Palliative care

Palliative care is a component of health care designed to provide relief from the symptoms and stress of serious illness. It can impact New Brunswickers of any age. 

Palliative care uses a team approach to improve the quality of life for patients and their caregivers to support them through the challenges that come with life-limiting illnesses. 

A palliative approach to care is provided to people of all ages who have a life-limiting illness when a cure is not possible. It can be provided along with treatments to control disease and is not limited to end-of-life care. It may include pain and symptom management, social, psychological and spiritual assistance to support quality of life. 

Palliative care can: 

• support a patient to live as actively and fully as possible 
• support a caregiver (including advice on providing care from medical and other health-care providers) 
• allow for a more peaceful and dignified death 
• support a patient’s family before and after their death 

There are different ways to access palliative care throughout your care journey, while managing your life-limiting illness. Palliative care can be accessed through various providers and delivered in multiple settings, depending on the patient’s needs. 

Providers may include: 

• primary care providers 
• The New Brunswick Extra-Mural Program (EMP) 
• hospitals (Horizon, Vitalité) 
• community-based services 
• hospice facilities 
• nursing homes 
• adult residential facilities 

Palliative care may be delivered in settings such as: 

• a clinic or doctor’s office 
• the patient’s home 
• nursing homes 
• adult residential facilities like special care homes 
• hospitals 
• home-like environments such as hospices 
• other community care settings or facilities 
• To find out about palliative care in your community, you can reach out to: 
• your family doctor or nurse practitioner 
• your extra-mural program service provider  
• your social worker 
• your spiritual care provider  
• the New Brunswick Hospice Palliative Care Association (email [email protected]) 

Hospice services can support palliative care in any type of setting in community. Services can include volunteer programs and supportive care. Hospice care may also be provided in a community facility or in a hospital when appropriate. 

Services vary depending on where you live in the province as there are community-based organizations offering various levels of support. Currently, there are four residential hospices with partial clinical funding agreements with the Department of Health in New Brunswick: Bobby’s Hospice in Saint John, Hospice House in Fredericton, Albert House in Moncton, and Vondy's House in Miramichi. 

Advance care planning is about sharing your values, beliefs and wishes for future health care in case you're ever unable to speak for yourself. It helps guide others to make decisions that reflect what you would want. 

You can include general guidance or specific instructions, for example, what treatments you would or wouldn’t want in certain situations, especially near the end of life. It's helpful to explain when those instructions should apply. 

Anyone with the ability to understand and make decisions (known as capacity) can create a health-care directive. Capacity can vary by situation and may change over time. 

Advance care planning ensures your preferences are known and respected when it matters most. 

You can make a health care directive using the form (PDF 100KB), from the Public Legal Education and Information Service of New Brunswick. You are not required to use this form. But, if you use a form from another source, it may not follow New Brunswick’s legislation. 

You don’t need a lawyer to make a health care directive, but if one is helping you with an enduring power of attorney for personal care, you can ask for their advice. An attorney for personal care makes decisions about your health and personal care if you’re unable to. 

It’s a good idea to talk to your doctor or nurse practitioner before writing your directive. They can help you understand the treatments you might face and what instructions you may want to include. 

Keep the original directive in a safe place, and a copy somewhere easy to find, like your fridge or bedside table, in case of emergency. Bring a copy if you go to the hospital or travel. 

You should also give a copy of your health care directive to: 

• your attorney for personal care (if you have one) 
• any other family member or friend who is likely to deal with health care providers on your behalf 
• your doctor or nurse practitioner (if you have one) 

It’s important to discuss your health care directive with your attorney for personal care (if you have one), and your family or friends. This can help them understand your instructions and enable them to make the decisions you want when the time comes. 

Medical assistance in dying follows clear guidelines and eligibility requirements. For more information, check with your local health authority.  

Horizon
Vitalité

A forum was established to help identify common challenges in palliative care, including timely access to care, meeting needs with increasing demand and the lack of skilled providers. 

This conceptual framework and the strategic directions outlined in it support the development and standardization of palliative care services to meet the needs of people living with life-limiting illness in New Brunswick.