Hamilton paramedics join pilot to help palliative care patients 'stay where they want to stay'

Hamilton paramedics have joined a province-wide pilot allowing them to treat palliative care patients at home rather than driving them straight to emergency departments. 

Change helps people who are at the end of their lives remain with their families, says superintendent

Dave Thompson, paramedic service superintendent, says treating people at home allows them to stay in a comfortable environment. (Samantha Craggs/CBC)

Hamilton paramedics have joined a province-wide pilot allowing them to treat palliative care patients at home rather than driving them straight to emergency departments.

Paramedic service superintendent Dave Thompson said the program will help palliative care patients "stay where they want to stay." 

"I've been a paramedic for a long time, and there's nothing worse than having to take somebody to the hospital that doesn't want to go," he said. "Keeping them at home is good for the patient, is good for the paramedics." 

A media release from Flamborough—Glanbrook MPP Donna Skelly announced the program on Thursday. The change means eligible palliative care patients can receive appropriate care directly by paramedics or in the community. 

Thompson said being able to treat and refer people within their community is a "huge win."

Paramedics trained in administering medications

Prior to the launch, the release said, paramedics were required to bring 911 patients to hospital emergency departments. 

Now, palliative care patients who dial 911 will have the option to be treated on scene for pain management by paramedics. Afterward, they'll be referred for follow-up care with their primary palliative care team. 

Thompson said the change will help keep people together during the pandemic. (Richard Lyons/Shutterstock)

Hamilton paramedics — over 400 now — have received 17 hours of training in administering medications. All the medications, with one exception, can be used by any level of paramedic.

At any time, the release said, a patient can still request to be taken to the emergency department. 

Staying in a comfortable environment

The program started on April 7, and Thompson said there are about 20 enrolments. 

As it launches, home and community care will refer patients to the program. Once registered, Thompson said someone's address becomes like a "flag" so paramedics on a 911 call to the site know one of these patients is present. 

Thompson said many of the calls deal with pain management, but also nausea and vomiting or delirium.

Especially for delirium, he said, taking someone from an environment they're used to being in and putting them in an ambulance and eventually an emergency room can perpetuate or make the delirium much worse.

Keeping families together

The goal is to meet a patient's wishes, he said, and treating people at home allows them to stay in an environment they're comfortable with. 

"Giving palliative care patients the choice to be treated by paramedics in the comfort of their home ultimately improves the quality of life for patients and their families," said Michael Sanderson, chief of the Hamilton Paramedic Service in the media release. 

Thompson also noted that people going through end of life stages during the pandemic aren't able to see their loved ones when sent to the hospital. They become cut off from their families, he said. 

"Nobody wants to go through end of life disconnected from their family, or the family being disconnected from somebody that's going through that," he said. "With everything that's going on now, it also addresses some of those challenges that we're seeing."

Relieving pressure on emergency departments

Ultimately, Thompson said, the move can also take some burden off emergency departments in the city. 

Skelly's release said the approach will avoid "unnecessary visits" to hospitals as the province responds to the third wave of the COVID-19 pandemic.

"As Hamilton's hospitals continue to face unprecedented capacity pressures during the third wave of the pandemic, this new model of care will enable our world-class paramedics in Hamilton to support our most vulnerable patients in the most appropriate setting," she said.

It will be in place for one year and will be evaluated afterward. To date, similar 911 models of care pilots have been approved in 33 Ontario municipalities.