Resident Care in the “In-Between Time”: Cross-Sector Perspectives on Enhancing Synergy Between Palliative Care and Permanent Supportive Housing

Abstract

Despite established disparities in serious illness prevalence among formerly homeless people living in permanent supportive housing, there is a dearth of research aimed at promoting and enhancing palliative care service delivery in this setting. This paper describes current practices, perceived barriers, and recommendations in permanent supportive housing for residents living with serious illness through a thematic analysis of interviews with cross-sector stakeholders (n = 30) from the Research and Supportive Care at Later-life for Unhoused People (RASCAL-UP) study. Themes identified across resident care, program collaboration, and policy and environment areas included: (1) unique resident care needs; (2) on-site relationships; (3) adaptation of aging, disability, and healthcare services for residents; (4) internal implementation barriers; (5) preparing the environment for serious illness; and (6) missing levels of care. From these results, we put forth recommendations for future collaborative care intervention development, supportive housing policy, and capacity-building efforts for healthcare and housing providers alike.