McMaster Health Forum key contributor to OMA strategy on end-of-life care

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BY Sue Johnston

June 2, 2014

Researchers and staff at the McMaster Health Forum played a key role in the Ontario Medical Association’s recently announced strategy to improve end-of-life care and encourage advance care planning among physicians and citizens of Ontario.

The OMA has released a comprehensive strategy on end-of-life care that aims to increase the number of citizens who engage in advance care planning, increase the knowledge about advance care planning and palliative care, improve access to palliative services and supports, and make dialogue about death and dying a more normal part of healthcare discussions.

Soon after the OMA decided last year to take a leadership role in improving end-of-life care for Ontarians, the association partnered with the Forum to gather evidence and organize discussions among key stakeholders, as part of the efforts to develop the strategy.

The McMaster-led forum organized a stakeholder dialogue focused on improving end-of-life communication, decision-making and care in Ontario, and prepared an evidence brief that examined the best available evidence on challenges being faced at the end of life and on options to address the challenges, to inform discussions being led by the OMA to move forward their strategy.

The OMA’s recently launched strategy includes various products available to both physicians and citizens to help them think about and plan for end-of-life care. The strategy envisions family physicians initiating discussions with patients about advance care planning, well in advance of any serious illness.

Among the statistics that point to the need for the OMA strategy are:

  • Among all Canadians, 86 per cent have not heard of the concept of advance care planning;
  • While 80 per cent of Canadians say they are comfortable talking about end-of-life care and related issues, only one-quarter of those over the age of 30 have made end-of-life care plans, and even among seniors, only 40% over the age of 70 have made such plans;
  • The majority of Canadians (69 per cent) say they would prefer to receive end-of-life care at home, yet 65 per cent die in hospitals; and
  • Only a fraction of the Canadian population (16 to 30 per cent) have access to high-quality palliative care.

The OMA’s members-only website now has a new end-of-life feature that contains resources, tools, research material, videos, and source documents used in developing the strategy, including the Forum’s evidence brief on the subject.

Ontario’s Doctor’s, the OMA’s site for the public, also now includes a section on end of life, with content to support talking about end of life with family and caregivers. It offers tools to guide discussions about values, wishes and beliefs, explains substitute decision-making, defines the concept of palliative care, and provides the OMA’s strategy framework. It also includes a link to a citizen brief developed by the Forum that informed a panel discussion among selected citizens from Hamilton and area, on improving access to palliative care.

The stakeholder dialogue and citizen panel were part of the Forum’s overall project on end-of-life communication, decision-making and care, supported by McMaster’s Labarge Optimal Aging Initiative. The project also featured two other citizen panels – one on end-of-life communication and decision-making and the other on care for people with multiple chronic diseases – as well as a public talk on memory and the aging brain. All three citizen panels were supported by the Government of Ontario, through a Ministry of Health and Long-Term Care Health System Research Fund grant entitled Harnessing Evidence and Values for Health System Excellence.

All products from the various events organized by the Forum to improve public awareness of end-of-life care are available through the products page on the Forum’s website.