End-of-life care for homeless people in shelter-based nursing care settings: A retrospective record study.
Palliat Med
; 34(10): 1374-1384, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32729794
ABSTRACT
BACKGROUND:
Homeless people experience multiple health problems and early mortality. In the Netherlands, they can get shelter-based end-of-life care, but shelters are predominantly focused on temporary accommodation and recovery.AIM:
To examine the characteristics of homeless people who reside at the end-of-life in shelter-based nursing care settings and the challenges in the end-of-life care provided to them.DESIGN:
A retrospective record study using both quantitative and qualitative analysis methods. SETTING/PARTICIPANTS:
Two Dutch shelter-based nursing care settings. We included 61 homeless patients who died between 2009 and 2016.RESULTS:
Most patients had somatic (98%), psychiatric (84%) and addiction problems (90%). For 75% of the patients, the end of life was recognised and documented; this occurred 0-1253 days before death. For 26%, a palliative care team was consulted in the year before death. In the three months before death, 45% had at least three transitions, mainly to hospitals. Sixty-five percent of the patients died in the shelter, 27% in a hospital and 3% in a hospice. A quarter of all patients were known to have died alone. Documented care difficulties concerned continuity of care, social and environmental safety, patient-professional communication and medical-pharmacological alleviation of suffering.CONCLUSIONS:
End-of-life care for homeless persons residing in shelter-based nursing care settings is characterised and challenged by comorbidities, uncertain prognoses, complicated social circumstances and many transitions to other settings. Multilevel end-of-life care improvements, including increased interdisciplinary collaboration, are needed to reduce transitions and suffering of this vulnerable population at the end of life.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cuidado Terminal
/
Personas con Mala Vivienda
/
Cuidados Paliativos al Final de la Vida
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Palliat Med
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2020
Tipo del documento:
Article
País de afiliación:
Países Bajos