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Frequently asked questions

Palliative care had always been provided on a discreet, informal basis under the name of “compassionate care.” The movement had its real start in Canada with the pioneering work of Dr. Balfour Mount at the Royal Victoria Hospital in Montreal, out of concern for the comfort and quality of life of patients who had reached the end of their lives.
Palliative care is an entire range of care and treatment provided for a patient suffering from an incurable illness such as cancer, or some other form of illness that has reached a stage when death seems imminent. The aim is to provide better quality of life for the patient and their loved ones, and to ease their suffering. Beside the relief of pain and other physical symptoms, it includes psychological, social and spiritual support, and counselling for family members experiencing bereavement.
A palliative care team includes doctors, nurses, social workers, psychologists and other healthcare workers and professionals. Spouses and life partners, family members and friends also play an active role. Every person in their final illness or last stage of life should be able to enjoy this care and its benefits – in hospital, in a palliative care hospice, or at home.
The palliative care approach regards everyone whose life expectancy is shortened due to illness – seniors, adults, or children – not as a dying patient, but as a person with a life to live as fully as possible.

Palliative home care services vary in different regions. If you contact your nearest CLSC, they will be able to advise you. You’ll find addresses and telephone numbers online at:
http://www.msss.gouv.qc.ca/reseau/rls/prf/liste95csss.doc
http://www.msss.gouv.qc.ca/reseau/rls/

The foundation partners with CLSCs in and around the Montreal region.

The Fondation Jacques-Bouchard works in partnership with CLSCs. They are the foundation’s key partners at present. In areas where palliative care for residents is adequate but not comprehensive, the foundation supports local caregiving teams by providing complementary high-quality services. This approach ensures fully integrated patient management and promotes access to palliative home care within the healthcare system.

No. The effort to provide better quality of life, with a supportive caregiving team and methods to relieve pain and suffering, can begin the moment a patient’s diagnosis or medical outlook is confirmed. At this difficult time, it’s important for the person who is ill and their loved ones to gather information about palliative care, discuss their various options and consider their future needs.

Palliative care services are the same in hospital or at home. What matters is the patient’s condition and wishes, as well as those of their loved ones. These factors will determine the best place to receive care. The decision should take account of the patient’s and family’s needs, as well as the types of palliative home care services available in their community. Other factors to consider:

-Physical capacity in terms of hygiene or mobility
-Condition and medical needs (administration of medications, monitoring of symptoms)
-Social and spiritual needs
-Financial situation

Palliative care can be provided at home, in hospital, in long-term care facilities, or hospices that specialize in palliative care.
At home
Palliative home care programs provide a range of services fully comparable to those received in a hospital setting. Caregivers make regular visits and support services are on call. The interdisciplinary team that delivers this care includes palliative care volunteers, physicians and other staff. Response teams are available 24 hours a day in case of emergency.
According to numerous testimonials, people who stay at home while terminally ill, with their loved ones around, have the feeling that they are leading a more “normal” life than they would in hospital. In the peace and privacy of their home, they’re also more likely to be thought of as “living” persons than as patients.
Sometimes the situation doesn’t allow palliative care at home, and other more appropriate solutions must be found.
Hospital
Palliative care services are provided in some hospitals. These may have special palliative care units, or other units where beds are reserved for this purpose. Mobile palliative care teams work in cooperation with the regular caregiving staff.
Long-term facilities.
Some assisted living or residential and long-term care centres (CHSLDs) also provide palliative care, though most do not have the proper environment for this purpose.
Special palliative care homes (hospices)
There are some palliative care homes (hospices) in Quebec. They provide an appropriate environment and palliative care services.

Palliative care may vary from region to region and also from case to case, since it’s a personalized approach tailored to each situation. Services may include: Care planning by the caregiving team, patient and family, medical treatment to relieve pain and other symptoms, ursing and comfort care, basic hygiene care, respite care, housekeeping assistance, visits by qualified volunteers, emergency telephone service, counselling and support for loved ones before and after death.

Palliative care is appropriate for anyone suffering from incurable illness or illness associated with old age, especially when there is a need to relieve pain and ease other physical symptoms and causes of discomfort. Many of those who benefit are cancer patients, but others may have heart disease, respiratory ailments, kidney failure, Alzheimer’s disease (dementia), HIV or other immune system failure, or multiple sclerosis.

Yes. The patient and their family are the prime focus of any decisions that concern them. Freedom of choice is a core aspect of palliative care. By discussing different options with the physician or members of the caregiving team, they can choose the type of care and treatment that best meets their needs and their family or social situation. Be sure to ask these important questions: What are the side effects? Do I have to be hospitalized, or go to the hospital? What does the care or treatment cost, and who must pay for it? What are the chances of success? Quality of life – the best possible – personal attention, comfort and reassurance are ongoing priorities for all caregivers on the team that works with the patient and their loved ones..

Many people think that a patient’s last days of life must be a time of pain and distress, but this isn’t usually the case. Most people, when dying, pass their last days resting or sleeping. Gradually, the body’s functions close down and cease to operate. Which is why patient needs diminish at the very end. They eat or drink only a little or not at all, because they no longer have sensations of hunger or thirst. It’s true that family members and other loved ones may feel anxious or helpless at this difficult stage. Normally, however, the palliative care provided at this point maintains the patient’s well-being, besides controlling pain and other physical symptoms.

