title: When dying at home is not an option: exploration of hostel staff views on palliative care for homeless people.
abstract: BACKGROUND
  The Department of Health in the UK suggest that hostel staff are the most appropriate key workers for their dying homeless residents and that hostel-based palliative care may be the best way forward. However, little is known about the views of hostel staff with regard to this.
  
  
  METHODS
  Semi-structured qualitative interviews were conducted with seven participants from hostels distributed across three counties. A total of 37 specific case studies were discussed involving homeless residents with a wide range of life-limiting or palliative conditions.
  
  
  RESULTS
  Eight main themes emerged: understanding palliative care; working with limited medical information; taking responsibility; building rapport; upholding residents' dignity; recognising physical deterioration; managing environmental challenges; role limitations and support needs of hostel staff.
  
  
  CONCLUSIONS
  Discussion centred around the following four topics: policy, principles and practice of palliative care; professional boundaries as a threat to holism and a hindrance to dignity; the social undesirability and invisibility of homeless people; 'community living' as a barrier to hostel-based palliative care and a new concept of family.
authors.affiliation: Palliative and Medical Advanced Nurse Practitioner, Evesham Community Hospital, Worcestershire Health and Care Trust, UK.
authors.forename: Wendy Ann
authors.initials: WA
authors.lastname: Webb
mesh_terms: D003643:Death; D006703:Ill-Housed Persons; D006801:Humans; D010166:Palliative Care; D006113:United Kingdom
keywords: Dying; Homeless; Hostel; Marginalised; Palliative care