Palliative care support system not there for Richmond County, says physician

A doctor who provides palliative care in Richmond County, N.S.,sayshe'll stop taking new patients as ofthis week, because the supports necessary for end-of-life care aren't being provided by the Nova Scotia Health Authority.

Dr. Robert Martel's entire practice has been providing mostly home-based, palliative care to patients in the county.

• Opinion |Dr. Robert Martel: Nova Scotia health care 'keeps me up at night'

Martel said the current provincial model provides a palliative care co-ordinator, who would ask a physician to provide care to an individual patient if needed at a frequency of once every three weeks.

Information Morning - NS13:19Doctor says NS Health Authority not helpful on rural palliative care

Dr. Robert Martel in Richmond County will stop offering palliative care this week because he says the Health Authority is not offering the support necessary to provide that care. Tricia Cochrane is a Vice President with the Nova Scotia Health Authority.

"That's not the vision that I had for palliative care here, but that's what it morphed into," he said.

"It does not provide any structure whatsoever for support of familyco-ordination of services, acute management in the home, and all the other aspects of care, especially in the last month of life."

According to Martel, a lot of the palliative care actually falls to nurses, while the doctor provides medical oversight, like pain and symptom management as well as medication monitoring.

In an area of the province with one of the oldest and sparsest populations, Martel saysnurses aren'tbeing given the support needed and so neither are the patients.

"These individuals have done yeoman service in a vacuum and they need support," he said.

"But from my perspective, unless there is a structure with a quality piece attached to this and support for professional development, we're doing a disservice to the patient," said Martel.

'That is not true'

Martel also told CBC's Information Morningthat nursing for palliative care isn't available after standard business hours, but a vice-president with the Nova Scotia Health Authority said that's not accurate.

"That is not true, there is evening service available in Richmond County, as in other counties," said Tricia Cochrane.

We need to plan and we are working in that area to try to understand.- Tricia Cochrane

Cochranesaid individual plans are created based on individual needs.

"Care plans are done for each client in consultation with the family and based on that nursing service is available," she said.

Cochrane added that since the health authority took over a year ago, it hascompleted a review of what palliative care resources are in place. While they do differ across the province, she said they are on par with national standards.

However, she said the authority will further look at the resources available and continue to work with staff, including Martel, to figure out what works best.

"We need to plan and we are working in that area to try to understand," she said.

"The local folks have done some planning, our palliative care provincial co-ordinator is now involved in that to try to understand what those gaps might be and how with community partners we can address them."