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Recommendations for Improving the End-Of-Life Care System for Homeless Populations: A Qualitative Study of the Views of Canadian Health and Social Services Professionals

Resource type
Date created
2012
Authors/Contributors
Abstract
BACKGROUND:Homeless populations have complex and diverse end-of-life care needs. However, they typically die outside of the end-of-life care system. To date, few studies have explored barriers to the end-of-life care system for homeless populations. This qualitative study involving health and social services professionals from across Canada sought to identify barriers to the end-of-life care system for homeless populations and generate recommendations to improve their access to end-of-life care.METHODS:Semi-structured qualitative interviews were conducted with 54 health and social services professionals involved in end-of-life care services delivery to homeless persons in six Canadian cities (Halifax, Hamilton, Ottawa, Thunder Bay, Toronto and Winnipeg). Participants included health administrators, physicians, nurses, social workers, harm reduction specialists, and outreach workers. Interviews were audio-recorded, transcribed verbatim and analysed thematically.RESULTS:Participants identified key barriers to end-of-life care services for homeless persons, including: (1) insufficient availability of end-of-life care services; (2) exclusionary operating procedures; and, (3) poor continuity of care. Participants identified recommendations that they felt had the potential to minimize these barriers, including: (1) adopting low-threshold strategies (e.g. flexible behavioural policies and harm reduction strategies); (2) linking with population-specific health and social care providers (e.g. emergency shelters); and, (3) strengthening population-specific training.CONCLUSIONS:Homeless persons may be underserved by the end-of-life care system as a result of barriers that they face to accessing end-of-life care services. Changes in the rules and regulations that reflect the health needs and circumstances of homeless persons and measures to improve continuity of care have the potential to increase equity in the end-of-life care system for this underserved population.
Document
Published as
BMC Palliative Care 2012, 11:14 doi:10.1186/1472-684X-11-14
Publication title
BMC Palliative Care
Document title
Recommendations for Improving the End-Of-Life Care System for Homeless Populations: A Qualitative Study of the Views of Canadian Health and Social Services Professionals
Date
2012
Publisher DOI
10.1186/1472-684X-11-14
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Copyright is held by the author(s).
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You are free to copy, distribute and transmit this work under the following conditions: You must give attribution to the work (but not in any way that suggests that the author endorses you or your use of the work); You may not use this work for commercial purposes.
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Peer reviewed?
Yes
Language
English
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