Serious illness care in the margins: Envisioning loving psychosocial-spiritual care delivery for unsheltered individuals.

Abstract

Guidance on psychosocial-spiritual care for people experiencing homelessness (PEH) is limited. Through a descriptive phenomenological analysis of interviews with interdisciplinary professionals, chart documentation, and input of a practicing homeless palliative care (HPC) social worker, this study provides exploratory guidance on administering psychosocial-spiritual care in a street outreach-based setting. Analysis produced four themes: (1) Building intimacy and consistency, which illustrates strategies for meaningfully meeting client need; (2) Assessment and treatment planning, in which providers' knowledge of their client helps tailor the care plan; (3) Widening the lens for stationary service practitioners, which demonstrates how providers must reframe traditional understandings of care teams to support continual client care; (4) Psychosocial-spiritual intervention, in which practitioners proactively prepare to support client's relational needs and meaning-making. Implications for this exploratory research includes future directions for adapting best practices for psychosocial-spiritual end-of-life interventions and developing models of care that begin to fill structural gaps in care.