Hospice Care in British Columbia: A Current State Assessment

In autumn 2019, BC Centre for Palliative Care conducted a current state assessment of the not-for-profit hospice care sector in British Columbia to generate a deeper understanding of: 1) the variety of hospice programs and services in BC; 2) the people and care settings supported by these programs; 3) funding sources; 4) workforce structure. 

The administrators of 71 hospice organizations in BC were invited to complete an online survey between September 3rd and October 6th, 2019. The survey was completed by 53 hospice organizations, resulting in a 75% response rate. 

The hospice organizations that participated in the survey reported that they serve an average of over 10,000 people monthly through their hospice palliative care and education programs. Hospice clients include individuals with life-limiting illnesses, older adults with chronic conditions and comorbidities, caregivers, and grieving family members and friends, among others. 

Hospice services focus on the unmet psychosocial and practical of their clients and are provided in a variety of settings including in the person’s home, long-term care homes, hospitals, and assisted living residences. Most hospice organizations have programs that provide one-to-one palliative support, companionship, grief support, vigil support, practical support, caregiver support, and arts-based therapy.

Only a few hospice organizations operate inpatient hospice beds or facilities. The survey participants (including those who do not operate hospice beds) reported that they support more than 300 hospice beds across various care settings in the province.

Many hospice organizations have established education programs to raise public awareness and knowledge of the benefits of hospice palliative care and how to access these services when needed. In addition, they offer education sessions for the public to enhance their selfcare skills and support their engagement in advance care planning which can help people get the care that is consistent with their wishes.

Most hospice services are provided by well-trained volunteers who support the highly qualified hospice staff at a nearly 10:1 ratio. More than 70% of hospice organizations reported that at least 50% of volunteer hours are allocated to provide direct care and support to patients and families. Hospice volunteers receive 30 hours of basic training before commencing their hospice work and 20 hours of annual training to further develop their skills in facilitation and related topics.

Almost all of the survey participants who do not operate hospice beds report that an overwhelming percentage of their funding (approximately 75%) is derived from community sources including fundraising, gaming grants, and donations. The few organizations that operate hospice beds reported that over 50% of their funding is provided by the Ministry of Health and/or health authorities.

The results of the survey highlight the unique strengths of the hospice care services and workforce structure. The well-trained volunteer networks and highly qualified staff allow hospice organizations to provide a wide range of direct and indirect care to a larger segment of the BC population, thus supporting more individuals and their caregivers to live well in the place of their choice

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