Can I get end-of-life care at home if I don’t want to die in a hospital?

You can get palliative care, or end-of-life care, in your home. Palliative care is special medical care for people living with a serious illness. It focuses on providing relief from the symptoms of the illness.

The Ontario Health Insurance Program (OHIP) might pay for some of the care. But it depends on:

• how sick you are,
• what kind of care you need, and
• whether you have family members or friends who will help look after you at home.

Getting services at home

First, contact Home and Community Care Support Services (HCCSS) to find out what services they can provide. They'll ask for your health card number. Someone else, like a family member, can make the call for you.

To find the HCCSS in your area, use the Find Your Local Branch feature at the top of their website. Or call 310-2222 (no area code). For TTY service, see the instructions on their Contact page.

HCCSS can provide:

• nursing and personal care
• medical supplies and medication
• pain management
• medical tests
• help getting to other health services and medical appointments
• hospital beds and other hospital equipment
• home hospice services, including home visits and respite care by trained volunteers

What services you can get depends on:

• how long your doctor says you're likely to live, and
• what care and treatments you'll need to manage pain and keep you as comfortable as reasonably possible.

You can find other resources through your doctors, nurses, friends, and family.

You can also contact community groups and organizations like Hospice Palliative Care Ontario and the Ontario Caregiver Organization.

If you need more care, you might have to pay for services from a private agency.

Rules for care providers who visit you

If you have a contagious illness that spreads easily, like COVID-19 or the flu, care providers who come to your home must follow special rules. This is to protect them and to protect you.

The Ontario Ministry of Health has guidelines that all health-care providers should follow when they come to your home to provide services.

And the Ontario Personal Support Workers Association has guidance for personal support workers to follow when they come to your home.

When the care provider arrives at your home, you may have to be screened for illnesses, such as COVID-19.

Your care providers will have to wear a surgical or N95 mask, and other personal protective equipment (PPE) like gloves. If you have COVID-19 or another respiratory illness, they may ask you to wear a mask. If you don't have one, they'll give you one.

If you have symptoms of COVID-19 or another respiratory illness, your care providers may also need to wear other PPE, such as face shields, goggles, and gowns.

Instead of visiting you at home, doctors and nurses may:

• talk to you by phone, or
• meet you online, using a tool like Zoom.

Preparing for your death

It's very important to prepare for your death by making your funeral arrangements and having a will.

You should also name your substitute decision-makers (SDMs). These are the people who can make personal care decisions for you when you're too sick to make those decisions yourself.

Think about making:

• a Power of Attorney for Personal Care, to name one or more people to make decisions about your personal care, and
• a Power of Attorney for Property, to name one or more people to make decisions about your finances and manage your property until you die.