Destitute and dying: interventions and models of palliative and end of life care for homeless adults – a systematic review

Coverdale, Megan Rose; Murtagh, Fliss

doi:10.1136/spcare-2024-004883

Destitute and dying: interventions and models of palliative and end of life care for homeless adults – a systematic review

Coverdale, Megan Rose; Murtagh, Fliss

Authors

Megan Rose Coverdale

Professor Fliss Murtagh F.Murtagh@hull.ac.uk
Professor of Palliative Care

Abstract

Background Homeless adults experience a significant symptom burden when living with a life-limiting illness and nearing the end of life. This increases the inequalities that homeless adults face while coping with a loss of rootedness in the world. There is a lack of palliative and end of life care provision specifically adapted to meet their needs, exacerbating their illness and worsening the quality of their remaining life. Aim To identify interventions and models of care used to address the palliative and end of life care needs of homeless adults, and to determine their effectiveness. Methods Standard systematic reviewing methods were followed, searching from 1 January 2000 the databases: Ovid MEDLINE, EMBASE, SCOPUS, Web of Science, CINAHL and PsycInfo. Results were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and described using a narrative synthesis. Study quality was assessed using Hawker’s Quality Assessment Tool. Results Nine studies primarily focused on: education and palliative training for support staff; advance care planning; a social model for hospice care; and the creation of new roles to provide extra support to homeless adults through health navigators, homeless champions or palliative outreach teams. The voices of those experiencing homelessness were rarely included. Conclusion We identified key components of care to optimise the support for homeless adults needing palliative and end of life care: advocacy; multidisciplinary working; professional education; and care in the community. Future research must include the perspectives of those who are homeless.

Citation

Coverdale, M. R., & Murtagh, F. (2024). Destitute and dying: interventions and models of palliative and end of life care for homeless adults – a systematic review. BMJ Supportive & Palliative Care, 14(e3), e2411-e2422. https://doi.org/10.1136/spcare-2024-004883

Journal Article Type	Article
Acceptance Date	Aug 5, 2024
Online Publication Date	Aug 17, 2024
Publication Date	Dec 19, 2024
Deposit Date	Jan 24, 2025
Publicly Available Date	Jan 28, 2025
Journal	BMJ Supportive and Palliative Care
Print ISSN	2045-435X
Electronic ISSN	2045-4368
Publisher	BMJ Publishing Group
Peer Reviewed	Peer Reviewed
Volume	14
Issue	e3
Pages	e2411-e2422
DOI	https://doi.org/10.1136/spcare-2024-004883
Public URL	https://hull-repository.worktribe.com/output/4836308

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© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ Group. https://creativecommons.org/licenses/by/4.0/
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