Equity in Palliative Approaches to Care (ePAC)

What is ePAC?

Equity in Palliative Approaches to Care (ePAC) is a community collaborative informed by a research program led out of the University of Victoria. Members of the collaborative work together to conduct research with local, national and international partners, and develop resources and tools, programs, and services aimed at improving access to quality care for people facing the end-of-life and who also face inequities like homelessness, poverty, isolation, racism, and stigma. 

To access our ePAC newsletter and blog, equity-informed tools and resources, and information about Victoria's Palliative Outreach Resource Team (PORT) head to www.equityinpalliativecare.com 

Why equity in palliative approaches to care?  

People who face inequities like homelessness, poverty and stigma and who are also living with a life-limiting condition (like cancer, lung, liver or kidney disease, organ failure) are considerably disadvantaged as their health declines. We believe that a palliative approach to care for people facing inequities and declining health will result in a better quality of life until death, and that such an approach promotes a compassionate, person-centred and community-informed response to the inequities faced by some people in our society. 

Who is involved in ePAC?  

Our collaborative includes university-based researchers, clinicians (such as doctors, nurses, social workers), inner city workers, chosen family members and friends, health and social care administrators, volunteers, and peers who work together to support quality care and minimize barriers that are often faced by people experiencing inequities as they are coming toward the end of their lives. We believe that understanding and caring for people who face inequities and experience declining health is a collective responsibility.

How did ePAC begin?

In 2011 a group of Victoria inner city service providers began working together with the aim of improving quality palliative care for their clients. This initial collaboration resulted in the creation of the Victoria Palliative Outreach Resource Team (PORT). The team provided support to dying clients and acted as a resource in the inner city community but with little funding to support continued work. On the invitation of PORT, a PORT-University of Victoria alliance was formed and such began the ePAC collaborative. 

Lead Researcher – Equity in Palliative Approaches to Care

Dr. Kelli Stajduhar, RN, PhD, FCAHS
Professor, School of Nursing
Research Affiliate, Institute on Aging and Lifelong Health
University of Victoria

Ashley Mollison, MA
ePAC Project Coordinator
Institute on Aging and Lifelong Health
equitableaccess@uvic.ca or 250-472-5501

Who funds our work?

Vancouver Foundation

Canadian Institutes of Health Research

Canadian Cancer Society Research Institute

Saint Elizabeth Health

 

Publications

Stajduhar, K., Mollison, A., Giesbrecht, M., McNeil, R., Pauly, B., Reimer-Kirkham, S., Dosani, N., Wallace, B., Showler, G., Meagher, C., Kvakic, K., Gleave, D., Teal, T., Rose, C., Showler, C., & Rounds, K. (2019). “Just too busy living in the moment and surviving”: Barriers to accessing health care for structurally vulnerable populations at end-of-life. BMC Palliative Care 18(11). doi: 10.1186/s12904-019-0396-7

Giesbrecht, M., Stajduhar, K., Mollison, A., Pauly, B., Reimer-Kirkham, S., McNeil, R., Wallace, B., Dosani, N., & Rose, C. (2018). Hospitals, clinics, and palliative care units: Place-based experiences of formal healthcare settings by people experiencing structural vulnerability at the end-of-life. Health and Place, 53(September), 43-51. doi:10.1016/j.healthplace.2018-06-005

Stajduhar, K.I., Mollison, A., Gleave, D., & Hwang, S.W. (2017). Editorial: When cancer hits the streets. Current Oncology, 24(3), 1-2. doi:10.3747/co.24.3698

Reimer-Kirkham, S., Stajduhar, K., Pauly, B., Giesbrecht, M., Mollison, A., McNeil, R., & Wallace, B. (2016) Death is a social justice issue: Perspectives on equity-informed palliative care. Advances in Nursing Science, 39(4), 293-307. doi: 10.1097/ANS.0000000000000146

Op-eds and media

Hunter, Justine. (2019, April 19). Planning for death, when life is a struggle – project helps marginalized populations prepare for a dignified end. The Globe and Mail and UVic News. https://www.theglobeandmail.com/canada/british-columbia/article-planning-for-death-when-life-is-a-struggle-project-helps/

