Access to services that encompass both the physical and psychological aspects of palliative care is irregular across the country. As members of C-TAC, we must continue to be mindful of the structural factors that isolate communities based on socioeconomic status. The Palliative Education and Care for the Homeless (PEACH) Program, based in Toronto, Ontario, Canada serves as a powerful model for meeting communities where they are by establishing safety and trust early on.
Leeann Babici, Health Navigator at PEACH shared her meaningful experiences with her clients and celebrates the ways in which PEACH epitomizes its commitment to recognizing structural vulnerabilities. In her role, Babici addresses and improves social determinants of health including housing, income, food insecurity, transportation, and access to the healthcare system. She elaborates on how her work as a Health Navigator directly informs PEACH’s unique, trauma-informed approach to care delivery: “it means acknowledging the structural factors that perpetuate vulnerability among the client population I serve. With the added layers of a life-limiting illness, mental health diagnosis, or presence of substance use, using a trauma-informed approach to care is key to establishing safety and trust with people experiencing structural vulnerability”.
Babici kindly shared several of her own client stories with C-TAC to effectively portray how PEACH operationalizes trauma-informed care throughout the client’s journey with the palliative care team, beginning with the initial intake assessment:
“For example, asking a client to clarify their “preferred name” opens up the opportunity for a client to tell us how they would like to be addressed. In fact, one client shared that they do not wish to be addressed by the name on their government ID because it is a reminder of the trauma perpetuated by their physically-abusive parent. In another example, one client shared that they go by a different name in order to protect their identity from a previously abusive partner. Through these meaningful conversations, our team has had the opportunity to establish trust early on in our work with our clients”.
Being cognizant of a client’s traumatic past and allowing it to take precedence in the continuum of their care is critical to earning trust and guaranteeing positive outcomes. In the second story that Babici shared with C-TAC, she emphasizes how PEACH holds itself responsible for creating a safe space in order to empower clients to make decisions that will improve their quality of life as they battle a life-threatening illness.
“For example, I work with a 40-year-old who has significant heart disease secondary to IV drug use. In the early days of working with them, I learned that this client experienced abusive and violent trauma throughout their life. I recall during one of the first conversations we had once the client was stably housed, they passively shared that a knock at their apartment door triggers past traumatic experiences of being confined. I picked up on this comment and took the time to initiate ways of communicating with the client in ways that establish and maintain safety. I no longer knock at the apartment door to announce my arrival. I follow a process of text and phone call communication in advance of my visits so that the client is not taken off guard – another trauma-informed approach informed by this client’s stated wishes. In initiating these practices, I have seen successful results in establishing a rapport based on safety and trust”.
Trauma can be incredibly destabilizing and potentially exacerbate health conditions or even make one vulnerable to developing additional physical and mental difficulties. C-TAC is committed to dismantling the stigma that surrounds trauma, and alongside PEACH, will work to better integrate trauma-informed approaches and programs into its work with structurally vulnerable populations.
Written by Sabreen Huq | Intern
