Elderly man receiving hospice care. Pixabay/Creative Commons

New hospice to aid homeless on the journey home

  • December 31, 2017

The journey home can be hard, but it’s harder for the homeless.

That’s why the home-care specialists at St. Elizabeth Healthcare are teaming up with other organizations to launch a new hospice for Toronto’s homeless population.

Named the Journey Home Hospice, the new four-bed facility is a joint initiative of St. Elizabeth Healthcare, the homeless health specialists at Inner City Health Associates of St. Michael’s Hospital and the volunteer specialists at Hospice Toronto.

It will open in downtown Toronto in February backed by a $245,000 contribution from the provincial Ministry of Health and Long-Term Care. The ministry will also kick in $105,000 per bed per year to keep the facility operating.

But the four-bed facility, located at the Toronto headquarters of the Homes First Foundation, is just a beginning. The plan calls for a 10-bed facility in 2019.

A hospice geared to the needs of the homeless is good news for the dignity of Toronto’s poorest and most vulnerable, said Good Shepherd Centre executive director Br. David Lynch.

“That’s wonderful news. I’m very excited about it,” Lynch said. “Anything that gives the homeless more dignity as they go home to God is a blessing. Certainly if any of our clients needed such a service I would be making a recommendation.”

As it stands, when Good Shepherd users are facing the end of life inside a shelter they generally wind up in one of Toronto’s big hospitals.

“Just like anybody at the end of life, they need specific end-of-life care, but not necessarily in a hospital,” said Lynch.

The vast majority of palliative care in Toronto is delivered in hospital settings.

The problem for the homeless dying in hospital is that they find themselves more alone and isolated than ever, said St. Elizabeth Healthcare senior vice-president and chief clinical officer Nancy Lefebre.

“When most people want to die at home, where do people who don’t have a home go to die?” asked Lefebre. “I see this as creating a hospice that meets their unique and complex issues and needs — where their street family can come to visit them and be supportive of them.”

Just getting the hospice open is far from the end of the story, said Lefebre.

“We need $10 million to run a 10-bed hospice,” she said. “That will allow us to get space. It will allow us to cover our operational costs for a couple of years out.”

Unlike hospital care, hospices are only partially funded by the province and rely to a great extent on fundraising to cover capital costs including real estate, buildings and equipment. Even staffing is only partially covered by provincial funding, despite an Ontario provincial government commitment to spend $75 million over three years on expanding hospice and palliative care.

The Journey Home Hospice will be the second hospice in Ontario that specializes in end-of-life care for the homeless. The partners in the new venture have already been to visit Ottawa’s Diane Morrison Hospice, which maintains 19 beds for the homeless in Ottawa in association with The Ottawa Mission.

Journey Home will be the sixth stand-alone residential hospice to open within a 50-km radius of downtown Toronto and the third Toronto hospice that specializes in a specific population. Casey House serves people living with HIV and people dying of AIDS. Emily’s House maintains 10 beds for children.

The group behind the Journey Home Hospice has yet to draw up its policies around transferring patients who request an assisted death. But Lefebre doesn’t see any clash on the horizon between Catholic rejection of assisted suicide and advocates for medically induced death.

“What we’re focussed on is providing good palliative care,” said Lefebre. “That’s our focus — providing good end-of-life care, access to physicians to help with pain management and support, creating an environment where there’s harm reduction… There won’t be any showdown.”

The St. Elizabeth answer to death on demand is “trying to give people, with the best access to pain and symptom management, good palliative care, emotional support, spiritual care, all of those kinds of things,” Lefebre said.

Getting Canada’s overstretched palliative care system focussed on the most vulnerable is important, she said.

“We know that the homeless population in particular has unique needs. Because they are homeless, they die at an age that’s half the age of average Canadians,” said Lefebre. “Wouldn’t it be fantastic to give people a place to go, as opposed to dying on the street or dying alone for that matter.”

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