How has access to palliative care changed over the last 5 years in Canada? Who isn’t getting the palliative care they need? How can we improve palliative care?

A thread….🙏🏽 What is palliative care?

Palliative care improves quality of life for people with a life-limiting illness. It should be provided early so people don't have to suffer and can plan for the future. It ensures that people can die in their preferred settings with proper support.

Earlier this month, we crossed a grim milestone in Canada...10,000 #COVID19 deaths in #LTC.

They were human beings, and not just "numbers." Every life mattered.

Here are some year-end reflections on Canada’s LTC crisis:

(THREAD) 1/ In March, the first death in #LTC due to #COVID19 in Canada occurred at the Lynn Valley Care Centre in North Vancouver. B.C. went on to “nationalize” their LTC sector, largely avoiding the catastrophe of Ontario & Quebec in wave 1.
theglobeandmail.com/canada/article…

Are we racist in healthcare? Here’s some evidence about racial bias in pain management (THREAD):

#medtwitter #BlackLivesMatter 1/ A 20 year meta-analysis and systematic review revealed black patients were 22% less likely than white patients to receive any pain medication. pubmed.ncbi.nlm.nih.gov/22239747/

As a frontline #palliativecare physician, I am aware of the importance of discussing goals of care during a viral pandemic, such as #COVID19, when ventilators may be in short supply.

Here is a quick user’s guide for any health worker having this conversation (THREAD): 1/ On the topic of Critical Care, consider this: Would your pt accept being connected to a breathing machine, and not being able to talk, eat or speak? Would they be ok with dying in the ICU, or if they lived, discharge to a nursing home?

What is the importance of #palliativecare during a viral epidemic such as #COVID19? Surprised to see this critical need is not being openly addressed. Thread to follow about how we should prepare, and some of the expected challenges.

#publichealth #cdnhealth #medtwitter 1/ As the #COVID19 epidemic continues, ICU services could go from limited to unavailable. It is expected that the need for critical care could be 200% of capacity, or even much higher. More patients may be denied ICU than those who will receive it.

Some time ago, I saw a pt with severe untreated suffering at #EOL alongside aggressive & unproven life-prolonging interventions. When I asked the medical team, they said they were doing “what the family wanted.”

Sharing some of my thoughts about this below 👇🏾👇🏾👇🏾 1/ Rejecting paternalism does not imply that we take ourselves out of the decision making process altogether. We should always work together with our pts & families rather than just “doing what they want.”

#hpm #hapc #bioethics