The Canadian Researchers at the End of Life Network (CARENET) is a group of health care professionals from across the country that collaborate with each other to understand and improve palliative and end-of-life care.

Developing the Framework on Palliative Care in Canada would have been impossible without the participation and direction-setting provided by key organizations, groups and individuals, including provinces and territories and other federal government departments. 

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Death is the ultimate inconvenient truth, its inevitability a conversation that far too many doctors still go out of their way to avoid, according to a recent report by Britain’s Royal College of Physicians. Talking about dying: How to begin honest conversations about what lies ahead looks at why doctors and other health care professionals find it so difficult to talk about dying to patients who are frail or terminally ill. Everyone realizes that early and honest conversations allow both doctors and patients to better explore the choices around their future care. So why isn’t it happening as often as it should? Read More>

They say the kitchen is the heart of the home. It’s a place of congregation and conversation; where meals are created, coffee is brewed, and stories are shared.

After embarking on a renovation project this summer, I’ve come to discover there are many common threads between kitchens and home care, particularly when it comes to design and the need for innovation. In both cases, the goal is to create something that works for your needs and fits with your lifestyle, preferences and patterns. With that in mind, here are my top three tips and some practical insight for updating your kitchen – or better yet, modernizing home care in Ontario.

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Regardless of one’s healthcare condition, contemplating end-of-life care is never an easy thought process for the patient or loved ones. For nurses who are tasked with helping to guide decisions related to the initiation of palliative care and advanced directives, no two scenarios are the same and ethical dilemmas can often arise. ADVANCE recently spoke with three nurses who shared their most frequent types of ethical decisions that they’re confronted with and how they have attempted to navigate specific encounters. Read More>

Shared decision making (SDM) is a process by which a healthcare choice is made by the patient, significant others, or both with one or more healthcare professionals. However, it has not yet been widely adopted in practice. This is the second update of this Cochrane review. Read More>

Dementia carers require more support and guidance to navigate the end-of-life care for their loved one, a new international study has found. Read More>

The Institute of Medicine identifies that quality palliative/end-of-life (EOL) care should be provided to patients with serious, life-limiting illnesses and their families by competently prepared health professionals.Read More>

New international research from Advance Care Planning Australia (ACPA) reveals that dementia carers need more support and guidance to navigate end-of-life care for their loved one. 

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Emergency-room doctor Kevin Haselhorst had an epiphany while he tried valiantly to save an elderly man who’d been through one-too-many traumas. His book, “Wishes To Die For: A Caregiver’s Guide to Advance Care Directives,” was the first step toward a new advocacy. Dr. Haselhorst continues to work toward helping people understand the importance of healthcare directives and the ability to make their own decisions about end-of-life care. Curious about more of Dr. Haselhorst’s views, the Candid Caregiver contacted him through email for the following interview. Read More>

End-of-life debates in medical ethics often centre around several interrelated issues: improving care, avoiding coercion, and recognising the dignity and rights of the terminally ill. Care ethics advocates relational autonomy and non-abandonment. These commitments, however, face system pressures—economic, social and legal—that can be coercive. This article takes up two related aspects in this domain of ethics. Firstly, that competence and communication are core clinical ethics principles that can sidestep the overplayed dichotomies in end-of-life care. And secondly, it questions the assumption that advance directives are universally benevolent—comparing the provisions of the Council of Europe’s 1999 recommendations on protection of human rights and dignity of the dying within the framework of the Irish context. The article also registers the unintended impacts of changing legal frameworks in relation to euthanasia and assisted suicide in Europe, including recent proposals in the Netherlands. A focus on human dignity can provide a theologically and philosophically shared normative orientation that argues for present directives rather than only advance directives, and a presumption in favour of ‘living up to death’. Dignity approaches not only grant rights but secure them by supporting ongoing initiatives that honour, rather than erode, the ‘longevity dividend’. Read More>

The relief of patients’ suffering – both physical and non-physical – is a primary aim of palliative care, and has been described as an obligation and ethical duty for palliative care providers. This paper suggests that common approaches to relieving patients’ non-physical suffering – such as creating opportunities to make meaning, achieve personal growth, and hone one’s resiliencies – comprise the larger, more tellable part of the palliative care discourse. A more marginal, less tellable part of the discourse acknowledges that some non- physical suffering cannot necessarily be relieved. Inspired by Foucauldian writings, this paper suggests that palliative care discourse may be disciplining the relief of non-physical suffering, with unintended ramifications for front-line practice. Making more space for both the tellable and untellable stories of patients’ non-physical suffering holds potential for an evolved palliative care discourse; one that un-disciplines dying. Read more>

Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. Read more about the study.

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