"What Community-Based Care Can Look Like"

In March 2026, our research team, alongside members of the Urban Indigenous Guidance Circle that guides our research program, spent two weeks in Edmonton, meeting with housing and health teams and building connections across the community as part of a Canadian Institutes of Health Research-funded study exploring the barriers and facilitators to dying at ‘home’ for structurally vulnerable populations.

We were there to learn how different communities are approaching care for people who are often excluded from it, and what it would take to support dying in places that feel like home.

We already know that access to end-of-life care is experienced inequitably. People facing housing instability or poverty are more likely to encounter fragmented services, limited care outside of hospitals, and experiences of stigma within the healthcare system. These conditions shape not only whether care is available but where it happens.

Although this trip exposed different barriers than those we see in Victoria, what Edmonton showed us is that community-based care can be delivered and organized differently.

What stood out to our team is how different parts of the system are working together. Health services are integrated into housing environments, rather than something people have to seek out elsewhere. In several of the spaces we visited, such as the Hope Mission-Herb Jamieson Centre and Ambrose Place this looked like clinical care built directly into shelter and housing settings, with 24-hour healthcare staff alongside access to basic supports like showers, laundry, and drop-in spaces. This integration also looked like a social work office in the downtown library, supporting people in navigating services in places they already go.

Just as important are the people doing this work. There is a kind of consistency and relational depth across teams that is difficult to describe but immediately felt. Meeting Dr. Bablitz, an Indigenous family and palliative care physician in the community, and others working in these settings made it clear that community-based models of care depend as much on relationships and trust as they do on infrastructure.

One place that brings these elements together is George’s House, a five-bed residential hospice for people facing structural inequities. There is 24-hour nursing support, meals are provided, and each resident has their own room where guests are welcome. But what matters most is the flexibility built into daily life. If someone doesn’t want dinner at a set time, they can cook later. If they want to spend time elsewhere with friends or family, they can. The expectation is communication, not compliance.

There are still rules, of course. But they exist alongside a level of autonomy and respect that is rare in many care settings. It reflects a model of care where people aren’t expected to give up their routines or relationships in order to receive necessary care.

The teams working in Edmonton are showing what quality end-of-life care can look like when we build care around people’s lives rather than asking them to adapt to rigid and exclusionary systems. This starts with being open to the idea that care can look different for everyone. It also means recognizing that healthcare and housing don’t operate independently and shouldn’t be treated as separate. Embedding healthcare into housing is not a new idea. What Edmonton demonstrates is that it can be done in ways that are practical, relational, and sustainable. It changes who can access support, how early care is offered and whether people are able to remain in spaces that feel familiar at the end-of-life.

What I left with was a sense that Edmonton is doing something important and something it may not fully recognize. It is not perfect and it should not be described that way. There are gaps, and there are still inequities, with much work left to do. But compared with what I have seen elsewhere, Edmonton feels further along in its willingness to imagine community care differently. The challenge now is to learn from this work, support it and ask what it would take to build more spaces and systems like this elsewhere.

Lexy recently completed her Master’s degree at the University of Victoria and is currently a research assistant with Dr. Stajduhar’s Palliative Approaches to Care in Aging and Community Health research program.