Chapter 1: Understanding the work

Providing care at the end of life

The palliative care expert says
Dr. Alix Carter explains the difference paramedics make for the family of someone who is dying.(3:22)Video transcript
Dr. Susan MacDonald explains what palliative care is. (3:22)Video transcript
Sarah Walker explains the philosophy of palliative and hospice care. (3:22)Video transcript

Paramedicine has evolved and expanded over the past 30 years from:

  • A “scoop and run” emergency transport service, to also

  • Providing complex care on scene, to also

  • Delivering palliative care to people in their homes.

While paramedics are experienced in caring for people dying as a result of catastrophic events, such as accidents, medical events, and injuries, this new involvement in palliative care brings unique challenges and opportunities to their professional practice.

What is palliative care?

Palliative care refers to care provided to someone with an illness or condition that will shorten their life and ultimately result in their death. It's person- and family-centred, addressing the physical, emotional, social, and spiritual needs of both the individual with life-limiting illness and their family. It can be provided from the time of diagnosis through to death and includes bereavement support for friends and family. Unlike other areas of health care that focus on a specific body part, this care is focused on the “whole person” and their family as a unit. 

The desire to die at home

Many people want to be cared for and to die at home. In the last days and weeks of life, the patient’s symptoms often change, sometimes quickly, and this frequently results in a call to 911. It’s been shown that both patient and family experiences are greatly improved when paramedics are trained to support them at home. Using their expertise, paramedics help people avoid hours of waiting and possibly dying in busy, impersonal emergency departments. Remaining at home allows families to stay together in familiar surroundings for the last days and moments of life. 

See also:10 Myths about palliative care infographic.