Fostering trust with a young man experiencing homelessness and advanced cancer Journal Article


Authors: Rosa, W. E.; Andersen, L. J.; Frierson, E.; Fulton, C.; Moryl, N.
Article Title: Fostering trust with a young man experiencing homelessness and advanced cancer
Abstract: Persons experiencing homelessness (PEH) face countless barriers to equitable health, social, and palliative care across all settings. Brandon was a 23-year-old male, well-spoken, groomed, and polite despite difficult circumstances. He was severely abused then abandoned as a child, living in multiple foster homes until 18. With no consistent caring adult figure, he predictably fell into a chaotic lifestyle, had 3 children by different mothers, and became homeless in New York City. He presented with newly diagnosed renal cell carcinoma metastatic to lung, lymph nodes, and bone. Spine and pelvic metastases caused paralyzing somatic pain that interfered with walking and sitting and prevented Brandon from performing the activities of daily living essential for his survival on the streets and safekeeping of opioids. Lack of basic social support and a history of multiple abandonments made a care plan for this young, homeless, and truly isolated man very challenging. The inpatient and outpatient interdisciplinary team members partnering with Brandon each earned his trust with time. A “safe place” opened hearts on all sides of the therapeutic relationship and led to a plan that was acceptable for both the patient and the palliative care team. Clinicians are often challenged to provide sustained and pragmatic palliative care services for PEH due to complex barriers. Continued advocacy for equitable and tailored services that ensure high-quality palliative care for PEH is critical at individual, institutional, and system levels to promote health equity and dignified care. © The Author(s) 2021.
Keywords: adult; child; young adult; case report; neoplasm; neoplasms; palliative care; psycho-oncology; health promotion; daily life activity; activities of daily living; trust; humans; human; male; psychosocial oncology; social determinants of health; homelessness; homeless persons; opioid stewardship; person experiencing homelessness; homeless person
Journal Title: Journal of Palliative Care
Volume: 37
Issue: 3
ISSN: 0825-8597
Publisher: Centre Recherche Institut Univ Geriatrie Montreal  
Date Published: 2022-07-01
Start Page: 265
End Page: 269
Language: English
DOI: 10.1177/08258597211013957
PUBMED: 33904342
PROVIDER: scopus
PMCID: PMC8569716
DOI/URL:
Notes: Article -- Export Date: 2 September 2022 -- Source: Scopus
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  1. Natalie Moryl
    65 Moryl
  2. William   Rosa
    220 Rosa