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Toronto palliative care team sees caseload double since start of COVID-19

Click to play video 'Patient roster doubles for Toronto palliative care team amid coronavirus pandemic' Patient roster doubles for Toronto palliative care team amid coronavirus pandemic
WATCH ABOVE: A group of palliative care nurses and physicians say their patient roster has doubled since the pandemic hit. With COVID-19 case counts rising and winter not far away, doctors say they are worried this could be a deadly combination given their clients fall on the homeless spectrum. Katherine Ward reports. – Nov 26, 2020

Dr. Naheed Dosani has a passion for helping people experiencing homelessness and since 2014 he has been part of the PEACH (Palliative Education and Care for the Homeless) team, a group dedicated to helping people experiencing homelessness with end-of-life care.

The PEACH program operates through Toronto’s Inner City Health Associates. Before the pandemic, the group had roughly 50 patients on their roster and now more than 100 are under their care.

Dosani said many supports that used to be in place have been paused because of COVID-19.

“People who are living on the streets and experiencing homelessness previously had supports in drop-ins, or respites, or various shelters. Many of these places are now closed,” Dosani said.

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

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Click to play video '‘Good wishes project’ helps fulfill dreams for Toronto palliative care patients experiencing homelessness' ‘Good wishes project’ helps fulfill dreams for Toronto palliative care patients experiencing homelessness
‘Good wishes project’ helps fulfill dreams for Toronto palliative care patients experiencing homelessness – Nov 27, 2020

Many medical services have also moved their services online since the start of the pandemic. The PEACH team said when this happens for their patients, it can make accessing medical care difficult.

Dr. Trevor Morey joined the team in the summer.

“With COVID, it’s just made everything more complicated,” he said.

Click to play video '‘Working alongside patients’ key to success for PEACH program, health care workers say' ‘Working alongside patients’ key to success for PEACH program, health care workers say
‘Working alongside patients’ key to success for PEACH program, health care workers say – Nov 26, 2020

Morey said helping patients successfully navigate the new challenges added to the health-care system is what continues to motivate him in his work.

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“If you get a new diagnosis of cancer and you are living in the shelter system, and trying to coordinate something like a specialist appointment… if you don’t have a phone how are you supposed to get to those visits?” Morey said.

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“If you can get somebody feeling better and feeling like they have a quality of life where they want to continue to live for the months that they have, for us that’s the best.”

Click to play video 'COVID-19 has increased challenges for palliative care patients experiencing homelessness' COVID-19 has increased challenges for palliative care patients experiencing homelessness
COVID-19 has increased challenges for palliative care patients experiencing homelessness – Nov 26, 2020

The group is made up of doctors, nurses, social workers, and palliative care physicians.

The support they offer takes many forms. Sometimes it is a simple as a weekly check-in, picking up prescriptions or arranging meals. Other times staff will help patients arrange transportation for appointments or help them with virtual consultations by bringing a phone to them wherever they are in the city.

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Numbers from the City of Toronto suggest there are between 8,000 and 9,000 people experiencing homelessness in the city.

Dosani said this number could be even higher given the number of people who are not accounted for. He estimates there could easily be over 10,000 people on that spectrum.

Read more: Toronto considering ambitious plan to combat homelessness amid COVID-19 pandemic

With winter just around the corner and COVID-19 case numbers continuing to rise, Dosani said he is concerned about what lies ahead for his patients and others living on the streets.

“I worry about their well-being. I worry about the infrastructure that’s needed to support them,” Dosani said.

“Have we built relationships and trust with these communities to support them in ways that are meaningful?”

City of Toronto staff said they have been trying to find solutions that can support those experiencing homelessness. Forty new shelter locations have opened as part of the City’s response to COVID-19, including 19 hotels.

Click to play video 'Challenges increase for Toronto palliative care patients experiencing homelessness, doctors say' Challenges increase for Toronto palliative care patients experiencing homelessness, doctors say
Challenges increase for Toronto palliative care patients experiencing homelessness, doctors say – Nov 25, 2020

Officials said since April, 1,044 people have been referred from encampments into shelters and hotel programs. In September, the city endorsed a plan to create 3,000 new permanent affordable housing units.

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Dosani said he hopes that all levels of government continue to make these types of investments.

“COVID-19 has shown that we have the ability to move systems and governments can now talk to each other in ways that we thought they couldn’t before,” Dosani said.

“Why can’t COVID-19 be the cure to homelessness? I hope that this is impetuous that can motivate us to do that.”