‘Dying with dignity:’ Mobile team brings palliative health care to those experiencing homelessness

A one-of-a-kind team is providing palliative care for people in the GTA who are experiencing homelessness. Faiza Amin speaks to the team about how they help those often forgotten by the heath care system.

By Faiza Amin

A one-of-a-kind team is providing palliative care to those who have limited access to that kind of supports in Toronto.

The Palliative Education And Care for the Homeless (PEACH) team, which was formed in 2014, looks after people experiencing homelessness who oftentimes feel forgotten by the medical system.

The team, which consists of palliative care doctors, nurses, a psychiatrist, a social worker and more recently, a health navigator, provide these patients with tailored supports beyond just medical care.

Jamie was struggling with a multitude of health issues, including an HIV diagnosis, while also experiencing homelessness for a decade, when doctors told him nothing more could be done.

“He didn’t want respite. He wanted to get better. They were saying you can’t get better, you’re terminal,” Jamie’s mother Sandra Read told CityNews. She received a letter from the hospital saying Jamie had been admitted to the hospital with a terminal illness, and they weren’t going to be able to treat him.

“I thought, they’re not trying to kill you,” shared Read. “They’re just willing to let you die and this is a fact because he’s still alive.”

The reason he is alive is because of the PEACH team. “I begged people to help Jamie and then I got in touch with the PEACH team. They heard my plea and came to my aid.”

Dr. Naheed Dosani is a part of the mobile team that is funded by the Inner City Health Associates. They travel by car, transit, bike and on foot, spending hours on the road treating these patients.

The team meets their patients wherever they are whether it is parks, shelters, rooming houses or on the streets, to deliver what they say is “trauma-informed” compassionate care.

“People experiencing homelessness deserve the compassionate kind of healthcare that every Canadian deserves access to,” said Dr. Dosani. “There are lots of instances where we come in and we do the right things technically and medically, but the person doesn’t trust us, because they’ve been traumatized by the healthcare system in the past.”

The newly added health navigator role helps address some of these health inequities that prevent patients from accessing care and services while also bridging the gap to provide basic necessities.

“Palliative care is not just the prescribing of medications, it’s also putting in place the supports that the person may need usually that relate to social determinants of health. [Things like] housing, income, and transportation, social factors that play a role in determining health status of individual,” said Leeann Trevors, who is the health navigator for the PEACH team.

Recognizing that these factors can transform the lives of patients that have faced systemic barriers in accessing even the basic necessities during vulnerable period in their life.

“All of a sudden, they can really turn around. They can improve,” explained Dr. Dosani. “In the case of Jamie, you can see how good palliative care, which is a good approach to care that recognizes a person’s humanity, people can thrive and can outlive their prognosis.”

The turning point for Jamie was being able secure housing at an HIV-specialty hospital through the PEACH program. At that point, his prognosis changed.

“They got food for him. They got people to come. They tracked down his old doctor,” explained Read. “When they say frontline, the PEACH team is frontline.”

Lisa Gayle was diagnosed with incurable metastatic breast cancer in 2020, leading her to struggle to make ends. “I was working then I got sick with an illness, then I lost my job and during that time, I got diagnosed with cancer.”

Despite being on a waitlist for Toronto housing for over eight years, it was the PEACH team and caseworkers with other social services that helped her secure a roof over her head.

“It’s been very helpful to me to share my experiences with cancer and looking for homes,” said Gayle, adding it alleviated a lot of the pressure. “It’s so overwhelming, you need everything.”

PEACH psychiatrist Dr. Daniel Rosenbaum said securing housing can be impactful on his clients, in the case of Gayle, he tells CityNews he noticed a big difference.

“It can be the case, when people do secure housing, that some of the larger concerns sink in a different way, the work in therapy is different,” added Dr. Rosenbaum. “What I try to do is meet with people and help them process some realities that come with adjusting to a life-limiting illness.”

Dr. Rosenbaum’s clients are often dealing with socio-economic challenges, but when someone is unhoused, he said, their survival needs are different and so is the weight of a serious illness.

“The weight of things like that hasn’t sunk in, because they’re still thinking about not having a roof over their head or where their next meal will come from … there is the realization that they might die on the street, for instance, that comes with deal with indignity.”

Another key part of the PEACH team is their advocacy for what Dr. Rosenbaum calls, “solvable problems with good social policy.”

“Housing is simply a human right that people deserve to lead dignified lives where their fundamental needs are met. The fact that our system doesn’t provide that security is a real shame in my opinion.”

Lisa Gayle passed away in June 2022 after CityNews spoke with her. Gayle expressed that she was most proud of being able to share her story and hoped that it would lead to a ripple effect of change in communities across Canada.

This is just one of several stories on how the medical system is failing Canadians across the country. Watch “Veracity: The Broken Normal” for more on Sunday Aug. 14 at 9 p.m. EST only on Citytv.


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