Homelessness and End of Life Care: Analysis of the Living Wills of Homeless Individuals

Abstract

In the Twin Cities metro area over 4,000 youth and adults are in temporary housing programs and over 600 are unsheltered. Homeless individuals experience a greater risk of death and more barriers to healthcare than any other disadvantaged population. As a result of barriers to regular healthcare, homeless individuals are hospitalized and admitted to the emergency room at four times the rate of the general population. Few other studies have looked at the content of advance directives and no other study has looked at what the homeless write in their advance directives. A qualitative study of 73 advance directives of homeless individuals from Minneapolis showed evidence against many misconceptions people may have regarding the homeless: The majority of people named a family member as their healthcare agent and discussed family throughout their living will. Many of the homeless individuals discussed specific healthcare goals and were eager to improve or maintain their health. Many of the people wrote about specific accomplishments when asked what they were most proud of and wanted to be remembered for their personal traits, such as being good, kind or helpful.