A PORT in the Storm: A day of education and discussion about equitable access in palliative care

On Thursday, October 29, 2015 the University of Victoria Equitable Access to Care Study Team (PI Kelli Stajduhar), Victoria Hospice, and the Palliative Outreach Resource Team (PORT) hosted an interactive and educational event about palliative care for structurally vulnerable people. Structural vulnerability recognizes that particular groups of people are more vulnerable to harm as a result of intersecting factors (e.g., poverty, homelessness, gender, disability, race, illicit drug use, mental health issues, etc.). The intent of this day was to foster dialogue between formal palliative care providers (e.g., hospice personnel, home care workers, etc.) and downtown service providers (i.e., health, housing, faith and social service organizations) to identify challenges in our community with regards to palliative care access for these populations.

The day began with a welcome from City Councillor Marianne Alto who spoke about the significance of dignified palliative care services for Victoria's inner city population. Participants then heard about current research on palliative care and structurally vulnerable populations through presentations by Dr. Kelli Stajduhar, Lead Investigator with the University of Victoria's Equitable Access to Care study, and Dr. Ryan McNeil from the BC Centre for Excellence in HIV/AIDS, a leading researcher in the field.

A series of presentations followed on promising practices in palliative care from Dr. Naheed Dosani, lead physician with PEACH (Palliative Education and Care for the Homeless) in Toronto; Dr. Sue Burgess, a physician providing palliative care in Vancouver's Downtown Eastside; and Victoria's Palliative Outreach Resource Team. After lunch, a panel of practitioners from Pacifica Housing, Cool Aid Community Health, Victoria Hospice, the Dandelion Society, Our Place Society and AIDS Vancouver Island spoke about the challenges to providing and accessing palliative care for the people they serve.

The remainder of the event was spent in small group discussions where participants with diverse employment backgrounds, including front line workers, health care professionals, managers, executive directors, spiritual practitioners and people with lived experience of poverty and homelessness participated in discussions about challenges to palliative care access in Victoria. Finally, Dr. Dosani facilitated break-out groups where participants had the opportunity to discuss how 7 palliative care principles (i.e., flexible admission criteria; consistent and continuous case management; maximize flexibility of program policies; foster peer-support networks; employ diverse and holistic care models; prioritize client dignity; provide palliative care within intensive supportive housing) could be implemented in various organizations for a community-based response to this important issue.

The day was a great success and people left feeling inspired. We are currently in process of writing up the main findings of the day which will be made publicly available. The Equitable Access to Care study will continue with data collection until spring 2016. We plan to host another community forum with people who have lived experience of poverty and/or homelessness to seek feedback on findings as well as to contribute to project recommendations. For more information about the Equitable Access to Care study please contact Ashley Mollison, Project Coordinator at equitableaccess@uvic.ca.

Thanks to our generous funders and contributors: The Sovereign Order of St. John of Jerusalem Knights Hospitaller Victoria Commandery, Victoria Hospice, the Canadian Institutes of Health Research (CIHR) and the UVic Centre on Aging; and our presenters, panelists and facilitators.

Media links:

CFAX: Dr. Kelli Stajduhar's CFAX Interview with Terry Moore on October 29, 2015.

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