A few weeks ago the Canadian Hospice Palliative Care Association sat down with Peggy Taillon, Interim Director of the new Ottawa Hospice Services.
Ottawa Hospice Services is the result of the recent merger between the May Court Hospice and the Friends of Hospice. Both organisations have struggled to survive financially for the past few years, having to raise the majority of their funding. However, Taillon says the larger organisation will qualify for more funding and will be able to streamline and expand its services for the terminally ill across the city. The organisation aims to offer city-wide care, with a goal of three more hospices opening throughout the city. Here, she discusses the roles and plans of the Ottawa Hospice Service with us, and the future of hospice palliative care in the city.
Previously, Taillon was the senior vice-president at the Ottawa Hospital, but always wanted to “do something else.” She became involved in international development in Kenya, but after coming back to Ottawa in 2008, she wanted to work more deeply within the community. Always a systems thinker and a problem solver, she knew she wanted to help improve systems from the perspective of the people who are using them, rather than controlling organisation’s view. For Taillon, “Health care is the central social justice issue for Canada. Our obligation in health care is to build a system that is intuitive, that moves people through seamlessly, and responds to people’s need no matter how complex they are. No health care organisation has the right to say ‘We can’t help you.’”
Taillon envisions a health care system based on a system of referrals, with a goal of serving Canadians, and especially vulnerable Canadians, in the best way possible. Although “we have a great health care system,” says Taillon, “there are challenges, and there are places for improvement.” When Medicare was conceived, Canada was a young country, and health care focussed on the suburbs, short-term interventions, and maternity wards. “We weren’t thinking about the future and the fact that young Canada was going to age. That short sightedness almost became non-policy, and government at all levels didn’t consider what to do when the population ages, what our philosophy around ageing was. We’re now faced with the beginning of the bulge and the lack of foresight is hitting us at all levels of government.”
Hospices provide a solution to this looming healthcare problem. “I really thought I knew hospices,” says Taillon, “but when I started to work with them, I started to realise that I didn’t know what I thought I knew. I’m inspired by the work they do, the environment they foster, and the care that they provide. [They’re] client and family centred.” However, Taillon finds herself continually “frustrated at the fact that this really important part of the health care system hasn’t been taken seriously and hasn’t been resourced appropriately.” Taillon calls the previous funding model for both the May Court hospice and Friends of Hospice “flawed:” 35% of their funding came from the government and the rest they had to fundraise. “You can see how on any given day with that kind of formula you are literally going month to month, yet they are providing this tremendous service.”
From a systems perspective, the goal of health care is an integrated system that will better serve clients, patients, and their families. “Integration for [Ottawa Hospice Services] meant merging two organisations… Coming together was a great opportunity and a great way to forge a better system with a goal of centralized access and referral.” Friends of Hospice and the May Court Hospice, the two merging organisations, took the leadership in this initiative. The two organisations plan to merge to provide sustainability, seamless continuum of care that works in true partnership to improve client service, and to ensure a vision for growth that they could not accomplish alone.
A few years ago a study reported that Ottawa needed 68-88 hospice beds to serve the Ottawa-area, and Ottawa currently has only 9, all at the May Court hospice. The Ottawa Hospice Services have mapped out a plan to grow to a half-way point of 40 beds throughout four sites across the city. Each site will offer residential service alongside community based services and supports. Taillon says that the Champlain Local Health Integrated Network (LHIN) approved their plan in principle and is committed to phase one: 10 new hospice beds in Ottawa’s West End. While Ottawa Hospice Services continue through fundraising and development, they plan on having a temporary site of 10 beds up and running before the winter holidays.
Taillon says that the greatest challenge facing Ottawa and Canada in the coming years is the increasing reality of multiple and more complex health conditions. With medical advances people are living longer, but they are living longer with chronic diseases and their needs are more complex. “Canadians need to feel comfortable talking about end of life issues,” says Taillon. “There is a lot of stigma associated with it, but you need to have a conversation about what your options are. A lot of people haven’t thought about what’s going to happen. We want to create a national dialogue.” She says most people assume they are going to die in a hospital and that dying in a hospital is “better.” However, Taillon says that not only is hospice care more appropriate, more effective, and better at meeting the needs of patients, clients, and families, but it’s also more cost effective: for every 10 hospice beds opened, 4 hospital beds could be closed. Hospice care is a “win-win; there’s not downside to this.”