2023-24 Annual report

​​​Bridging gaps in access to high-quality palliative care 

Making palliative care a reality for everyone 

Providing individuals who experience homelessness or vulnerable housing with access to palliative care is essential to ensuring they receive dignified end-of-life support and holistic care. This year, CPAC continued to implement the Improving Equity in Access to Palliative Care initiative in partnership with Healthcare Excellence Canada (HEC). 

This initiative is making a real difference in 23 communities across Canada – 10 that took part in the initiative’s first cohort, and an additional 13 that joined the second cohort in 2023–24. By providing funding, educational resources, networks of expert faculty and coaches, and peer-to-peer networking and learning opportunities, the initiative empowers communities to develop their own high-quality palliative care models tailored to the specific needs of people experiencing homelessness or vulnerable housing. 

The initiative aims to achieve several key goals: 

• Timely and safe care – Ensure equity-denied populations receive the palliative care they need, when and where they need it, in a safe and supportive environment. 
• Choice and dignity – Empower people experiencing homelessness or vulnerable housing to receive palliative care in the place they call home, with respect for their individual preferences. 
• Reduced hospital stays – Minimize unnecessary emergency department visits and hospital admissions by providing palliative care in more appropriate settings. 

The initiative recognizes the importance of cultural sensitivity and past experiences. From the beginning, CPAC and HEC have collaborated with health equity specialists to inform the design of the initiative. This ensures strong and trusting relationships with the communities being served, leading to better care experiences for everyone. 

The Improving Equity in Access to Palliative Care initiative is a trauma-informed, macro-level policy response to the fact that it is unacceptable that structurally vulnerable people have to suffer as they approach end of life in this country. This initiative is something to be very proud of and is the type of intervention that we must continue to build on to better our healthcare systems. 

I feel very honoured to be a part of this program and an organization that isn’t just talking the talk when it comes to equity, but is walking the walk too.

—Dr. Naheed Dosani, Health Equity Advisor 

Read about the promising practices and innovative models that communities across Canada have designed to improve equity and access to safe and high-quality palliative care for individuals who experience homelessness or vulnerable housing. 

Expanding access to culturally safe palliative care 

The Equitable Palliative Care Closer to Home initiative is expanding access to culturally safer palliative care services for First Nations, Inuit and Métis by funding and supporting the development of culturally appropriate palliative care approaches. Indigenous organizations collaborate with non-Indigenous partners to create: 

• Tailored resources – Educational materials and palliative care programs designed specifically for Indigenous communities, reflecting their unique needs and traditions. 
• Enhanced home and community care – Increased access to high-quality palliative care services delivered in familiar settings like homes or cultural centres. 

The initiative fosters collaboration between Indigenous and non-Indigenous healthcare providers, building trust and respect. Importantly, it empowers First Nations, Inuit and Métis individuals to connect with their communities and cultural practices throughout their end-of-life journey. 

By year’s end, CPAC had signed funding agreements with two Ontario partners involving engagement with multiple communities, and more are expected across Canada. Initial projects are: 

• Co-creating palliative and end-of-life care tools, including care guides, resources and videos to support caregivers with culturally relevant information and education for First Nations  
• Providing education and training to communities and healthcare providers with the goal of identifying the need for palliative care as early as possible in a patient’s journey 

Adding the element of spiritual care 

In 2021, CPAC and partners released the Canadian Interdisciplinary Palliative Care Competency Framework – a curriculum guide for educators and reference manual for people providing palliative care. The framework is designed for jurisdictions that lack an explicit set of palliative care competencies, and provides high-level guidance to those with their own competency frameworks. 

This year, CPAC collaborated with the Canadian Association for Spiritual Care on a key update to the framework: a spiritual care section that recognizes the important role spiritual care professionals play in palliative and end-of-life care. Especially in a palliative setting, people often experience spiritual distress as they navigate life-limiting illness and prepare to die. Integrating spiritual care in a patient’s care plan can help providers address needs and alleviate suffering.  

As the practice of palliative and end-of-life care changes across Canada, the framework will continue to evolve to meet the needs of those who use it, as well as reflect the other members of the interdisciplinary team, such as physio- and occupational therapy and others. 

To date, the framework has been endorsed by more than 20 national and provincial healthcare organizations, and incorporated in various curricula, hiring practices and accreditation standards across Canada. 

In addition, Pallium Canada has developed and piloted an app called Learning Journey, which enables healthcare providers to do a palliative care competency self-assessment and then connect with resources that meet their learning needs.