Palliative Care

Frequently Asked Questions
What is palliative care?

Palliative or end-of-life care is an approach to care that improves the quality of living and dying for the patient and their families. The palliative approach provides exceptional care to alleviate suffering and provides important physical, psychological, social, spiritual and practical supports.

Palliative/end-of-life care is appropriate for any individual and/or family living with a life-threatening illness due to any diagnosis, with any prognosis, regardless of age. It may co-exist with and enhance therapy of a disease, or it may become the total focus of care.

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Where can I access palliative care?

Palliative/end-of-life care is one element within the continuum of care, and is available in any care setting, including the home, in a palliative care unit (in a hospital or acute care setting) or in a hospice, a personal care home (PCH) or any other health care facility.

The Winnipeg Regional Health Authority (WRHA) Palliative Care program provides access to care 24 hours a day to people registered with the WRHA program. The program also provides consultative services to patients and health care professionals across Manitoba.

Direct palliative care services in the community are provided through home care in some regional health authorities. For more information, please contact the palliative care program within your regional health authority:

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Where can I get more information about hospice and palliative care beds?

End-of-life care delivered at a hospice facility is intended for individuals who have symptoms that are relatively well-controlled and who do not require specialized treatments in an acute care facility. In general, hospice is considered if a patient has a prognosis of one to three months and cannot or do not wish to receive care at home.

In the Winnipeg Regional Health Authority (WRHA), hospice beds are available at Grace Hospice and Jocelyn House. For further information on the Grace Hospice, please visit their website at: www.gracehospital.ca/hospice/. For information about Jocelyn House, please visit their website at: www.jocelynhouse.ca/. Access to these beds is managed through the WRHA Palliative Care Program: (204) 478-6372.

For individuals needing more specialized treatments in a health care facility at end-of-life, there are palliative care beds available within each regional health authority.  Within the WRHA, palliative care beds are available at Riverview Health Centre and St. Boniface General Hospital. Access to these beds is managed through the WRHA Palliative Care Program: (204) 478-6372.

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How can I get assistance paying for the cost of my medications?

The Palliative Care Drug Access Program (PCDAP) provides deductible-free drug coverage for individuals who choose to remain at home for the final days of their life. Manitoba Health already covers the costs of drugs for individuals who are in hospital or a personal care home, so the PCDAP ensures that the same cost-free coverage is available to those who reside at home in their final days.

The PCDAP is administered through Manitoba Health, and includes the costs of all eligible drugs prescribed by an eligible health care provider. Individuals enrolled in the program will not be charged for their prescribed medication when filling their prescriptions at the pharmacy of their choice.

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Who is eligible for the Palliative Care Drug Access Program?

The program is open to residents of Manitoba with a current Manitoba Health registration number. When an eligible health care provider makes a palliative diagnosis, an application form must be completed and signed by the patient (or guardian) and their health care provider. The health care provider will then send the completed application form to the palliative care coordinator in the local regional health authority. If the patient is eligible for coverage, the form will be forwarded to Manitoba Health for registration.

Application forms are available to eligible providers through the palliative care coordinator at the regional health authority. The patient or guardian will receive notification about acceptance into the program from their eligible health care provider or palliative care coordinator.  For more information, please visit: www.gov.mb.ca/health/pcdap/

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Advanced Care Planning

Advanced care planning (ACP) is a reflective process that allows you to reflect on your values, beliefs and wishes for care. ACP often includes conversations with family and friends to let them know your future health and personal care wishes in case you become unable to speak for yourself.  ACP may also include writing down your wishes, and talking with healthcare providers and financial or legal professionals.

The National Advance Care Planning Task Group Speak Up Campaign website contains information to help people with ACP. For more information, please visit their website: www.advancecareplanning.ca/

The Winnipeg Regional Health Authority has developed a set of instructional tools to help you with all aspects of advanced care planning. Please visit their website for more information: www.wrha.mb.ca/acp/

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Health Care Directives

A health care directive, also known as a living will, is part of advanced care planning. As a Manitoba citizen, you have the right to accept or refuse medical treatment at any time. The Health Care Directives Act allows you to express your wishes about the amount and type of health care and treatment you want to receive should you become unable to speak or otherwise communicate this yourself. It also allows you to give another person the power to make medical decisions for you should you ever be unable to make them yourself. For more information about health care directives, including sample forms, please visit: www.gov.mb.ca/health/livingwill.html.

