Victoria palliative-care team taking it to the streets

A new Victoria move to provide palliative care to the poor and homeless will take medical care directly to the patients, whether it’s in a car, tent or one-room apartment.

The initiative unveiled Thursday is a collaboration between the University of Victoria, Island Health, Victoria Cool Aid and Victoria Hospice Societies. It has provided support following three deaths and currently has seven patients.

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It’s called PORT, for Palliative Outreach Resource Team, and employs a nurse three days a week and a physician one day a week to make house calls, wherever they may be.

“We provide and facilitate care for people where they are at, whether that’s on the street, supported housing, a motel, a car or a tent,” PORT nurse Katie Leahy told reporters.

PORT arose out of a three-year UVic research program that followed 25 people living homeless or barely housed while they dealt with life-threatening medical conditions.

UVic nursing professor and lead investigator Kelli Stajduhar said the research showed poor or marginalized people struggle to deal with support systems, such as housing assistance, health care and social support.

If a marginalized person is also dealing with a terminal medical condition the ability to access those systems deteriorates as the condition worsens. “They struggle to access services in a system that is so silent that even a healthy person has difficulties navigating it,” said Stajduhar, a 30-year palliative care specialist.

But research also shows the sooner people start thinking and preparing for the end of their lives the better the successes of palliative medical treatments.

Stajduhar said during her research some of the palliative patients even told her their end-of-life treatment was the first time they felt “cared for, respected or even loved.” She said everybody deserves that.

“Palliative care should really be as important for dying Canadians as prenatal and obstetric care is for newborns,” said Stajduhar.

PORT will be funded during its first year by Island Health and the Saint Elizabeth Health Community, an organization with a focus on end-of-life care for marginalized people.

Stajduhar said one of the biggest challenges in offering end-of-life care to people living on the street is separating palliative patients when the entire population is at imminent risk of dying.

It’s risk made even more acute by the opioid crisis. “People who are affected by homelessness or poverty or stigma, they have much shorter life expectancies and their disease burden is higher than the general population,” said Stajduhar.

“The PORT team can’t provide care for everybody,” she said.

So Stajduhar said the team starts with a conversation to learn who might best benefit from palliative medical care.

For those who aren’t palliative patients, other assistance or guidance or assistance is offered.

“We are not going to say: ‘No, sorry, close the door,’ ” said Stajduhar.

“It’s more like ‘Maybe you don’t have palliative needs right now but there are services that we can help you access,’ ” she said.

rwatts@timescolonist.com

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