Hearing Their Voice: Advance Directives for Vulnerable Populations

In this episode The Vitals, Jeannette Meyer, MSN, RN, CCRN-K, CCNS, PCCN-K, ACHPN, discusses the importance of advance directives in critical care and her work with homeless populations.

For this episode of The Vitals, Oncology Nursing News® spoke with Jeannette Meyer, MSN, RN, CCRN-K, CCNS, PCCN-K, ACHPN, a palliative care clinical nurse specialist with UCLA Health about the value of advance directives for vulnerable populations. Meyer highlights her personal experience working with unhoused populations near and around Los Angeles, California. Meyer works with programs including “Hearing Their Voice” and “Hospice Under the Bridge,” which seek to help homeless patients connect with much needed medical resources and help providers understand the personal health goals of individual patients who may one day present in the hospital. 

Episode Highlights

“Our homeless patients are dying of the same things that we are all dying of… they have cardiac disease, they have cancer, they have liver failure, they have pulmonary disease.” Time stamp [TS] 5:07

“We wanted to figure out a way to hear their voice. To honor them. To respect what they would want for their health care and their choices.” TS 8:39

“Whenever we ask these people, not just “how would you want to live?” but “how would you want to die?” They are asking—most of the time—for 2 simple things: to be treated with dignity and not to be in pain and suffering.” TS 20:36

“I don't know what your line in the sand is. I don't know what an acceptable quality of life for you is, or what gives you joy or what gives you meaning. But I beg of you to document those things, so that whomever might be making decisions for you will know what you want.” TS 24:14

Episode Notes

The Vitals Podcast:

Oncology Nursing News® Online Articles

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Oncology Nursing News® Publication Features


  • Cortez DM, Meyer J. Hearing their voice: advance care planning for the homeless. Crit Care Nurs Clin North Am. 2022;34(1):57-65. doi:10.1016/j.cnc.2021.11.010
  • Meyer J. When goals of care are not enough. Coalition for Compassionate Care of California. June 23, 2016. Accessed October 28, 2022. https://bit.ly/3NkCY47
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