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Trailblazing a Path to Quality Care: Canada’s Supportive Palliative Service for the Unhoused

By: Sabreen Huq, C-TAC Partnerships & Programs Intern

Founded in 2014 by Dr. Naheed Dosani, the Palliative Education and Care for the Homeless (PEACH) program is a supportive palliative service advanced by the Inner City Health Associates (ICHA). Aimed at meeting the complex needs of people experiencing subsequent housing insecurity and serious illness, PEACH focuses on care delivery that enhances quality of life through patient agency over end-of-life goals and decisions. PEACH operates as a “trailblazing” mobile unit, providing care in shelters, on the streets, and with community-based services in collaboration with Toronto Central Local Health Integrated Network’s Home & Community Care team. The program supports and educates mainstream palliative care services in Toronto to work successfully with people experiencing homelessness.

PEACH has played a critical role in transforming the way individual’s experiencing housing insecurity access quality palliative care. Working within an anti-racist and equity-driven framework, PEACH is advancing the prioritization of key social drivers of health, such as housing, in the delivery of care for people living with serious illness.

PEACH’s holistic approach towards enhancing quality of life has impacted countless lives, including 56-year-old Jay. Having received a 2-month prognosis following the discovery of end stage liver disease, Jay was referred to the PEACH program in July 2020. Insecure housing resulted in Jay constantly being “lost to follow up” after being discharged. Without a phone, it was difficult for his health care team to reach him to schedule appointments. PEACH’s prioritization of Jay’s social determinants of health allowed him access to his liver and lung specialists, and a physician to discuss his symptoms. The program also provided Jay with assistance that supported his capability to be healthy through food security, housing security, and transportation access.

PEACH’s interventions and continued compassion allow for Jay to receive the quality care he needs. According to Jay, PEACH’s services led him to feel “better for the first time in a long time.”

C-TAC recognizes that to achieve health equity for vulnerable populations within the serious illness field, innovative solutions are needed to improve interactions between our health systems and marginalized populations. Our 2021 Policy Agenda highlights this need and provides insight on C-TAC’s approach to dismantling systemic barriers to high quality serious illness care for all.

The PEACH team offers a unique perspective on care delivery that underscores the needs of a widely-overlooked community in our field. Increased efforts to address the complex social needs of patients will help advance efforts to deliver quality healthcare services for all people living with serious illness.

To learn more about PEACH, visit the ICHA website here!

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