Dignity is an important issue in end of life care, but has not been considered as a possible predictor of advance care planning (ACP). This presentation will describe a study to determine predictors of willingness to participate in ACP among homeless persons, determinants of loss of dignity, and contributors to dignity at the end of life. A prospective, single-blind, randomised trial comparing self-guided completion of an advance directive (AD) with professionally assisted ACP at 8 sites serving homeless persons recruited 262 homeless persons in 2007-08. Subjects were offered a brief presentation and written materials related to ACP versus one-on-one ACP counselling by a social worker. Measures included pre-intervention written surveys and subsequent AD content analysis. The overall completion rate for ADs was 26.7%. Older age, problems finding a place to sleep (OR = 0.29), and feeling a loss of dignity (OR = 0.37) were independently predictive of completion of an AD, with either a self-guided process or individual counselling. Loss of dignity almost every day was reported by 35% of subjects. Being treated with dignity was described as 1) being respected 2) having preferences honoured, 3) receiving adequate care, and 4) having comfort maintained. In summary, lacking a place to sleep and loss of dignity negatively predict willingness to complete an AD among the homeless. Loss of dignity is a frequent problem in this population. There are practical ways providers can maintain dignity in care of homeless at the end of life.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.