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Am J Hosp Palliat Care. 2014 Mar;31(2):183-8. doi: 10.1177/1049909113482176. Epub 2013 Mar 21.

Does end-of-life decision making matter? Perspectives of older homeless adults.

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  • 11San Diego State University School of Social Work, San Diego, CA, USA.


This qualitative pilot study explored perspectives, needs, and concerns relating to advance care planning among older homeless adults. Twenty-one older adults residing at a transitional housing facility in an urban area of the West coast were interviewed in person. Key emergent themes included discomfort with the topic, trust in God's decisions, physicians preferred as decision makers, and planning is important but not an immediate concern. Further, people who are homeless want to be approached with sensitivity. Instead of simply eliciting life-sustaining treatment preferences of homeless people, health care professionals should assess their unique concerns and needs regarding death and dying, prepare them to consider their possible end-of-life situation, and assist them to plan in accordance with their needs.


advance care planning; cultural sensitivity; end of life; homeless; older adult; perspective

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