Advances in End-of-Life Care in Canada: Implications for Oncology Nursing

TL;DR

The paper discusses recent improvements in end-of-life care for cancer patients in Canada, emphasizing the importance of palliative care, advance care planning, and medical assistance in dying.

Contribution

The paper highlights the evolving role of palliative care in oncology and the need for better training and access to end-of-life care services for Canadian cancer patients.

Findings

Early integration of palliative care improves quality of life and can extend life for cancer patients.

Barriers to palliative care include misconceptions, late referrals, and limited access in rural areas.

Ongoing education and expanded access to palliative care are essential for improving end-of-life care in Canada.

Abstract

In Canada, cancer remains a leading cause of death. Recent advances in end-of-life care have improved quality of life for patients. Palliative care, which focuses on relieving symptoms and supporting emotional, spiritual, and physical well-being, is now recommended from the time of diagnosis, alongside cancer treatment. Early integration of palliative care has been shown to reduce suffering, improve patient and caregiver quality of life, and sometimes even extend life after a cancer diagnosis. Advance care planning (ACP) helps patients express their values and make decisions about future care, and nurses play a key role in guiding these conversations. Medical assistance in dying (MAiD) is another option available to Canadians experiencing suffering after a cancer diagnosis. Ensuring oncology nurses have sufficient training, skills, and competencies in palliative care and advance care planning is essential for compassionate, patient-centered care throughout the illness trajectory, including at the end of life.

This paper explores recent advancements in end-of-life (EOL) care in Canada, focusing on palliative care (PC) in oncology, advance care planning (ACP), and medical assistance in dying (MAiD). Despite improvements in cancer treatment, cancer remains a leading cause of death in Canada, with patients facing significant physical, psychosocial, and emotional challenges throughout the illness trajectory. Over the past few decades, PC has evolved to address serious illness from diagnosis onward, enhancing symptom management, quality of life, and patient satisfaction, while reducing hospital admissions and unnecessary treatments. However, barriers such as misconceptions about PC, late PC referrals, and limited access to PC, particularly in rural and remote areas, still exist. This perspective paper draws on the authors’ collective clinical and research experience in oncology and PC, complemented by a focused review of key literature. Ongoing education for oncology nurses on EOL care, including on PC, ACP, and MAiD, as well as continued efforts to expand access to PC for all Canadians, are imperative in order to improve the EOL experience for people affected by cancer nationwide.

Figures