There is certainly something ironic in that statement especially since palliative care takes place when a terminal patient has reached a point where life-sustaining procedures are no longer viable. It is designed to promote comfort and enhance quality of life to ensure the patient dies with dignity and pain free. It is not intended to increase the patient’s survival rate.

A recent study published by the New England Journal of Medicine has come to show that patients with a  fatal type of lung cancer who received early-on introduction of palliative care not only had an improved survival rate, but also had lower rates of depression and  enhanced mood. It also decreased the overall cost of treatment.   If palliative care is so beneficial, why is it that less than 5% of Canadians receive adequate palliative care?

There seems to be an overall lack of awareness when it comes to palliative care. When the discussion is brought to the table, it is a sign of the inevitable. People associate it with the “no other options” speech and because of this they are inclined to avoid discussion and vie for other options, such as euthanasia.

In fact, the debate about euthanasia has resurfaced in Quebec since the Montreal Gazette ran an article earlier this week outlining the fact that a staggering 71% of Canadians would favor euthanasia as an appropriate way to die with dignity. Perhaps, it’s not that surprising since Canada’s recent 9^th place ranking on the Quality of Death index released last month. (Read blog) Citing that Canadians rarely discuss palliative care options, it is clear that the benefits of palliative care are not well understood.  Frustratingly, it’s not as if the advantage of discussing palliative care early in a diagnosis is a novel concept.  Studies have shown that when patients talk openly to their physician about end-of-life options, they are more willing to accept palliative care.

So how do we get Canadians to understand that euthanasia doesn’t necessarily have to be the end-all to a patient’s suffering?  The answer may seem simple: get doctors talking about palliative care with their patients; get the government to sanction and pay for public health policies for palliative care; get people talking about the benefits of palliative care. Yet, to change the minds of so many Canadians is a large obstacle to overcome.

Studies, such as the one released in the New England Journal of Medicine, are a start.  They spark a gamut of debates and increase the public’s knowledge of what’s going on in the field of palliative care. The idea is not to provide false hope that people with terminal illnesses can ultimately survive longer with adequate palliative care, it is to illustrate the continued benefits for someone who does receive appropriate end of life care.

There is clearly something to be said about the British cancer patients who lived three months longer than their terminal counterparts.  The necessity for palliative care in the final stages of life is obvious and a good palliative caregiver may be worth a hundred times more than the decision to euthanize.

 It’s hard to ignore: Technology in the health care setting is everywhere.  Whether it’s a new iPhone app or a new electronic gadget or software program, everyday there is something new on the market designed to personalize the medical home and enhance the patient’s quality of care.

 Thanks to recent technological advances in home care monitoring, children can have peace of mind knowing that their parents are safe and healthy from a distance.   Likewise, parents can have peace of mind knowing that they will be able to stay in their own home as they age.  They can take their blood pressure, get weighed, check their blood glucose level and be reminded to take their medications with electronic medication dispensers all within the comfort of their own home.  As technology revolutionizes home care, the burden of the sandwich generation becomes a little lighter.

 Recently, certain telemonitoring systems allow children to monitor aging relatives from their home using motion detectors to track their parent’s every move and respond appropriately.  If a parent is at high risk of falling, a system such as this may be the very thing that could safe their life.  Yet, amidst the exciting home care breakthrough of having access to a parent 24/7, there is something intrusive about knowing when your parent uses the washroom or opens the refrigerator door. Systems like these have certainly taken home care to a whole new level, but has this new level gone too far?  When parents ask to stay at home, electronic babysitting is not likely what they have in mind. 

 There are masses of new monitoring systems, all essentially with the same goal in mind: to help maintain a person’s independence at home while being able to provide personalized care at the same time.  However, the problem with advancing technologies is that they lack the quality of care behind the service.  It is positively welcoming when children take the initiative to encourage their parents to remain in their home, but there is nothing comparable to the one-on-one interaction and provision of services between caregivers and their clients.  What these home monitoring systems lack is obvious: compassion, empathy, personality, availability – humanity. 

 This is where home care companies, like Equinoxe, come in. Through it’s stringent hiring processes and ISO mandated policies, Equinoxe provides premium at-home care with a specialized staff of Care Managers that oversee, match and train caregivers to deliver a higher standard of care. Equinoxe’s telehealth incorporates electronic medication dispensers and monitoring systems in conjunction with it’s other services.  The monitoring systems are connected to a computer network that generates and relays information via Equinoxe’s medical call center.  Family members are notified right away regarding the status of their loved one.  By integrating telemonitoring systems with highly trained staff, patients can experience both the benefits of human relations and technological aids. 

 There’s no question, technology has a deserving and much needed place in home care.  It’s a matter of deciding at what point technology has compromised the care associated with caregiving.

 Think about what you ate today.  Chances are you have already exceeded the recommended daily intake of sodium. Generally speaking, a healthy diet should contain about 1500mg of sodium per day up to 2300mg.  Canadians, however, consume, on average, 3400mg per day.    The front page of Friday’s Globe and Mail spells it out loud and clear: Canadians eat way too much salt! 

 What sodium does to your body

Sodium is vital for the body to function properly.  It keeps the fluids in your body balanced and helps to transmit nerve impulses as well as contracting and relaxing your muscles, including your heart.  But, if there is too much sodium in the body, more water is retained causing blood pressure to rise.  This can lead to an array of problems.   3 out of 10 Canadians are hospitalized for problems related to sodium intake.

Where does your sodium come from?

• Many processed foods contain preservatives that elevate sodium levels.  Ingredients that enhance color and taste or add to texture are likely to contain lots of sodium such as MSG (monosodium glutamate).
• Naturally, vegetables, dairy products and meat contain sodium in small amounts.  Foods that are cured, like ham and bacon however, sometimes can have up to 1/3 of your daily sodium in one serving.
• Condiments – you may not realize it but adding dressing or ketchup to your meals can increase your sodium content more than the meal itself.  Soy sauce alone can have close to 1000mg for one tablespoon.

What is the spoonful a day challenge?
By 2016, Health Canada wants to have Canadians consuming no more than 2300mg per day: a spoonful of salt.  You can start your challenge today.  Try to keep a log of what you are consuming every day.  Lower your sodium intake by keeping each meal between 300-400mg of salt if you can.  You will be surprised at how fast it adds up. 

 How to reduce your sodium intake?

• Avoid high sodium products – look at your labels. If you buy canned goods or boxed items, chances are they are loaded with preservatives – go for the low sodium options
• Eat fresh fruits and vegetables – try munching on these instead of salty snacks like pretzels
• Use different spices, other than salt, to flavour your cooking
• Don’t eat out as much – most restaurants don’t control the amount of sodium in their food and usually cook with ingredients that are loaded with salt.  If you do eat out, ask for sauces on the side or go with the meal that contains the most amounts of raw vegetables. While fast food restaurants are getting better, one meal will often account for your whole day’s worth of sodium

  Results from the Interstroke study we blogged about last month indicated that high sodium content ranks as the fourth modifiable cause of 90% of strokes. (Go to blog)  While we may not be as bad as our American counterparts, who consume on average 5000mg per day, we are still putting our health at risk every day by choice.  Getting Canadians to cut out the salt is going to be tough but it’s a lifestyle choice that needs to be made. 

 Based on the Globe and Mail’s figures, if Canadians can reduce their sodium intake to one teaspoon per day, a savings of 1.4 billion dollars of health care spending per year can be reduced.  Now, think about what you are going to eat tomorrow.