#58 The challenges of Advance Care Planning for people experiencing homelessness and work and impact of the PEACH programme with Dr Naheed Dosani

In this episode it is my pleasure and honour to talk with Dr. Naheed Dosani. Naheed is a palliative care physician and health justice activist dedicated to advancing equitable access to healthcare for people experiencing structural vulnerabilities like poverty and homelessness. Naheed’s achievements include founding the Palliative Education and Care for the Homeless (PEACH) Program at the Inner City Health Associates, serving as the Medical Director of Kensington Hospice in downtown Toronto, a Health Equity Expert Advisor at the Canadian Partnership Against Cancer and as a palliative care physician at St. Michael’s Hospital at Unity Health Toronto.

We talk about early influences in Naheed’s life and career, the impact of structural vulnerability, and I learn how the PEACH programme is supporting Advance Care Planning for people experiencing homelessness.

Key messages from guest

• Naheed describes how he grew up the son of parents who came to Canada from Uganda as refugees and how he noticed differences in the availability of healthcare in places..

• Caring for Terry, a person with mental health illness, drug addiction and who had experienced long homelessness, proved a pivotal moment for Naheed. Terry’s death was a traumatic event for Naheed and was a catalyst for him to think how could so many people “fall through the cracks” in a health care system.

• Naheed and his team launched Palliative Education and Care for the Homeless (PEACH) in 2014, this is  Canada’s first mobile street and shelter based palliative care programme. 

• In  2023 PEACH became the largest programme that provides care for people experiencing homelessness in non-traditional settings.

• Naheed describes the work of PEACH and how it can pivot to respond to the physical and social crises faced by people experiencing homelessness.

• Naheed shares the impact of the PEACH Programme.

• Grief Circles are described by Naheed, these are  a way of remembering a person who has died and supports everyone impacted by the death.

  
  

Resource specific to this podcast

• Find out more about PEACH – Palliative Education and Care for the Homeless 

• Find out more about Equity-Informed Advance Care Planning 

• Watch A film of personal stories and journeys to health from people who have experienced and overcome homelessness 

• Access resource from Advance Care Planning Canada: Advance Care Planning in Canada

Research and training

• Initial qualitative study: End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care (sagepub.com)

• Find out more about barriers to discussing palliative care with people experiencing homelessness: Challenges to discussing palliative care with people experiencing homelessness: a qualitative study

• Find out more about training for hostel staff Evaluation of training on palliative care for staff working within a homeless hostel

• Find out more about twinning hospices and hostels:The benefits and challenges of embedding specialist palliative care teams within homeless hostels to enhance support and learning: Perspectives from palliative care teams and hostel staff

• Homelessness and palliative care toolkit: Supporting people experiencing homelessness with advanced ill health | Homeless Palliative Care Toolkit

• Museum of homelessness: 1313 people experiencing homelessness died in 2022, we honour each person. — Museum of Homelessness

• Access data through Homeless monitor 2022: Homelessness Monitor 2022 | England | Crisis UK

•  Homeless and palliative care ECHO network: Homelessness network (mariecurie.org.uk)

Bio

Dr. Naheed Dosani
MSC, MD, CCFP(PC), BSc
Palliative care physician & Health justice advocate

As a palliative care physician and health justice activist, Dr. Naheed Dosani is dedicated to advancing equitable access to healthcare for people experiencing structural vulnerabilities like poverty and homelessness. These efforts include founding the Palliative Education and Care for the Homeless (PEACH) Program at the Inner City Health Associates, serving as the Medical Director of Kensington Hospice in downtown Toronto, a Health Equity Expert Advisor at the Canadian Partnership Against Cancer and as a palliative care physician at St. Michael’s Hospital at Unity Health Toronto. Dr. Dosani shares his passion for palliative care and health equity with learners as an Assistant Professor with the Department of Family and Community Medicine at the University of Toronto. His research interests include improving care models for people experiencing structural vulnerabilities and access to palliative care for culturally diverse communities. Dr. Dosani has received many prestigious honours for his trailblazing work. These awards include the Meritorious Service Cross for Humanitarianism from Canada’s Governor General in 2018, a humanitarian award from the Canadian Society of Palliative Care Physicians in May 2019 and the Early Career Leader award from the Canadian Medical Association in 2020. Most recently, Dr. Dosani received an Honorary Degree (Doctor of Laws) from Ontario Tech University in 2022.

Affiliations

Palliative Care Physician, Department of Family & Community Medicine, St. Michael's Hospital at Unity Health Toronto

● Founder and lead physician, Palliative Education And Care for the Homeless (PEACH), Inner City Health Associates

● Medical Director/Health Equity Lead, Kensington Hospice/Kensington Health

● Health Equity Expert Advisor, Canadian Partnership Against Cancer

● Assistant Professor, Division of Palliative Care, Department of Family & Community Medicine, University of Toronto

● Recipient of the Governor General of Canada’s Meritorious Service Cross for Humanitarianism

Twitter: @NaheedD