Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis

BMC Public Health

Research Article

Ryan McNeil¹  Laura B Dilley²  Manal Guirguis-Younger³  Stephen W Hwang⁴  Jeffrey Turnbull⁵  Tim D Aubry⁶ 

[1] British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;Faculty of Education, Simon Fraser University, Surrey, BC, Canada;Faculty of Human Sciences, Saint Paul University, Ottawa, ON, Canada;Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;Ottawa Inner City Health, Ottawa, ON, Canada;Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada;School of Psychology, University of Ottawa, Ottawa, ON, Canada;

关键词: Care Service;    Illicit Drug;    Harm Reduction;    Outreach Worker;    Homeless Person;   

DOI  :  10.1186/1471-2458-12-312

 received in 2012-02-09, accepted in 2012-04-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundHomeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs.MethodsA qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life.ResultsHarm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death.ConclusionsWhile partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

【 授权许可】

CC BY   
© McNeil et al.; licensee BioMed Central Ltd. 2012