For Caregivers

Two young children, being held by their parents, hold hands with each other

The effects of liver disease are felt by many people, on many levels.

As a caregiver of someone living with liver disease, you may share many of the same emotions your loved one is experiencing: fear, isolation, or even anger. This is why part of our job at the Canadian Liver Foundation is to help you turn those negative emotions into feelings of hope and strength.

To avoid the burnout that is often felt while dealing with an illness at any level, it is important to take care not only of your loved ones, but of yourself as well. The information on this page has been designed specifically with caregivers in mind – from expectations to support programs provided by the Canadian Liver Foundation.

To request more caregiver-specific resources or to learn more about the support available to you, please contact us.

liver questions

What to Expect

liver support services

Support Services

tips for liver health

Tips for You

liver health resources

Additional Resources

What to Expect

As a family member or a caregiver looking after someone who has liver disease, you may need to play a variety of roles, which often means taking on responsibility for both physical and emotional support. These responsibilities often include;

  • Taking care of household activities such as grocery shopping, preparing meals, cleaning, and managing finances
  • Helping with grooming, bathing and dressing
  • Managing medical care including maintaining medical records and giving medication
  • Watching for signs and symptoms of worsening liver disease and side effects of medication
  • Scheduling medical appointments
  • Driving and accompanying the person you care for to medical appointments
  • Learning about liver disease and communicating with healthcare and social service providers on behalf of your loved one
  • Listening and providing the necessary emotional support
  • Advocating on behalf of your loved one in all situations

Common questions and concerns from caregivers include:

What can I expect if my loved one’s disease becomes advanced?
As liver disease progresses, the scarring of the liver continues, and your loved one may develop symptoms and complications which may include:

  • loss of appetite, nausea and vomiting, weight loss
  • a yellow discoloration of the skin and whites of the eyes (jaundice)
  • itching (pruritus) which is primarily caused by retention of bile products in the skin
  • fluid build-up and painful swelling of the legs (edema) and abdomen (ascites)
  • confusion and other mental changes, potentially leading to coma
  • swelling or rupture of veins in the esophagus from increased blood pressure in the blood vessels
  • weakness

Even when complications develop, they can often be treated. Please discuss treatment options with your loved one’s healthcare provider.

Can I get a liver disease from my loved one?
There are over 100 liver diseases: some that are caused by viruses (such as hepatitis A, B and C), some that are inherited (like hemochromatosis, Wilson disease) and others that are caused by lifestyle and the environment. If your loved one has viral hepatitis (hepatitis A, hepatitis B or hepatitis C), talk to your healthcare provider about prevention and getting immunized against hepatitis A and hepatitis B. For more information on a specific liver disease and how to safeguard yourself, please read our Liver Diseases section.

What can I do for my child that has liver disease?
If your child has liver disease, the treatment varies with the cause. In general, your child’s physician may prescribe a special baby formula as well as vitamin supplements. Some metabolic diseases, such as galactosemia, require specific diets or drug treatments. For some diseases, such as biliary atresia, surgery on the liver is required.

In many cases, childhood liver diseases can be managed or controlled through diet, medications or other interventions. If the liver is too damaged to function effectively, a liver transplant may be necessary in the first year of your baby’s life.

Please talk to your healthcare provider regarding the specific diet and treatments your child may require.

What are the warning signs of continuing liver disease?
A yellow discolouration of the skin and whites of the eyes (jaundice) that does not disappear is a sign of ongoing liver disease and generally indicates severe liver problems. In an infant who appears to recover from a liver disorder, the return of jaundice is a sign of ongoing disease.

Does liver disease recur in the same family?
Viral infections and biliary atresia are extremely unlikely to affect more than one person in a family. Metabolic disorders of the liver are usually inherited and therefore may occur in more than one family member. Older children in the family should be checked for these diseases, and infants should be followed carefully after birth. Prenatal diagnosis is available for some of these disorders, and genetic counselling may be useful to families who have a history of hereditary liver disease.

