Trumble, Tanner; Jensen, Francine (Utah Valley University)
Faculty Advisor: Jensen, Robert (Utah Valley University, Nursing)
Background: Individuals who experience homelessness lack the necessary components needed receive end of life care (EOL). However, due to personal and structural barriers such as cost of care, lack of insurance, addiction, and many who experience mental health and intellectual disabilities, homeless individuals are unable to receive palliative or hospice care. Because homeless individuals lack the necessary components of basic living such as food, water and shelter, their quality of life is significantly lower than that of the general population, and this affects their EOL experiences.
Purpose: To explore the factors that affect the homeless population and the barriers they face when accessing health care, including their needs at the EOL, and to provide recommendations for better EOL care.
Methods: A focused literature review was performed using the databases PubMed, Google Scholar and Science Direct using the keywords homeless, end of life, and palliative care covering the years 1985 to 2018.
Findings: Homeless individuals want to experience a "good death". Unfortunately, homeless individuals who seek medical treatment feel deterred due to unfair treatment and belittlement from previous health care experiences and the social stigma surrounding homelessness. This can delay their treatment of chronic or acute conditions and lead to long-term health consequences. One effort to aid in EOL care for homeless individuals is the Social Model Hospice, which provides holistic EOL care in home like setting. Social model hospice overcomes barriers to lack of insurance, social support and a location where EOL care can be delivered for homeless individuals.
Significance: Many barriers are limiting medical care for the homeless that should be available to them at the EOL. It is evident that healthcare providers need to be more aware of the needs of this population to help improve and provide the EOL care homeless individuals deserve.