Increasing access--a qualitative study of homelessness and palliative care in a major urban center.

Rates of morbidity and mortality are significantly higher in homeless populations. Homeless people experience many barriers to receive adequate palliative care. This qualitative study examines how a major urban city's palliative care resources can be improved to increase access and better serve the homeless. Audiotaped interviews were preformed with 7 homeless care providers in Toronto, Canada, and their transcripts were analyzed using thematic analysis. The findings of the study suggest that in order to increase access and to serve the city's terminally ill homeless better, the following 4 areas must be addressed: (1) increasing positive interaction between the health care system and the homeless, (2) training staff to deal with the unique issues confronting the homeless, (3) providing patient-centered care, and (4) diversifying the methods of delivery.