Minding the gap: access to palliative care and the homeless

BMC Palliative Care

Debate

Lise Huynh¹  Blair Henry²  Naheed Dosani³ 

[1] Department of Palliative Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada;Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada;Ethics Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;Inner City Health Associates, Toronto, ON, Canada;Department of Family & Community Medicine St Michael’s Hospital, Toronto, ON, Canada;Division of Palliative Care, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada;Division of Palliative Care, William Osler Health System, Brampton, ON, Canada;

关键词: Palliative care;    End-of-life care;    Social determinants of health;    Homelessness;    Access;    Socio-economic status;   

DOI  :  10.1186/s12904-015-0059-2

 received in 2015-07-01, accepted in 2015-11-06,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundWith an ever increasing number of individuals living with chronic and terminal illnesses, palliative care as an emerging field is poised for unprecedented expansion. Today’s rising recognition of its key role in patients’ illnesses has led to increased interest in access to palliative care. It is known that homelessness as a social determinant of health has been associated with decreased access to health resources in spite of poorer health outcomes and some would argue, higher need. This article aims to discuss the current state of affairs with regards to accessing palliative care for the homeless in Canada.DiscussionRecent review of the literature reveals differential access to palliative care services and outcomes with differing socio-economic status (SES). Notably, individuals of lower SES and in particular, those who are homeless have poorer health outcomes in addition to poor access to quality palliative care. Current palliative care services are ill equipped to care for this vulnerable population and most programs are built upon an infrastructure that is prohibitive for the homeless to access its services. A preliminary review of existing Canadian programs in place to address this gap in access identified a paucity of sporadic palliative care programs across the country with a focus on homeless and vulnerably-housed individuals. It is apparent that there is no unified national strategy to address this gap in access.SummaryThe changing landscape of the Canadian population calls for an expansion of palliative care as a field and as many have put it, as a right. The right to access quality palliative and end of life care should not be confined to particular population groups. This article calls for the development of a unified national strategy to address this glaring gap in our healthcare provision and advocates for attention to and adoption of policy and processes that would support the homeless populations’ right to quality palliative care.

【 授权许可】

CC BY   
© Huynh et al. 2015