Home-based palliative care not sufficiently well developed in Quebec

Publié le : 10 January 2014

 In Quebec, and according to the Fédération des Médecins Omnipraticiens (Federation of Omnipractitioners), palliative care is "medicine’s poor relation". However, one Montreal hospital is proving an exception to the rule. In fact, Doctors Geneviève Dechêne and Robert Marchand "do not consider death in the same way as most of their colleagues", according to the Lapresse.ca website.
For both physicians, who have been working with the terminally ill for 10 years in the Centre de santé et de services sociaux (CSSS) du sud-ouest et de Verdun (South West and Verdun Health Centre and Social Services Sector), the loss of a patient does not represent "
defeat" or "treatment failure". Dr. R. Marchand emphasises the fact that he "feels just as proud in helping to create a tranquil environment for the terminally ill as he does when delivering a healthy baby". Their aim is as follows: to allow patients to die at home if they wish to do so. More patients die in their own homes in this region of Quebec than in the rest of Montreal, namely 150, i.e. 55% compared to 15%.       

In fact, "Just 9.8% of Quebec’s terminal cancer patients die at home", compared to 18% in Alberta, 17% in British Columbia and 26.5% in France. However, the Conseil de la santé et du bien-être du Québec (Quebec’s Health and Well Being Advisory Board) has set alarm bells ringing. In 2003, this body was already expressing concerns that "due to a lack of organised services[…], the terminally ill had no choice but to be admitted to hospital". Today, Dr. Dechêne deplores the fact that the situation has not changed. He nevertheless goes on to add that home care is considerably less expensive: It costs 900 $ to treat a terminally ill patient in hospital compared to 200 $ at home. 
And if the CSSS succeeds in developing palliative care, it is because it wants to, explains Yves Dujardin, Deputy General Manager: "It needs clear direction from the top, committed physicians and a dedicated care team including nurses who focus solely on this sector, and who ultimately become specialists in their chosen field". 

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