British Columbia

Doctor and nurse go mobile to provide palliative care to Victoria's homeless

A new mobile Palliative Outreach Resource Team (PORT) in Victoria connects people with life-limiting illnesses who are homeless and barely housed to health support systems like palliative care.

Judgment and stigma discourage people from accessing proper care, says local researcher

Dr. Fraser Black is a palliative care physician with Victoria's new Palliative Outreach Resource Team (PORT). (Photo courtesy of the University of Victoria)

Katie Leahy, a registered nurse in Victoria, says she was able to help a homeless man on the street before he died of cancer.

"He was having a lot of trouble with pain," she recounted. "He had no way of getting his medications, so I brought them to him with my bike."

She learned a couple of days later that he'd passed away.

"It's very comforting that at least he had pain medication for that time," she said. 

Leahy works as part of Victoria's new mobile Palliative Outreach Resource Team (PORT), which connects people with life-limiting illnesses who are homeless and barely housed to health support systems like palliative care.

Katie Leahy, a palliative care nurse, bikes around Victoria offering care to those who are homeless or barely housed. (Photo courtesy of the University of Victoria)

The two-person team — Leahy and physician Dr. Fraser Black — bike and drive around town, bringing their medical kit and expertise to people living on the street.

"We provide care where they're at, [be it] on the street, in shelters, supportive housing, in a motel, a car, or a tent," Leahy said Thursday at the program's launch event in Victoria.

Based on similar programs in Toronto and Calgary, PORT allows those in need to refer themselves, or be referred by front line community workers. Leahy and Black will then help manage their pain and bring them medication, inform any caregivers they may have, and help patients and their loved ones cope with grief.

The program is a collaboration between the University of Victoria, Island Health, the Victoria Cool Aid Society, and the Victoria Hospice. 

'So much judgment'

Dr. Kellie Stajduhar is the lead investigator for PORT. She says it's extremely difficult for those who are homeless or in poverty to receive palliative care if they have illnesses like cancer, heart failure, and lung disease.

"We see a [health-care] system that's so siloed that people can't get the care they need. There's so much judgment, so much stigma," she explained. 

Dr. Kelli Stajduhar, from the University of Victoria, says it's extremely difficult for homeless people to access proper end-of-life care when they're focused on their own survival every day. (Adam van der Zwan/CBC)

Stajduhar, a professor at the University of Victoria, published a report that examines how our health-care systems "fail vulnerable Canadians as they die." 

The study found that vulnerable people who had proper end-of-life care experienced improvements in their quality of life.

Bridging gaps and breaking stigmas

Leahy said the program has already received 23 referrals and has helped three people die more peacefully since it informally launched in July.

Paige Phillips works with the Society of Living Illicit Drug Users, and is now helping PORT connect with people who need help. As a formerly homeless person, Phillips said she's made connections with street communities. 

"It's really easy to identify people who could use support," she said. 

Phillips said PORT is helping to bridge long-standing communication gaps between health and support services. This helps build understanding for health-care workers who may have preconceived ideas about people who are homeless or addicted to drugs.

Doesn't meet Indigenous needs

But Bernice Kamano, a local Indigenous outreach coordinator, says while PORT is a huge step forward, it still doesn't meet the needs of Indigenous people. 

"Our community doesn't like hospitals. It's a difficult place for them to go," she said, referring to generations of cultural abuse and the residential school system.

Bernice Kamano, a local Indigenous Outreach Coordinator, says the new PORT program won't meet the needs of First Nations people. (Adam van der Zwan/CBC)

She said about one-third of homeless people in Victoria are Indigenous, and it's important for them to connect with healers and elders to "help honour who they are, and allow them to pass with dignity."

Recently, she called a meeting with various First Nations stakeholders, including the First Nations Health Authority, to discuss ways a palliative care program could be adapted for the Indigenous community.

Stajduhar said non-Indigenous health groups can't assume what the right strategies will be for Indigenous people. 

"It has to be spearheaded by people who are Indigenous," she said.

About the Author

Adam van der Zwan is a journalist based in Victoria, British Columbia. You can send him a news tip at adam.van.der.zwan@cbc.ca.