Hearing Their Voice: Advance Directives for Vulnerable 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:

• Using Education to Understand the Realities of Palliative Care
• Capturing the Voice of the Child in Cancer Care
• How to Create a Welcoming Environment for LGBTQ Patients

Oncology Nursing News® Online Articles

• Personalized Sedation Goals May Help Standardize End-of-Life Care for Patients with Agitated Delirium
• Incorporating Palliative Practices Into Critical Care
• Better End-of-Life Options Are Needed for AYA Patients With Advanced Cancer
• What Oncology Nurses Should Understand About Medical Aid in Dying

Video Interviews

• Oncology Nurses Provide Patients an Avenue to Supportive Care

Oncology Nursing News® Publication Features

• End-of-Life Conversations: What Nurses Are Saying
• Oncology Nurses Must Navigate Difficult End-of-Life Discussions

References

• 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