Background
With
an ever increasing number of individuals living with chronic and terminal
illnesses, palliative care as an emerging field is poised for unprecedented
expansion. Today’s rising recognition of its key role in patients’ illnesses
has led to increased interest in access to palliative care. It is known that
homelessness as a social determinant of health has been associated with
decreased access to health resources in spite of poorer health outcomes and
some would argue, higher need. This article aims to discuss the current state
of affairs with regards to accessing palliative care for the homeless in
Canada.
Discussion
Recent
review of the literature reveals differential access to palliative care
services and outcomes with differing socio-economic status (SES). Notably,
individuals of lower SES and in particular, those who are homeless have poorer
health outcomes in addition to poor access to quality palliative care. Current
palliative care services are ill equipped to care for this vulnerable
population and most programs are built upon an infrastructure that is
prohibitive for the homeless to access its services. A preliminary review of
existing Canadian programs in place to address this gap in access identified a
paucity of sporadic palliative care programs across the country with a focus on
homeless and vulnerably-housed individuals. It is apparent that there is no
unified national strategy to address this gap in access.
Summary
The
changing landscape of the Canadian population calls for an expansion of
palliative care as a field and as many have put it, as a right. The right to
access quality palliative and end of life care should not be confined to
particular population groups. This article calls for the development of a
unified national strategy to address this glaring gap in our healthcare
provision and advocates for attention to and adoption of policy and processes
that would support the homeless populations’ right to quality palliative care.
Full article at: http://goo.gl/G2a2F8
1Department of Palliative Medicine,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
2Division of Palliative Care, Department of
Family and Community Medicine, University of Toronto, Toronto, ON, Canada
3Ethics Centre, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
4Inner City Health Associates, Toronto, ON,
Canada
5Department of Family & Community
Medicine St Michael’s Hospital, Toronto, ON, Canada
6Division of Palliative Care, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
7Division of Palliative Care, William Osler
Health System, Brampton, ON, Canada
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