Word has been spreading about the excellent work of ePAC and PORT (Palliative Outreach Response Team) and community members are stepping forward in response. This unsolicited, grassroots reaction is providing a welcome boost in the effort to create equitable approaches to palliative care in Victoria. In January 2020, a small group of community members began meeting biweekly and coalesced to form the ePAC Crew to support the needs of structurally vulnerable folks who require palliative attention. I am a member of the Crew.

We see ourselves as part of a growing movement, locally and internationally. Compassionate Communities and Cities are popping up around the world recognizing that care for the dying and their families is everyone’s responsibility. While access to pain and symptom management and other clinical care is essential, most care at the end-of-life is social. As we develop, we look to other organizations and groups for inspiration including New West Hospice Society’s Compassionate City Crew.

This time-sensitive need for social connection opens our awareness to abundant opportunities for voluntary involvement in equity approaches to palliative care. Guided by principles of inclusiveness, equity, and collaboration, we’ve been exploring how best to support initiatives such as PORT by providing community-based assistance for our vulnerable downtown neighbours who struggle with life-threatening or end-of-life situations. From the beginning we’ve been sensitized to the complex web of needs that each person experiences when their health and well-being is threatened at the same time they are coping with stresses resulting from other life hardships. While social services offer professional support, others can play a key role in ensuring community care is available to people in compromised living conditions.

Although the COVID-19 crisis has temporarily derailed some of our efforts, ePAC Crew members have continued their involvement, albeit from a safe distance. ePAC Crew members are mobilizing assistance for people who face serious illness and are increasingly socially disadvantaged as service cuts and temporary agency closures occur.

Members of our Crew have participated in an Advance Care Planning (ACP) initiative adapting ACP language and resources for inner city settings. We are currently “tweaking” the ACP document as people living and working in the inner city use it and provide feedback. It will be available publicly soon! Some of us have been cooking and delivering food and other supplies to individuals living with serious illness and their caregivers (e.g., street family) who are socially isolated. Nourishment and sustenance come in many shapes, sizes and flavours! A couple of our members have had the honour of providing companionship for dying people, holding vigil, and connecting them with family whenever possible.

Among the many tragedies that COVID-19 has wrought, it has also heralded a heightened awareness that caring for ourselves and for one another is as basic to the human condition as breathing. Collaboration and compassion belong wherever human beings are present. As members of the ePAC Crew, we have just begun to figure out how we can cooperate to strengthen our contributions to the well-being of fellow citizens who require equitable access to palliative resources, services, and companionship in our community. We’ve only just begun and are eager to share the journey ahead!

Sylvia McMechan & the ePAC Crew

Equity in Palliative Approaches to care (ePAC) is a community collaborative informed by a research program led out of the University of Victoria. Members of the collaborative work together to conduct research with local, national and international partners, and develop resources and tools, programs, and services aimed at improving access to quality care for people facing the end-of-life and who also face inequities like homelessness, poverty, isolation, racism, and stigma.

Email: equitableaccess@uvic.ca

Twitter: @access2care