The Pan-Canadian Gold Standards in Palliative Home Care:
Toward Equitable Access to High Quality
Hospice Palliative and End-of-Life Care at Home
(December 2006)

The Need
Most Canadians with life-threatening illnesses would prefer to die at home surrounded by family and friends, yet about 75% of deaths in Canada still occur in hospital or long-term facilities.ⁱ The gap between Canadians’ preference and current practice in the health care system is due to a number of factors, including lack of awareness of hospice palliative care servicesⁱⁱ available to people in their homes and the wide variation in the type of hospice palliative care services provided by home care organizations in different jurisdictions.

Why a Gold Standard?
To support provincial and territorial government efforts to fulfill their commitment, the Canadian Hospice Palliative Care Association in partnership with the Canadian Home Care Association has defined the “gold standard” for each of the four home care services to be funded by government: case management, nursing, palliative-specific pharmaceuticals and personal care at the end of life.

Our goal is to ensure all Canadians have equitable access to high quality end-of-life care at home.

To develop the gold standards, the two associations consulted with experts in hospice palliative care, experts in home care, and a wide range of professionals who would be part of hospice palliative care teams, including physicians, nurses, pharmacists, personal care workers, social workers, case managers and home care administrators. Draft standards were reviewed by individuals across Canada with appropriate knowledge and expertise, and revised based on their feedback.

The gold standards provide the benchmarks for high quality hospice palliative care at home. They are based on the National Principles and Norms of Practice for hospice palliative care, developed by hospice palliative care providers, organizations and consumers through a consensus building process led by the Canadian Hospice Palliative Care Association.ⁱⁱⁱ

The gold standards establish the ideal level of care and support that all jurisdictions should strive to provide for people receiving hospice palliative care at home. They are designed to encourage and support a consistent approach across the country to hospice palliative care services at home.

We recognize that provinces and territories are at different stages in developing home care services for clients and families requiring hospice palliative care. Some may already be delivering gold standard care; others may still be working to define or refine their services. While the gold standards encourage consistency, they do not imply uniformity. Jurisdictions may differ in the policies, procedures, strategies and staffing models they use to provide home care; however, their goal should be the same – to provide home care services that meet the gold standard in hospice palliative care in order to relieve suffering and improve the quality of living and dying for people at end of life.

The Pan-Canadian Gold Standard for Palliative Home Care: Toward Equitable Access to High Quality Hospice Palliative and End-of-Life Care at Home – Full Document

Next Steps
Over the next few months, the hospice palliative care community will be contacting the federal, provincial and territorial governments to offer advice and support, and to ensure actions are taken to improve the availability, quality and consistency of hospice palliative care at home. In a year’s time, we will publish a report on the progress made across Canada in providing end-of-life care at home.