The Jane and Finch neighbourhood of Toronto is home to a diverse multicultural population, but it’s also known for having some of the highest rates of crime and poverty in the city. Given the complex issues affecting health in the region, advance care planning may not seem like a priority. The Jane and Finch Family Health Team, however, sees these conversations as critical to the wellbeing of patients and their families, and an integral component of care.

“Many of my patients don’t have the finances to do wills or meet with lawyers to go over details such as choosing a substitute decision maker,” says Dr. Suzanne Strasberg, a member of the Family Health Team. “We wanted to provide them with information and tools to help them share their wishes for care with us and with their family and friends.”

Dr. Strasberg uses tools from the Speak Up Primary tool kit, which includes posters, handouts and pamphlets that describe advance care planning and how to create a plan. Given that many of her patients are not native English-speakers, she uses materials are clearly written and easy to understand. The team is currently prioritizing patients based on age or health issues, broaching the topic at appropriate times during care.

Along with classroom sessions, social workers on the Family Health Team have had more than 50 one-on-one counseling sessions with patients. The initiative has also been recognized by Cancer Care Ontario as a notable change idea for quality improvement. Dr. Strasberg says that while there was a bit of resistance at the beginning, patients tend to be relieved to have the conversation. “Patients appreciate that we care enough to ask — and that we take the time to know more about them.”

See the Primary Care Toolkit