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Nova Scotia Health needs doctors, nurses and other staff to open its five-bed palliative care unit at Fishermen’s Memorial Hospital in Lunenburg, N.S., according to a spokesperson.
The challenge of finding qualified personnel continues delay the opening of the unit more than four years after its announcement.
“Efforts are focused on continuing to work to secure the rest of the equipment necessary to open the beds,” said the health authority, which in June hired a medical director for the unit.
“Staffing the unit is more complex than just looking at the numbers,” a spokesperson said when CBC News asked how much more staff is needed to open the unit.
“For example, when we hire different types of nursing staff, their skills vary, so it’s not as simple as having a set number of positions.”
Daniel Nowoselski, senior director of advocacy at the Canadian Cancer Society, says this is a reality that many palliative care units, home care services and hospices across the country, especially in rural communities.
“Unfortunately, this is not a unique situation,” he said. “These challenges are very important and will continue to impact us, especially as demand increases.”
According Statistics Canada, older people could represent momore than 20 percent of the country’s population in 2030.
While palliative care is not exclusive to seniors, Nowoselski said, aging is one of the factors contributing to increased demand.
Nova Scotia’s rural populations are aging more than urban communities. According to a 2023 report by the government of Nova Scotia, the middle age cIt continues to increase in most of the province, with the exception of the regional municipalities of Halifax and Cape Breton.
Shortage of workers
Nowoselski saidThe exact number of palliative care staff nationwide is unknown, so the number needed to meet current demand is also a mystery.
What we do know, he said, is that “we don’t have enough people trained and capable of providing those services across the country.”
Dr. Caitlin Lees, assistant professor in the division of palliative medicine at Dalhousie University, says that while urban areas are in greater demand due to larger populations, attracting palliative care specialists to rural areas is difficult.
“Part of the problem is that there is a smaller community of practice, we would say. Therefore, there are not as many other physicians available to provide support,” he said. “And a lot of people want to live in cities.”
He said he typically has one or two palliative care graduates from the family medicine training stream each year.
Lees, who also works as a doctor in this field, said there are other factors that prevent people from practicing the profession.
“It’s one of the lowest-paid medical subspecialties. So I could do other jobs in internal medicine and make a lot more money, but I don’t do it because I really love my job. But I think for the trainees who are starting now in particular, their debt loads are much higher,” he said.
“It’s hard for them to think about doing an extra year or two of training to become a palliative medicine subspecialist and then making much less money than they would have made in another field.”
According to the Association of Canadian Medical Faculties, graduates have an average of $84,172 in debt for medical school expenses, in addition to non-education-related debt.
And it’s an emotionally charged job, Lees said.
“It’s hard to build relationships with patients and their families and then have them die,” he said.
What it means for rural families
Keith Savory, whose mother and father lived near Fishermen’s Memorial Hospital, says he would like to see a palliative care unit closer to home.
When his mother needed hospice care, he and his family had to travel more than an hour to Kentville and spent a considerable amount of money renting an Airbnb to be near her for her last three weeks.
But he said he realizes some families can’t do what his family did.
“I think maybe some of these people don’t have the ability to travel, cancel [work] daily. “There is the cost factor.”
As for Lees, he said it’s important to plan ahead considering the aging population in rural areas.
“We know this from our family medicine training program, but when we train residents in those areas, they are more likely to stay,” he said. “Therefore, improving the capacity to train subspecialists, such as palliative medicine specialists, in more rural areas would likely also improve access.”
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