A pilot project starting Oct. 4 and running until March 2022 from the Guelph-Wellington Paramedic Services (GWPS) will see at-home palliative care offered in Guelph and Wellington County for patients registered with the palliative team of Home and Community Care.
The project will provide care for patients at their end-of-life stage while increasing the support for families and respecting the patient’s wishes, which is often to die in dignity at home surrounded by family.
"The goal is to respect the wishes of the family and the patient, and if their wish was to die with dignity at home with loved ones we are now able to support that rather than transport (to hospital),” said Leanne Swantko, deputy chief Guelph Wellington Paramedic Services. “Most palliative patients will have a palliative team wrapped around them, however, there are still times they call 911 when the patient's symptoms are just not manageable at home.”
Guelph-Wellington paramedics will be able to treat the patient at home and provide medications they have been trained to administer.
The program is delivered in partnership with Hamilton Health Sciences, Centre for Paramedic Education and Research, Home and Community Care Palliative Care support teams and Hospice Wellington. Palladium Canada has provided course materials and program training to paramedics.
The palliative care program will offer end-of-life care at home for patients from Guelph-Wellington paramedics who have undertaken specialized training by palliative care physicians.
"Every paramedic took on a six-hour online course, prior to having six hours face-to-face with a palliative care physician,” said Swantko.
Training started in early September, and currently, the GWPS has 96 full-time and 76 part-time staff that have completed the training.
Malcolm Fan, an advance care paramedic with GWPS said palliative care doesn’t necessarily mean death is imminent, and what they are trying to do is work collaboratively with other agencies to meet as many of the patient’s needs as possible.
“Traditionally we take the patient to the hospital, and that may not be their wishes necessarily, so instead of trying to fit the patient’s care plan into a box the palliative care approach is a value-centred approach based on the patient’s wishes,” said Fan. “If they want to stay home that is perfectly appropriate. We have new medications we can use to try and make them comfortable so they can stay home.”
Data collected during the pilot project will be analyzed and used to determine if the project will be implemented full-time.
Paramedics will provide feedback, as well the family members of those who used the service.
“Part of the requirements from the Ministry of Health is to ensure that we survey patients and their families, and also our paramedics - the caregivers - to determine the level of satisfaction with the program,” said Swantko.
GWPS is one of the only paramedic services in Ontario able to transport registered patients directly to hospice through another Provincial pilot program which started May 1, 2021.
“At the heart of this program is good, patient-centred care. Paramedics can spend more time at the bedside in the home supporting patients and families and allows them to coordinate more directly with the other members of the patient’s care team. This enables all of us to better support their goals of care including more flexibility around whether that care takes place in the home or hospital,” said Dr. Clare Francisco Wallner, Physician, Centre for Paramedic Education and Research in a press release.
