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Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice
Author(s) -
Hubbell Sarah A.
Publication year - 2017
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/phn.12333
Subject(s) - advance care planning , psychological intervention , directive , public health , nursing , medicine , health care , end of life care , gerontology , qualitative research , narrative , psychology , palliative care , political science , sociology , social science , linguistics , philosophy , computer science , law , programming language
Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end‐of‐life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end‐of‐life concerns among people experiencing homelessness. Trials of clinician‐guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision‐maker designation. End‐of‐life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives.