Providing palliative care to adults experiencing homelessness or vulnerable housing

Background and Purpose: Registered nurses face unique challenges providing palliative care to adults experiencing homelessness or vulnerable housing, such as difficulty establishing a therapeutic relationship, acquiring adequate resources, and facilitating care in their preferred setting. The purpose of this practicum project is to improve equitable palliative care by developing an e-learning module to inform and support registered nurses. Method: Multiple strategies were employed to gain a comprehensive understanding of the issue. An integrative literature review was conducted to identify existing barriers for unhoused people, challenges encountered by registered nurses, and lessons learned from nursing interventions. An environmental scan and consultations were performed to explore these complex issues locally. Results: Adults facing homelessness or vulnerable housing preferred to receive care outside of healthcare facilities, but they faced several barriers due to extensive social insecurities and disconnected services. Registered nurses found it challenging to provide palliative care to unhoused patients due to increased clinical complexity, lack of adequate resources, and strained therapeutic relationships. Based on these findings, an interactive, self-paced, e-learning module was developed to inform registered nurses of patient barriers, nursing challenges, and nursing strategies. Conclusion: The developed e-learning module supports nurses in recognizing critical patient barriers, addressing nursing challenges, and applying evidence-informed strategies to promote equitable access to care. Next steps include completing stakeholder review, publishing the module on Nova Scotia Health’s Learning Management System, and evaluating its effectiveness. Future development may involve expanding the module to other healthcare providers or adapting it for additional vulnerable populations.