Toronto palliative patients on homeless spectrum confront new challenges due to COVID-19

Jimmy Evans spent several years living on the street experiencing homelessness, but it was only after he got affordable housing in 2017 with the help of the Ontario Disability Support Program that his biggest challenge became apparent.

“I was across the street with friends, I went to my knees and I puked blood about five feet. There were huge blood clots in it,” Evans said.

Doctors diagnosed Evans with end-stage liver disease. It was unclear how long he would live.

“They said a year to two years,” Evans said.

“Then they said, ‘Do you realize that in the past five months you have also had two heart attacks?’”

Doctors said part of the challenge in treating Jimmy was that he started missing appointments. Because he was vulnerably housed, it was difficult to conduct follow-ups.

Alberto Salanic has a similar story. He has lived on the streets for many years and was able to get housing, only to discover he had metastatic colorectal cancer.

1:01 Palliative care physicians say homelessness is not a static situation

While Salanic has a roof over his head, he too falls on what Dr. Naheed Dosani refers to as the spectrum of homelessness.

“Sometimes when people think about homelessness, they think of the person on the corner on the street with a sign panhandling,” Dosani said.

“That describes a very static situation.”

0:26 Toronto palliative care patient on homeless spectrum describes greatest fear with health diagnosis

Dosani is a palliative care doctor with The PEACH program (Palliative Education and Care for the Homeless), a program run through Toronto’s Inner City Health Associates. Evans and Salanic are two of the team’s patients after getting a program referral during the summer.

“People can be on the streets, they can be in shelters, they can be couch surfing, they can have supportive housing and then lose their job, get an illness and be back on the streets,” Dosani said.

“What COVID has done is made the safety net that supported people from moving towards more homelessness even weaker.”

Tweet This Click to share quote on Twitter: "What COVID has done is made the safety net that supported people from moving towards more homelessness even weaker."

Dosani said since COVID-19, his patients have been struggling with additional barriers. He said some are scared to go to hospitals, some are worried they will get sick if they leave the safety of their encampments or apartments.

Leeann Trevors works as the team’s health care navigator and started in the summer. Her role is funded through a grant and is only guaranteed for a year. She helps keep track of the patients’ day-to-day needs through her weekly check-ins.

“Sometimes it’s filling out paperwork, sometimes it’s getting groceries,” Trevors said.

“We never want to push to say this is what you need. We would rather ask them, what do you need and how can we support you?”

Since Evans got referred to PEACH, he has not missed a single appointment.

“They are great people, and very concerned about the people they help,” Evans said.

“I feel so honoured.”

Salanic said he feels as though he finally has people in his corner despite the isolation the pandemic has created.

“Emotionally I was alone, you know? But now I have a team fighting with me… with my disease. It makes me so strong,” he said.

Tweet This Click to share quote on Twitter: "Emotionally I was alone, you know? But now I have a team fighting with me… with my disease. It makes me so strong," he said.

“Every day I am so thankful, and thank God.”