National curriculum builds on community expertise
A new palliative and end-of-life care resource is providing frontline workers nationally with tools and strategies to better support people who are aging with serious illness alongside poverty and homelessness.
The University of Victoria-led collective of researchers, frontline workers and palliative care practitioners launched the new curriculum at the Montreal International Congress on Palliative Care.
Kelli Stajduhar is a Canada Research Chair (Tier 1) in Palliative Approaches to Care in Aging and Community Health at UVic and professor in the School of Nursing and Institute on Aging & Lifelong Health. She heads the UVic research program that developed the curriculum, called Palliative Care Is… Strengthening Community-Based Approaches to Palliative and End-of-life care in Homeless and Harm Reduction Settings.
Q: Why do frontline workers need palliative care information?
Our research over the last decade has shown that frontline workers are often the trusted source of support for people experiencing homelessness. As the main point of contact for care, they walk alongside people experiencing cancers, lung disease and heart conditions in homeless service settings; however, frontline workers often aren’t recognized or supported in the care work they do. While doctors and nurses are recognized as part of the care team, these frontline workers can be left out, and their knowledge and experience excluded.
Q: What does this palliative care curriculum include?
The curriculum includes a facilitator guide, a slide deck, and series of five discussion guides that cover topics like recognizing serious illness and how to talk about hard things. The curriculum is designed for homeless and harm reduction service settings like shelters, housing facilities and outreach services.
Learners are encouraged to use their own experiences as a basis for working through case studies and engaging discussion prompts. While the curriculum was developed with and for frontline workers, there is value for all settings where people experiencing social inequities get care including health-care and hospice settings.
Q: What research informed this palliative care curriculum?
The curriculum development process started in 2024 but drew on research from the last decade on the palliative and end-of-life needs of people experiencing homelessness. The team included palliative care practitioners, frontline workers, and researchers representing over 15 agencies across Canada and was tested with 350 learners.
Q: How does the palliative care curriculum speak to larger health-care issues?
Our work is grounded in both harm reduction and a palliative approach to care. These approaches recognize that suffering is shaped not only by illness, but also by poverty, homelessness, racism, colonialism, discrimination and other systemic inequities. Many of the people we support have experienced harm within health and social systems, and many workers have experienced the distress of witnessing preventable suffering and death while feeling unsupported themselves.
This curriculum recognizes these realities, explores how we can reduce suffering in the present, never forgetting that we need long-term, structural changes so that early illness and unjust death do not happen in the first place. We hope these discussions help us better recognize the value of care work, strengthen collaboration and support more equitable, compassionate responses to serious illness, dying, grief and loss.
