Friday, March 30, 2007

Hospice and Palliative Care for the Homeless

Every urban city has them somewhere. Viewed too often as invisible humanity, they watch their cardboard requests for help filter through society’s windshields. Shivering in countless layers of clothing, they roam while preaching to unseen characters. They are homeless people who may or may not have lived in the past like any reader of this blog.

But what happens or should happen to millions of homeless people when they are terminally ill? Those with bodies racked with years of substance abuse can only last so long, especially when strong social supports and medical insurance are lacking. When each day is a struggle to meet basic needs, the odds of detailed planning of end-of-life care are slim.

“The Journal of the American Medical Association” discusses how to serve the terminally ill homeless population with these summary conclusions:

1) Needs of the homeless can best be met with a multidisciplinary team that addresses their complex needs.

2) Those who continue to abuse drugs must have frequent clinic visits, specific dosages of long-acting pain medications, and a written pain agreement.

3) Their end-of-life concerns must be discussed with them and documented.

4) Due to lack of finances, homes, and social supports, the homeless rarely receive inpatient hospice care. However, inpatient palliative care at hospitals can enhance the quality of their end-of-life experience.

Like everyone else, homeless people are entitled to all the benefits of dignified death journeys.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog


  1. I have been caring for the elderly for 20 years and recently became a hospice case manager R.N. I wanted to thank you for sharing your ministry. I plan on sharing your site at our new volunteer orientations. It is very insightful! Thank you.

  2. Thanks for your response, and congratulations on your new position. If the new ones ask what they'll get out of volunteering, tell them they'll get to be better people. I wish you all the best.

    Frances Shani Parker
    Hospice and Nursing Homes Blog