U of M Bioethics Center Receives Award to Study End of Life Homeless Care

Study will empower homeless to create advance directives

MINNEAPOLIS / ST. PAUL (August 13, 2007) — University of Minnesota researchers are about to embark on a three-year research project that aims to improve end-of-life decision-making and care for homeless people.

Its goal is to determine whether homeless people are willing to create an advance directive, if the assistance of a social worker will increase their rate of doing so, and – most importantly – whether the process will spark a change in care when homeless people become hospitalized or die.

The University of Minnesota’s Center for Bioethics received a $900,000 grant from the National Institutes of Health to fund the research endeavor.

“It’s relevant because there are a lot of homeless people – many more than most of us appreciate – and homeless people suffer high rates of mortality,” said John Song, M.D., M.P.H., M.A.T., principal investigator of the research project. “Given the fact that many homeless people live very difficult lives, perhaps in their deaths we can provide some respect and dignity.”

Previous research headed by Song concluded that homeless people are especially interested in completing a legal document of some kind to ensure that their end-of-life wishes are communicated.

Furthermore, homeless people experience disproportionately high rates of illness and death, often die at a young age, lack basic resources for health care, and may be estranged from their families and communities, Song said. They also think about death frequently and dying without a memorial service.

Advance directives for health care give people an opportunity to legally appoint someone to make health care decisions for them when they are unable to do so. In addition, one can write specific directions for health care management in the event of serious illness.

This study will implement a unique health care directive to address the concerns of homeless people. The directive will include descriptions of specific physical features for body identification, will ask about wishes after one dies, and will specifically ask about what health care personnel could do to enhance their dignity.

Besides Song, Edward Ratner, M.D., and Dianne Bartels, R.N., M.A., Ph.D., from the University of Minnesota’s Center for Bioethics and Medical School, Melanie Wall, M.D, M.S., Ph.D., from the Division of Biostatics in the School of Public Health, and Dr. Lillian Gelberg, M.D., M.S., Ph.D, from the University of California, Los Angeles will conduct the study, which will include participation by 300 homeless people living in Hennepin County.

Research will begin in the next few months, at area shelters, food shelves, and homeless health clinics.

The Academic Health Center is home to the University of Minnesota’s six health professional schools and colleges as well as several health-related centers and institutes. Founded in 1851, the University is one of the oldest and largest land grant institutions in the country. The AHC prepares the new health professionals who improve the health of communities, discover and deliver new treatments and cures, and strengthen the health economy.

Contact: Nick Hanson, Academic Health Center, (612) 624-2449, hans2853@umn.edu
Laura Stroup, Academic Health Center, (612) 624-5680, stro0481@umn.edu