Mr. Speaker, I have a return to written question asked by Mr. Brendan Bell on July 5, 2000, regarding palliative care.
1. Q. Recognizing the demand for palliative care facilities and the need for alternative care will surely increase over the years, I would be interested to receive statistics relating to the number of deaths per year due to terminal illness and deaths of palliative care patients.
A. There are approximately 200 deaths per year in the NWT, The NWT Health Status Report 1999 (chapter 4) indicates that between 1991 and 1996, cancers accounted for about 25 percent of all the deaths, circulatory diseases for about 23 percent and respiratory diseases for about 18 percent of all deaths.
How many of these deaths result from terminal illness depends on how terminal illness is defined. One way to answer the question about terminal illness would be to determine the proportion of deaths attributable to chronic illness. This has not been done because death certificate data on the length of illness is not sufficiently reliable.
Information about the number of palliative care deaths is not available as statistics on deaths due to terminal illness and palliative care may be one and the same. Palliative care is a specialized form of managed health care for individuals who, along with their families, are living with a life-threatening or terminal illness (usually at an advanced stage). Palliative care services are helpful not only when an individual is approaching death, but also in the early stages of a terminal illness. It is at this point that where the care for the terminally ill becomes the same as palliative care.
2. Q. Please provide a breakdown as to whether deaths occurred in hospitals, other facilities or in home settings over the past five years.
A. Statistics on the place of death for the terminally ill or palliative care client will not be available until the fall of 2000. The data will provide information about the location of death (i.e.. whether it occurred in a hospital, other facility or home care setting), but it will not identify clients who die in palliative care beds because the type of bed (e.g., emergency, palliative, long term) is not recorded on the death certificate.
3. Q. Please provide a cost analysis of palliative care for the terminally ill, including a breakdown of the hours of care required to provide service by physicians and nurses, as well as the additional costs incurred for other hospital services.
A.It is not possible to provide an accurate analysis for all costs relating to palliative care.
Physicians fee schedules and diagnostic codes do not identify terminal or palliative care conditions. In addition, systems currently used do not have the capability to provide a breakdown of precise information on time spent by a physician, nurse or support staff with each terminally ill or palliative care client.
The length of a stay of a terminally ill or palliative client in a hospital, home care setting or other facility is only a partial indicator of the time and costs. Other elements of palliative care will have been administered at various times during the earlier stages of the client's illness, The gradual inclusion of these elements, such as visits to nurses at community health centres, home visits, home care services, are also not broken down into a statistical format.
Likewise, palliative care services are provided by a variety of other trained and untrained caregivers, including family members, social workers, spiritual counsellors, home care workers and nurses. Other supports may be obtained from dieticians, physiotherapists, occupational therapists and volunteer workers. The main goal of palliative care is to provide comfort and dignity to the individual and their family.
4. Q. What is the number of current hospital beds allocated at Stanton Regional Hospital to accommodate the needs of the terminally ill or those requiring palliative care?
A. Stanton Regional Hospital has two rooms specifically identified for palliative care. One room is on the Extended Care Ward and one room is on the Medical Ward. Each room has one bed.
As there are often a number of terminally ill clients on both floors, whether for a brief or extended period of time, there may be elements of palliative care being administered to a varied number of clients at various locations and levels of the hospital. The admission of a client to a palliative care room does not limit the use of palliative care in other rooms and in other locations such as the client's home or a community long-term care facility.