Community Knowledge Centre - Toronto Community Foundation

About this organization

Mission

Hospice Toronto staff and trained volunteers provide and facilitate access to compassionate care for people with life threatening illnesses, offering them support options, honouring their choices and supporting their families and friends.

History of Organization

In 1988 at the Church of Holy Trinity in Toronto, a small and passionate group of people came together to care for Margaret Fraser, a friend and member of their community, by supporting her wish to die peacefully at home. These exemplary efforts were documented by June Callwood in her book, Twelve Weeks in Spring.

Margaret’s story is both the inspiration and seed of Hospice Toronto, as members of this initial Care Team went on to form Trinity Home Hospice: Toronto’s first not for profit, volunteer-based, in-home hospice palliative care program. In 2005, Trinity Home Hospice was renamed Hospice Toronto.

Accolades and Accomplishments

In 1991, Hospice Toronto received the New Directions Award in “recognition of creative leadership in caring for the terminally ill in the community” from the Mayor’s Committee on Aging, City of Toronto.

In 2005, 2008 and 2009, Hospice Toronto was awarded grants through The Toskan Casale Foundation's Youth and Philanthropy Initiative as a result of winning presentations from students in the Ontario-wide Grade 11 Civics competition on Philanthropy. The value of our work has also been recognized through multi-year grants awarded by The Ontario Trillium Foundation’s Community Program in 2001 and 2005. Additionally, through the Hospice Association of Ontario (HAO), we were one of the first hospices in Ontario to receive Level One and Two certified accreditation through the HAO’s Hospice Palliative Care in 2005, 2006 and 2009.

The highest honour received as tribute to our work is when a family member or the caregiver of someone we served volunteers and takes our intensive home hospice training to serve others in need of care and support.

Since 1988, Hospice Toronto’s volunteers and professional staff have provided continuity of care and support to 4,697 individuals free of charge, directly impacting the lives of over 23,485 friends and family members.

Programs

>Creating Caring Communities
>Volunteer Support Program

Care Team Support - Planning and coordination of Care Teams consisting of family members, friends, neighbours and specialist caregivers working closely together to design and implement an effective care program tailored to the client’s needs.

Children’s Support - Individual support for children living with terminally illness and those affected by illness in their families through Kit for Kids: one-on-one support to help children (aged 4 to 12 years old) address anticipatory grief, bereavement or living with a life-threatening illness.

Diverse Community Support - Working in partnership with local community agencies and their affiliate networks, we engage people living in Toronto's diverse communities through outreach and facilitated focus groups to help address complex healthcare issues encountered by those living in the community through our Creating Caring Communities projects. 

Expressive Arts - Group-based, high-impact expressive arts program working with paints, pastels, clays, fabrics, song, drums and poetry in a safe and meaningful environment allows adults, youth and children, and their families and caregivers to share their journey of illness, loss and grief in a creative, safe and non-threatening environment.

In-Home Support - Visiting, in-home hospice palliative care and support, complementary therapy (by registered professionals, i.e., massage and music therapy, healing and therapeutic touch, reiki and reflexology), and Children Support volunteers play a vital role in the continuous delivery of in-home hospice palliative care and client/family/caregiver support.

Volunteer Support - Our programs could not exist without our volunteers: flagship program recruits, educates and trains, coordinates and supports volunteers in providing thousands of hours of home hospice care and support to clients; serve on our Board and in Committees; and help with fundraising activities.

Creating Caring Communities

Working in partnership with local community agencies and their affiliate networks, we engage people living in Toronto's diverse, multicultural communities through outreach and facilitated focus groups to address complex healthcare issues relating to seniors living in the community. Through a series of positive, experiential, problem-solving activities, we share knowledge and information with local community members. The information is then integrated into our volunteer-based, home hospice palliative program to provide services that are sensitive to the community's diversity and culture. In addition to increasing the capacity and impact of our volunteers, we introduce a healthcare model that supports family caregivers, while also further engaging community members to become actively involved in both reaching out to those in their community who would benefit from volunteer-driven hospice care, and assist in providing that care in culturally sensitive ways.

