Imagine you are at the end of your life and you wish to move to another province to be with your family in your final weeks; imagine being told you need to wait three months to receive anything more than necessary care, which means that palliative care will be out of your reach. Three months isn’t a very long time, especially when looked at in most other terms: a three-month relationship is hardly considered long term; a three-month-old baby is still so young, so small, with so many milestones ahead; a twelve-week term of employment goes by faster than a blink. But when you’re at the end of your life and all you want is to die at home surrounded by family, three months is time you don’t have.
Dan Duma and his wife returned to Ontario in 2016; he was suffering from terminal liver cancer and wished to die surrounded by his children. The couple had moved to Alberta three years earlier for work, and Duma had lost access to Ontario’s publicly funded home care services when they left the province. To get it back, there was a three-month waiting period. One of Duma’s daughters is a registered nurse, and she asked Dr. Darren Cargill to provide care for her father.
Dr. Cargill is a palliative care physician; when he was approached by Duma’s daughter, he was probably not a stranger to the challenges faced by terminally ill patients in Canada wishing to return to, or travel to, Ontario from other provinces to die surrounded by family. The spotlight shone on the issue by Duma’s family provided Dr. Cargill an opportunity to advance a cause he understands all too well. Along with the Duma family, Dr. Cargill has become a champion advocate of Dan’s Law, aiming to change the current Ontario Health Insurance Plan (OHIP) by abolishing the three-month waiting period for home care services for terminally ill people moving or returning to Ontario.
Dr. Cargill has noted that while he was able to care for Duma in his final weeks, the care he was able to provide was disjointed, and he has commented that forcing terminal patients to wait three months for care seems backward. In the end, Duma passed away in a hospice care facility, rather than at home as he wished, only one month into OHIP’s imposed three-month waiting period for palliative care.
The Duma family and Dr. Cargill are devoted advocates, raising awareness about necessary access to palliative care for so many patients who cannot wait three months. Their efforts may be rewarded beyond Ontario’s borders … only time will tell.