CHARBONNEAU – All I want is a good death. Is that too much to ask?


LIKE MOST CANADIANS, I’d like to die in my home surrounded by friends and family. Canadians consistently indicate that is their preference, about 85 per cent of the population.

Or, second best, a home-like setting like the lovely Kamloops Hospice House.  That peaceful setting is where my wife spent her last days as she was dying of cancer.

But contrary to Canadians’ wishes, only 15 per cent die at home.

More often we die in hospitals; more than comparable countries.  Most Canadians, 61 percent, die in hospital. Far more than the Netherlands at 30 per cent. And although we like to boast about our healthcare system, only 20 per cent of Americans die in hospitals according to a report from the C.D. Howe Institute (Globe and Mail, Oct. 26, 2021).

We die in hospitals in the most unpleasant way, hooked up to tubes and machinery that unnecessarily delays the inevitable. Our lives may be prolonged slightly but the declining quality of life is hardly worth the price of suffering.

Canadian cancer patients have the highest rates of hospitalization in their last six months of life (87 percent), compared to England (83 percent), the Netherlands (77 percent) and the U.S. (75 percent).

It’s so unnecessary.

Cancer patients whose condition is stable or reacting positively to treatment don’t require hospitalization. Those dying of cancer, as was my wife, typically require assistance with activities of daily living only in the final weeks or months of life. Terminal cancer patients differ from those dying of almost every other illness — those dying of other illnesses typically require assistance for many months or years before they die.

Older Canadian cancer patients are more likely to die in hospitals and less likely to receive palliative care.

Palliative care primarily focuses on improving comfort and quality of life, often avoiding hospital-based, invasive, costly and potentially inappropriate care. Palliative care is preferably delivered outside of acute care settings, including in patients’ homes.

It’s not the fault of doctors in hospitals or because healthcare workers are unfeeling or uncaring. It’s because of the way the system is structured.

There are too few palliative care beds.  Canada has one-half the number of hospice and palliative-care beds as the United Kingdom.

Treating patients at end of life in hospitals, rather than palliative care beds, is expensive.

Our per capita hospital costs are US$21,840. Canada’s costs are 18 per cent greater than that of the U.S., 100 per cent greater than Netherlands, and 233 percent higher than England. Canada’s relatively poor performance in terms of costs and quality of end of life care is clearly related to the high use of hospitals.

The authors of the report suggest the following remedies:

1 Canada must stop treating end-of-life care as acute care.

2 Palliative and end-of-life care must be provided across multiple healthcare settings. It cannot be the sole responsibility of hospices and palliative care facilities.

3 Training for clinicians, caregivers, even for patients must be provided to recognize the end of life period.

We must have a frank discussion about death. Unless we know the signs of death’s knock on our door, we will be poorly prepared.

David Charbonneau is a retired TRU electronics instructor who hosts a blog at

About Mel Rothenburger (9378 Articles) is a forum about Kamloops and the world. It has more than one million views. Mel Rothenburger is the former Editor of The Daily News in Kamloops, B.C. (retiring in 2012), and past mayor of Kamloops (1999-2005). At he is the publisher, editor, news editor, city editor, reporter, webmaster, and just about anything else you can think of. He is grateful for the contributions of several local columnists. This blog doesn't require a subscription but gratefully accepts donations to help defray costs.

2 Comments on CHARBONNEAU – All I want is a good death. Is that too much to ask?

  1. Having watched people die from cancer, I can honestly say that it was very clear to me that those who got the best care were those who died in a good hospital with a good doctor . A good doctor will not have you connected up to tubes you do not want or having treatment you do not want. Dying at home is really not all it’s cracked up to be, its not like in the movies. Unless you are lucky and die unexpectantly in your sleep, or you have a very uncomplicated death, then dying at home can be very traumatic. For me it is not location but the amount of care and it is difficult to get enough care at home. It would be nice to think we could all have adequate care at home, but this is a fairy tale. If care is complicated then few people have enough available and capable extended family to provide 24 hour care. Many do not want their family members to have to lose their employment or their businesses . Many do not want family members to become exhausted from carrying the full burden of 24 hr care without adequate support. It is easier to spend quality time with family members when family members are distressed with exhaustion and guilt because they are unable to fulfill all the care as well as they wished they could. Dying at home is cheaper but not always better. Most people in the world who die at home, do so because they have no choice. I hope care is better in Canada than it is here.

  2. Ian MacKenzie // November 11, 2021 at 9:21 AM // Reply

    Well researched and stated, David. I’m considerably past an average shelf life myself and when, not if, the time comes I would MUCH prefer to have palliative treatment applied in THE COMFORT AND FAMILIARITY of my own home.

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