By strategically engaging community members to share information and participate in volunteer-base caregiving, we build upon the community's knowledge using an "asset-based community development" approach by incorporating the information into our training and volunteer programs, and service delivery. This ultimately results in the community building its own capacity to provide in-home hospice palliative care and support for its members in their own language and culture.

Funding and Program Partners

Through Human Resources and Skills Development Canada's (HRSDC's) New Horizons for Seniors program (2007) and the Ontario Ministry of Health and Long-Term Care's Aging at Home Strategy (2008), we received strategic grants to partner with St. Christopher House and their grassroots organization, Portuguese Women 55+ to pilot our Creating Caring Communities project.  This resulted in Portuguese-speaking volunteers receiving 35+ training through our Volunteer Support program to provide in-home hospice palliative care and support for seniors in their community in their own language and culture.

The pilot was further developed in St. James Town through renewed Aging at Home Strategy funding (2009), in partnership Community Matters Toronto to conduct strategic community outreach and engagement.  Along with the generous support of the Green Shield Canada Foundation (2009), we increased the community's awareness and navigation of the complex health care issues relating to seniors living in the community with the development and implementation of a 16 hour Community Health Care Navigator training curriculum for local residents to assist their neighbours.  This also resulted in volunteers from St. James Town trained through our Volunteer Support program to provide care and support to members of their community who are living with a life-threatening illness or dying.

Program Impact

Since the pilot project in Toronto's Portuguese communities in 2008, we have engaged over 120 Portuguese-speaking community members in outreach/education forums to address hospice palliative care issues and concerns relating to their seniors, with members assuming an advocacy role within their communities. This resulted in a 10% increase in referrals to support Portuguese-speaking clients and their families; and 15 Portuguese-speaking caregivers attending our home hospice workshops, with six individuals enrolling in our 35+ hour, visiting home hospice volunteer training program (thereby, equipping them to support the chronic and end-of-life care needs of their community members in their own language and culture).

Toronto's Vital Signs® indicator(s) addressed by Program

“Toronto’s seniors will outnumber its children within 25 years:

• 53% of all seniors in the GTA live in Toronto
• Low-income rates for Toronto seniors were nearly double the Ontario rate
• More than 1 in 4 seniors lived alone in 2006”

“Toronto’s supply of long-term care beds has not kept pace with its aging population: Toronto ranks 11th of 14 Ontario municipalities, and is not meeting the provincial standard of ensuring long-term beds for 10% of the population 75 and older.” (Toronto’s Vital Signs®, 2009)

Creating Caring Community addresses Toronto’s steadily growing elderly population and its inability to meet the provincial standard of ensuring long-term beds for 10% of the population; and the fact that many seniors choose to remain at home.

Participant Vignette

Having first attended a community forum, this Portuguese-speaking volunteer registered for the more in-depth hospice training. She then applied to join Hospice Toronto as a Care Team volunteer, and participated in our home hospice training program.  She had the following to say about her training experience: "Thank you for everything and your excellence ... as well as the materials and professional speakers you had during this excellent course:  They made all the difference and confirmed that we need to get more people out to volunteer...  It was an exceptional diversified group and a real honour to have been included with all of them."

After successfully completing the screening and training, she was then matched with a newly referred Portuguese family. The client is a frail, elderly woman who lives alone. She has a daughter (with three young children) who lives in the same community and is her primary caregiver. The client speaks only Portuguese, and has limited mobility and high needs. She has personal care workers who assist her daily. However, they do not speak Portuguese. The daughter has to be present through the day. By providing a trained volunteer who speaks Portuguese, the client receives hospice care and support, while the daughter much receives much needed respite.

This volunteer continues to visit weekly, providing ongoing support. Both she and her client “are enjoying the visits very much, with the client's daughter getting a much needed break from taking care of her Mother."