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Support Programs & Services

When someone is first diagnosed with liver disease, they may have many questions about their condition, how it will impact their lifestyle and what treatments or other interventions might be available to them. As a caregiver, you will likely have the same questions about your friend or family member’s health. It is important to know there is help available for both you and your loved one.

National Help Line:
This support resource gives you and your loved one somewhere to turn for answers after diagnosis, can help you better understand your disease, and provides you with the resources you need. You can call 1 (800) 563-5483 Monday to Friday from 9am to 5pm EST.

The Peer Support Network:
This is a national network of people living with liver disease that have offered to share their experiences with others. It was developed by the Canadian Liver Foundation as a means to link Canadians who have a family member who has liver disease, who care for someone who suffers from liver disease, or who have been diagnosed with a liver disease, to talk about your concerns with a peer in a similar situation.

If you would like to be connected with a peer supporter in your area, or would like to join the peer support network, please call the National Help Line at 1 (800) 563-5483 or email Billie Potkonjak.

On the day that 17-year-old Matthew Ayuen was scheduled to take his G2 road test, driving was the furthest thing from his mind. Instead of being behind the wheel, Matthew was in surgery having part of his father’s liver transplanted into his body.

During the stressful time between his initial diagnosis of PSC and his transplant, Matthew and his family attended the Canadian Liver Foundation’s Living with Liver Disease Program. The sessions allowed them the opportunity to connect with other individuals and families coping with the same concerns. Now Matthew and his family make their own contribution by helping to raise awareness and funds for liver research and education.

Looking for extra support, or for ways to give back to your community? Learn more about the many ways you can help.

Tips for You

  • Do not neglect your own needs, both emotional and physical. It is important to remember that you also need a break from the disease and the toll it can take on you.
  • Having a support network is important for your own emotional wellbeing. The Canadian Liver Foundation is here to help you access resources like the Peer Support Network where you can connect with others who are going through the same experiences that you are.
  • Ask your healthcare provider, employer, social assistance worker, social worker or someone in your social circle to help you find the resources you need.
  • If your financial circumstances change, rent and mortgage payments may become difficult to manage. If you think that your housing situation will be affected due to a change in income, check with your bank or financial advisor to see if they may be able to provide some short-term solutions for you and your family.
  • Many employers belong to an Employee Assistance Program (EAP) and provide free counselling services to employees. Contact your benefit advisor at your workplace for details on how to access this support.
  • If your loved one becomes very sick or has difficulty getting dressed, walking or bathing, you may be able to have a nurse or home care provider come to your home so your loved one does not have to enter a hospital. A nurse may be able to arrange for other support to allow your loved one to stay at home. Talk to your healthcare provider who can arrange home care services.

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Additional Resources

In Canada, all drugs must go through a drug review process, before they can be made available for sale to patients or access through publicly funded drug plans.  The drug review and approval process starts when a drug manufacturer submits an application to Health Canada. Health Canada scientists and other outside experts review the safety, effectiveness, quality, as well as the potential benefits and risks of the drug.  Once they agree that the drug is safe and effective, it is approved and issued a Drug Identification Number (DIN). The manufacturer is then able to sell the drug in Canada.

Once a drug has been approved by Health Canada, the manufacturer must submit an application to the Common Drug Review (CDR) if they wish to have their drug listed on publicly funded drug plans. The CDR reviews and makes recommendations as to whether new drugs should be covered under publicly funded drug plans. All provinces and territories, with the exception of Quebec, participate in the CDR.  Once a recommendation is made, the provincial drug plans decide whether or not to include the drug on their provincial formulary.  Provincial drug plans are not required to follow the CDR recommendation, because each province and territory takes into account their own health care priorities and available resources.

Private health insurance or drug plans
If you have private health insurance or a drug plan at work, you may be able to have the medication paid through your plan. Please consult your private health insurance or drug plan provider to see if your drug is covered.

