I really believe that we should harness whatever resources we have, and if it is everyone's business, then absolutely, a PSW or a paramedic can play a critical role in helping out. In fact, we're seeing this happening in Nova Scotia and P.E.I., where we went out and developed a LEAP paramedics course. It's a one-day course that trains paramedics. They do some online learning beforehand and then they come together in a classroom.
We're beginning to see some of those early successes in reduced admissions or transfers to the emergency room. Why? Well, it's for two reasons. First of all, the paramedics are now equipped with some of that knowledge and the skill sets, and they are more comfortable addressing a situation, including undertaking some discussions about goals of care and even advanced care planning.
Second, it's part of a whole system. If we also train the emergency staff so that they often phone with the basic essential skills of palliative care, then everyone's talking the same language and everyone's on the same page, and you start seeing things changing. Instead of saying, “Bring the patient over”, it becomes, “Okay, let's look at this. What's the situation? Let's try to care for the person at home and let's put in resources that are available in the home.”