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End-of-Life Care: What to Do When Hospice Isn’t Enough (Canadian Version)

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When doctors diagnosed Beth’s father with less than six months to live, she ran into a frustrating predicament:

Since Mom died, Sissy and I make regular trips to visit Dad. Lately, his health has been declining and now he needs hospice care, but he really wants to stay in the home he and mom shared. We want to honour Dad’s wishes, but hospice won’t come unless Dad has a full-time caregiver. We live so far away, we’ve got our own kids to take care of, and neither one of us can afford to give up our jobs.

Hospice Care Requires Additional Support
The proportion of seniors in Canada, particularly those 85 years of age and older, is growing. In Canada, 93 per cent of seniors are currently live at home and want to stay there as long as possible. Although hospice care can be part of the senior care solution, it is usually intended as a complement to home care, so family caregivers continue to play a crucial role.
If a senior does not have sufficient support from a family caregiver, it can be difficult to avoid moving them into a long-term care facility. In an analysis of four provinces across Canada (British Columbia, Manitoba, Ontario and Nova Scotia) only 2-3 per cent of seniors who received home care are without a family caregiver, according to a Health Council of Canada report, “Seniors in Need, Caregivers in Distress: What are the home care priorities for seniors in Canada?”

In-Home Care as a Supplement to Hospice Care
The good news is that you don’t necessarily have to be the designated round-the-clock caregiver. Non-medical in-home care providers, such as the Home Instead® network, can supplement the care given by hospice or palliative care teams by providing:

  • Emotional support,
  • Companionship,
  • Housekeeping,
  • Personal care*,
  • Assistance with day-to-day activities, and
  • Vital respite for you and other family members.
    *Please check your local office as not all Home Instead locations offer personal care services. 

Professional in-home caregivers compliment the care hospice provides services up to 24/7 for your loved one when you can’t be there. Caregivers employed by a home care service can work closely with the hospice team to ensure your loved one spends his or her final days with dignity and in comfort. Non-medical in-home care services can be provided in the home or in an assisted living, extended care, hospital or hospice facility.

Take a Break to Care for Yourself
According to the Canadian Hospice Palliative Care Association, more than one in four caregivers show signs of distress, including feelings of anger, depression and feeling overwhelmed. Whether you opt for hospice care at home or in a care facility, if you are the primary family caregiver, the Canadian Caregiver Coalition says it’s important for you to practice self-care by ensuring you take a break from your caregiving responsibilities.

Respite for caregivers can take a number of forms: going for a walk, spending time with other friends or family members, or chatting with a counselor can provide a feeling of relief and contribute to overall health and stress management, which can help you provide better care for your loved one. With the right support system, you can spend critical time with your loved one while still meeting your other responsibilities.

Hiring In-Home Care Services to Support Your Hospice Team
If you’d like information about how Home Instead CAREGiversSM can work with your hospice team, please visit or call the Home Instead Support LineSM at 800-640-3914 to locate an office near you.

How to Choose a Hospice Agency
Start your search for a hospice agency by asking your loved one’s physician or a geriatric care manager for recommendations. You can also call the Canadian Hospice Palliative Care Association at 800-668-2785.

Download the Hospice Guide
The Truth About Hospice: A Guide for Family Caregivers (PDF 1100k)

Last revised: April 5, 2013

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