Thread by @CroakeyNews

Dr Naheed Dosani is the Opening Plenary presenter #21OPCC - @NaheedD is a #palliativecare physician in Toronto, Canada and a health justice advocate. Some of his work includes implementing the Palliative Care and Education for the Homeless (PEACH) program cbc.ca/radio/whitecoa…

He helps provide #PalliativeCare for people who experience structural inequities

He started out when he met someone living on the streets who had cancer who did not follow up with healthcare due to structural challenges and denied access to medications #21OPCC

Sadly, the man died before he received support and healthcare #21OPCC. This is what motivated @NaheedD to help homeless people access #PalliativeCare

@NaheedD Hostile/defensive architecture are some of the barriers people experiencing homelessness face when they look for #healthcare #21OPCC

@NaheedD Vast majority of people who experience vulnerabilities are due to structural/social determinants of health and the environments around them #SDOH #21OPCC Image shows an example of structural barriers (outside a hospital) to accessing #healthcare

@NaheedD Aboriginal and Torres Strait Islanders are 14 times more likely to become homeless than other Australians #SDOH #21OPCC

@NaheedD People experiencing homelessness are often the sickest people - huge difference in mortality :( #21OPCC #SDOH

@NaheedD People who are experiencing homelessness wish to die at home, similar to people in general populations. #21OPCC

@NaheedD Best practices of #palliativecare not available to people experiencing homeless #21OPCC

@NaheedD New model of #palliativeCare developed = PEACH (Palliative Care and Education for the Homeless). Humble beginnings providing mobile #healthcare in a Honda Civic #21OPCC

@NaheedD Evaluations of PEACH found that 80% of people died where they wanted to :) #21OPCC

@NaheedD As well as clinical #palliativecare, they provide advocacy for people experiencing homelessness #21OPCC

@NaheedD Other programs providing #palliativecare for people experiencing homelessness in Canada #21OPCC

@NaheedD Seven lessons to improve #PalliativeCare for people experiencing structural vulnerabilities #21OPCC
1) the survival imperative

Lesson 2) the normalisation of death #21OPCC
"Everyone in this community is at risk of dying"

Lesson 3) recognising the need for palliative services
#21OPCC

@NaheedD says it is really hard to triage people experiencing homelessness #21OPCC

@NaheedD Wondering if any of our audience and #21OPCC delegates know if there are similar #palliativecare programs for homeless in other countries? #21OPCC

@NaheedD Lesson 4) silos to bring down, cracks to fill
PEACH aims to break down these silos in #palliativecare for people experiencing homelessness #21OPCC

@NaheedD Lesson 5) Risk management: a barrier to dying at home, based on findings from the "Too Little, Too Late" report #21OPCC

@NaheedD Have to ensure people and staff workers are safe, but that barriers to dying at home are removed. #21OPCC

@NaheedD Lesson 6) A bereaved community: supporting workers and "chosen" family #21OPCC
Beautiful quote by inner-city nurse

@NaheedD During #COVID19 PEACH staff have held more grief circles than ever before, to help #palliativecare staff grieve together #21OPCC

@NaheedD Lesson 7) Justice at the end for some #21OPCC

@NaheedD "Death is a social justice issue" - @naheedD equity in death needs to be addressed, as it is in birth #21OPCC #SDOH

@NaheedD Think about your role in healthcare - Racism is a public health emergency, and it's important for those who work in healthcare and #palliativecare to be political and advocate #21OPCC

@NaheedD What a great, informative and inspirational plenary by @NaheedD #21OPCC

@NaheedD #21OPCC Q&A with @NaheedD
Q from many people in audience - how do you get funding and be financially viable to run programs such as PEACH?
A - recognise ppl come from diff regions- not all regions need dedicated system like PEACH. PEACH funded through Ontario Ministry of Hlth

@NaheedD ...cont A - only covers physician services. Many other organisations work to help PEACH come together. Community-organisations that already do the work. #21OPCC

@NaheedD Q from @didarmody - what would be different for someone like Terry today if PEACH were not avail?
A - hope that someone would recognise that this is a gap in the system. Other hope is that various shelters would recognise help needed and direct him to appropriate support #21OPCC

@NaheedD @didarmody Thanks @NaheedD for amazing plenary and start to #21OPCC

@NaheedD @didarmody Publication that @NaheedD discuss in presentation about evaluation of PEACH (unfortunately under paywall) #21OPCC liebertpub.com/doi/10.1089/jp…

@NaheedD @didarmody 'Too Little, Too Late' report #21OPCC virtualhospice.ca/Assets/report-…