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Palliative care refers to care for patients and their families facing a serious, life-limiting illness. Palliative care is patient-centred, coordinated care that aims to relieve suffering and improve quality of life for patients and their families at all stages of the illness.1
For more information, please visit https://www.ontariopalliativecarenetwork
Who can make a referral for palliative care services?
Anyone, including the patient, family members, friends, caregivers, or healthcare providers, can make a referral.
How to make a referral?
Contact Hospice Waterloo Region
Or
Visit the Ontario Health atHome website and use the map to locate your local branch and their contact information.
Call: 310-2222 (no area code needed).
What happens after a referral?
You may be asked some questions to understand your needs. You will either be connected with a care coordinator or referred to a community program or service.
Palliative Care is a multidisciplinary approach that improves the quality of life of persons and their families living with a serious illness, through the prevention and relief of suffering by means of early identification and assessment, and treatment of pain and other problems, whether physical, psychosocial, or spiritual.2
The KW4-OHT is implementing the Palliative Model of Care (PMOC).
The framework outlines three models of care, supported by a competency framework and tools for early palliative care identification. The purpose of this framework is to guide the organization and delivery of palliative care that is evidence-based, person-centered, and equitable.
The Model of Care (MOC) approach considers the organization, integration, and delivery of health services for a patient group as they progress along a care pathway. Its objectives are to:
Optimize the use of health human resources (HHR).
Identify when care can be delivered in a less resource-intensive setting or closer to home.
Integrate opportunities to leverage technology, streamline, or better manage care.
The KW4 Ontario Health Team (KW4-OHT) is implementing the Palliative Model of Care (PMOC).
The Health Services Delivery Framework (HSDF) outlines three models of care and recommendations, supported by a competency framework and tools for early palliative care identification. Together, they align with Ontario’s Quality Standard for Palliative Care for adults with life-limiting illness. The goal is to guide the delivery of palliative care that is evidence-based, person-centred, and equitable across Ontario. The PMOC promotes sustainable, flexible, and locally responsive care.
Focus Area 1: Adults Receiving Care in Community Settings
Focus Area 2: Adults Receiving Care in Hospital-Based Settings (Pending)
Focus Area 3: Pediatric Populations Receiving Care in All Care Settings (Pending)
For more information, please visit here.
A Palliative Clinical Coach works directly with community organizations to:
You play an instrumental role in improving access to high-quality, person-centred palliative care across the community.
Here’s how to get involved → please contact the Palliative Clinical Coach through Hospice Waterloo Region or email hospice@hospicewaterloo.ca .
QA MOC Implementation Legislation 2025 (PDF)
FAQ – A Palliative Approach Frameworks (PDF)
Health Services Delivery Framework & Recommendations (PDF)
End of Life Care Toolkit (PDF)
Tools to Support Earlier Identification (PDF)
Palliative and End-of-Life Care
HPC Consultation Services: Clinical Resources
