Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate s...

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Published inBMC public health Vol. 12; no. 1; p. 312
Main Authors McNeil, Ryan, Guirguis-Younger, Manal, Dilley, Laura B, Aubry, Tim D, Turnbull, Jeffrey, Hwang, Stephen W
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 17.05.2012
BioMed Central
BMC
Subjects
Acquired immune deficiency syndrome
AIDS
Alcohol Drinking - epidemiology
Alcohol Drinking - prevention & control
Alcohol use
Analysis
Attitude of Health Personnel
Canada
Case studies
Drug use
Female
Harm Reduction
Health aspects
Health Services Accessibility - statistics & numerical data
HIV
Homeless persons
Homeless Persons - statistics & numerical data
Hospitals
Human immunodeficiency virus
Humans
Illegal drugs
Interviews as Topic
Male
Methods
Mortality
Palliative treatment
Professional-Patient Relations
Program Evaluation
Research Design
Residence Characteristics
Risk Management
Settlements & damages
Severity of Illness Index
Social service
Social Support
Street Drugs
Substance Abuse, Intravenous - epidemiology
Substance Abuse, Intravenous - prevention & control
Substance-Related Disorders - epidemiology
Substance-Related Disorders - prevention & control
Terminal care
Terminal Care - utilization
Canada
Online AccessGet full text

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Abstract Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
AbstractList Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
Background Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. Methods A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Results Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. Conclusions While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
Abstract Background Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. Methods A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Results Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. Conclusions While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
Doc number: 312 Abstract Background: Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. Methods: A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Results: Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. Conclusions: While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.
ArticleNumber 312
Audience Academic
Author Aubry, Tim D
Turnbull, Jeffrey
McNeil, Ryan
Dilley, Laura B
Hwang, Stephen W
Guirguis-Younger, Manal
AuthorAffiliation 3 Faculty of Education, Simon Fraser University, Surrey, BC, Canada
7 Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
5 Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
4 School of Psychology, University of Ottawa, Ottawa, ON, Canada
2 Faculty of Human Sciences, Saint Paul University, Ottawa, ON, Canada
1 British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
6 Ottawa Inner City Health, Ottawa, ON, Canada
AuthorAffiliation_xml – name: 7 Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
– name: 5 Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
– name: 4 School of Psychology, University of Ottawa, Ottawa, ON, Canada
– name: 6 Ottawa Inner City Health, Ottawa, ON, Canada
– name: 2 Faculty of Human Sciences, Saint Paul University, Ottawa, ON, Canada
– name: 1 British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
– name: 3 Faculty of Education, Simon Fraser University, Surrey, BC, Canada
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  givenname: Ryan
  surname: McNeil
  fullname: McNeil, Ryan
  email: rmcneil@cfenet.ubc.ca
  organization: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. rmcneil@cfenet.ubc.ca
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  surname: Turnbull
  fullname: Turnbull, Jeffrey
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  surname: Hwang
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/22545586$$D View this record in MEDLINE/PubMed
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Snippet Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to...
Background Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that...
Doc number: 312 Abstract Background: Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go...
BACKGROUND: Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that...
Abstract Background Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers...
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biomedcentral
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StartPage 312
SubjectTerms Acquired immune deficiency syndrome
AIDS
Alcohol Drinking - epidemiology
Alcohol Drinking - prevention & control
Alcohol use
Analysis
Attitude of Health Personnel
Canada
Case studies
Drug use
Female
Harm Reduction
Health aspects
Health Services Accessibility - statistics & numerical data
HIV
Homeless persons
Homeless Persons - statistics & numerical data
Hospitals
Human immunodeficiency virus
Humans
Illegal drugs
Interviews as Topic
Male
Methods
Mortality
Palliative treatment
Professional-Patient Relations
Program Evaluation
Research Design
Residence Characteristics
Risk Management
Settlements & damages
Severity of Illness Index
Social service
Social Support
Street Drugs
Substance Abuse, Intravenous - epidemiology
Substance Abuse, Intravenous - prevention & control
Substance-Related Disorders - epidemiology
Substance-Related Disorders - prevention & control
Terminal care
Terminal Care - utilization
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Title Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis
URI https://www.ncbi.nlm.nih.gov/pubmed/22545586
https://www.proquest.com/docview/1014402513
http://dx.doi.org/10.1186/1471-2458-12-312
https://pubmed.ncbi.nlm.nih.gov/PMC3355019
https://doaj.org/article/f4be8877b74143319ade6fb7e7f01825
Volume 12
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