Challenges related to the chaotic lifestyles associated with being homeless
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Death in the day to day context of homelessness
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Previous negative experiences of death and fear of death
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Peer advocates/community services to facilitate attendance & engagement
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Unconventional living arrangements & social isolation
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Training for staff around addiction issues and associated complications
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Attitudes to health care; substance misuse & competing priorities
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Previous negative experiences or perceptions of health care & mistrust of professionals
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Poor engagement with services
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Substance and alcohol misuse
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Complex care needs & competing priorities
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Trends in accessing health care and poor adherence to treatment
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Communicating about death, dying and advance care planning
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Challenges to the delivery of end of life care and specialized palliative care within a hostel
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The hostel environment
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Limited resources
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Advocacy
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Difficulty accessing support and specialist services
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Greater collaboration with medical services – MDT discussion
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Limited medical information
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Greater in hostel support from medical and social services
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Practical and emotional burdens for staff
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Limitations of staff roles
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Increased training & specialised services
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Emotional burden for staff
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Challenges to the provision of palliative care to homeless persons relating to mainstream health care systems
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Inflexibility of the health care service and limited planning
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Inflexible services and systems
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Flexibility in care model & locations
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Strict rules and regulations
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Harm minimisation strategies
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Lack of specialised services
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Linking with community services
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Limited planning, especially at discharge
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Training for health care professionals
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Health care professionals’attitudes and inexperience in supporting homeless people
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Attitudes of professionals
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Person centred care
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Emotional & practical burdens
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Increased training & specialised services
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