Bethany reside in Montreal. (Photo by Heather Grace Stewart)
But it was a note from a regular DeanOnCampus reader, Dr. James Armstrong (Meds’89), suggesting that I write about Dr. Mount and palliative care that led to this blog.
Dr. Armstrong told me about Dr. Mount’s 1986 lecture to the second year medical school class on palliative care. He and his classmates were “mesmerized” by Mount’s “compassionate support of the dying, for his understanding of the meaning of life and how we as physicians have a humble, yet important role to play in that journey, which we will all take, from life to death.”[ii] Indeed, I have known about Dr. Mount since the early 70’s. Dr. Mount was one of my teachers, when I was a young medical student at McGill.
Balfour Mount is widely known at the father of palliative medicine in North America. He opened Canada’s first palliative-care ward at the Royal Victoria Hospital in 1973. He is credited with coining the term while studying at St. Christopher’s House a London hospice. Interestingly the palliative term came about from a translation issue, “I thought hospice would be a great name, but for francophones the word carried the implication of les hospices in France, which had a reputation for mediocre, warehouse care. Looking for a different term raised the possibility of the word “to palliate,” which means to mitigate or improve the quality.”
Forty years later, end of life care is a global concern. The World Health Organization (WHO) stated, “Population ageing and the implications these present for care towards the end of life are major public health issues for the 21st century”[iii].
Here are some of the facts in Canada, courtesy of the Canadian Hospice Palliative Care Association (CHPCA)[iv] and from the 2010 Senate Report – Raising the Bar: A Roadmap for the Future of Palliative Care in Canada[v]:
- From mid-2008 to mid-2009, there were 242,863 reported deaths in Canada. Population growth forecasts envision that the number of deaths occurring annually in Canada will nearly double to almost 480,000 annually by the year 2056.
- Seventy-five percent of all deaths occur in people over 65 years of age.
- Ninety percent of Canadians who die can benefit from palliative care
- Seniors are the fastest-growing age group and could account for between 23% and 25% of the total population by 2036, nearly double the 13.9% in 2009
- Each death in Canada affects the immediate well being of an average of five other people, or more than 1.25 million Canadians each year.
- A 2004 Ipsos-Reid survey reported that Canadians estimate 54 hours per week are needed to care for a dying loved one in their homes: 64% of those polled indicated they could not devote this number of hours per week.
- Canadian families frequently shoulder 25% of the total cost of palliative care due to costs such as nursing and personal care services.
- Despite ranking in the top ten internationally (The Economist’s Intelligence Unit ‘Quality of Death’ index, 2010), we are still unable to provide valuable hospice palliative care services to over 70% of those dying within Canada.
In fact, the Senate report referred to above was tabled by The Honorable Sharon Carstairs P.C. (who was also responsible for three other landmark studies into end of life care). Retired from Senate, The Honorable Ms. Carstairs now chairs the board of directors for the Technology Evaluation in the Elderly Network, Network of Centres of Excellence (NCE) based at Queen’s and Kingston General Hospital. Armed with $23.8 million in federal funding, the network is dedicated to dramatically improving the care choices for our aging population in Canada. Follow this link to find out more http://www.tvn-nce.ca
All of us confront end of life issues with ourselves, or our families, and sadly, it is all too often burdensome and enormously stressful. Canadians should be very grateful to Dr. Balfour Mount for breaking the trail that led to palliative care becoming a highly respected and vital area in the healthcare professions and biomedical sciences.
To express thanks to Dr. Mount and to all those engaged in end of life care I will share this message from Sharon Carstairs in her 2010 report: “There are no words, in any language, which can convey the extent of the gift they give of themselves. They define our most human values, and remind us that the most basic and important value in life is to care for each other.”
I’d like to thank Peter Aitken for his research on this blog.
If you have any thoughts about palliative care, or memories of Dr. Mount, respond to this blog, or better yet… please drop by the Macklem House, my door is always open.
[i] The last human freedom – Heather Grace-Stewart, Queen’s University Alumni Review (Spring 2013) http://queensu.ca/news/alumnireview/last-human-freedom
[ii] Die softer: How we can give life a better ending, Sandra Martin, The Globe and Mail (Apr. 13, 2013) – http://www.theglobeandmail.com/life/health-and-fitness/health/die-softer-how-we-can-give-life-a-better-ending/article11173497/
[iii] – The Solid Facts: Palliative Care, World Health Organization – Europe
[iv] Fact Sheet: Hospice Palliative Care in Canada (2012) – http://www.chpca.net/media/7622/fact_sheet_hpc_in_canada_may_2012_final.pdf
[v] Raising the Bar: A Roadmap for the Future of Palliative Care in Canada, Senate of Canada, The Honourable Senator Sharon Carstairs, P.C. (June 2010) – http://www.virtualhospice.ca/Assets/Raising%20the%20Bar%20June%202010_Senator%20Sharon%20Carstairs_20100608160433.pdf