Palliative Care
Advanced Integrative Palliative Care
The Integrated Health Clinic offers a truly first-in-class Advanced Integrative Palliative Care approach for patients diagnosed with any serious and life-limiting illness. This includes cancer, and also advanced heart, lung, liver, kidney, autoimmune or other chronic illness.
FAQs
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Palliative Care focuses on providing the support necessary to enjoy the best quality of life while living with a serious illness. Palliative care aims to incorporate the mental, physical, psychosocial, and spiritual needs of a patient and their family and caregivers through an interdisciplinary team approach.
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A palliative care consultation is recommended soon after a serious illness is diagnosed to ensure a holistic approach- addressing physical, emotional and spiritual needs- can be integrated into the treatment of cancer or other diseases.
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In many parts of the world these terms are often used interchangeably but in British Columbia we use them to mean two different, but related, things. Hospice refers to a facility that provides end-of-life care. It is designed for patients who would benefit from 24/7 supportive care, have a life expectancy of 3 to 6 months, and have chosen to forgo any disease-directed treatment.
Palliative care is suitable at any stage of a serious illness and can be provided alongside disease-directed treatment. It is tailored to the patient’s needs and delivered in various care settings to ultimately enhance quality of life while managing a serious illness.
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Integrated Health Clinic is proud to have BC’s only truly integrative palliative care team, with our NDs providing generalist palliative care alongside palliative care specialist Dr. Kevin Sclater, MD, CCFP(PC). Dr. Sclater is a family physician with specialist certification in palliative care who practices at our White Rock clinic. Dr. Sclater has developed a growing interest in naturopathic and integrative medicine. Dr Slater requires a referral from your family physician to have his fee covered by MSP. Call the office for more information.
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Dr. Sclater has served as a palliative care physician for over 25 years. He is certified by the College of Family Physicians of Canada with an “added competency in palliative care” and was previously granted certification from the American Board of Hospice and Palliative Medicine. For 19 years, he worked as an attending physician at Crossroads Hospice in Port Moody. Additionally, he has also provided palliative care services in both hospital and community settings as a consultant physician and continues to provide after-hours support for hospice and community clients within Fraser Health.
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Advance Care Planning (ACP) is the process of thinking, talking, and documenting your wishes and preferences for future healthcare in the event that you are unable to make decisions for yourself. This process also involves discussing your wishes with trusted individuals in your life. Advance care planning is essential regardless of your age or current health status. It is a process that should be carefully considered, discussed, and reviewed every few years.
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Planning Steps
Think: what is right for you? What are your values, wishes, beliefs and understanding about your care and specific medical treatments?
Learn about medical procedures as some may improve quality of life, and some may only keep you alive longer?
Decide on a substitute decision maker. Choose someone who would honour and follow your wishes, values, and beliefs if you were unable to speak for yourself.
Talk about your wishes with your loved ones, family physician and care team.
Record and Review your wishes; written or voice recording.
In order to guide you through this process, we have created an Advance Care Planning Activity to encourage patients to determine what their wishes are and who their decision makers may be.
Palliative Care Resources
Please find below references and resources that can help support patients and their families in a variety of circumstances.
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My Advance Care Planning Guide: Because my wishes matter.
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My Wishes, My Care: Advance Care Planning Information Booklet.
Your Rights and Legal Options
Representation Agreements:
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Enduring Power of Attorney: https://www2.gov.bc.ca/assets/gov/health/managing-your-health/incapacity-planning/enduring_power_of_attorney.pdf
Representation Agreement: Section 7
Also requires:
Certificate of Representative or Alternate Representative
Certificate of Monitor (if Representative Agreement names a Monitor)
Certificate of Person Signing for the Adult (is person signing the agreement on behalf of the adult)
Certificate of Witnesses
https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/10_199_2001#section7
Representation Agreement: Section 9
Definitions
Please find below definitions that can help support patients and their families in understanding terms they may become exposed to during the palliative care process.
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A capable adult thinking, talking, and documenting their beliefs, values, and wishes regarding future health care treatments. This information can then be referenced in the event the adult is unable to speak for themselves.
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A legal document created by a capable adult that outlines decisions regarding the acceptance or refusal of specific healthcare treatments, including life support and life-prolonging interventions. This document is intended for healthcare providers in the event that the adult unable to make decisions.
It does not need to be prepared up by a lawyer or notary.
Must state:
A healthcare provider may not administer any healthcare services that you have declined in your advance directive.
A person may not be selected to make decisions on your behalf regarding any health care for which you have provided written instructions on in this directive.
Capability
All adults are presumed capable of making healthcare decisions to until there is clear evidence on the contrary. This decision may be based on:
Understanding information related to their health decisions.
Understanding the nature of the proposed healthcare.
Understanding the information provided applies to them.
Committee
A person appointed by the court to make healthcare and personal decisions for the benefit of an adult who is incapable of making decisions independently.
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A legal document that enables adults to designate another individual to manage their financial and legal affairs in the event that they are unable to do so themselves.
General POA: can be limited to a single bank account or a specific asset, or it can encompass all financial and legal affairs for a designated period of time.
Enduring POA: designates an individual to manage your legal and financial affairs in the event that you require assistance with decision-making or become incapable of making decisions on your own.
PDF of the Enduring POA form
Representation Agreement
A legal document in which a competent adult designates a representative to make decisions on their behalf in the event that they become unable to do so.
Section 7: Standard Representation Agreement
Allows: decisions regarding healthcare, personal care, legal matters, or routine financial decisions.
Does not permit: decisions regarding life support or life-prolonging medical interventions on your behalf.
Must include:
Certificate of Representative or Alternate Representative
Certificate of Monitor
Certificate of Person Signing for the Adult
Certificate of Witness
Section 9: Enhanced Representation Agreement
Allows: decisions regarding personal care and health care, including life support and life-prolonging medical interventions.
Does not permit: financial and legal decisions
Temporary Substitute Decision Maker
A person designated to make decisions on your behalf if you are unable to do so and have not legally appointed an individual.
Chosen by a doctor or health care provider
The person must be over 19 years old, capable, have no disputes with you, and have been in contact within the past year.
Approach list is as follows:
Your spouse
Son or Daughter
Parent
Brother or sister
Grandparent
Grandchild
Anyone else related to you by birth or adoption
A close Friend
Personal immediately related to you by marriage