Alex, C. (2018, October 28). Palliative care offers homeless people ‘dignified death’, says University of Victoria prof. CBC News, Thunder Bay. https://www.cbc.ca/news/canada/thunder-bay/palliative-care-homeless-thunder-bay-1.4878721

Watts, R. (2019, Sept 20). Palliative-care team taking it to the streets. Vancouver Sun and Times Colonist. https://vancouversun.com/news/local-news/new-program-provides-palliative-care-to-victorias-homeless 

Van der Zwan, Adam. (2019, Sept 20). Doctor and nurse go mobile to provide palliative care to Victoria’s homeless. CBC News. https://www.cbc.ca/news/canada/british-columbia/doctor-and-nurse-go-mobile-to-provide-palliative-care-to-victoria-s-homeless-1.5290760

Weston, S. (2019, Sept 19). New palliative care program provides end-of-life support for Victorians living in poverty. CTV News. https://vancouverisland.ctvnews.ca/new-palliative-care-program-provides-end-of-life-support-for-victorians-living-in-poverty-1.4601281 

UVic News. (2019, Sept 19). New program provides mobile end-of-life support to people in poverty. UVic News. https://www.uvic.ca/news/media/2019+port-pallitive-care-stajduhar+media-release 

Crescenzi, N. (2019, Sept 19). Mobile palliative care team launches for downtown Victoria’s homeless population. Victoria News. https://www.vicnews.com/news/mobile-palliative-care-team-launches-for-downtown-victorias-homeless-population/

Stajduhar, K. (2018, September 28). Comment: Housing crisis makes sick people sicker. Times Colonist. https://www.timescolonist.com/opinion/op-ed/comment-housing-crisis-makes-sick-people-sicker-1.23445228

Meissner, Dirk. (2018, September 26). BC cancer patient’s cases exposes gaps in care for homeless people, advocates say. The Globe and Mail. Also picked up by the National Post, Toronto Star, and Global News and across several BC’s Black Press publications. https://www.theglobeandmail.com/canada/article-bc-cancer-patients-case-exposes-gaps-in-care-for-homeless-people/

Cheung, Simon. (2018, September). Final Indignity. Megaphone Magazine. file:///C:/Users/learn/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/7CRAP5LJ/Megaphone211_Web.pdf

Stajduhar, K., & Mollison, A. (2017, July 10). Opinion: Community workers, street family hit hard by B.C.’s opioid crisis. The Globe and Mail. https://beta.theglobeandmail.com/opinion/community-workers-street-family-hit-hard-by-bcs-opioid-crisis/article35651815

Stajduhar, K., & Mollison, A. (2016, August 14). Comment: Homeless deserve end-of-life care, but aren’t getting it. Times Colonist. http://www.timescolonist.com/opinion/op-ed/comment-homeless-deserve-end-of-life-care-but-aren-t-getting-it-1.2322386

Nair, R. (August 15, 2016). Dying on the streets: UVic study examines palliative care for the homeless. CBC News. http://www.cbc.ca/news/canada/british-columbia/palliative-care-homeless-victoria-1.3721373

Stajduhar, K. (August 15, 2016). UVic researcher Kelli Stajduhar on end-of-life care for homeless patients. CBC’s On the Island. http://www.cbc.ca/news/canada/british-columbia/palliative-care-homeless-victoria-1.3721373

Stajduhar, K. (October 29, 2015). CFAX interview with Terry Moore. (recording unavailable)

Stajduhar, K. (November 2, 2015) CBC interview with Robyn Burn's from All Points West (recording unavailable)

 

Community events

Symposium on integrating a palliative approach for structurally vulnerable people in Victoria. (October 17, 2017). Victoria City Hall, Victoria, BC. Report back.

A PORT in the Storm 2: “Lunch & learn”. (October 27, 2016). The Victoria Event Centre, Victoria, BC. Report back.

A Port in the Storm: A day of education and discussion about equitable access in palliative care for structurally vulnerable people in Victoria. (December, 2015). Ambrosia Centre, Victoria, BC.