Dissertation
Advance Care Planning for People Experiencing Homelessness
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: There are high rates of chronic conditions (i.e. substance use, mental illness, diabetes, heart disease) and mortality within the homeless population, resulting in a life expectancy that is much lower than the average American (NAEH, 2023; USICH, n.d.). Yet many people experiencing homelessness do not engage in advance care planning (ACP) discussions (Cortes & Meyer, 2022). Studies have found the PREPARE for Your CARE Program to be an effective AD for this population (Kaplan et al., 2020; Sudore et al., 2018). Purpose: This EBP project aimed to establish an advance care planning process for people experiencing homelessness, utilizing the PREPARE for Your Care program and advance directive (AD). Methods: An EBP project was conducted with 56 chronically homeless individuals who are currently in permanent supportive housing (PSH) and seven case managers. Case managers were provided with an ACP workshop and case manager knowledge, attitudes and perceptions of ACP were evaluated using a pre-/post-survey. Additionally, completion rates of ADs were collected to assess response to PREPARE for Your Care Program. Creation and proposal of an End-of-Life Policy for the organization. Findings: Results indicated a clinically relevant improvement in case managers knowledge, attitudes, and perceptions. Case managers improved their knowledge scores from an average 3.14/5 on the pre-survey to 4.56/5 on the post-survey. Seven of the nine items on the four-point Likert-Scale on perceptions and attitudes improved in score. Additionally, 21/56 (37%) chronically homeless tenants had a completed AD at project completion. Furthermore, the End-of-Life Policy was adopted by the organization. Discussion: The findings suggest that the PREPARE for Your Care program was an effective method for educating case managers on ACP, thereby increasing the chances of people experiencing homelessness to engage in ACP and have an opportunity to complete an AD.
Details
- Title: Subtitle
- Advance Care Planning for People Experiencing Homelessness
- Creators
- Ashley Duncan - University of Iowa
- Contributors
- Amalia Gedney-Lose (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Family Nurse Practitioner
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Ashley Duncan
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841038302771
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