Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson Cynthia D. Connelly, PhD, RN, FAAN Kathleen M. Stacy, PhD, APRN-CNS


homeless, homelessness, advance health care planning, long-term care, nursing home, POLST


Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. Social workers employed at these facilities helped to identify potential participants. Transcribed interviews were analyzed utilizing Colaizzi’s (1978) method for phenomenological research until saturation of the themes was attained.

Results:Five themes emerge among these vulnerable homeless individuals: (a) lack of self-efficacy, (b) lack of awareness of health, (c) locus of control, (d) perception of death, and (e) yearning for a true home.

Conclusions: Most participants lacked family support, financial support, and had a history of drug abuse. All of the participants were diagnosed with at least one geriatric syndrome, were unaware of their health status, and had little-to-no communication with their health care provider. Further research is needed to explore how health care providers and policymakers can educate and inform this vulnerable population in the meaning of advance health care planning.

Key words: homeless, homelessness, advance health care planning, long-term care, nursing home, POLST.

Document Type

Dissertation: Open Access