What an NS palliative care unit tells us about Canada’s rural health care challenges

Nova Scotia Health needs doctors, nurses and other staff to open its five-bed palliative care unit at Fisherman’s Memorial Hospital in Lunenburg, N.S., according to a spokesperson.

The challenge of finding qualified employees continues To Delay of more than four years in opening of the unit after its announcement,

“Efforts are focused on continuing work to secure the rest of the team needed to open beds,” said the health authority, which appointed a medical director to the unit in June.

When CBC News asked how many more staff were needed to open the unit, a spokesperson said, “Staffing the unit is more complex than just looking at the numbers.”

“For example, when we hire different types of nursing staff, they have different qualifications, so it’s not as straightforward as a set number of positions.”

Daniel Novoselsky, senior advocacy manager at the Canadian Cancer Society, says it’s a reality that many palliative care units, home care Service And hospices face problems across the country, especially in rural communities.

“Unfortunately, this is not a unique situation,” he said. “These challenges are significant and will continue to impact us, especially as demand increases.”

according to statistics canada, Senior people can represent mo2. More than 20 percent of the country’s population030,

While palliative care isn’t just for older people, increased care is one of the factors contributing to the high demand, Novoselsky said.

Nova Scotia’s rural population is aging more than urban communities. according to a 2023 report By the Government of Nova Scotia, the average age cRates continue to climb across most of the province, except Halifax and Cape Breton Regional Municipalities.

labor shortage

Novoselsky saidThe exact number of specialized palliative care staff nationally is unknown, so the number needed to meet current demand is also a mystery.

What we do know, he said, is that “we don’t have enough people who are trained and able to deliver those services across the country.”

Dr. Caitlin Lees, assistant professor in the department of palliative medicine at Dalhousie University, says there is greater demand in urban areas due to larger populations, but it is difficult to attract palliative care specialists to rural areas.

“Part of the issue is that there’s a small community of practice, we’ll call it. So there aren’t as many other physicians to support,” he said. “And a lot of people want to live in cities.”

He said they usually have one or two graduates each year from the family medicine training stream specializing in palliative care.

Lees, who also works as a physician in the area, said there are other factors keeping people away from the profession.

“It’s one of the lowest-paid medical subspecialties. So I could do other work in internal medicine and make a lot more money, but I don’t because I really love my job. But I think especially for trainees coming in now, their debt load is too high,” she said.

“It’s difficult for them to actually do one to two years of additional training to become a palliative medicine subspecialist and then make much less money than in any other field.”

In addition to non-education-related debt, graduates owe an average of $84,172 for medical school expenses, according to the Association of Faculties of Medicine of Canada.

And it’s a job that comes with a huge emotional burden, Lees said.

“It’s hard to build relationships with patients and their families and then have to watch them die,” he said.

What does this mean for rural families?

Keith Savory, whose mother and father lived close to Fisherman’s Memorial Hospital, says he would like to see a palliative care unit closer to home.

When his mother needed palliative care, he and his family had to travel more than an hour away to Kentville and spend a fortune renting an Airbnb to be close to her during the last three weeks.

But he said he realizes some families aren’t able to do what his family did.

“I think maybe some of these people don’t have the ability to travel, to cancel (work) every day. There’s the cost factor.”

For Lees, he said it is important to plan ahead considering the growing aging population in rural areas.

“We know from our family medicine training program, but when we train residents in those areas, they are more likely to stay,” he said. “So improving the capacity to train subspecialists, such as palliative medicine specialists, in more rural areas will likely also improve access.”

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