Bruyère Drives Change in a Palliative Approach to Care

Bruyère is a multi-site academic health care organization comprised of both specialized hospitals and long-term care homes. As a provider of palliative services, both in clinical and long-term care settings, Bruyère researchers are working to transform when and how we can provide care, so patients, residents, and their families and care partners receive the greatest benefit possible. A recognized leader in palliative care, Bruyère is improving the quality of life for patients and their families.

For many Canadians, discussing death, dying, and end-of-life care can be challenging; something to be avoided. Yet an open conversation with loved ones and health care providers can alleviate fear and help to initiate a stage of care that supports symptom management and the emotional, psychological, and spiritual needs associated with care at end-of-life.

Recognizing the Need

Research at Bruyère focuses on overcoming many of the challenges in accessing and providing quality palliative and end-of-life care. Among the top priorities is the need to improve how clinicians and care teams identify patients and residents who are in, or entering, a phase of their care journey that could benefit from a palliative approach.

For care teams, making an accurate and timely call can be challenging. Tools that focus on prompting staff or care partners about the risk of impending mortality can be the key to ensuring patients and residents are offered palliative care planning options early enough, so their health and well-being is supported at all stages.

In hospitals, a modified Hospital-patient One Year Mortality Risk (mHOMR) assessment alerts admission staff of patients with an elevated risk of mortality in the upcoming year as a means to consider the potential need for palliative care planning. In long-term care and the community, the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool (RESPECT) helps older adults evaluate life expectancy and facilitates informed end-of-life conversations and decisions with family and care teams.

The research behind these tools and their potential across care settings highlight how prediction models and big data can be a valuable support to care teams and transform how and when palliative care is delivered across the Canadian health system.

Making an Impact

Once patients and residents with life-limiting illnesses are engaged in discussion with clinicians, families, and care partners, delivery of palliative and eventually end-of-life care focuses on pain and symptom management and quality of life. Recognizing that the average life expectancy in long-term care is under two years from moving in, Bruyère's research has helped to equip long-term care teams to recognize the need to initiate conversations around end-of-life planning.

Research at Bruyère has focused on the unique challenges and considerations of palliative care delivery both in and out of clinical settings, addressing the changing demographics, increased pressure on caregivers, and person-centered care. Paired with evidence-based long-term care team education provided by the Ontario Centres for Learning, Research and Innovation in Long-Term Care, ongoing research initiatives are making their way into the hands of healthcare managers and frontline workers.

Whether it's new tools, innovative models of care, or educational resources, the Bruyère Research Institute, now home to many of the research initiatives under the Pan-Canadian Palliative Care Research Network, has been dedicated to advancing palliative care in Canada to improve the experience for care teams, patients, residents, and their loved ones.

Research at the Bruyère Research Institute supports a paradigm shift, moving from a focus on end-of-life itself to palliative care; compassionate care that supports quality of life while we live.