%0 Journal Article
%T What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?
%A Donna M. Wilson
%A Boris Woytowich
%J International Journal of Palliative Care
%D 2014
%R 10.1155/2014/529681
%X Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll. 1. Introduction Currently, 55 million people die each year worldwide [1]. Although many different illnesses and other factors are responsible for these deaths, most deaths occur in old age after advancing senescence has reduced life expectancy [1]. With population aging starting to accelerate now that the first members of the large baby boom generation have reached the age of 65, a rapid increase in deaths is expected [2, 3]. For instance, in 2030, when the entire baby boom cohort has reached the age of 65, 500,000 deaths are anticipated for Canada, double the current number [4, 5]. With most hospitals and nursing homes in Canada at full capacity now and with rising healthcare costs being a concern in Canada if not in all other countries, the prospect of an increasing number of terminally ill and dying persons is daunting. However, although some terminal illnesses (defined as the period following the diagnosis of a life-limiting illness) and some dying processes (defined as the last minutes or days of life when death is obviously imminent) are highly problematic, end-of-life care needs to vary considerably [6¨C10]. Needs may be minimal to extensive in number, short- to long-term in nature, and basic to complex in terms of type [6¨C10]. All people who suffer from a difficult terminal illness or dying process, such as when severe intractable pain is present, should receive the services of a palliative care medical or nurse practitioner specialist [7, 9¨C11]. Not only are difficult symptoms or other problems more likely to be successfully addressed but
%U http://www.hindawi.com/journals/ijpc/2014/529681/