The Future of Hospice & Home Care in Canada

The Future of Hospice & Home Care in Canada

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Hello and uh welcome to CareSmartz360 On Air. I’m Dennis Gill, Senior Sales Consultant at Caresmartz. Today we are honored to host Laurel Gillespie, former CEO of the Canadian Hospice Palliative Care Association. With over 20 years of nonprofit leadership and a sharp strategic lens, Laurel is shaping how Canada prepares for aging, access, and advanced care planning. So, in this episode, she joins us to explore the future of hospice and home care in

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Canada and what leaders must do now to ensure compassionate, sustainable care for every community. So, welcome to the podcast, Laurel. Thank you so much Dennis uh and CareSmartz360 for hosting me today. And I’d like to begin by acknowledging my gratitude to our indigenous people in Canada and how proud I am to live in a beautiful city modernly known as Ottawa, the capital of Canada. Ottawa was built on unseated Anesnabi Alangquin territory and honors the peoples of the land of the Anesnabi Alangquin nation as well as all first

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nations Inuit and Matei peoples. So thank you. Thank you. Thank you. We’re really glad you’re able to take out the time today for our listeners and uh without wasting any time I’ll straight away jump in with my first question to you. All right. So Laurel, from your perspective, uh what are the biggest structural gaps in hospice and home care across Canada today? >> Uh yeah, I think it’s really important just to provide a bit of context with how our system works here in Canada. So

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We have the Canada Health Act and it covers a range of health services including medically necessary hospital services that are deemed medically necessary by a health care professional. So physician services, surgical dental services, extended health care services um and the Canada Health Act ensures that these services are provided to insured persons without financial um burdens uh or barriers otherwise promoting access to quality health care for all Canadians. So there’s 13 different systems with our 10 provinces

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and our three territories that we’re dealing with. So therefore we have 13 different jurisdictions that are governed by the Canada Health Act. Palliative care though is an approach to care in ensuring from the onset of a new diagnosis that you have access to those supports and programs that may benefit um an individual and can last several years. Um so the recommended number of hospice beds per 100,000 is seven and as of May 22 we fell short at the average about 3.97. So that’s not meeting the targets

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that are set forth by who. >> Um so I think access to care um and uh increasing the number of beds that are available either in the community at home through long-term care or hospitals or individual hospices is where the gap is needed as well as the appropriate funding from federal government to those provinces in order to deliver the service. >> Oh okay. And uh how can home care agencies better align with the national hospice and palliative care priorities while managing operational realities

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too? >> Well, I think one has to look at the sociodemographics of our aging population and how we can best prepare uh for that in the future. You know, unfortunately, fortunately, the silver lining of CO was that it really um removed the layer or took the cloak off of what the reality is um in dealing with, you know, fragility and aging um and how can we best support and care people while preserving their dignity. So, where I see an opportunity is embedding a palliative approach and keeping people out of those most

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expensive beds, which are acute care beds and hospitals. We don’t go to the hospital to die. We go to the hospital to get fixed or get better. So I think we really have to shift that whole mindset around um how we deliver service and keeping uh people out of unnecessarily out of those acute care beds um when a palliative approach to care might be uh better serviced or served to them. >> Okay. And what policy shifts should agencies be preparing for to ensure sustainable funding and access to end of

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life care? I think one of the biggest shifts and and in in from people that I’ve talked to from a personal perspective u not so much you know the policy and is that people want to be at people want to be at home >> that’s where their comfort spaces you know be surrounded by their own familiar belongings their pets their family their loved ones neighbors coming in to visit um so I think we really in order to meet the needs of an aging population a shifting demographic the uh the burden

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um that unnecessarily sometimes is placed on transferring people from like long-term care with the fall in the middle of the night to the emergency room. Well, you know, if we talk about what that person’s wishes are, do they if they’re 89 or 95, you know, and they have significant other um co-occurring um issues, do they want to be put under for a hip replacement at 95? You know, these are discussions that can happen to keep people out of. And so I’m trying to introduce a little bit in there the

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philosophy behind advanced care planning um and having these difficult conversations with family well ahead of time when they’re needed. So I think people keeping people at home where they want to be um is a really huge opportunity to fill those gaps. >> Yeah. The comfort place. Okay. And how can agencies integrate advanced care planning into everyday workflows without overwhelming care teams? Well, I think it’s a win-win right? I’ve um been a caregiver a few times over now and had the personal

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experience of having a loved one die that’s had an advanced care plan and then another that didn’t. Um the one that didn’t, like you’re left in the end with, you know, did I do this right? Did I honor them? Was that what they wanted? Whereas when you have these, albeit they can be difficult to start. Um, but these conversations are essential and I believe that now is now is a time that’s more important than ever historically because of the demographics and the competing

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priorities for tax dollars to be spent on healthcare. How can we do it smartly or more smartly and more effectively and efficiently? Um, so advanced care planning, I’ve had this dream of embedding a QR code on our universally funded um, universally funded public health care system in Canada where we each in each province have our health card and on the back of that you have a QR code that boom takes you to everything from blood type, medications, who your specialists are and oh my goodness, your advanced care plan. Um,

