As an election looms, one issue is the lack of residential hospice care as part of an overall end of life care strategy. A Needs Assessment was government's delayed response to our business plan. It will not be completed in time to have any meaningful impact on planning for the current government, and the issue will likely be pushed further down the charts as a new government of whatever stripe fulfills its mandate.
When Lionel Kelland House started this process several years ago, Newfoundland and Labrador and Nova Scotia were the only jurisdictions without residential hospice. Nova Scotia now has three leaving us the only province without one. How much longer do we wait and when do we say enough is enough? We are where we are through the collective neglect of successive governments. While we bog ourselves down in red tape, a euphemism for delay, our most vulnerable people continue to die in inappropriate environments.
Government tells us palliative care beds will be added to long-term care facilities as part of an end of life strategy, if so what happens when there is need for additional long-term care beds? What happens to palliative care beds that are going to have periods of vacancies? Will they be used "temporarily" for long-term care? It was not long ago that long-term care patients were housed in acute care beds for the very same reason. Government will say this will not happen, but if you asked a similar question about ER capacity, no one would foresee patients in hallways either. End of life care is the point where medical science becomes more of an art form. The wishes of an end of life patient may well dictate a freshly baked apple pie, or a salt meat dinner, as opposed to sterile institutional food. Palliative care is a medical specialty like any other and should be delivered as such.
If palliative care, as an adjunct to long-term care is the panacea, why does every other province have residential hospice? The answer quite simply is they have done their homework and determined residential hospice is a critical component in the total care spectrum. There is no reason to believe an analysis in this province would yield different results yet we study and we delay and people continue to die without the dignity residential hospice offers. You can move an ER patient from a hallway to an acute care bed or a long-term care patient from an acute care bed to long-term care facility but in end of life care you don't get a second chance.
Lionel Kelland Hospice is a registered charity with a board of directors, corporate governance and a building waiting to be converted to the province's first residential hospice. It is well resourced with almost $800,000 of public donations to the project, yet the government dithers and dawdles. Governments always have money to do that which they wish to do. Is the lack of response to our funding request tantamount to a “no”? Government will have to tell you why that it is, we would be happy to be proven wrong, but the evidence suggests otherwise.
Newfoundland and Labrador will one day have its first residential hospice, of that we can be absolutely certain, however, the opportunity that has presented itself to the provincial government via Lionel Kelland Hospice will not be available in perpetuity and the window is rapidly closing. Without a path forward, that can only come with government's financial partnership, the existing building will serve some other purpose and the donor funds will be returned and when the first residential hospice does happen, it will be considerably more expensive. A cheaper alternative present today seems fiscally prudent.
No public figure will take issue with the importance of end of life care. At every point of contact with bureaucrats and politicians we have received praise for the work we have done and our vision. Our dream requires more than platitudes. It requires action. It is indeed time for the provincial government to choose leadership and financial support over the past pattern of neglect. If they don't, it is our opportunity to choose a government that will.
Lionel Kelland Hospice Board of Directors
LETTER: End of life care is an issue for everyone