The gap between what the system provides and what families actually need
Ontario's publicly funded palliative care system provides real and meaningful support — nursing visits, some PSW hours, access to a palliative physician and team. For many families, it is where they start, and it is an important foundation.
But the hours are limited. Nursing visits may come a few times a week. PSW support may cover mornings or evenings, but not both, and not overnight. Weekends are often thinner. And as a person's care needs increase — as the illness progresses and the support required becomes more constant — the gap between what is funded and what is needed grows.
Families fill that gap themselves, until they can't. A spouse who hasn't slept properly in weeks. An adult child driving two hours each way to check in. A parent who is anxious and in discomfort between visits, without anyone there to sit with them. This is the situation Arcadia's palliative support is built for — not to replace the care team, but to fill the space they cannot cover.
What private palliative home care support can include
The support Arcadia provides in palliative situations is flexible and built around what the family and care team identify as the greatest gaps. Common elements include:
Overnight and 24-hour presenceConsistent overnight support so that the person is never alone and family caregivers can sleep. Around-the-clock care when the situation requires it.
Personal care and comfortAssistance with bathing, positioning, hygiene, and skin care — provided gently and at the person's pace, with attention to comfort and dignity.
Companionship and presenceSitting with the person, reading aloud, playing music, talking — or simply being there in silence. Presence matters, and it is something the clinical team cannot always provide.
Meal support and hydrationPreparing foods that are appetizing and manageable, monitoring intake, and sitting with the person during meals — adapting as appetite and swallowing ability change.
Medication reminders and observationPrompting comfort medications at the right times and observing for changes in pain, breathing, or distress — communicating promptly with the palliative care team when something shifts.
Respite for family caregiversGiving family members time away — to rest, to attend to their own lives, to be a family member rather than a caregiver for a few hours. This is not a luxury in a palliative situation. It is essential.
Support through the final stageArcadia's caregivers are experienced in end-of-life care at home. They work alongside the palliative team to ensure the person's final days are as peaceful, comfortable, and dignified as possible.
After a death, Arcadia can help connect families with bereavement resources through the Ontario Health atHome system and other community supports if needed.
For a more detailed description of how Arcadia structures palliative home care, see our Palliative Home Care service page.
We are here when you are ready to talk
There is no script, no assessment form to fill in before we speak to you. Call us, tell us what is happening, and we will listen. Whatever comes next, we can help you think through it.
(844) 977-0050Talk to Our TeamWhat good palliative home support looks like in practice
Palliative home care is not a standard service delivered in a standard way. The needs of someone in the early stages of a serious illness are different from those of someone in the final weeks of life. Good palliative support adapts continuously — and the people providing it need both clinical competence and genuine human presence.
Caregivers who are comfortable in this setting
Not everyone is suited to palliative care. It requires the ability to be present with grief, to work quietly and without agenda, and to provide comfort without false reassurance. Families should ask directly whether the caregivers assigned to a palliative situation have experience in end-of-life care — and any provider worth working with will answer that question honestly.
Clear coordination with the palliative care team
Private home care in a palliative situation only works well when there is clear communication with the rest of the team. Caregivers need to know the comfort plan, understand what symptoms to watch for, and know how to reach the palliative nurse or physician quickly when something changes. Families should not have to be the relay point between providers.
Flexibility as needs change
The care plan that is right today may not be right in three weeks. A good provider adjusts without friction — adding hours, changing caregivers, shifting the focus of support — as the illness progresses and the family's needs evolve. Rigidity in care planning is a problem in any context; in a palliative one, it can cause real harm.
Support for the family, not only the person who is ill
A serious illness in the family affects everyone. Family caregivers carry an enormous amount — practical, emotional, and often invisible. Good palliative support acknowledges this and builds in genuine relief for the people who love the person being cared for, not just the person themselves. If you are experiencing caregiver exhaustion, our section on
caregiver burnout support is worth reading alongside this one.
Understanding publicly funded palliative care in Ontario
Ontario Health atHome coordinates publicly funded palliative care in the community. This includes nursing, personal support, and in some cases occupational therapy and social work. Families who are not yet connected to this system can request a referral through their family physician, specialist, or hospital team.
The funding available through Ontario Health atHome is meaningful but limited. The hours allocated rarely reflect the full level of support a family needs — particularly overnight, on weekends, or as the illness progresses toward its final stage. Private home care is not a replacement for publicly funded support. It is a way of filling the gaps so that the person can remain at home with the continuity of presence they deserve.
Arcadia works alongside Ontario Health atHome and the broader palliative care system across Toronto, North York, Scarborough, Etobicoke, Markham, Richmond Hill, and Mississauga.
For health professionals referring palliative patients
Palliative care teams, hospital social workers, and discharge planners can refer directly to Arcadia for supplementary home care support. We respond promptly to referrals, communicate clearly with the sending team, and adapt our support as the clinical situation changes. To refer a patient, use our professional referral form or call us directly.
Frequently Asked Questions
Questions families ask about palliative home support
We already have a palliative care team. Why would we need additional home care support?
Publicly funded palliative care in Ontario provides nursing visits, some PSW hours, and access to a palliative care team — but the hours allocated rarely match what a family actually needs around the clock. Gaps in coverage — overnight, on weekends, between nursing visits — are common. Private home care fills those gaps so that your loved one is never without support, and so that family caregivers can rest.
Can Arcadia provide overnight and 24-hour care for someone in palliative care at home?
Yes. Overnight and around-the-clock support is one of the most common reasons families in palliative situations contact Arcadia. As care needs intensify, consistent presence becomes essential — both for the person receiving care and for family members who need to sleep, eat, and have moments away from caregiving without worry.
How does Arcadia coordinate with our existing palliative care team?
We work alongside your palliative care nurse, physician, and any other providers already involved — not instead of them. Our caregivers follow the care plan established by the clinical team, communicate changes promptly, and document what they observe so that the treating team has an accurate picture of how things are going between visits.
What if my loved one wants to die at home? Can Arcadia support that?
Yes — and this is one of the most meaningful things we do. Staying at home through the end of life requires consistent support, good communication between all care providers, and caregivers who are comfortable and compassionate in this setting. Our team has experience supporting families through end-of-life care at home, and we approach it with the seriousness and humanity it deserves.
How do we know when it is time to ask for more support?
Usually when the current level of support is no longer adequate — when a family caregiver is not sleeping, when there are gaps that feel unsafe, when the person receiving care is expressing distress that the current team cannot address with the hours available. If you are beginning to ask the question, it is usually worth having the conversation — before the situation becomes harder to manage. A conversation with our team costs nothing and helps clarify what additional support would actually look like.