In 2014, the University of California, Los Angeles Medical Center in Santa Monica
launched the Homeless Advance Care Planning committee with help from the Coalition for Compassionate Care of California
This advance care planning outreach effort is intended to offer the homeless—particularly those with chronic illness—a voice in their own healthcare decisions, especially at the end of life. To date, more than 125 advance directives have been distributed to homeless individuals in the Santa Monica/Venice area of West Los Angeles. Additionally, six trainings have been offered to UCLA staff, homeless outreach volunteers and healthcare providers from neighboring organizations.
Many of the homeless individuals we have worked with shared they would not want to be hospitalized, supported “on machines,” or end their lives in nursing homes away from their friends and community. And yet, even when these wishes are captured through an advance directive, there are few alternatives. An average of 30 homeless people die each year on the streets of Santa Monica, many of them without the pain and symptom management needed at the end of life.
In order to honor the wishes of the homeless, UCLA Medical Center, Santa Monica, is attempting to partner with hospices, homeless outreach programs and other healthcare facilities to create a new program: Hospice Under the Bridge, with the goal of providing the dying homeless with basic needs such as food, clothing and shelter, as well as symptom management and spiritual support.
We plan to honor the wishes of the members of the homeless at the most vulnerable time in their lives.
For additional information on UCLA’s Advance Care Planning for the Homeless and Hospice Under the Bridge projects, contact Jeannette Meyer at [email protected]
Liked this blog post? Read UCLA Medical Center pilots strategies for having end-of-life conversations with homeless community in Santa Monica
Jeannette (Jeannie) Meyer, RN, MSN, CCRN, CCNS, PCCN, ACHPN, is a clinical nurse specialist in palliative care at the Santa Monica UCLA Medical Center and Orthopedic Hospital, and an assistant clinical professor at the UCLA School of Nursing.
The Advance Care Planning Coalition at the UCLA Medical Center, Santa Monica also includes Delia Cortez, LCSW, Lori Koutouratsas, MDiv, and Diana Ramirez.