51猎奇入口

Walsh, J. J. & Sussman, T. (2026, June). A place to call home at end-of-life: A case study of hospice practices and the built environment for older homeless adults [paper presentation]. 2026 Canadian Association of Social Work Education Conference. Ottawa, Ontario, June 4 - 7th, 2026.

Abstract

Older people experiencing homelessness (OPEH) are structurally excluded from most mainstream hospice palliative care programs. Their exclusion extends into end-of-life research where their voices and experiences are strikingly absent from most academic literature and other knowledge products guiding practice and service models. Issues of mistrust, social exclusion, and daily survival needs create barriers for OPEH to access end-of-life care and participate in research. Clinically, a small number of specialized community hospices in Canada have developed promising practices and built environments addressing these barriers. Academically, literature on how these practices shape inclusive end-of-life care places is limited. This presentation shares the findings of a case study of a specialized community hospice which aimed to better understand how practices and the physical space shape inclusionary places for OPEH at end-of-life. Drawing on relationally accountable, trauma-informed, and socially just principles, seven OPEH at this hospice were recruited to explore their experiences of inclusive practices and built environments. Diverse data collection methods were used to find that practices and the environment addressed the many barriers to end-of-life care for OPEH, promoted mutual care between residents, and resisted a sense of institutional care by creating a sense of home and community. An intersectional analysis found that gender, ethnicity, and mobility also uniquely shaped inclusion or exclusion through hospice admission, as well as access to practices and space.