BACKGROUND: People experiencing homelessness often encounter progressive incurable somatic diseases in combination with psychiatric and psychosocial problems, and many need palliative care at the end of their lives. Little is known about how palliative care for this group can be started in good time and provided optimally. The objective of this paper is to give insight into the extent people experiencing homelessness have access to good palliative care.
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Purpose: Self-managed institutional homeless programmes started as an alternative to regular shelters. Using institutional theory as a lens, we aim to explore the experiences of stakeholders with the institutional aspects of a self-managed programs.Method: The data we analysed (56 interviews, both open and semi-structured) were generated in a longitudinal participatory case-study into JES, a self-managed homeless shelter. In our analysis we went back and forth between our empirical data and theory, using a combination of systematic coding and interpretation. Participants were involved in all stages of the research.Results: Our analysis revealed similarities between JES and regular shelters, stemming from institutional similarities. Participants shared space and facilities with sixteen people, which caused an ongoing discussion on (enforcement of) rules. Participants loathed lack of private space. However, participants experienced freedom of choice over both their own life and management of JES and structures were experienced more fluid than in regular care. Somestructures also appeared stimulated self-management.Conclusion: Our analysis showed how an institutional context influences self-management and suggested opportunities for introducing freedom and fluidity in institutional care.
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The use of social networking and e-health technology through mobile (and other) devices, like smartphones and tablets, has been increasing in the last 20 years. This is equally true for people in marginalized situations, like homeless people. Earlier research shows that the majority of homeless people own a smart phone (Heaslip et al., 2021) and that mobile technology has the potential to support the health and wellbeing of persons who are homeless (Calvo & Carbonell, 2019). In our presentation, we will explore this potential further and shed light on how and why online social networking is used by homeless people and their social workers.We will present findings from our two-year qualitative research project ‘Social Network First?’ on network support offered to homeless people in Amsterdam and Haarlem, two cities in the Netherlands. In the recent decade, the Netherlands has seen the number of homeless people doubled (CBS, 2021) and the urgency to support this disadvantaged group has increased. Whereas policy in previous years focused predominantly on a ‘housing first’ approach, in which the main priority is to accommodate homeless people, the belief grows that this approach is not sufficient. For that reason, in addition to housing, Dutch shelter organizations are implementing a novel network support approach in the care of homeless people. With this approach, loosely based on the resource group method, social workers attempt to empower their homeless clients by involving and strengthening their clients’ social contacts. To understand the network support approach and its contribution to the empowerment of homeless people, we have conducted 25 semi-structured interviews with homeless people, their relatives and friends, social workers, and other professionals involved. The analysis of the interview data reveals that online social networking is of crucial importance for the network support approach. Our (preliminary) results show that especially WhatsApp is used by social workers to connect the homeless person to his/her social network in two ways. Firstly, WhatsApp is used for thoroughly mapping the social network of the client. Secondly, WhatsApp is used to create an online support group, which offers the client and his/her network possibilities for (re)connection and mutual support. In addition, WhatsApp is used extensively by social workers to easily maintain contact with homeless clients. This is important because, especially with clients who are not ready yet to work on their recovery, using WhatsApp allows social workers to just check in once in a while, while giving control of the process to the client. Whereas these results are predominantly positive, we will also discuss the cons of social networking technology, like privacy issues. In conclusion, our presentation offers a comprehensive exploration of the opportunities of social networking technology in the context of supporting homeless people. By examining the implications for social workers, we aim to inspire attendees with insights in how digital communication methods can be used to improve their social work practice. Subsequently, we aspire this contributes to developing pathways out of homelessness with the help of others.
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