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“This project gives individuals the resources and medications they need to receive end-of-life care where they are most comfortable,” said Premier Ghiz. “That is why I am pleased to announce that my government is extending this project. We will continue to cover the cost of medications that qualified patients need to keep them comfortable and symptom free, in the place of their choice, during the last days of their lives.”

The Palliative Home Care Drug Pilot Project is an extension of the Integrated Palliative Care Program, which aims to enhance client and family options for palliative care through access to trained, qualified health care teams in the most appropriate setting.

“This project is designed to give people choices and to compassionately provide respect and dignity to individuals in the final stages of life,” said Health Minister Doug Currie. “Giving individuals the option to remain at home helps strengthen communities and reduces the emotional and financial burden on families. This project is a solid example of how improvements to services for Islanders are being achieved through integrated health system change.”

The province is investing an additional $750,000 to continue covering the cost and delivery of the project.

Eligibility for the project is based on a number of criteria that define the patient’s need for end-of-life care. Staff who are trained in palliative care work closely with family and caregivers to ensure the patient is a good fit. Once it is determined that a patient qualifies, and is registered with Pharmacy Services, clients are able to obtain palliative specific medications from their own local pharmacist.

QUESTION & ANSWERS

Palliative Home Care Drug Pilot Project Extended

What is the Palliative Home Care Drug Pilot Project?

The Palliative Home Care Drug Pilot Project is an extension of the existing Integrated Palliative Care Program. It provides coverage for end-of-life medications for patients who prefer to receive palliative treatment at home.

For the purposes of this project, home is defined as wherever the person is living, whether in their own home, living with family or friends, or living in a supportive living residence. It does not include a hospital setting, a palliative care unit, or a provincially operated long term care facility.

How long has the project been operating?

It officially began operating October 2008 as a 12 month pilot.

How long is the project being extended?

The provincial government is investing an additional $750,000 to continue covering the cost and delivery of the project for another 18 months. The province previously invested $547,500.

What is required to make this project a provincial program?

The program needs to be developed in phases based on recommendations that will be determined by the upcoming results of an on going evaluation process. This process is being carried out by the pilot project manager and staff of the current Integrated Palliative Care Program.

Additional resources will also be required.

What information is available on the project based on the ongoing evaluation process?

Since the implementation of the project:

• 81 patients have been registered, ranging in age from 18 months to 96 years

• average number of days per patient in program is 61 days

• total number of program days is 5789 - out of this, total number of days patients have been able to remain at home is 4626 (79 percent) - average number prior to project was 55 percent

• total number of days in hospital is 378

• total number of days in designated palliative care bed is 785

• total number of hospital days reduced by this project is 1110

• patients have spent 24 percent more time at home during illness than prior to project

• additionally, this has resulted in estimated savings to the health care system of more than $1 million (estimated hospital/institutional care rate is $1000 per patient, per day)

• 41 patients have died, of those, 12 died at home - 18 died in designated palliative care beds, 11 died in hospital

Who is eligible for the project?

A patient must first be eligible for the Integrated Palliative Care Program. A patient who is diagnosed with a life threatening disease can be referred to the Integrated Palliative Care Program for assessment. Following assessment, a home care nurse, trained in palliative care, and other resources are assigned as needed. Then a Palliative Performance Scale (PPS) assessment is performed. This scale measures the functional status of an individual. In order for a patient to qualify for the project, the family, care givers, and patient must agree that the treatment protocol is of a palliative nature.

How does a patient apply?

A patient who has been diagnosed with a life threatening disease can be referred to the Integrated Palliative Care Program for assessment. Home care palliative care nurses will assess the needs of the patient to determine the level of care and medication requirements.

If a patient is eligible, the palliative care nurse registers the patient with Pharmacy Servies. Once registration is complete the patient can obtain palliative medications through their local pharmacy. The patient will be required to pay a small co-payment of two dollars per prescription.

Is there a time limit for coverage?

No, there is no time limit of coverage for end-of-life medications in the Palliative Home Care Drug Pilot Project.

Will a patient need to reapply if hospitalization is required?

No, if the client is hospitalized, coverage through the project is suspended. Once the client returns home, coverage resumes. Coverage continues while the client is receiving home based palliative care.

What does the project cover?

It covers most end-of-life medications. These are medications that are used for pain and symptom management, ranging from anti-depressants and laxatives to pain relieving medications, such as morphine.

This project supplements the care that is already provided by the Integrated Palliative Care Program, which may include a Nurse, Occupational Therapist, Home Support Worker, Social Worker, Physiotherapist, Dietician, Community Support Worker, Pharmacist, and Hospice volunteers.

What is not covered by the project?

Medications that are considered active life-prolonging drugs, such as chemotherapy drugs, Total Parenteral Nutrition (TPN), and nutritional supplements, are not covered. This is a drug pilot project, therefore, most palliative equipment is not covered. There is a minimal amount of palliative care equipment provided by the Integrated Palliative Care Program that will still be provided to patients depending on availability.