What is palliative care?
Palliative care is medical care that is committed to easing the end-of-life transition for terminally ill patients. The palliative care approach is based on accepting death as a natural part of life. It aims to relieve physical and psychological pain and to enhance the quality of life for terminally ill patients. What’s more, as soon as a palliative approach is initiated, the wishes and desires of the dying person are considered, as are the needs and roles of the family, friends and caregivers who accompany the terminally ill person. The goal is to offer an end of life imbued with compassion, respect and humanity.
What is a palliative care home?
A palliative care home is a facility that provides palliative care on an inpatient basis to terminally ill patients who are at the end of life. It offers care on a human scale, in a familiar and reassuring environment, ideally resembling a home. Patients entering a palliative care home typically have a life expectancy of one month or less.
What is a palliative care day centre?
A palliative care day centre is a facility that provides palliative care on an outpatient basis to terminally ill patients who have ceased curative treatments and who typically have a life expectancy of one year or less. Day centres offer a complete range of medical, psychosocial, recreational, and personal care and services to patients in a warm and welcoming environment, while providing necessary respite to caregivers. By beginning to care for patients much earlier on and by accompanying them through their transition, palliative care day centres improve patients’ self-worth and quality of life, and even extend their life expectancy to some extent. The concept has proven its value elsewhere in the world, and there are a few day centres in the province of Quebec, but none on the island of Montreal.
Are palliative care homes part of the Quebec health care system?
Palliative care homes are independent non-profit organizations. They are governed by the Quebec Health Ministry, through accreditation and contractual agreements with the local CIUSSS (Centre intégré universitaire de santé et de services sociaux). A portion of their operating costs is funded through government subsidies; however, most of their funding comes from donations.
How many palliative care homes are there in Quebec?
There are currently 32 independent palliative care homes in Quebec in 14 different regions.
At what point can a patient be admitted to the home?
Patients are admitted when their physical state and medical needs are such that they can no longer remain at home and no longer be cared for by their loved ones and caregivers. These patients typically have a life expectancy of less than one month.
What is the average length of stay in the palliative care home?
Currently, the average length of stay for patients in palliative care homes is 14 days or so.
Can loved ones and caregivers stay with the patient at St. Raphael’s?
Yes, loved ones and caregivers will be able to stay with the patient while at St. Raphael’s, for as long as they wish.
Are any religious rituals or services offered to patients at St. Raphael’s?
While St. Raphael’s will be a non-denominational facility, great care will be taken to respect patients’ wishes and preferences, including their desire to observe religious traditions or rituals of all kinds.
Who can be admitted to St. Raphael’s? How will patients be selected?
At the palliative care home, the 12 beds will be registered with the health and social services network. When a patient needs to be placed in palliative care, their doctor will be the one who undertakes the process of finding an available bed; if the patient wishes to be placed in a palliative care home, a bed is assigned, generally with a preference for the patient’s residential neighbourhood. Admission requests at St. Raphael’s will be analyzed and prioritized based on the physical and psychosocial, safety and comfort (pain management) needs of the patient.
At the day centre, any person may attend, subject to the centre’s capacity limit; however, priority may be given in accordance with the patient’s or the caregiver’s place of residence.
If I make a donation, can I place a loved one who is terminally ill?
We are extremely grateful for any and all support we receive for St. Raphael’s. However, it is not possible to manage admissions to the home or day centre on the basis of donations we may receive.
Will a patient who regularly visits the day centre automatically be admitted to the home when the time comes?
We hope so, but that might not be the case. Patients will be placed according to demand for and availability of beds, generally with a preference for the patient’s residential neighbourhood. The fact that we will know the patient and the evolution of their state of health may allow us to add them to the home’s waiting list ahead of time.
Why a day centre?
As soon as a palliative care approach is initiated, the patient can benefit from a number of services that will help them get through this difficult period, even when they are still living at home. The day centre will be a warm, family-oriented gathering place where patients can receive services, and also relax and find comfort, and it will offer loved ones and caregivers a beneficial break. While this concept has already proven its worth elsewhere, there are no palliative care day centres in Montreal at this time.
Will the day centre offer services only to patients, or to their loved ones and caregivers as well?
Day centre services will primarily be intended for terminally ill patients. However, some support services will also be offered to loved ones and caregivers.
How can people access the day centre’s services and activities?
Day centre services and activities will be accessible on a first-come, first-served basis. Patients will be able to sign up ahead of time, and will typically visit the day centre on the same day each week.
Are the services offered for free?
Yes, all services at St. Raphael’s will be offered free of charge.
Why does St. Raphael’s need to raise money for services that are offered for free by the health-care system?
Doesn’t the Quebec Government pay for these services?
It is true that palliative care is included in the health services paid for by the government. However, there is a lack of palliative care beds in Montreal, so there’s a great need to add more. If we want to offer free palliative care services to the Montreal community, they must be financed mainly through private donations. The Quebec government does not finance the construction of private health care buildings, but it provides subsidies to fund a portion of the operating costs for palliative care beds, as well as tax credits for private donations. Overall, this model has proved less expensive for society than one where the government directly assumes one hundred percent of the costs.
How will St. Raphael’s finance its operating costs once it opens?
The Health Ministry has already agreed to finance part (approximately 38%) of the operating costs for the 12 palliative care beds. The remaining funds needed to operate the home and day centre will come from private donations, through annual campaigns and other fundraising efforts. In addition, we have asked the Health Ministry for an additional subsidy to cover a portion of the operating costs of the day centre and are awaiting confirmation from the ministry regarding this request.
Is the Catholic Church involved in this project?
The Archdiocese of Montreal has generously transferred (through an emphyteutic lease) the use of the building and land that will become the home and day centre, which will welcome people from all walks of life, regardless of their social condition, ethnic origin or religious beliefs.
Will St. Raphael’s offer medically assisted death?
St. Raphael’s will offer palliative care; therefore, it will not offer medically assisted death. Palliative care aims to relieve the suffering and discomfort of a person in the terminal phase of an incurable illness so as to improve the quality of their end of life. We are convinced that if a person receives high-quality palliative care in a warm and family-oriented environment, surrounded by loved ones and caregivers, they will not wish to resort to medically assisted death. St. Raphael’s service offering will be clearly explained to potential patients during the admission process. Should patients subsequently change their minds and request medical assistance with dying, a process will be in place to ensure that their wishes are respected.
Who are the donors?
For a complete list of our major donors, please visit our website at maisonstraphael.org. We are very grateful to have several large organizations and well-known philanthropists supporting our cause. We are currently in the middle of a $10 million major fundraising campaign and will continue to solicit donations from residents in the boroughs and cities served by the CIUSSS West-Central Montreal, including Outremont, Mount Royal, Côte-des-Neiges—Notre-Dame-de-Grâce (CDN-NDG), Ville-Marie, Plateau-Mont-Royal, Villeray-St-Michel-Parc-Extension, Montreal West, Hampstead, Côte Saint-Luc, and Westmount, as well as from companies, financial institutions, private foundations and, of course, the Friends of St. Raphael’s.