When it comes to end-of-life care, the importance of community hospices cannot be overstated. These facilities offer patient-centered care that prioritizes comfort, dignity, and the autonomy of individuals nearing the end of life. Historically, religious and hospital-affiliated hospices have played significant roles in providing this care. However, these institutions often come with ideological or institutional restrictions that can limit patients’ options, especially for those seeking Medical Assistance in Dying (MAID). Independent community hospices fill this crucial gap, offering inclusive, secular, and comprehensive services that respect the diverse needs and choices of patients.

The growing divide between hospitals and hospices highlights the critical role that independent hospices play in our healthcare system. While hospitals are designed to handle acute medical needs, they are often ill-equipped to provide the holistic, compassionate care that terminal patients require. This mismatch puts a strain on both the hospital system and patients. When hospices are underfunded or unavailable, hospitals become overburdened, diverting resources from acute care and struggling to meet the specialized needs of terminally ill patients. Independent community hospices help alleviate this burden by providing dedicated, specialized care for end-of-life patients, allowing hospitals to focus on their primary mission of acute care.

A key issue that continues to hinder hospice care is funding. In Ontario, the cost of operating a hospice bed is far less than that of a critical care hospital bed, reflecting the differences in care intensity and resource demands. The daily cost of a hospice bed ranges from $439 to $628, a price that is subsidized through community donations, as government funding typically covers only 60% of expenses. This is a stark contrast to the significantly higher costs of hospital care. For instance, an ICU bed in Canada averages around $3,500 per day, while the cost of a general hospital ward ranges from $850 to $1,100 per day. This significant financial disparity underscores the cost-effectiveness of hospice care, which offers a more home-like environment at a fraction of the expense associated with hospital-based critical care.

In Ontario, many palliative care patients still die in hospitals, with over 52% of deaths occurring in hospital settings in 2017/18. The average length of stay for palliative patients in these settings is around 13.5 days. If a significant portion of these patients were transitioned to independent hospices, the potential cost savings could be substantial – reaching millions of dollars annually. This not only speaks to the financial efficiency of hospices, but also to the human side of the equation: patients would have the opportunity to spend their final days in a setting that better aligns with their personal values and comfort.

Another compelling reason to support independent hospices is their commitment to inclusivity. Religious-affiliated facilities, while providing valuable care, may impose beliefs that do not align with all patients’ values, potentially alienating those from different backgrounds. Independent hospices, however, embrace Canada’s rich cultural and spiritual diversity, ensuring that all patients receive care that is free of judgment and tailored to their personal wishes. For rural and underserved populations, these hospices help reduce barriers to access, ensuring that equitable care is available to those who may otherwise face challenges in receiving it due to geographic or institutional constraints.

The case for investing in independent community hospices is both an economic and moral imperative. Not only do these facilities provide compassionate, patient-centered care, but they also offer a more affordable alternative to hospital-based care, ease the strain on hospitals, and ensure that patients’ right to choose is respected. It is essential for both governments and communities to prioritize the development and funding of independent hospices, ensuring that end-of-life care remains dignified, accessible, and inclusive for all Canadians.