A First Voice Perspective of Homelessness and End-of-life Care: A Vicious Cycle of Deteriorating Circumstances

Abstract

Despite an increased risk of progressive illness(es) and mortality, there are limited resources available to serve the multifaceted end-of-life care (EOLC) needs for those experiencing homelessness. This population faces many barriers in accessing EOLC services due to systemic and structural injustices. Utilizing an interpretive phenomenological methodology and the theoretical lens of critical social theory, this study set out to explore how and in what way, individuals who are experiencing homelessness and living with progressive illness(es), experience EOLC. Through in-depth semi-structured interviews, the meaning that each individual gave to death and dying was uncovered and the perceived, and/or real, barriers that participants faced in accessing health/EOLC services were discussed. Resulting in themes surrounding the perception of discrimination and COVID-19 as barriers in access, late access and/or being unsure of their diagnoses/prognosis, experience of existential struggle, wishing to die at ‘home’ (wherever that may be), and fear of dying alone/in pain.