Grant: Project Grant

Vulnerable and marginalized populations - including those who are homeless, experience mental health and substance use issues and who are living in poverty - experience "accelerated aging" compared to the general population. They also have higher rates of illnesses that will lead to their death. While most older people who are coming toward the end of their lives are cared for at home by family members, this is not the case for many seniors who are vulnerable and marginalized. Our recent research found that older adults who are vulnerable are cared for by many people that we would not traditionally think of as "family" caregivers. These included people like inner city housing workers, "street family" and sometimes biological family members. But there is little known about these caregivers - who they are and what they do and how caregiving affects them. In this study we will work with inner city palliative care teams in Victoria and Toronto to examine who the caregivers are of vulnerable and marginalized older adults. We will also explore factors that influence their capacity to give care and document what impact caregiving has on them. Our research will involve repeated observations over 2 years of inner city palliative care teams in Victoria and Toronto. We will also conduct interviews with these team members and other providers like housing and harm reduction workers, health care providers working in home and community care, and executive directors and clinical leaders in inner city agencies that support vulnerable and marginalized people. We will also interview caregivers of vulnerable and marginalized populations after asking them to take pictures that depict their caregiving work. Our goal is to provide a detailed description so that we can figure out how to best provide supports to these caregivers in order to reduce negative health outcomes including emotional distress, trauma, grief and burnout.