Introducing the Saint Elizabeth Foundation National Centre for Equity and Innovation in End-of-Life Care

At the Saint Elizabeth Foundation, we believe that every life, every journey, and every person matters — every step of the way. This belief is the driving force behind the creation of the National Centre for Equity and Innovation in End-of-Life Care, a national effort to ensure that compassionate hospice and palliative care truly reach everyone, especially those who have historically been excluded.

The Centre exists to transform how care is delivered to structurally vulnerable populations by offering care that reflects who each person is, what they value, and what they need. Every decision is guided first and foremost by each person’s voice and choices. This is not an aspiration — it is a commitment rooted in lived experience, evidence, and more than a century of personalized care.

Rooted in the Global Hospice Movement

The roots of our work stretch back to the foundations of modern hospice care, inspired by Dame Cicely Saunders and St. Christopher’s Hospice in the UK. Her pioneering vision reshaped how society cares for the dying and helped spark a movement that spread across Canada more than 50 years ago.

In Canada, the hospice movement has grown from a simple but powerful idea: neighbours caring for neighbours, volunteers showing up with kindness, and communities believing that no one should die alone. Yet the earliest hospice models assumed stability — predictable illness, secure housing, and built-in family support. Today, Canada is more diverse, more mobile, and more unequal than any time in our history. For too many people, end-of-life care remains out of reach.

These inequities are not at the margins. They sit at the heart of our system — and demand a new response.

Lessons From Journey Home Hospice

The inspiration for our Centre comes directly from what we’ve learned at Journey Home Hospice, Canada’s only specialized, nurse-led hospice for people experiencing homelessness and other structural vulnerabilities. Over the past eight years, our residents have taught us what equitable end-of-life care must look like: unconditional, trauma-informed, culturally safer, and grounded in dignity.

Through Journey Home Hospice, we have developed proven, compassionate models of care that are co-designed with people who know these realities firsthand. These models have shaped not only our thinking, but our mission as leaders in specialized end-of-life care, research, innovation, and advocacy.

Why the Centre Was Created

The Saint Elizabeth Foundation National Centre for Equity and Innovation in End-of-Life Care was created to re-think, re-imagine, and rebuild hospice care so that it reaches everyone, including those most often left behind. We will advance this work through a three pronged approach:

1. Compassion in Action

Providing equitable hospice and palliative care for structurally vulnerable populations, centred on dignity, choice, flexibility, and unconditional support.

2. Voices to Shape Change

Ensuring that people with lived and living experience inform, influence, and lead the policies and programs that shape end-of-life care.

3. Innovation Rooted in Experience

Scaling trauma-informed, harm-reducing, and culturally safer care models developed through research, community partnership, and decades of practice.

A National Infrastructure with Global Reach

Our work is strengthened by robust national and international networks that make collaboration, knowledge-sharing, and best-practice adoption possible. Through the Saint Elizabeth Healthcare infrastructure — built over 115 years of delivering personalized care in the places people call home — our Centre has access to education, research, and technology that makes scalable, sustainable solutions possible.

This includes launching innovative pilot programs in diverse and challenging settings such as social housing, shelters, and correctional facilities. Our holistic, person-centred approach ensures we can meet people wherever they are — whether in hospice, on the street, or in places where traditional care systems simply do not reach.

Our work is grounded in the longstanding pillars of our organization:

• Listening with compassion
• Honouring dignity
• Empowering communities
• Advancing equity in end-of-life care

A Shared Global Challenge — and a Shared Opportunity

Canada cannot do this work alone. Around the world, hospice leaders face similar questions:

• How do we reach people who are excluded?
• How do we adapt hospice for complexity, trauma, and inequity?
• How do we design care that meets people exactly where they are?

That is why partnerships — particularly with organizations like Hospice UK and Pallium Canada — are essential. Their leadership in innovation, education, equity, and community engagement has shaped our own journey, influencing the direction of our new national centre in profound ways.

Together, we are forging a path forward rooted in solidarity, shared learning, and a vision of hospice care that is accessible to all.

A Call to Collective Action

We know we cannot do this alone. Building the future of equitable end-of-life care requires a coalition of the willing — partners, communities, advocates, and leaders committed to ensuring that people who have nowhere else to turn are met with warmth, dignity, and compassionate care.

Together, we can bring compassion, hope, and humanity to those most in need across Canada — because every life matters, to the very last moment