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Mental Health and Spiritual Care

When someone becomes seriously ill, it usually starts an intense process of medical testing and therapy with treatments that may involve some degree of pain and stress. Understandably, each phase of a major illness has emotional and psychological effects.

Active treatments may bring about troubling physical side effects, perhaps with no certainty of a cure. Throughout these periods, declining physical function, changes in family and social roles, increasing dependence on the health-care system as well as the threat of death are all sources of psychological stress.

Over the long term, however, people who adopt active coping strategies, such as seeking support from others, constructive problem-solving and finding positive meaning, tend to show the best adjustment.

Most people who are told they have an advanced illness will experience periods of anxiety, sadness and grief, and anticipation of loss and death. These can all be considered part of a normal adjustment process, albeit a difficult one. For many medically ill people, however, these emotions can become quite overwhelming and develop into difficulties in their own right. For example, it has been estimated that about 25 per cent of people with advanced cancer will exhibit depression or anxiety disorders. These problems are important to recognize and treat. Not only are they distressing, but they also make it more difficult to manage physical symptoms and to face the full spectrum of concerns involved in preparing for the end of life.

Support and assistance is available for you and/or your loved one. The information and websites below are good places to start, and contain contact information for a variety of services and resources that can help.

Additional Resources

Canadian Virtual Hospice (www.virtualhospice.ca)
A comprehensive website devoted to all aspects of end-of-life care. The website features a section on emotional health and how to access professional help when experiencing stress, depression and anxiety.

Family Caregiving for People at the End of Life (www.chpca.ca)
A useful resource for caregivers coping with the stress associated with caring for a loved one.

Mental Health Resource Guide for Winnipeg
This online guide includes some self-assessment resources for depression and anxiety, and offers a comprehensive menu of support and treatment options in Winnipeg including self-help options through to crisis services. Education and support groups for families are also included. The province-wide telephone bereavement support line is included:
mbwpg.cmha.ca/resources/mental-health-resource-guide-for-winnipeg/

Palliative Manitoba (palliativemanitoba.ca/)
Palliative Manitoba is another resource for individuals, families and caregivers, who provide programs, services, education and information.

The Canadian Mental Health Association (cmha.ca)
This website has information and resources about stress and mental health challenges – both general information and specific information related to grief.

The Canadian Association of Psychology (www.cpa.ca/docs/File/Publications/FactSheets/PsychologyWorksFactSheet_EndOfLife.pdf)
An online fact sheet is available with information on psychological distress and coping with advanced illnesses/end of life, and discusses psychological treatment and support.

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Financial assistance programs offered by the Government of Canada

The Government of Canada offers and administers several funding programs available to Canadians caring for a critically-ill family member or require additional assistance following the death of a loved one. For information or an application package, please contact a Service Canada Centre or follow the links provided below: www.canada.ca/en/employment-social-development/corporate/portfolio/service-canada.html.

Federal Benefits for Parents of Critically Ill Children:
Available for eligible parents who have to be away from work to provide care or support for a critically ill or injured child.
www.canada.ca/en/services/benefits/ei/caregiving.html

EI Compassionate Care Benefits:
The program provides Employment Insurance (EI) benefits to people who have to be away from work temporarily to provide care or support to a family member who is gravely ill and who has a significant risk of death.
www.canada.ca/en/services/benefits/ei/caregiving.html

Service Canada Centre:

Federal Benefits following a death
Information from the Government of Canada website regarding resources that can help you when someone passes away:
https://www.canada.ca/en/employment-social-development/services/benefits/family/death.html

Additional Information Regarding Palliative/End-of-Life Care Resources/Options:
Government of Canada site:
https://www.canada.ca/en/health-canada/topics/end-life-care.html

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