PRIORITIES: Home-Based Palliative Care

FACILITATING DIFFICULT CONVERSATIONS

Facilitating difficult conversations is essential in home-based palliative care, where patients and families face complex emotional and medical decisions. To support healthcare providers, the CHCA offers practical resources designed to build confidence, structure, and compassion in communication. Grounded in practical experience, expert insight, and patient perspectives, these tools help healthcare providers engage in meaningful dialogue, align care with patient wishes, and deliver more person-centred, supportive care in the home setting.

BUILDING CONFIDENCE IN COMMUNICATION

Clear, practical guidance on what to do, when, how, and why helps nurses feel more confident in difficult conversations. In this video, home care leaders share how the Be Prepared: Palliative Care Emergencies in the Home Conversation Guides are strengthening care—one conversation at a time.

Be Prepared: Palliative Care Emergencies in the Home Conversation Guides

The CHCA, in partnership with the Montreal Institute for Palliative Care, developed the Be Prepared Conversation Guides to help healthcare providers manage six common palliative care emergencies in the home. These guides were created in response to an urgent need for improved preparedness and communication around serious events in home-based care. A key influence in their development was the work of Dr. Cornelius Woelk, a Canadian palliative care physician, who championed proactive and compassionate conversations to help families anticipate and respond to crises. His clinical insights emphasized the emotional distress caused by unmanaged emergencies and the essential role of healthcare providers in guiding families with clarity and empathy.

Each guide contains three main sections:

  1. Conversation Checklist: A structured, step-by-step tool for initiating difficult conversations with empathy and confidence.
  2. Emergency Information: Clinical summaries, including symptoms, risk factors, and treatment options, with suggested language for explaining key information to families.
  3. Patient & Caregiver Tool : A simple, one-page summary offering guidance and immediate actions for families to take while waiting for professional support.

The guides are available as downloadable PDFs and can be customized with your organization’s logo for use in training, education, and frontline care.

Breathing (dyspnea)

Balance (Hypercalcemia)

Bleeding (massive hemorrhage)

Brain (seizures)

Bones (spinal cord compression)

Blockage (superior vena cava obstruction)

Instructional Videos on How to Use the Conversation Guides

Video that details how and when the guides can be used.

Role-play presentation from the VHA Home HealthCare team.

Advance Care Planning in Canada: Resource Guide for Home Care Providers

This resource guide offers practical, field-tested tools to help home care providers strengthen their capacity in advance care planning. It supports early and ongoing conversations, understanding and documenting patient wishes, and integrating those wishes into care plans with appropriate legal considerations.

Designed for organizations providing home-based palliative care, including policy planners, program developers, educators, and team leaders, the guide features adaptable resources to build knowledge, processes, and motivation among both regulated and unregulated care providers. While not an exhaustive list, the resources were carefully selected based on expert interviews and a review of open-access Canadian tools. The guide is intended as a practical starting point for embedding Advance Care Planning into everyday care.

Home-Based Palliative Care page

This project has been made possible through a financial contribution from Health Canada.
The views expressed herein do not necessarily represent the views of Health Canada.

This post is also available in: French

Established in 1990, the Canadian Home Care Association (CHCA) is a national non-profit membership association dedicated to advancing excellence in home and community care.

National Office: 905-567-7373     |    General Inquiries: chca@cdnhomecare.ca

2000 Argentia Road, Plaza 3, Suite 302. Mississauga, Ontario, L5N 1W1

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This post is also available in: French