Publicly funded drug plans
Each province and territory has their own rules.  Some provincial drug plans provide coverage for individuals 65 and older, or those on social assistance.  Some provinces (e.g. Ontario) provide special support to low income individuals. Please call your Provincial Ministry or Department of Health to get more information about the terms of the publicly funded drug plan in your province. (see links on page 13 of the “How To Health Guide”)

Quebec public drug program
In Quebec, everyone must be covered by prescription drug insurance either through private or publicly funded plans.

Each provincial and territorial government offers a drug benefit plan for eligible groups. Some are income-based universal programs. Most have specific programs for population groups that may require more enhanced coverage for high drug costs. These groups include seniors, recipients of social assistance, and individuals with diseases or conditions that are associated with high drug costs. For more details, please contact your provincial or territorial health care ministry, or click on the appropriate link below.

• Alberta(Prescription Drug Programs)
• British Columbia (Pharmacare)
• Manitoba (Pharmacare Program)
• New Brunswick (Prescription Drug Program)
• Newfoundland (Pharmaceutical Services)
• Northwest Territories (Drug coverage)
• Nova Scotia (Pharmacare)
• Nunavut (Drug coverage)
• Ontario (Drug Benefit Program)
• Prince Edward Island (Drug Cost Assistance Programs)
• Quebec (Prescription Drug Insurance)
• Saskatchewan (Drug Plan)
• Yukon (Insured Health)

Pharmaceutical companies
Some pharmaceutical companies provide medications to patients who cannot afford them or who do not have government or private insurance under the Compassionate Use Programs. Each program has its own terms for eligibility. Please talk to your doctor to see if you are eligible for such a program.

Available Patient Assistance Programs for Hepatitis C treatment
Abbvie Care 1 (844) 471-2273
– Holkira Pak (Ombivasvir/ paritaprevir/ ritonabir + dasabuvir)
– Maviret (Glecaprevir / pibrentasvir)

Gilead Momentum HCV Support Program 1(855) 447-7977
– SOVALDI (Sofosbuvir)
– EPCLUSA (Sofosbuvir / velpatasvir)
– HARVONI (Ledipasvir / sofosbuvir)
– VOSEVI (sofosbuvir / velpatasvir / voxilaprevir)

• MerckCare Hepatitis C Program 1 (866) 872-5773
– Zepatier (Grazoprevir / elbasvir)

Available Patient Assistance Program for Hepatitis B treatment
Gilead Momentum HBV Support Program 1 (888) 453-8885
– VEMLIDY (Tenofovir Alafenamide)

Available Patient Assistance Program for Primary Biliary Cholangitis treatment
• NAVIGATE Patient Support Program 1 (844) 628-4484
– OCALIVA (Obeticholic acid)

Knowledge is the Best Medicine (KIBM) is a program that helps you take control of your health and work with your prescriber and the rest of your healthcare team to manage your medicines safely and appropriately. This program is supported by leading health organizations in Canada who believe that an educated patient is a healthier patient.

KIBM products will enable you and your family to:

• Keep an up-to-date medication list with you at all times
• Communicate your medication/health related needs at each point of contact with the healthcare system
• Easily access medication/health related information

To learn more about Knowledge is the Best Medicine, click here.

If you, or someone you love and care for, are trying to find health services support or information for an illness or disease, there are actions you can take to help get the best possible health care. The Health Charities Coalition of Canada has prepared a How to Health Guide that can help you:

• Understand the health care system
• Find the information and services you need
• Talk with your doctor or health care provider
• Ask for a second opinion
• Manage your condition
• Pay for your medication
• Participate in a clinical trial
• Advocate and ask for the support you need

To download The How to Health Guide, click here.

The Canadian Biliary Atresia Registry (CBAR) is a collaboration between the Canadian Pediatric Hepatology Research Group (CPHRG) and the Canadian Association of Pediatric Surgeons (CAPS), the two well-established networks in Canada involved with the care of children with biliary atresia.

To view the Canadian Biliary Atresia Registry’s Resources for Patients and Parents, click here.