In the last hours of life, breathing becomes less regular and gradually slows until it finally stops. By watching the loved one carefully, it is possible to recognize the end as it draws near, due to noticeable changes in their condition, especially their breathing. It sometimes happens – though rarely – that the patient experiences distress in their last moments. If this happens, you must contact the caregiving team at a special phone number or by dialling 911.

Living through a terminally ill person’s last moments at home can be a troubling experience for family members and loved ones – physically as well as emotionally. Which is why it’s crucial to work closely with the palliative care team. Caregivers on the team are responsible not only for the patient but also for their loved ones. They can provide them with respite care or supportive counselling during this difficult stage. The family may feel that they need to talk about what they are experiencing. It’s crucial to ask for support and help at this time in order to prevent fatigue or exhaustion.

Remaining at home until their life comes to an end is the wish of many terminally ill patients. However, if the patient must remain in hospital, despite their family’s best efforts, and can’t return home, they must be grateful for the quality time they were able to spend at home, with their family’s support.

At every stage of the illness, as it progresses, we urge family members and loved ones to talk with their doctor or someone on the palliative care team at their CLSC. This is a good way to get information on what they need to know when caring for a loved one at home in their final days.

Support and counselling family members before and after the death of a loved one is part of palliative care. This support is provided by a professional or a trained volunteer. Their job is to listen to the family’s needs and to comfort and help them deal with the difficult emotions they may experience.

The costs associated with palliative care should be covered by the government under an official palliative home care program (see the Politique en soins palliatifs de fin de vie du Québec [Quebec policy on palliative/end-of-life care]). This varies from region to region, depending on how local palliative home care services are structured. Some healthcare centres provide only a limited number of professional services and support hours at home. Once this quota is met they must find other sources of funding. Some people must pay for home care out of their own pockets. Others may have private health insurance or receive assistance from social and community organizations in their area. The Fondation Jacques-Bouchard was founded precisely to deal with situations like this.

You must talk about your wishes with your family and express your preferences. You can also put your wishes in writing for your family and caregivers, if you think you may no longer be able to communicate with them. You can also speak to your notary about this.

The foundation depends entirely on the generosity of individual donors and charitable institutions. Our organization receives no government assistance or subsidy.

Everyone who contributes to the foundation, whether in money or in services, becomes a member. However, some members may choose to keep their names or the nature of their contributions private.

What is palliative care?

Palliative care had always been provided on a discreet, informal basis under the name of “compassionate care.” The movement had its real start in Canada with the pioneering work of Dr. Balfour Mount at the Royal Victoria Hospital in Montreal, out of concern for the comfort and quality of life of patients who had reached the end of their lives.

Palliative care is an entire range of care and treatment provided for a patient suffering from an incurable illness such as cancer, or some other form of illness that has reached a stage when death seems imminent. The aim is to provide better quality of life for the patient and their loved ones, and to ease their suffering. Beside the relief of pain and other physical symptoms, it includes psychological, social and spiritual support, and counselling for family members experiencing bereavement.

A palliative care team includes doctors, nurses, social workers, psychologists and other healthcare workers and professionals. Spouses and life partners, family members and friends also play an active role. Every person in their final illness or last stage of life should be able to enjoy this care and its benefits – in hospital, in a palliative care hospice, or at home.

The palliative care approach regards everyone whose life expectancy is shortened due to illness – seniors, adults, or children – not as a dying patient, but as a person with a life to live as fully as possible.

Palliative care statistics

Demand for palliative care


  • Some 259,000 Canadians die every year[i], including over 50,000 in Quebec.[ii]

  • 75% of these deaths occur among people 65 years of age or older.[iii].

  • Palliative care programs can be beneficial to those suffering from cancer or from cardiovascular or respiratory diseases. Together, these three causes account for 73% of all deaths in Canada.[iv].

  • Access to home palliative care: Only 9.7% of cancer patients able to enjoy the benefit of palliative care die at home. Yet if they had the choice, up to 80% say they would prefer to die at home.[v].

  • From 1994 to 1998, 87% of all deaths occurred in a long- or short-term medical care facility[vi].

  • Approximately 85% of those Canadians who need home palliative care cannot access these specialized services.[vii].

  • Despite the Quebec government’s official End of Life Palliative Care Policy (2004), the ways, means and access to palliative care throughout all of Quebec have yet to be achieved.

[i] Canadian Hospice Palliative Care Association (CHPCA): Fact Sheet: Hospice Palliative Care in Canada
[ii]Canadian Cancer Society. Canadian Cancer Statistics 2003. Site web cancer.ca.
[iii] CHPCA Fact Sheet : Final Report of the Subcommittee to update “Of Life and Death
[iv] ACSP Fact Sheet : Les soins palliatifs au Canada.
[v]Burge, F., Lawson, B., and Johnston, G. « Trends in the place of death of cancer patients, 1992-1997. » Canadian Medical Association Journal, 2003; 168(3): 265-269
[vi] Dechêne, Dion, Gratton : Où meurent les Québécois I et Où meurent les Québécois II, Recherche sur la population québécoise de 1994 à 1998; Médecin du Québec volume 39 nº 4, avril 2004 et volume 39 nº 8 2004.
[vii]Standing Senate Committee report (see note 3, above).