Hospice, palliative, and end-of-life care (HPE) are not adequately accessible or culturally appropriate for the large majority of Canadian seniors. This is particularly true for seniors with dementia and seniors who live in long-term, congregate, or hospital care settings.

Despite having a mortality rate of 4.3 times higher than seniors without dementia, HPE is rarely offered or provided to seniors with dementia. They are less likely to be referred to palliative care teams, are prescribed fewer palliative care medications, and are infrequently referred to, or are in fact, denied access to hospice care.

Recommendation #44: Dementia

Work with stakeholders such as Alzheimer’s Societies and healthcare providers to integrate HPE care into dementia supports.

Recommendation #45: Dying at Home

Expand HPE care into home settings. The government and stakeholders in the sector should work with home care providers and families to increase education and training for HPE at home.

Recommendation #46: Advance Care Planning

Integrate legal education on substitute and supported decision-making, rights, and Powers of Attorney/Representation Agreements (or local provincial equivalent) into health and social care training as a required component of licensing. Support healthcare training to support conversations about the importance and benefits associated with advance care planning.

Recommendation #47: Medical Assistance in Dying (MAiD)

Ensure equitable and accessible access to appropriate medical assistance in dying (MAiD). Develop resources to support the education of patients and healthcare professionals about disability rights and supports, HPE care and MAiD. As MAiD qualifications develop and modernize, ensure expanded access and knowledge tools are made available to individuals, caregivers, and healthcare professionals.