End-of-life care for homeless people in shelter-based nursing care settings : A retrospective record study
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
Palliative medicine - 34(2020), 10 vom: 01. Dez., Seite 1374-1384 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van Dongen, Sophie I [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Epidemiology |
|---|
| Anmerkungen: |
Date Completed 14.05.2021 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/0269216320940559 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM313053952 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM313053952 | ||
| 003 | DE-627 | ||
| 005 | 20231225145737.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/0269216320940559 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1043.xml |
| 035 | |a (DE-627)NLM313053952 | ||
| 035 | |a (NLM)32729794 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van Dongen, Sophie I |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a End-of-life care for homeless people in shelter-based nursing care settings |b A retrospective record study |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.05.2021 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a DESIGN: A retrospective record study using both quantitative and qualitative analysis methods | ||
| 520 | |a SETTING/PARTICIPANTS: Two Dutch shelter-based nursing care settings. We included 61 homeless patients who died between 2009 and 2016 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Medical records | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a homeless persons | |
| 650 | 4 | |a palliative care | |
| 650 | 4 | |a patient transfer | |
| 650 | 4 | |a social support | |
| 650 | 4 | |a vulnerable populations | |
| 700 | 1 | |a Klop, Hanna T |e verfasserin |4 aut | |
| 700 | 1 | |a Onwuteaka-Philipsen, Bregje D |e verfasserin |4 aut | |
| 700 | 1 | |a de Veer, Anke Je |e verfasserin |4 aut | |
| 700 | 1 | |a Slockers, Marcel T |e verfasserin |4 aut | |
| 700 | 1 | |a van Laere, Igor R |e verfasserin |4 aut | |
| 700 | 1 | |a van der Heide, Agnes |e verfasserin |4 aut | |
| 700 | 1 | |a Rietjens, Judith Ac |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Palliative medicine |d 1996 |g 34(2020), 10 vom: 01. Dez., Seite 1374-1384 |w (DE-627)NLM074816403 |x 1477-030X |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2020 |g number:10 |g day:01 |g month:12 |g pages:1374-1384 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/0269216320940559 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2020 |e 10 |b 01 |c 12 |h 1374-1384 | ||