1. Why is there a need to focus on rural people? Palliative Care and End-of Life Meeting Edmonton, Alberta May 20, 2010 Sharon Baxter, CHPCA

2. Overview of National facts What does this mean to rural Canada Policy perspectives – Questions to Ponder

4. Canada: 9,900,000 Square Km

5. Overview of National facts 2 nd biggest country (land mass) in the world yet only 33 million people An aging population like much of the developed world Nationally funded health system – Canada Health Act – does not cover all settings of care

6. Federal government responsible for health care to First Nations and Inuit peoples, Veterans, military and federal prisoners 10 Provinces and 3 Territories – responsible for the implementation of health services Most have some sort of regional health systems/authorities/CLSC/LIHNs except PEI and Alberta Over 100 different health systems

7. 259,000 Canadians died in 2007 74,000 of cancer (28%) so what about the other 72% Somewhere between 15 – 36% of Canadians have access to hospice palliative care services in Canada. (CIHI 2008) Rural and remote Canada is generally doing much worse

8. Hospice Palliative care is a set of services offered in a variety of settings including acute care, long term care facility/complex continuing care, residential hospice, home or occasionally on the street. It can look different based on the needs of the patient and family and the setting of care. We need seamless transition between settings. What happens in rural and remote Canada that may not have access to various settings

9. What does this mean for rural Canada Settings of care are often more limited Settings of care are often not in one’s own community Often means leaving your own community for care – isolation from family Often means that family, caregivers and community takes on more care --if they remain in home – often without much support

10. Who provides the care – what are their needs Need to address primary health care provision of services Need to connect primary and tertiary care settings Need better supports for family/informal caregivers – roster of programs Need research/dissemination of best practices Where Are We Now

11. Policy Perspectives – Questions to Ponder How do we create some minimum level of care that all Canadians could access How do we provide a more seamless transition between jurisdictions like provincial borders How do we provide a more seamless transition between settings of care

12. How do we meet the needs of a minority of people (living in rural Canada) that have little voice in policy development We need to open the dialogue on death and dying and Advance Care Planning – engaging Canadians