Grant: Project Grant

If given a choice, most Canadians consider home an ideal place to be cared for and die. What happens though when people have no home or they experience housing instability? Our current CIHR-funded research has shown that risk and safety, functional decline, and current housing policies/regulations, pose significant barriers for vulnerable and marginalized older adults who wish to be cared for and die at home. These older adults experience eviction when they are sick as well as risk of losing their transitional or shelter-based housing. These older adults often face stigma and harm when entering institutional settings (ex. hospitals or long term care homes). Our partnerships with inner city housing, harm reduction, and outreach workers suggests that if proper strategies and supports were employed, the ability to care for and "die in place" would significantly improve the quality of life for highly marginalized older adults. This study will investigate how to facilitate care for, and the dying in place of, older adults facing inequities while nearing the end of their lives. We will do this by (1) identifying the governing factors within current health and housing sectors that influence the ability to be cared for and die in place. We will (2) explore the experiences of being cared for and dying in place from the perspective of those facing inequities, their support persons and the service providers that care for them. We will then (3) determine interventions, and policy options that will promote change; and finally (4) we will synthesize and apply our findings to inform the co-development of an actionable set of evidence-informed recommendations to help guide health and housing sector leaders to promote care for and the "dying in place" of older adults who are vulnerable and marginalized that is consistent with their wishes.