A Grass Roots Beginning

As you learned in the previous section, the CCC model was first developed and facilitated by Hospice Toronto in 2008. The CCC model was born out of Hospice Toronto’s long history of taking a grassroots approach to palliative care.

At the same time, the initiative emerged in the context of increasing diversity across the city and a growing need for care within the community. Hospice Toronto recognized that it would not be possible to train enough volunteers who spoke the wide range of languages or understood the many cultural contexts represented in the communities they served. There was also a growing need to better understand and respond to differences in care preferences and barriers to accessing support.

The question is not why George died. We all die. Why was George allowed to live so long in squalor?

— Joe Fiorito for the Toronto Star (Feb. 16, 2009)

Hospice Toronto recognized that many isolated and socially vulnerable community members would not be reached through more traditional volunteer-based palliative care approaches, which typically rely on referrals from individuals already connected to the health and social care system. A different approach was needed.

The CCC initiative in St. James Town was rooted in the understanding that neighbours within the community are among the most effective resources for identifying and engaging isolated and vulnerable individuals. By recruiting staff and volunteers from within the neighbourhood, and using a community development approach, CCC enabled learning from and co-shaping care with equity-deserving communities, building more culturally responsive, accessible, and trusted forms of support.

The St. James Town program, which began in the winter, is the TCF’s response to two facts gathered in the Vital Signs report:

The city’s share of long-term beds has remained unchanged since 2000 while the population of elderly continues to rise.
 Only 16 per cent of Canadians who die have access to or receive hospice palliative and quality end-of-life care services. However, funding for hospice care has not increased.

Adrien Veczan for the Toronto Star (Oct. 5 2010)

Co-Learning Through Authentic Community Collaboration

The foundation of CCC was deeply influenced by our early partnership with Community Matters. During this initial collaboration, we learned that certificates and formal training held significant value within the community—not just as credentials, but as symbols of recognition and empowerment.

This insight became a catalyst for innovation. Motivated by the community’s emphasis on formal learning, we co-designed a new training program modeled after hospice core training. However, we intentionally adapted it to be more accessible: greatly reduced in length and intensity and shaped collaboratively with community members to reflect their cultural preferences and address local issues that were vital to shaping our care approach.

This co-created model not only honored the community’s values but also laid the groundwork for a care philosophy rooted in mutual respect, cultural relevance, and shared learning.