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Paramedics to support palliative care patients

Palliative care patients in Nova Scotia are now able to get more support from paramedics for pain and symptom management, without being transported to hospital, thanks to funding from the Canadian Partnership Against Cancer and Health Canada.

"Many people don't want to spend any part of their remaining months in hospital, they want to stay home, with their loved ones, in a setting that gives them comfort," said Dr. Alix Carter, Medical Director of Research for Emergency Health Services and EMS Division Director of Dalhousie Department of Emergency Medicine.

"But when they are experiencing unmanageable pain or other symptoms, and their regular care team is unavailable, they may end up calling 9-1-1 and being transported to hospital. This program provides paramedics with new tools and skills, allowing them to provide palliative support according to the person's wishes, including the possibility of managing symptoms at home."

Until now, 9-1-1 calls from palliative care patients required paramedics to transport them to hospital.

All ground-ambulance paramedics in Nova Scotia have received training to increase their skills and resources to manage palliative care symptoms -- such as pain, breathlessness, fear and anxiety. Prince Edward Island is also a project partner. Their paramedics are scheduled to receive training in Fall 2015.

In Nova Scotia, palliative care patients should register in Emergency Health Services Nova Scotia's (EHS) Special Patient Program (SPP). This will make it easier for paramedics to provide care according to patients' wishes.

“One of the main goals of this project is to improve access to palliative and end-of-life care for palliative care cancer patients,” said Marianne Arab, Manager of Supportive Care, Cancer Care Nova Scotia and project co-lead. “Currently, after hours and on weekends many patients have limited access to palliative care services. Because Emergency Health Services are available 24-7 across Nova Scotia, all residents will have access regardless of how remote or rural their community.”

Patients and families wishing to learn more about the program or how to register should speak with their palliative care team, a Continuing Care Coordinator or their family doctor. Enrollment forms are available on the EHS website and should be completed in discussion with a health care provider, the patient and their family. Completed forms are then submitted to EHS for review and approval by the Provincial Medical Director.

Karen MacDonald, a family member advisor on the team introducing this program, cared for her husband at home for seven months before he passed away. She says this program will help families feel comfortable as they follow their loved ones' wishes to keep them at home.

"You're always questioning, wondering 'am I doing everything right?' You feel guilty. It's unknown territory for someone with no health-care training," Ms. MacDonald said. “Knowing that paramedics have this special training if a loved one has an issue when their care team is not available, will allow a lot more people to consider bringing their loved ones home.”

In addition to Cancer Care Nova Scotia, partners include the Department of Health and Wellness, Emergency Health Services, Dalhousie University's department of emergency medicine, Health P.E.I. and Island EMS. Project funding is provided by the Canadian Partnership against Cancer and Health Canada.

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