I need to write a 25 page paper about this. I need some help knowing where to start from. Also I need to do 20 articles with it.  Describe the best possible intervention used in hospice service...

I need to write a 25 page paper about this. I need some help knowing where to start from. Also I need to do 20 articles with it. 

Describe the best possible intervention used in hospice service for the terminally ill people who are either poor or homeless.

Expert Answers
kipling2448 eNotes educator| Certified Educator

Fortunately, the problems of homelessness and medical care, including “end-of-life” hospice care, have received significant attention over the years.  That is not to suggest that homelessness does not remain a problem, because obviously it continues to be a huge problem.  Nor is it to suggest that the issue of providing hospice care for terminally ill homeless people has been solved, because it has not.  What is fortunate is that there are a number of active programs or models designed to address these problems from which we can draw insights. 

The problem of homelessness is partly financial and partly psychological.  Homelessness caused by otherwise mentally healthy adults being unable to afford housing is one component of the broader issue.  What is known with absolute certainty, though, is that a large percentage of homeless adults suffer from some form of mental illness.  According to the National Coalition for the Homeless, that number could be as high as 25 percent of homeless adults. [See "Mental Illness and Homelessness,” http://www.nationalhomeless.org/publications/facts/Mental_Illness.pdf].  The reason that figure is important because homeless adults who suffer from mental illnesses are often highly resistant to efforts to help them.  That problem aside, though, the number of homeless people in the United States remains very high.  (The U.S. Department of Housing and Urban Affairs puts the number at over half-a-million people as having spent at least one night homeless during 2014. See “HUD Reports Homelessness in U.S. Continues to Decline,” http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/2014/HUDNo_14-135)

Obviously, not all of these homeless people are terminally ill.  The numbers do suggest, however, that the scale of the problem is daunting even if spread out across the nation.  The obstacles are outlined in a report by the HCH Clinicians Network:

“Homeless people face numerous barriers to hospice care, including lack of insurance to pay for it, lack of a fixed residence in which hospice care can be provided, and lack of a primary caregiver to oversee hospice care. In addition, a physician must certify that the patient has 6 months or less to live; this can be difficult for a doctor to determine and for a patient to accept.”[“HCH Clinicians Can Help Homeless People Die with Dignity,” http://www.nhchc.org/wp-content/uploads/2011/09/endoflife.pdf]

The key to addressing the issue of hospice care for the terminally ill homeless lies largely in charitable contributions from the public that, combined with federal and state aid, can largely resolve the problem if and when the category of homeless individual in question can be identified and transported to temporary shelter where hospice care can be administered.  One useful model is the San Diego, California-based Alpha Project’s Permanent Supportive Housing Program, which converted a former hotel into a large hospice facility specifically for the homeless, with additional housing and care administered at various off-site locations [See the link provided below].  Cooperative arrangements with state and local housing authorities, together with federal grants when available, and negotiated agreements with former housing owners (such as shuttered apartment buildings and hotels) can provide an invaluable resource for placing terminally ill homeless people in appropriate facilities.  Federal programs like Medicaid and Medicare are important sources of funding, when tapped, as they exist to help the elderly and the indigent and do include hospice care. 

In short, the resources sometimes do exist to address the problem of providing hospice care for the homeless.  Model programs like that in San Diego can be applied more broadly, and local governmental and nongovernmental organizations can solicit financial assistance from relevant agencies, in addition to privately-funded initiatives that constitute a tax-write-off for contributors. 

In addition to the references cited above and linked-to below, the following are more recommendations for further study, although the student’s ability to access some of the texts may require librarian assistance:










Further Reading:
proteach40 eNotes educator| Certified Educator

First, take a look at what they are asking you to do.  You are "describing"  the best possible intervention.  That means detailed explanation of what is done for the population mentioned in the question.  You may want to search for articles with subjects like "Top Options for Homeless Hospice Care" or other types of lists that people in the industry have put together to discuss how they see intervention.  If you are familiar with the hospice industry, who is the best caregiver by reputation?  What are their methods? 

Also, once you locate an article that you find useful, go to the bottom of it and look where THAT author found their source material.  It may lead you to more articles and therefore more information.  I would set up a bookmark list or file in your browser to place all 25 articles you find (if they are all electronic) so that way you could go back and locate what you need.

Lastly, if you haven't used EasyBib.com yet, it's worth looking into to help you with your Works Cited page.  MLA format changes all the time so it might be worth using it to create your entries and then your page. 

mariam15 | Student

thanks everyone that helps me to start on my paper. 

cshova0408 | Student

First try and find your sources and save them. Then, make an outline and identify the main points of each article. that way you can have s little over a page for each source. If you have each source summarized in a few sentences for you to remember it's going to make it easier for you to write the paper. Do a few sources a day so you can get breaks in between.