Advance Planning and Self-Management

By completing your Action Plan (COPD, Asthma, or Pulmonary Fibrosis) you are entering into a contract of shared decision making with your healthcare team based on your awareness of your normal symptoms and the management of your flare-up symptoms that lead to an exacerbation. 

• Don’t wait more than 48  hours after the start of flare-up symptoms to take your antibiotic and/or prednisone medications. A prior discussion with your provider or pharmacist is required.
• Follow up with your healthcare provider within 48 hours of starting flare-up medications.
• When you are well, be as active as possible. Weakness leads to more and worsening flare-ups.
• Stay up to date with your vaccinations for influenza (yearly), pneumonia (variably), COVID-19 (as recommended) and RSV (as recommended).

• Find something good about every day.
• Quit smoking

As your disease progresses, you may need additional support. When meals, personal care, home upkeep and transportation become challenging, reach out to rural, regional, or provincial/territorial resources for help. Your healthcare team can direct you to services in your community. Community support services found across Canada can ease the burden for you and your caregiver.

What is home care? 

Home and community care services allow people to receive some medical services and social support in the home. These services support independence in the home for as long as possible. Needs-based home care services are funded by provincial, territorial and some municipal governments. The federal government provides home care services to First Nations on reserve, Inuit in designated communities, members of the armed forces and the RCMP, eligible veterans, and inmates serving time in federal prisons. 

The goals of home and community care are to:

• Maintain and improve quality of life
• Assist in maintaining independence
• Support family/informal care givers who are caring for the ill
• Support persons needing treatment, rehabilitation or palliative care

Talk with your healthcare provider or team member in order to receive a referral for home care services. Home care services may include nursing, personal care, physiotherapy, occupational therapy, speech therapy, social work, dietitian services, homemaking services or respite care. 

Find out more about home care in your province or territory:

• Alberta
• British Columbia
• Manitoba
• Newfoundland and Labrador
• New Brunswick
• Northwest Territories
• Nova Scotia
• Nunavut
• Ontario
• Prince Edward Island
• Quebec
• Saskatchewan
• Yukon

What are palliative and hospice care? 

Both palliative care and hospice care support people who are living with a life limiting disease. The care approach of palliative and hospice care includes pain management and symptom management, as well as social, psychological, emotional and spiritual support for the you and your caregiver. These care and support services are provided by an interdisciplinary team of nurses, therapists, social workers, physicians, clergy, personal support workers and volunteers. 

Palliative care is generally received as your disease advances.  Palliative care helps you to maintain independence, dignity, comfort and the alleviation of distress. It offers access to information, as well as support in care decisions that will affect the quality end-of-life care, thereby supporting you and your family/caregiver.

Hospice care is a special type of palliative care reserved for the final stage of life. It provides a holistic approach to end-of-life care with the focus on comfort and dignity. It not only supports physical, emotional and spiritual comfort, but also provides you and your family/caregiver with an understanding of what to expect, as fears and hopes are discussed on an individual basis. Hospice care can be received in the home, in a special unit of a hospital or in a long-term care facility focusing on comfort care.

Accessing palliative care services 

• Provincial and territorial contact information for end-of-life care services (Government of Canada)
• How to access palliative care in Canada (Canadian Pulmonary Fibrosis Foundation)

You have the opportunity now to make decisions regarding your end-of-life care that reflect your wishes and your spirit. This is a gift to yourself and to those who care about you.

Advanced directives

Advanced directives are directions given about the care that you would like to receive and who you would like to make decisions for you if you can no longer make decisions yourself. Advanced directives are sometimes referred to as “living wills”.  Types of advanced directives and the terms used to describe them may vary between provinces and territories.

• It is important to consider and state your desires for resuscitation (DNR), terminating advanced medical assistance, and financial oversight, as well as your personal care preferences and any strong wishes regarding your religious convictions or cultural beliefs.

Power of attorney

Power of attorney (POA) is a legal document that gives someone you trust the ability to make decisions on your behalf. The person designated as your POA can be a spouse/partner or other family member, a friend or a lawyer or trust company. A power of attorney is only valid if you are mentally capable at the time you sign it. Each province and territory has its own laws relating to powers of attorney.  

Last will and testament

A will is a written, legal document, signed by you. The signing of this document must be witnessed by two individuals who are not beneficiaries or receivers of your properties or finances. A will directs how your properties and finances should be distributed or dissolved after your death. 

Consider:

• Who will receive your goods and possessions, particularly if there are special items?
• How do you want your assets distributed?
• Who will care for any dependents?
• Is there is a certain minimum age for receiving money? If so, the money should be placed in trust. 

What is Medical Assistance in Dying (MAiD)?

In 2021 the Government of Canada updated the eligibility criteria for MAiD. All of the following conditions must be met:

• You must be eligible for federal government, province or territory funded health services.
• You must be 18 years of age or older and mentally competent.
• You must have a grievous and irremediable medical condition.
• You must make a voluntary request for MAiD that is not a result of outside influence.
• You must give informed consent to receive MAiD.

To be considered as having a "grievous and irremediable medical condition", you must meet all of the following criteria. 

• You must have a serious illness, disease or disability. 
• You must be in an advanced state of decline that cannot be reversed.
• You must be experiencing unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions that you consider acceptable.

You do not need to have a fatal or terminal condition to be eligible for medical assistance in dying.

If you have a mental illness along with other medical conditions, you may be eligible for medical assistance in dying.

Eligibility is always assessed on an individual basis and takes all relevant circumstances into account. However, you must meet all the criteria to be eligible.

Visit the Government of Canada's site for more information on MAiD.