations to the palliative care consult services at the MGH and RVH
Introduction
Palliative Care THEN
Palliative Care NOW

then

The founding of Palliative Care services Canada wide

Dr. Balfour Mount
Dr. Balfour Mount,
founding director of the Palliative Care Service at the RVH, pictured here in 1970 working as a surgical oncologist.

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 study 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: a 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.

Illustration
Dr. Balfour Mount, founding director of the Palliative Care Service at the RVH, illustrated this hand of a volunteer holding the hand of a patient in end of life. Volunteers were a huge component of the “Whole Person Care,” bringing one-on-one compassion to each patient.

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 to the psychosocial, spiritual and existential challenges of advanced disease, an approach which would eventually be called “Whole Person Care.” The palliative care team went on to publish The RVH Manual on Palliative/Hospice Care, a volume that quickly became the reference text for developing Palliative Care Services worldwide through the 1970s and 80s.

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now

New Palliative Care Unit allowing for better quality of life for patients

Dr. Manuel BorodDr. Manuel Borod, MUHC director of the Palliative Care Department

The MUHC established the Balfour Mount Palliative Care Unit for palliative care patients and their families at the Montreal General Hospital this year. The new unit houses fourteen 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 unit.

Compared to the previous surroundings the new unit offers a more healing environment for patients and families and more efficient work space for staff. “Our goal is to maintain quality of life as long as possible,” says Dr. Manuel Borod, MUHC director of the Palliative Care Department. “Our new surroundings complement this objective.”

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.

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