David A Gruenewald1,2, Daniel Doan3, Anne Poppe4,5, Jacqueline Jones6, Evelyn Hutt7. 1. 1 Geriatrics and Extended Care Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. 2. 2 Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. 3. 3 General Medicine Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. 4. 4 Center of Excellence in Primary Care Education, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. 5. 5 University of Washington School of Nursing, Seattle, WA, USA. 6. 6 University of Colorado College of Nursing, Aurora, CO, USA. 7. 7 Department of Medicine, University of Colorado School of Medicine, Denver, CO, USA.
Abstract
OBJECTIVE: : To describe the barriers and facilitators of end-of-life (EOL) care for Veterans without stable housing (VWSH) as perceived by Veterans at 1 VA medical center and EOL care staff. DESIGN: : Qualitative descriptive study. Secondary applied content analysis of data from interviews and focus groups in our parent study. SETTING/PARTICIPANTS:: VA Puget Sound Health Care System and VWSH. RESULTS: : The core emergent theme in the words of Veterans and health-care workers was "meet me where I am," a statement of what many Veterans want most from their health care. Barriers and facilitators often reflected the presence or absence of important factors such as relationship and trust building, care coordination and flexibility, key individuals and services, and assistance in navigating change. CONCLUSIONS: : These findings suggest that to improve health care for VWSH, interventions must be multifaceted, including a suite of support services, flexibility and creative problem-solving, and adaptations in communication approaches. The authors offer specific recommendations for improving EOL care for VWSH based on these findings.
OBJECTIVE: : To describe the barriers and facilitators of end-of-life (EOL) care for Veterans without stable housing (VWSH) as perceived by Veterans at 1 VA medical center and EOL care staff. DESIGN: : Qualitative descriptive study. Secondary applied content analysis of data from interviews and focus groups in our parent study. SETTING/PARTICIPANTS:: VA Puget Sound Health Care System and VWSH. RESULTS: : The core emergent theme in the words of Veterans and health-care workers was "meet me where I am," a statement of what many Veterans want most from their health care. Barriers and facilitators often reflected the presence or absence of important factors such as relationship and trust building, care coordination and flexibility, key individuals and services, and assistance in navigating change. CONCLUSIONS: : These findings suggest that to improve health care for VWSH, interventions must be multifaceted, including a suite of support services, flexibility and creative problem-solving, and adaptations in communication approaches. The authors offer specific recommendations for improving EOL care for VWSH based on these findings.
Entities:
Keywords:
Veteran; death and dying; end-of-life care; homelessness; palliative care; qualitative research
Authors: Allyson L Varley; Ann Elizabeth Montgomery; Jocelyn Steward; Erin Stringfellow; Erika L Austin; Adam J Gordon; David Pollio; Aerin deRussy; April Hoge; Lillian Gelberg; Kevin Riggs; Theresa W Kim; Sonia L Rubens; Stefan G Kertesz Journal: Qual Health Res Date: 2020-01-02