Nova Scotia's hospice bed shortage leaves dozens waiting for dignified death

For workers at Hospice Halifax, the focalize is on console, lordliness and the personal journeying at the terminate of life.

But the care is out of reach for many in Nova Scotia, where a severe shortage of specialized hospice beds means a peaceful death is a privilege, not a guarantee. 

Claire Prashad, nurse manager at the hospice, underscores the critical need for more specialized end-of-life care.

Prashad says there should be seven hospice beds for every 100,000 people, but Nova Scotia isn't at that level.

There are only 30 hospice beds in all of the province — 10 in Halifax, 10 in the Annapolis Valley and 10 in Cape Breton.

To meet accepted standards, Nova Scotia needs up to 80 beds total, she says. The Halifax Regional Municipality would require up to 30.

Prashad says this leaves the hospice with the difficult task of juggling the 10 beds they have, with around 30 to 35 people waiting for care at any given time.

She says the process is heartbreaking.

"For every one person we can take in, two are turned away," she says.

A statement from the Department of Health and Wellness says it's conducting a review of hospice care across the province.

That includes hiring a medical director to oversee the phased expansion of services at Fisherman's Memorial Hospital in Lunenburg with five new hospice beds, the statement says.

Asked about the shortage this week, Health Minister Michelle Thompson said the province also offers 40 single palliative care beds as an alternative.

End-of-life care can be delivered in a number of ways, including in hospitals, long-term care or community settings, she said.

"We're aware that there's improvements that need to be made, and we'll continue to work on that issue," Thompson said.

But Prashad's experience points to a gap between other palliative settings and the specialized hospice model.

She said she collaborates with community nurses and hospital units to assess needs, aiming to prevent deaths in emergency rooms or ambulances.

Prashad says that hospice care provides a home-like setting, unlike a hospital palliative care unit located in an institution.

The small team of 14 regular staff are trained in presence and listening, she says.

They support each other through reflective briefings and memory books that record stories of each patient who has died.

"It's just kind of a switch in perspective," Prashad says. "Instead of looking at cure, you're looking at comfort, which is still just as powerful to be a part of."

The hospice started as a grassroots effort, growing from community support and donations, but it still requires government funding to operate, Prashad says.

She wants members of the public to write to their MLA and draw attention to the need for hospice services in their community.

"The people who know, know — and we're advocating."

Valley Hospice in Kentville also has 10 patient beds, but operates on a different financial model than its Halifax counterpart.

It was built by the Valley Hospice Foundation and is owned and operated by Nova Scotia Health.

Gerry Morey, chair of the foundation, says the only sustainable model in the Annapolis Valley was to raise the money to erect a building and put in the initial equipment, then hand it over to Nova Scotia Health.

The majority of Valley Hospice's funding comes from the province, he says. The foundation provides supplementary funding.

Since accepting its first patient in September 2020, Morey says there has been a steady increase in demand.

He says their current occupancy is over 80 per cent.

"They can't speak highly enough about the compassionate and empathetic care that they're receiving from the caregivers that are there, including the volunteers," he says of patient feedback.

For those who secure a bed, the experience is life-changing.

The hospice model provides care that fits each person's physical, emotional and spiritual needs.

This can include music therapy, pet visits and fulfilling final wishes.

Kaitlin Cantrell, the social work co-ordinator at Hospice Halifax, says each plan is unique and is tailored to meet a patient's needs.

A key benefit is the relief it brings to families, she says.

"Their families get to be their family instead of having to play caregiver and learn how to be a nurse or a personal support worker or an advocate or their transportation," she says.

"To be able to be here and just be a sister, a mother, a brother, a wife, a husband, a friend, is huge."

Reporter/Editor

Vernon Ramesar is a reporter and video and radio journalist originally based in Trinidad. He now lives in Halifax.

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