Volunteer Support Program

Receiving health related care at home is vital in client-centred care. With a health care system straining under the burden of an aging population and struggling to cope with the rise of chronic illnesses, home care is no longer simply about respecting patients' wishes – it is increasingly becoming a financial imperative. A trained volunteer providing home hospice palliative care and support offers a cost-effective alternative to an overburdened hospital system. Hospice Toronto helps to fill the gap – at no charge to clients – by recruiting and training volunteers to provide continuity of compassionate care and support in the home. Caregivers receive much needed help in the form of practical and emotional support, with opportunities for respite. When caregivers are provided with the help they need, it maintains their health and builds resiliency within the family unit, ultimately sustaining their caregiving role and optimizing the patient’s care at home. With capacity to serve clients in over 22 languages, our volunteers play an integral role in providing care and support in diverse communities, and to people of all ages. Where needed, specially trained volunteers support children who are addressing anticipatory grief, bereavement or living with a life-threatening illness through our Children's Support programs.

Funding and Program Partners

The Ontario Ministry of Health and Long-Term Care has kindly supported the program since its inception (1996), with corporations and foundations generously providing annual strategic grants.

The program is delivered in partnership with fellow local hospices and long-term care facilities to provide cross-training of volunteers in general end-of-life and chronic care, and Care Team support.  Additionally, we are partnering with Doane House Hospice, Evergreen Hospice, George Brown College and the Hospice Association of Ontario to develop an online training module for volunteers to be eventually trained provincial-wide.

Program Impact

Through our Volunteer Support program last year:

• 497 individuals received over 20,400 hours of home hospice palliative care and support from our trained volunteers and professional staff.
• 50 new home hospice palliative care volunteers received 35+ hours of training in general end-of-life and chronic care, and Care Team support.  Also, 15 new specially trained volunteers received an extra 21 hours of training to work with young people facing grief and loss in our Children's Support programs.

Since 1988, our volunteers and staff have provided care and support to 4,697 individuals, directly impacting the lives of over 23,485 friends and family members.

Toronto's Vital Signs® indicator(s) addressed by Program

“Toronto’s seniors will outnumber its children within 25 years:

• 53% of all seniors in the GTA live in Toronto
• Low-income rates for Toronto seniors were nearly double the Ontario rate
• More than 1 in 4 seniors lived alone in 2006”

“Toronto’s supply of long-term care beds has not kept pace with its aging population: Toronto ranks 11th of 14 Ontario municipalities, and is not meeting the provincial standard of ensuring long-term beds for 10% of the population 75 and older.” (Toronto’s Vital Signs®, 2009)

Our Volunteer Support Program addresses Toronto’s steadily growing elderly population and its inability to meet the provincial standard of ensuring long-term beds for 10% of the population; and the fact that many seniors choose to remain at home. Moreover, with income directly associated with health (and Toronto having the highest percentage of people living with low incomes in Ontario), residents in some of Toronto’s poorest, diverse communities are “proportionately less healthy than their wealthier neighbours.”

Participant Vignette

For some, the experience of death is frightening and full of sorrow.  Many of our clients, like the one quoted below, have a different experience, thanks to the support of Hospice Toronto’s volunteers and staff:

"I could never express everything the volunteers gave to our Mother.  They treated her with dignity, respect and amazing compassion. She was allowed to be stubborn and grumpy if she wanted, and they were ready to listen when she wanted to talk about her fears and anger – things she couldn’t say to her daughters for fear of upsetting us.

The volunteers also gave us (the daughters) an invaluable gift. I was given time I sorely needed. I realized that every moment spent with Mom was precious, but for the sake of my own mental health, I needed time to cry, to enjoy the early spring weather or just think. Our volunteers brought humour, compassion, encouragement and a small pot of pansies into an apartment that may otherwise have been filled only with sorrow.

At the funeral, a well meaning friend trying to offer solace said, “You’ve been through the worst of it.” My immediate response was, “No, we’ve been through the best part.” We will grieve our Mother for a long time, but we also have warm, intimate memories of her last days.  I will be forever grateful for the gift Hospice Toronto volunteers gave my family – the gift of a death that can be remembered with fondness and gratitude.  Our Mother died well."