Becoming Housed During Palliative Care Enrollment: Identifying Drivers, Deterrents, and Directions for Future Care

Abstract

Homelessness is associated with accelerated disease progression, and housing placements are less likely when experiencing serious illness. Little research to date has focused on how to successfully secure housing placement during serious illness and end of life. This study aimed to address this gap by examining factors influencing housing placement among seriously ill palliative care patients experiencing homelessness. By conducting reflexive thematic analysis of medical record data of palliative care patients who became housed during enrollment (n = 16), three themes were identified: (1) trends in placement timing showing most accessed housing within seven months of palliative care involvement due to the relationship between homelessness, disease progression, and goals of care; (2) social support networks that were involved in attaining housing to varying degrees; and (3) changes in internal motivation, such as identity affirmation, relational tasks, and accepting limitation, driven by illness and dying processes. Findings underscore the need for integrated medical and social support, expanded housing options for the seriously ill, and adaptable psychosocial-spiritual care within the housing care continuum.

Keywords: end of life; healthy places; homelessness; housing; multiple chronic conditions; palliative care.

Figure 1

Histogram depicting days before accessing housing across sample (n = 16).