Mobile Team Offers Comfort Care to Seattle Homeless at Life’s End

  • Experts are calling it the first U.S. program of its kind: a mobile team that provides palliative care — comfort care — to homeless people facing terminal illness.
  • Since January 2014, the pilot project run by Seattle/King County Health Care for Homeless Network and UW Medicine’s Harborview Medical Center has served more than 100 seriously ill men and women in the Seattle area, tracking them down at shelters and drop-in clinics, in tents under bridges and parked cars.
  • The team connects clients with the medical care they need, paid for through Medicaid or hospital charity.
  • Then it makes sure the patients follow up, in addition to helping them evaluate complicated treatment options.
  • And, importantly, when the time comes, the program may be with them when they die.
  • The effort, funded through 2017 by a federal grant of $170,000 a year, aims to reduce unnecessary or unwanted end-of-life care and to give homeless people a say in the process.
  • The cost savings are already apparent: according to a June 2016 report, for patients enrolled in the program for six months, the Seattle project has reduced hospital stays by 25% and emergency room visits by half.
  • The program is part of a larger move to address the booming numbers of elderly homeless, expected to reach 95,000 in the U.S. by 2050, according to the National Health Care for the Homeless Council (NHCHC).
  • NHCHC research shows that between 2008 and 2014, U.S. programs offering health care to the homeless saw a 50% jump in the number of patients older than 50. Living on the streets cuts life expectancy by about 12 years.
  • Worldwide, there are few other mobile palliative care programs, all outside the U.S. The closest one in North America is the Palliative Education and Care for the Homeless program — known as PEACH — in Toronto.
  • According to Sabrina Edgington, NHCHC Director of Special Projects, mobile programs are increasingly important because the are more likely to engage the hardest-to-reach patients, those distrustful of medical care and outsiders.

“There are times when our medical system focuses on longevity, [here] We’re focusing on comfort and independence.”

-Dr. Daniel Lam,  Director of inpatient and outpatient palliative care services.

Nurse practitioner Joe Hufford takes the blood pressure of Michael J. Reece on December 12, 2016, in Seattle. Reece, who was diagnosed with liver cancer and liver failure more than 18 months ago, meets with nurse Tony Boxwell (not pictured) every other Monday for a general check-up through the Mobile Palliative Care for the Homeless program. Photo by Jovelle Tamayo for KHN.

Feature photo by Jovelle Tamayo for KHN.

Author: Nicholas Efthimiadis

Seattle grown. Avid skier and occasional ski racer. Passionate about all things urban (particularly transportation & housing). University of Washington 2016 graduate: BA in Economics and a minor in Urban Design and Planning. Extensive experience in fictitious cartography and sand-city molding.