Palliative Care Is...Curriculum
In October 2026, we launched a discussion-based curriculum called Strengthening Community-Based Approaches to Palliative and End-of-life care in Homeless and Harm Reduction Settings.
This curriculum started taking shape in 2017 when we began gathering as researchers, frontline workers, and palliative care practitioners to learn from each other and carry out actions to improve access to care for people living with serious illness in Victoria, BC on the Territories of the Lək̓ʷəŋən (Songhees and Xʷsepsəm/Esquimalt) Peoples.
Our work together is grounded in both harm reduction and a palliative approach to care. These approaches recognize that suffering is shaped not only by illness, but also by poverty, homelessness, racism, colonialism, discrimination, and other systemic inequities. Many of the people we support have experienced harm within health and social systems, and many workers have experienced the distress of witnessing preventable suffering and death while feeling unsupported themselves.
The deaths we witness are not just statistics. They are people we know. People we care about. People we work alongside. Friends, family members, neighbours, and community members.
This curriculum recognizes these realities, explores how we can reduce suffering in the present, never forgetting that we need long-term, structural changes so that early illness and unjust death do not happen in the first place.
Death itself is difficult enough. But when there has been little planning, few conversations, and limited communication, the experience can become even more distressing. Workers, friends, and chosen family are often left out of decision-making, left without information, and left wondering what happened to people they cared deeply about.
A palliative approach to care creates opportunities to recognize serious illness earlier, plan ahead, strengthen support networks, reduce unnecessary suffering, and ensure that people receive care that reflects what matters most to them. A palliative approach to care can mean earlier diagnosis, better treatment options, improved pain management, and better life and death experiences.
Ultimately, this work is about helping people live as well as possible for as long as possible, while also supporting the workers, friends, families, and communities who walk alongside them.
The curriculum consists of a facilitators guide, 5 discussion guides, and a slide deck. It was purposively built to be flexible, and we encourage you to adapt it to your setting. During our pilot with over 15 agencies and 350 learners across Canada, people used the curriculum in various ways, including dedicated webinars and trainings, covering a topic in a staff meeting, and a reading group. The facilitators guide contains everything and is a good place to start to review the background, guiding principles, and advice for those who want to use this curriculum. The discussion guides include key messages, a case scenario, and guiding questions that cover the following:
1) Recognizing When Someone is Seriously Ill focuses on noticing when someone’s health may be changing or worsening (including changes in appearance, behaviour, abilities, symptoms, or use of services). Workers often see changes before anyone else because they know the person, their routines, and what is normal for them.
2) Talking About Hard Things explores conversations about health, illness, dying, and what matters most to someone. This discussion guide focuses on listening, noticing openings, asking questions respectfully, and following the person’s lead rather than forcing a conversation.
3) Planning for the Future looks at how conversations can support planning and promote access to palliative care if/when needed. Conversations can include learning who a person trusts, who they consider family, who they would want involved in their care, and what would be important to them if their health changed. This guide introduces advance care planning and substitute decision-making while recognizing that planning may look different for each person and may happen gradually over time.
4) Getting More Support focuses on building and strengthening the person’s circle of support. Formal systems often overlook the importance of friends, chosen family, and other community organizations and workers. Workers are important members of the circle of care and support, but they should be recognized, included, and supported rather than expected to fill every gap alone.
5) Grief & Resistance focuses on the grief that workers, peers, friends, families, and communities carry when people become seriously ill or die. This discussion guide creates space to acknowledge those experiences, consider collective ways of responding, and understand care, remembrance, advocacy, and community connection as forms of resistance to systems that allow preventable suffering and death.
We are currently working on a French version and hope to make this available by the end of 2026.
We look forward to hearing how you use the curriculum and any other thoughts and considerations you have. Please email us at palliative_approaches@uvic.ca with any questions or comments.
Discussion Guides
