The idea for a centre to foster hospice care for marginalized populations grew from the Journey Home Hospice for the homeless in Toronto, where 8,000 to 9,000 people are living in the street on any given day. Photo supplied by Saint Elizabeth Foundation; used with permission.

National Centre of Equity EOL Care Launched on a Prayer

By Alison Ramsey
IAHPC Newsletter Editor

It isn't often that a 118-year-old decides to kickstart a new project, one with a sweeping vision to comfort the country's most vulnerable at their most vulnerable time of life: marginalized people nearing death.

At the request of the Archbishop of Toronto, four nurses founded Saint Elizabeth's in 1908 to care for those in greatest need. It grew into Canada's largest provider of homecare services, and founded the groundbreaking Journey Home Hospice for the homeless in 2018.

Hospice for homeless fueled the centre

Father Matthew Durham. Photo used with permission.

"You only have one chance to do end-of-life care, so we wanted to do it well," says Father Matthew Durham, executive director of hospice palliative care at Saint Elizabeth and founding executive director of Journey Home. One compelling measure of success was how well the hospice weathered the COVID-19 pandemic. It remained open to volunteers, not a single employee quit, and a capital campaign even expanded it from a four-bed unit into a 10-bed hospice with three additional beds for those with chronic, life-limiting conditions.

Journey Home Hospice is not the new project, but it was the catalyst.

Despite the hospice tripling in size and opening a satellite location in Windsor, Ontario, "it's never enough," says Father Durham. "There's always a wait list. That was the impetus for a national centre." The Saint Elizabeth Foundation Centre: A National Centre for Equity and Innovation in End-of-Life Care launched in June.

A benefit of old age

Age has its perks. The foundation, in its maturity, didn't need to expand right away to accommodate its new role; the door was simply opened to provide its expertise serving marginalized people and communities more widely. Father Durham is now fielding four or five calls weekly from those with or without existing programs seeking advice.

"They may be looking at harm reduction and want to know our policies or how we mitigate risk. Sometimes it's just sharing a presentation with their board, to put them at ease." 

Depth of experience on offer

The centre can provide training; help communities design models of care that serve their particular needs; advise on the launch of pilot programs in social housing, homeless shelters, and prisons; organize and host webinars and continuous improvement; and more. The services it provides are free of charge.

The need is endless; opportunities to help are, too. Photo provided by Saint Elizabeth Foundation. Used with permission.

The foundation has vast experience advising healthcare professionals in 700 Indigenous communities and organizations, and recently received national research funding to build on the benefits of mindfulness training that Journey Home Hospice staff embraced.

Who are we not serving?

"I hope that our country eradicates homelessness," says Father Durham, "but there will still be those in the margins who need our care at end of life: First Nations peoples and those who are physically disabled, have undiagnosed or untreated mental health challenges, or have addictions.

"Hospice care in Canada has been a white, middle-class movement. I think the founders were so busy keeping things going that they weren't thinking of who we were not serving, so that's what we're doing."

Hope for the future includes finding a major sponsor to offer financial security for its inevitable expansion and would, as a happy corollary, enable the Saint Elizabeth Foundation Centre: A National Centre for Equity and Innovation in End-of-Life Care to adopt a shorter name.

Read more of this week's issue of Pallinews