PMID: 16613403Apr 15, 2006Paper

Shelter-based palliative care for the homeless terminally ill

Palliative Medicine
Tiina PodymowDoug Coyle

Abstract

The homeless have high rates of mortality, but live in environments not conducive to terminal care. Traditional palliative care hospitals may be reluctant to accept such patients, due to behavior or lifestyle concerns. The Ottawa Inner City Health Project (OICHP) is a pilot study to improve health care delivery to homeless adults. This is a retrospective analysis of a cohort of terminally ill homeless individuals and the effectiveness of shelter-based palliative care. As proof of principle, a cost comparison was performed. 28 consecutive homeless terminally ill patients were admitted and died at a shelter-based palliative care hospice. Demographics, diagnoses at admission and course were recorded. Burden of illness was assessed by medical and psychiatric diagnoses, addictions, Karnofsky scale and symptom management. An expert panel was convened to identify alternate care locations. Using standard costing scales, direct versus alternate care costs were compared. 28 patients had a mean age 49 years; average length of stay 120 days. DIAGNOSES: liver disease 43%, HIV/AIDS 25%, malignancy 25% and other 8%. Addiction to drugs or alcohol and mental illness in 82% of patients. Karnofsky performance score mean 40 +/- 16.8. Pain manageme...Continue Reading

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Citations

Sep 6, 2012·Journal of Social Work in End-of-life & Palliative Care·Stacey A PageConnie E Mahoney
Jun 24, 2010·Journal of Palliative Medicine·Virginia Dzul-ChurchWendy G Anderson
May 7, 2009·Journal of Palliative Medicine·Pippa Hawley
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