(Report dated  June 4, 1998, addressed to Community and Neighbourhood Services Committee, from the Commissioner of Community and Neighbourhood Services.)

Subject:Palliative Care Pilot Project for the Homeless

Purpose:

This report seeks Committee approval to set up a pilot project to provide palliative care to homeless men staying at the Seaton House Annex.

Funding Sources, Financial Implications and Impact Statement:

None.

Recommendations:

It is recommended that:

(1)the Department be authorized to set up a palliative care pilot program at the Seaton House Annex;

(2)this program be conditional on the appropriate support being provided by the Coroner=s Office and Mount Sinai Hospital;

(3)a progress report be submitted to Committee in about a year=s time on the outcomes of this pilot program and any research data developed; and

(4)the appropriate City officials be authorized to take the necessary action to give effect thereto.

Council Reference/Background/History:

The former Metro Council authorized the opening of the Seaton House Annex two years ago. This was in response to one of the recommendations of the Coroner=s Jury which investigated the freezing deaths of three homeless men. The palliative care pilot program now being proposed is a natural extension of the work of the Annex.

Comments and/or Discussion and/or Justification:

The Seaton House Annex has been referred to as a Awet hostel@ and the service is based on a harm reduction approach. It has 51 beds which are consistently filled. By all measures, this program has been exceptionally successful in reaching a group of severely alcoholic men who were living outside.

Tragically, many of our clients are in the last stages of life and need our help and care more than ever. Turning our backs on these men at this stage leaves them without acceptable options. Helping them to the end is the ultimate act of our harm reduction approach.

An abbreviated copy of the palliative care proposal developed by Annex staff is attached and provides a good overview. A more detailed background report is available upon request.

Staff have had a number of meetings with the Coroner=s Office, Mount Sinai Hospital and other agencies. The pilot program will only proceed when appropriate arrangements are in place with these other organizations.

Because palliative care is an emerging field and because this may be the first homeless shelter to include this service, a research feature will be included. If the service is successful, then this research may be extremely valuable to other organizations working with the homeless in Toronto, as well as other cities in North America.

Conclusions:

This proposal is realistic and is intended to alleviate human suffering. It is a frightening experience for these men to go into hospitals, or to be removed from friends and familiar surroundings. The palliative care proposal by the Annex staff should be supported.

Contact Name:

John Jagt

Director of Hostel Services Division

Tel.: (416) 392-5358

Fax: (416) 392-8876

E-mail: john_jagt@metrodesk.metrotor.on.ca

(Copy of attachment referred to in the foregoing, is on file in the office of the City Clerk.)