Today in America the homeless account for almost 1.8 million with nearly 44 % of them being men. Disease and mortality are greatest in the homeless, there has “been a 51% increase in the number of patients age 50 or older between 2008 and 2014 (Healthcare).” With these increasing numbers, the growing need for advanced care planning in the homeless is becoming more relevant.
The case study that was examined was Paul: No Surrogate. For Paul his situation is becoming more common in healthcare today. Paul does not have a living will or an advanced care plan for his end of life needs. From all indications Paul had been dropped off at the hospital, due to his weight loss, fever, chills, and cough he also probably had some cognitive deficits. He is clearly living on the streets, his value system is one that cannot be answered, but having a “friend” bring him to the hospital, showed he had some social interaction. Paul has no income, poor nutrition, and poor health care management. He even stated that he had never received care in the community. During his treatment in the
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The question remains do advance directives and living wills work for the homeless. Patients and in Paul’s case he may have a different opinion to what is his quality of life. For the health care team, they fought for Paul. Paul was unable to voice his desires, the medical team respected him. They were sensitive to his circumstances, his inability to care for himself, and remained his advocate. Attempts were made by the health care team to find a surrogate or family for Paul. He died with dignity and he died free from suffering. The ANA Code of Ethics directs nurses to practice “with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health