"Nobody Wants to Talk About It, Especially in This Building": A Qualitative Study of How People Living in Permanent Supportive Housing Approach End-Of-Life Care

Permanent supportive housing (PSH) is long-term affordable housing with onsite social services. End-of-life care (EOLC) involves a discussion about the type of medical care an individual hopes to receive at the end of their life. This qualitative study examines the goals, desires, and expectations for EOLC for people living in PSH. Semi-structured interviews were conducted with 17 formerly homeless residents in four PSH facilities in San Francisco, California and analyzed using the framework method. The interviews reveal how an individual's experience with housing precarity and with the PSH setting shape their preferences and expectations for the end of life. While PSH residents value social support in their final days, social isolation in PSH serves as a barrier to receiving such support. Results from this work can inform policies and programs to support people living in PSH in achieving their desired death.