“I had the opportunity to take part in a memorable training day focused on equity in palliative care, alongside three committed voices from the community and healthcare sectors. From the very first exchanges, their deeply human and compassionate approach set the tone for the day. What particularly struck me was their ability to combine clinical rigor, field experience, and compassion, while challenging certain traditional frameworks of care delivery. They encouraged us to adopt a stance of humility, to actively listen to the social realities experienced by patients, and to adapt our interventions accordingly. This day allowed me to step back and reflect on my own practice and to better understand the importance of integrating principles of equity at the heart of palliative care.”
Challenges Faced by People Experiencing Homelessness
People experiencing homelessness face particularly precarious health conditions, and traditional palliative care models often fail to meet their needs due to rigid eligibility criteria, complex care pathways, mistrust of the healthcare system, and a lack of suitable safe spaces.
Structural barriers also include fragmented services, the invisibility of needs, and staffing constraints. At the same time, care providers often face gaps in training related to equity, harm reduction, and trauma-informed care.
“The training day on ‘Equity-Oriented Palliative Care’ held on February 4 was profoundly meaningful. Dr. Naheed Dosani Dr. Naheed Dosani, Dr. Marie-Hélène Marchand, and Na’Kuset presented us with a harsh, often overlooked, yet very real reality: that of people in need of palliative care who are experiencing homelessness. Access to healthcare is universal, but not equitable. This is something we unfortunately tend to forget. Yet it is SO important. Every human being deserves quality care. This February 4th event was more than just a training session. It sent a clear message about the importance of adapting healthcare.
I am proud that Maison St-Raphaël has already taken steps in this direction, particularly by collaborating with the Mobile Home Project. Learn more about the initiative here: “Personne ne devrait mourir dans la rue, seul, en douleur”. I encourage us all to become agents of change by educating ourselves and raising awareness among those around us. 💚”
Lessons from Equity-Centered Palliative Care
The training highlighted five key lessons for providing palliative care tailored to vulnerable populations:
The emotional burden associated of end-of-life care is significant. Staff require dedicated spaces for post-intervention discussions, as well as rituals and commemorations. Burnout should not be viewed as a weakness, but rather as a signal calling for a culture that values rest and reflection. For patients, it is essential to respect their wishes, cultural and spiritual preferences, and to build care planning around their understanding of the illness and their trusted support networks.
Equity in palliative care requires rethinking traditional practices to include mobility, flexibility, harm reduction, peer support, and stable housing. A person-centered approach grounded in lived experience, combined with inter-service collaboration, significantly improves the experience of people at the end of life and strengthens social justice in access to palliative care.
The training session on February 4 at Maison St-Raphaël provided a concrete illustration of how these principles can be applied in daily practice to meet the needs of vulnerable populations, while supporting healthcare staff and fostering an inclusive and humane environment.
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