Providence Hospice Foundation launches end-of-life care program for homeless patients

A new program from the Providence TrinityCare Hospice Foundation seeks to change the end-of-life experience for unhoused individuals from a painful and lonely process to a dying in comfort and peace.

Thanks to an approximately $500,000 grant from Providence Community Investment, the foundation will provide housing and end-of-life care for 140 homeless individuals with a serious illness in the new year.

“For many of these patients, they haven’t had a guaranteed warm bed and a person who looks after them for decades,” said Dr. Martina Meier, Providence Hospice medical director.

“For them to die with the peace of mind that they’re going to be able to stay where they are and they’re going to be cared for no matter what happens, I think completely changes the way that they can experience their own end of life.”

Typically, when homeless patients come into the emergency room with a serious illness, they will be treated for the acute concern and then discharged with instructions for follow up care.

But because they are homeless, it’s challenging to ensure they receive the continuing care they need, Meier said.

It can be a struggle to get in contact with patients, to ensure they are following medical instructions, to transport them to follow-up appointments and to provide access to medication – in addition to the fact that homelessness itself often causes or exacerbates health concerns, she said.

It’s estimated that one third of homeless individuals are experiencing some form of serious illness, said Matthew Scelza, executive director of Providence TrinityCare Hospice Foundation.

The new end-of-life care program seeks to eliminate these barriers to care by moving homeless patients directly from Providence Saint Joseph Medical Center in Burbank, Providence Cedars-Sinai Tarzana Medical Center and Providence Holy Cross Medical Center in Mission Hills into housing placements for end-of-life care services. The program will also take patient referrals from homeless care providers and case managers across Los Angeles County, Scelza said.

“There’s so many challenges to taking care of patients who are not permanently housed,” Meier said. “This program is completely a game changer.”

The initiative was inspired by the struggles of a single homeless patient who was diagnosed with end-stage cancer at a Providence hospital and didn’t have any treatment options available to him, Meier said.

His medical team was loath to discharge him to perish on the streets and instead helped him secure a placement in a board and care home, which is a residential facility with a trained nursing staff. In this home, he was able to access quality end-of-life care and reunite with his mother.

“She was really grateful to be reconnected and to be reassured that he was going to die in a warm bed with people caring for him,” Meier said. “That story really is what triggered us seeking out this grant.”

The foundation has already begun placing patients in board and care facilities, Scelza said, but will roll out the pilot program in earnest in the new year, with an ambitious goal to serve 140 individuals. The foundation is also training staff in these board and care partner homes on how to best care for formerly unhoused patients.

“It takes more than just money to place a patient,” Meier said. “There has to be a mindset and the buy in to take care of people who are maybe not used to being housed.

“So we provided education to our staff and also had multiple conversations with board and care administrators and staff,” Meier added, “to make sure that our patients are going to experience really good care once they’re placed.”

The foundation will track various outcomes from the pilot program to see how it can be changed or expanded in the future.

That analysis will include looking at the speed with which patients are placed in housing, the satisfaction of partners providing end-of-life patient care, the length of time patients remain in care and whether the program is able to unite patients with friends and family, Meier said.

“We are looking forward to seeing the impact it does make,” Scelza said. “We’re definitely tracking closely the impact it makes on individual families and communities, what we can learn from it, and how we can build on this program locally, regionally and nationally.”