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Location

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Hours

Location

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Hours


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 What to Expect

The Supportive Care Neurology Clinic is a neuro-palliative care clinic for patients diagnosed with a serious neurological illness. The clinic includes a palliative care doctor and an advanced practice nurse who provide an added layer of support to patients/families living with neurodegenerative disease.

We focus on supporting advance care planning conversations, thinking ahead about what matters most to you and what kind of medical care you would want in the future. This includes conversations about code status, preferences about hospitalization, feeding tubes, and anticipated changes as your disease progresses, such as difficulty swallowing. We work alongside your other healthcare providers to ensure your medical care reflects your wishes and values as your condition changes. We offer both in-person and virtual appointments.

Of note, palliative care is not just end-of-life care or hospice care. We support patients at all stages of disease and can be provided alongside ongoing treatment.

What We Do Not Do

We unfortunately do not have a social worker, and thus, we do not arrange or refer to home care and community supports, coordinate long-term care referrals or facilitate support groups. If you need assistance with these services, please speak with your primary care physician or primary neurologist.

Services

Advance Care Planning and Goals of Care Discussions

Advance care planning is a process to help support adults at any stage of health to understand and share what matters most to you in order to help inform future health care decisions. These are evolving conversations as values may change over time. Our goal is to ensure that patients receive medical care that is consistent with their underlying values and preferences.

A key component of this is identifying a Substitute Decision Maker (SDM) who is a trusted person to help make decisions for you in the event you are unable to.

We provide guidance on what you may expect over time as your disease changes and help you plan for important healthcare decisions in the future. This may include support with changes such as increasing difficulty with swallowing, exploring preferences for treatment of illnesses such as infections, and care preferences if you become critically ill and require life-sustaining treatments.​

 Frequently Asked Questions

Common questions about our clinic, palliative care, and advance care planning.

No. Palliative care is not the same as hospice. Palliative care can begin at any point in a serious illness, even at diagnosis, and focuses on helping patients live well with their condition. Hospice is a specific type of care for patients in the final stages of life. We provide palliative care to help you plan for the future and make healthcare decisions that align with your values, regardless of where you are in your illness.

No. Many patients see palliative care doctors early in their illness and live for many years afterward. We help you think ahead about what matters most to you and plan for future healthcare decisions. This is especially helpful for progressive conditions like Parkinson's disease or Alzheimer's dementia, where you have time to clarify your values and preferences.

Yes. We encourage your substitute decision-maker or family members to attend. Having them there helps them understand your values and preferences, which is important if they need to make decisions on your behalf in the future. We offer virtual (video) or in-person appointments. If virtual, we can send the video link to your family members to log-in at the time of the appointment.

Initial visits are booked for 60 minutes, and follow-up visits are booked for 30 minutes.

We discuss symptom management strategies and preferences, but ongoing medication management is the role of your primary neurologist or primary care physician. We work alongside them to help manage symptoms that are not improving with standard treatments.

That is okay, many people need time to think about these questions. We're here whenever you're ready.

Yes. If you have cognitive changes, meaning changes in your thinking, memory, or ability to reason, we can still work with you and your family. We adjust our approach based on your abilities. Having these conversations earlier, when you can participate fully, is one reason early involvement is helpful.​

 Materials and Resources to Help You

Essential Materials

Understanding Advance Care Planning

Advance Care Planning (ACP) Canada provides free, accessible resources designed to help Canadians reflect on their values, designate a Substitute Decision-Maker (SDM), and document their personal and medical care preferences for the future. The resources are organized to make sensitive conversations easier and less intimidating.

Downloadable toolkits and workbooks guide you through a 5-step process to reflect on what matters to you, learn about your health, choose your SDM, and share your wishes.

The Conversation Lab

The Conversation Lab at University Health Network provides a Patient and Family Guide designed to support meaningful conversations about values, goals of care, and future health planning. It offers clear, practical information to help patients and families prepare for and participate in care discussions with their healthcare team.

Resources from the Patient & Family Education Program

Visit our Health Information section to find dedicated resources to help you understand your condition. Find the information you're looking for.​

 Meet Our Team
Our Supportive Care Neurology Clinic brings together a team of healthcare professionals who work collaboratively to support patients living with serious neurologic illness. Our clinic works alongside, not in place of, your existing neurology team. We provide an additional layer of support focused on supporting quality of life and future health-care decision-making.

Director and Palliative Care Physician

Dr. Melissa Li  

Dr. Melissa Li, MD, CCFP (PC)

Dr. Melissa Li is a graduate of the Temerty Faculty of Medicine at the University of Toronto and completed her Family Medicine residency at Western University, prior to completing her Enhanced Skills Palliative Care Residency Program at the University of Toronto. She joined Toronto Western Hospital as a staff palliative care physician in 2019, where she works as an inpatient palliative care consultant and is the Director of the Supportive Care Neurology Clinic.

Dr. Li is a clinician teacher and assistant professor at the University of Toronto within the Division of Palliative Care, Department of Family and Community Medicine.


Neurologist

Dr. David Tang-wai  

Dr. David Tang-wai, MDCM, FRCPC

Dr. David Tang-Wai is a professor of Neurology and Geriatric Medicine at the University of Toronto (UofT). He is the current Department Division Director for Neurology at UofT, co-director of the UHN Memory Clinic and the UHN Howard Cohen Normal Pressure Hydrocephalus Program.

Our clinic includes a neurologist with expertise in neuropalliative care who participates on a consultative basis.

Dr. Tang-wai does not replace or assume the role of your primary neurologist. Ongoing management of your underlying neurologic condition remains with your treating neurologist, while our consulting neurologist works collaboratively with our team to provide additional support and expertise when needed.

Clinical Nurse Specialist

Archna Patel, RN(EC) NP-Adult, MN, CHPCN (C)

Archna is a graduate of the Bachelor of Science in Nursing Program from the University of Alberta. She completed her Master of Nursing Program at the Lawrence Bloomberg Faculty of Nursing at the University of Toronto. She holds a Post-Master's Nurse Practitioner Diploma and a Canadian Nursing Association Certification in Hospice and Palliative Care. She joined the palliative care team at Toronto Western Hospital in 2019.

Administrative Assistant

Nirali Shah

Learners

As part of an academic health centre, our clinic may include medical students, residents, fellows, and other healthcare trainees who participate in patient care under supervision.​​
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