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and it doesn’t have to be very, it doesn’t have to be all dry and morbid. like my youngest is 25 and I am of that age and I don’t mind using my sense of humor is I said if I’m not able to convey um my or communicate or convey my wishes if I’m in that situation >> please make sure you bring a pair of tweezers in your handbag and if you see a little gray hair please get them out allow me to have some dignity that’s important to me it might not be important to me 20 years from now but it

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is now so you can have you know quite open candid conversations about a serious topic. Um, but it should be regular. Um, and also it’s about, you know, creating a culture where those >> conversations are expected, anniversaries, birthdays, at Christmas. And to me, my personal philosophy is that we have a moral imperative to take care of one another. >> Yeah. >> Um, but more importantly, I think that having these difficult conversations as a mom and a sister and a, you know, a

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partner, um, is that’s the greatest gift I can give to another human being. And it doesn’t really cost anything. >> It’s just having the conversation and documenting it. Uh and it also helps the health care professionals because then they too >> have some guided direction on where you’re headed with your care trajectory when things do get really tough. >> Definitely. Yeah, it was really nice to hear these things. >> Oh, good. Good. >> I’ll send you a copy.

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>> Surely, surely. I would love that. I would love that. And uh as we look forward toward 2026, in April now. So, what must home care leaders prioritize now to stay ready for Canada’s aging population surge? >> Uh there’s a couple points there. So, often when we talk about the aging population, um it’s something that’s coming. Um but for many parts of the system, we’re already here. It’s already happening. It’s just going to amplify and and balloon in the next five to six

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years. and we are not equipped or prepared um to provide the level of quality care that we’re used to. >> Um and we’ve seen that dangerous slippery slope. So I see it kind of as a trifecta um approach to it is health care human resources are absolutely a must and a priority in treating and taking care of our healthcare workers with the dignity and the pay that they deserve um and not being overburdened um so we can keep them in place. The second is engaging families to become a

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families or chosen family or those in your circle of care uh to be more engaged um with your care but being mindful of the burnout of caregivers at the same time. And the other one is the openness of the government and policy makers to actually ensure that we are using our tax dollars and our resources in the most efficient and effective way possible. Um, so we need to continue shifting the capacity out of hospitals as I mentioned before and into home and community settings in a very deliberate way. Um, and it’s never too

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early to start that. >> Oh, great. >> In my in my humble opinion, I guess. >> No, no, definitely. Uh, the things the pointers that I’m taking in today, all my listeners will be taking in today, uh, it’ll be really helpful for them. It’ll be really helpful for them. >> Yeah. And finally the last thing the topic everybody is talking about. So where do you see AI playing a meaningful role in hospice and palliative home care without compromising the human element?

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>> Right. Okay. So patient um confidentiality comes um first of mind and we have really good policies and laws with our uh health information uh protection uh policies that are in place. >> I think um you know there’s the good and bad with everything. I’m really incredibly excited uh about the potential for the use of AI in very helpful and healthy ways for both the end user who’s using the AI to help the patient but also protecting the patient and helping them be able to convey

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their needs. And I think there’s really a strong potential in the area of identifying patients earlier who would benefit from a palliative approach to care and getting that started earlier. Palliative care is not just about the last 3 weeks of life. It’s about living your best life at the onset of a newly uh diagnosed individual. It’s about helping them live fully and healthily. So palliative approach to care could be you know I’m 19 almost knock on wood um it may I’ll

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be 19 years out of a terminal diagnosis when I was 38 >> and you know the use of AI you know I’ve been living a palliative approach to care for that long because you know you’re chronically terminal cancer is not curable >> yet hopefully maybe and I’m hopefully not oversharing with your audience but I think it’s critical to talk about these things and how, you know, people can be identified earlier and put those social prescribing resources in place at the onset of a diagnosis, not 3 weeks before

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they die. And that’s where there’s a huge opportunity for that shift to take place. And also to support families from that caregiver perspective. Caregivers, there’s like one in four of us are currently caregiving and predominantly it’s women that are my age that are also juggling the, you know, the sandwich generation, right? We’re dealing with aged parents and family members as well as raising our own families. So, it could be a great support to me if I knew that AI was there to support me in

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helping to do my job better and carry my responsibilities and balance them with care approaches to care as a caregiver. So, I think there’s lots of opportunity, but we have to be mindful and intentful about how we use it in the direction that we take. Great pointers. Good pointers. Again, one thing I liked a lot was discussing the things maybe in the age, whatever age the person is, whatever the position the person is and discussing it on the occasions as you said that was a very good thing. I will definitely make

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a note of that thing and for all the listeners too. Okay. Okay. So, thank you Laurel. Thank you for your input today. It was a great session, a great informative session and I hope you also had a good time sharing your experience with us and all listeners. It would be a great time. >> Yeah. And at the end of the day, you know, Dennis, this is really about people like you’re in an industry where what you’re trying to do is help others and you know, how we support them, how we listen, how we honor what matters

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most to them as individuals. You know, like if we can build a system that consistently across the country, across your country, um then we’re not just improving care, we’re transforming it um for generations to come. >> So hopefully we can find ways to work collaboratively and work together in that pursuit of a moral imperative to take better care of one another. So thank you. I appreciate um yeah, I appreciate the time. >> Oh, thank you. Thank you for your time and thank you. Thank you to all my

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listeners today. So I am Dennis Gill signing off today and I’ll be shortly in touch with you again guys. Ciao